First Sleepy Head Data - Printable Version

First Sleepy Head Data - Printable Version

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First Sleepy Head Data - yenobstev - 02-15-2017

Hoping one of the experts can take a look at my data...

Thank you!!

RE: First Sleepy Head Data - Beej - 02-15-2017

The 3.74 is pretty good for a 1st night.
Leaks are pretty low, which is good.

There is some snoring; you might see if sleeping on your side helps with that and further reduces the hypopneas.

RE: First Sleepy Head Data - trish6hundred - 02-15-2017

Hi yenobstev,
WELCOME! to the forum.!
Hang in there for more answers to your data question, good luck to you with your CPAP therapy.

RE: First Sleepy Head Data - DeepBreathing - 02-15-2017

Hi yenobstev.

That looks like a good start. There are some leaks but quite briefly near the start of the night, so it's not too much of an issue. There are quite a few hypopneas associated with flow limitations. According to Resmed's literature, these would be obstructive in nature, which would require raising the epap a little to counteract them. I see you're using the straight ASV mode - you might get better results going to ASV-Auto and letting the epap float between (say) 8 and 12.

However if this is your first night I wouldn't make any changes for a week or so, to give you time to settle down with the new therapy. Then make changes if necessary, one change at a time. You might also try sleeping on your side, which often has a beneficial effect on obstructive events.

RE: First Sleepy Head Data - Melman - 02-15-2017

I'm new to this and don't claim to be an expert but have made significant progress in a short time thanks to this forum. Your AHI is pretty good but you have a lot of high flow limitations and you can see that they correspond to your H and OA events. I had a similar issue and corrected it by sleeping more on my side and using a buckwheat hull pillow to stabilize my head position to prevent chin tucks. The pillow could also be conformed to provide support for my neck to make the side position more comfortable. My 95% flow limit dropped from as high as 0.67 to 0.05 and I completely eliminated those that went to 1.0, which I understand, is considered severe.

You can find the pillow on amazon if you search for CPAP pillows. It is stuffed with buckwheat hulls and pieces of foam and costs $49. It sounds a little strange but I have found it to be more comfortable that a regular pillow. The big advantage is that you can mold it with a depression to stabilize your head and with a raised roll to support your neck. Until I got the buckwheat hull pillow the side sleeping position didn't work well for me. I still had a lot of severe flow limitations (I suspect due to chin tucks).

Check it out. It may help you as well and get your AHI to below 1.0 and perhaps to 0. My AHI went from the range you are at and much higher to 0.16 with the use of the buckwheat pillow. I got it to 0 with a a subsequent change from constant pressure to auto pressure but I think the buckwheat pillow was the major game changer.

It's still early days with this change for me but I'm convinced it will continue to help me. I'm sure some of the more experienced forum members will respond with respect to my comments.

RE: First Sleepy Head Data - yenobstev - 02-17-2017

(02-15-2017, 09:30 PM)Beej Wrote: The 3.74 is pretty good for a 1st night.
Leaks are pretty low, which is good.

There is some snoring; you might see if sleeping on your side helps with that and further reduces the hypopneas.

Beej:

Thank you very much for responding to my post. I will focus on sleeping more on my side.

Steve

Thank you!!

DeepBreathing:

This sounds like excellent advice! Thank you very much for responding. I will give it a try and see how things go!!

Steve

RE: First Sleepy Head Data - yenobstev - 02-17-2017

Melman:

I am going to shop around for one of those pillows. It is definitely worth a try!!

Thank you very much!!

Steve

RE: First Sleepy Head Data - yenobstev - 02-17-2017

(02-15-2017, 11:37 PM)DeepBreathing Wrote: Hi yenobstev.

That looks like a good start. There are some leaks but quite briefly near the start of the night, so it's not too much of an issue. There are quite a few hypopneas associated with flow limitations. According to Resmed's literature, these would be obstructive in nature, which would require raising the epap a little to counteract them. I see you're using the straight ASV mode - you might get better results going to ASV-Auto and letting the epap float between (say) 8 and 12.

However if this is your first night I wouldn't make any changes for a week or so, to give you time to settle down with the new therapy. Then make changes if necessary, one change at a time. You might also try sleeping on your side, which often has a beneficial effect on obstructive events.

DeepBreathing: Thank you very much for you wisdom and time in responding to my post!! I will try these things out.

I agree with you in waiting for a bit to make changes...

Thanks again, Steve

RE: First Sleepy Head Data - Sleeprider - 02-17-2017

Change to ASV Auto using the same settings. You may need to set EPAP min to 10 and EPAP max to 15, PS 2-10. While your AHI is 3.74, you can see many instances of the pressure support avoiding central events. The use of Auto ASV is one of the great advances of this technology in treating the obstructive component in complex apnea, and it is puzzling why you wern't set up to take advantage of it.

If you have an ASV titration study copy, it would be great to see the results.

RE: First Sleepy Head Data - yenobstev - 02-17-2017

(02-17-2017, 09:27 PM)Sleeprider Wrote: Change to ASV Auto using the same settings. You may need to set EPAP min to 10 and EPAP max to 15, PS 2-10. While your AHI is 3.74, you can see many instances of the pressure support avoiding central events. The use of Auto ASV is one of the great advances of this technology in treating the obstructive component in complex apnea, and it is puzzling why you wern't set up to take advantage of it.

If you have an ASV titration study copy, it would be great to see the results.

SleepRider:

Is it a good idea to change the settings now if the DME has access to my machine and settings? Could I be viewed as non-compliant by the insurance company if I change my own settings? Is it better to wait until I own the machine myself after the rental period?

I just got this new machine on Feb 1. I followed up with the RT at my DME. She tells me that I am doing great with my AHI being under 5.

I am definitely feeling better on most days. It seems that I do best when my AHI is furthest away from 5 toward 0. If I can "fine tune" things a bit, that would be great.

I am going to follow up with the RT in another week and find out if she is willing to "fine tune" my settings. If she says no, your AHI is under 5, that tells me much about her knowledge level and approach to therapy. I am wondering also why the ASV Auto mode is not being used? Is this something that is put specifically in the prescription by the doctor to not use this mode? Is she not aware of it? On my follow up with her, I asked her what the "Events Per Hour" meant on the sleep report. She said she had no idea what it was....???

I also have a follow up session with my sleep doc in 6 weeks. I will also ask if he can help "fine tune" my settings. If he says no, your AHI is under 5, I will have learned something about his approach to therapy also.

I guess the bottom line is I don't want to have issues with the insurance company or the DME in terms of reimbursement for renting and eventually owning the equipment.

I am not afraid to tinker a bit and calibrate things to make them better too... I think your advice and reputation are solid, and I would like to give them a shot..

Thanks again for all of your help...

Steve