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help to understand sleepyhead results
#21
RE: help to understand sleepyhead results
http://imgur.com/a/7VnjF

Sorry...... heres the link............
Sleepyhead in 5 easy steps
Beginner's Guide to SleepyHead

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#22
RE: help to understand sleepyhead results
Use the Flow, Apnea Infant!  (Sorry, attempted Star Wars joke.)

The Flow represents the Rate of airflow entering (positive Flow) or exiting (negative Flow) our airway/lungs.

The Flow waveform (unless Leak is very high or rapidly changing) will show clues about what type of apnea is occurring.  (If the Flow gradually starts and builds increasingly stronger for a few breaths and then gradually weakens and stops after a few more breaths, this indicates typical Central Apnea pattern; or if the Flow starts abruptly with strong gasping breaths and then gradually weakens and stops after several breaths, this indicates typical Obstructive Apnea pattern.)

In the data you've posted I think the marked Obstructive Apneas (OA) are correctly being flagged and counted by the machine.  Raising the pressure would tend to reduce how many obstructive events we get, but on some folks raising the pressure would tend to increase the number of Central Apnea (CA) events we get.

Obstructive Sleep Apnea is, for most people, strongly positional. May need low or moderate pressure if sleeping on our side, or may need much higher pressure if sleeping on our back.

To avoid OA, my guess is your Max Pressure setting may need to be set to 20 if you are rolling onto your back while asleep. But the high pressure needed to avoid OA when sleeping on our back may induce CAs.

If you can somehow guarantee you will never be sleeping on your back you might be able to avoid almost all Obstructive Apneas without raising your Max Pressure higher, or may be able to actually lower it.

Some have been successful avoiding rolling onto their back while asleep by wearing a light backpack filled with something light but bulky, or wearing a tee shirt with a tennis ball in a sock sewn in the middle between the shoulder blades or a little higher, or using a very long body pillow behind their back.

Also, right away, I suggest investing in a recording pulse oximeter. No prescription is needed, but it is possible that insurance may pay for it if a prescription for it is obtained. The type worn on the wrist, with separate finger sensor cup, is more comfortable. If we have normal lungs, I think an average SpO2 (percentage oxygen saturation in the blood, measured through the skin) between 94% to 96% is ideal while asleep. If we have COPD, I think an average between 90% to 92% may be much better while asleep, depending on the type of COPD. (By "average" SpO2, I mean ignoring short term dips during apneas.)

You may benefit from a higher class of CPAP machine called an Adaptive Servo Ventilator (ASV).  Ventilators breath for us when we don't or can't. That is, each breath the pressure rises for inhalation and falls for exhalation to help push air into our lungs and let it out again, without us needing to do any of the work.  ASV adaptively kicks in to help only when we would be having apneas or hypopneas, letting us breathe on our own at other times.

In the USA, usually insurance will not cover an ASV class 'PAP machine unless we are already using a more standard 'PAP machine but our CAI (CA index, the average number of CA per hr) is both above 5 per hr and is also higher than our average number of obstructive events per hr.  If we need help from insurance to pay for the machine, special insurance preauthorization is usually needed for coverage of an ASV titration first, to verify an ASV machine would solve the problem (avoid/treat both OA and CA).

The other thing, though, is the number of pressure-induced CA events usually decreases during the first couple months of therapy, as our body gradually becomes accustomed to breathing with pressure.  So our doctor may take a wait and see attitude for the first few weeks or months, before applying for insurance preauthorization for an ASV titration.

Take care,
--- Vaughn
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.  The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea.
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#23
RE: help to understand sleepyhead results
Thanks for that, Vaughn.

I have thoughts about getting an oximeter. Used one borrowed from the hospital for my first test which confirmed mild to moderate Sleep Apnea. It was the one with a clip on the third finger and a meter strapped to my wrist.

Believe there is advice in the wiki on best one to get which is data readable with sleepyhead. What is COPD?

Do not think it will be that easy to get an ASV from the NHS here. Was not even easy to get a nasal pillow so I just bought it myself as the FFM was not helping me at all with incredible leaks. I asked about an APAP instead of the CPAP Resmed Airsense Elite I was given but was informed that was not available. Here, once diagnosed you are given the devises even though they say it is on loan. Do not believe they come to collect it if you do not return it if not using. I was collating info and ammunition for a case for APAP in the early days when I was climbing the wall as therapy was not working well. Now that it has calmed down, I am looking to reduce pressure and impact of CAs. These, I know, are not the worse you can find in this forum but it is natural to want to understand and improve.

I am slowly feeling better but still find that my energy levels will dip after 7-8 hours where I used to keep going till bedtime previously.
Sleepyhead in 5 easy steps
Beginner's Guide to SleepyHead

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#24
RE: help to understand sleepyhead results
(06-18-2017, 02:21 AM)Apnea Infant Wrote: What is COPD?

USA:
http://www.webmd.com/lung/copd/oxygen-tr...sease-copd

UK:
https://patient.info/doctor/use-of-oxyge...py-in-copd

SpO2 recommended targets:
https://www.brit-thoracic.org.uk/documen...ctors-pdf/

Research:
https://www.brit-thoracic.org.uk/documen...-settings/
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.  The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea.
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#25
RE: help to understand sleepyhead results
Have been experimenting with EPR of 1 and since last Friday have been lowering Max pressure to 13.6cm H2O.

My intent is to feel good in the daytime, within the range of acceptable therapeutic numbers and pressures. Still want to understand how to interpret data such as the meaning of flow limitations, tidal volume etc etc and what they mean in the interpretation of the my development.

Not great night last night as have been a little unwell but would like to learn more.

http://imgur.com/a/rSnwB
Sleepyhead in 5 easy steps
Beginner's Guide to SleepyHead

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#26
RE: help to understand sleepyhead results
Also, the figures in brackets at the end of an event or leaks

For eg a leak at 05.43 had (388) - does that mean a leak for 388 seconds?
Sleepyhead in 5 easy steps
Beginner's Guide to SleepyHead

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#27
RE: help to understand sleepyhead results
Results of saturday 17th June when I dialled my settings down to

8-14 cmH2O
EPR1

I noticed the CAs dropped and with AHI of .75. So success even though leaks returned. Will HAVE to get that chin strap and memory foam pillow. Stayed at same till last Friday and dropped max to 13.6 as shown in last post. I shall investigate further reductions to help with leaks and monitor to see if my numbers remain good.

http://imgur.com/a/NvjuB
Sleepyhead in 5 easy steps
Beginner's Guide to SleepyHead

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#28
RE: help to understand sleepyhead results
(06-08-2017, 12:56 PM)bonjour Wrote: That is why the question about the sleep study,  Be cause of the lack of mention assume pressure onset CA.  

You are fixed but with EPR of 3.  Need to try EPR of 0 if not 0 as low as you can tolerate.  Effectively you have iPAP 14 ePAP 11.  Since ePAP supports obstructives (OA, H, FL and Snores)   I would target getting to 11 with no EPR.  

Your numbers are good though, you have no reason to change anything if you are comfortable.  How do you feel?

Bonjour, Bonjour

I realised I did not credit you with your insight 4 months ago into where I would be now-ie EPAP/IPAP at 11 with no EPR. Thank you very much.

The same to Vaughan, QAL, Marillion, SR and all the others-a massive thank you.

Eternal gratitude

AI
Sleepyhead in 5 easy steps
Beginner's Guide to SleepyHead

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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