Can someone explain what I am looking at?

[Nico65]

Hi,
first time here. 
I am using an ASV machine and a few days ago I noticed something in sleepy head which I don't understand.
Maybe someone can explain this. All events on my machine show as unclassified but some show a rise in mask pressure and normal pressure.
Some events show a complete stop in mask pressure and normal pressure doesn't go up at all. I first thought this would be a central event but I read that asv machines eliminate centrals and they are not visible on the chart.
I included a pic of each in case my explanation doesn't make much sense. 
Thank you. 

   

   

[Jay51]

Great question.  I have an s9 adapt asv and OSCAR.  Your first chart doesn't make any sense to me either.  Every time I would stop breathing from either an OA or CA, it would ramp up pressure very quickly.  It almost looks like a machine glitch when it doesn't ramp up mask pressure when you stop breathing.  I am not sure what else to make of it.  

How often does this occur?  Is it just a one off?

[Nico65]

Hi ,

thank you for replying.
Actually, it happens quite a lot.
I will ask my sleep doctor next time I see her ( in 4 months time) but I was hoping 
someone could explain these different events.
Included another 2 pics from another night.

Regards, Nic


   

   

[Sleeprider]

The pattern you are experiencing is usually the result of positional obstructive apnea. You can probably correct it with some minor changes to prevent chin-tucking. Please read our wiki article. https://www.apneaboard.com/wiki/index.ph...onal_Apnea

[Nico65]

Hi sleeprider,

thank you for the link.
I will get a collar and see if anything changes.
Still unsure though why there's events where the pressure goes up and some where pressure doesn't change. 

Thank you,

Regards, Nic.

[SarcasticDave94]

I think that would depend on the cause of the event. If therapy has been good for a while, the most likely thing that may have changed is the addition of Positional Apnea. And no machine available can fix that external airway kink.

Post a full night chart, and it'll likely be shown what's happening.

Can we pursuade you to get OSCAR charts?

[Nico65]

Hi,

 thank you SarcasticDave94,
Actually, therapy has never been good since I started to use an asv machine. The numbers seem more or less ok (around 5)
but I don't feel rested in the morning. I used to be on a philips Apap machine and even though my numbers were worse 
(15-20) because of the centrals, I slept a lot better, woke up rested and had a lot more energy throughout the day.
Anyway, I had a look back on the charts from back in '19 and the same pattern shows like nowadays. Sometimes,
pressure rises when there's an event, sometimes not. I ordered a collar as suggested by Sleeprider and will see what happens.
Included a chart. I have tried to raise epap to get a better result but it makes sleep more difficult and I am more tired in the morning.

Ps: I thought sleepyhead and oscar show the same information?

Cheers, Nic***


   

[SarcasticDave94]

OSCAR is similar to sleepyhead, but had been updated many times.

Include your left panel summary data next time please.

Mention your therapy settings also

What I'm getting with what's here:

Your leaks are high and leak control is not stable. Mouth leaks dominate, they're the broad upside down U pattern. There's also some mask leaking signified by the spikey look. Therapy will improve significantly in proportion to controlling leaks. ASV does not like having this to deal with. It'll make you pay with high blowing.

You have a Ramp set that is allowing events through. Once we get you dialed in better, Ramp can and should be removed.

EPAP looks static from likely ASV mode. You may be able to get better results switching to ASV Auto mode, EPAP 6-12 or so. Probably fine tune after we see a night of it.

[Nico65]

Hi Sarcastic Dave,

I am in the process of having my machine replaced (3 G has been phased out in Australia). I am getting a new 4 G machine because
the sleep nurse at the hospital wants to able to check. I have heart disease and apparently it's kind of important for the nurse and specialist to 
be able to keep track of my sleep. In March I'm also booked in for another sleep study. So, at the moment I am on ASV epap 9, ps min 3 ps max 10. I am sleeping with a chin strap that also covers my mouth. 
I thought I was doing ok looking at my numbers and like I said before, zero apneas don't always mean you have a good night sleep. 
I read about people with no events and still felt miserable when waking up. In my case it's not so bad but I know it could be better because of when I was on an APAP machine.  The doctor changed my machine to ASV auto once for a week but it woke me up every half hour or so and I ended up exhausted. Also I am not to worried about a few events in the ramp up phase because it's hard to fall asleep without it. 
Anyway, thank you for your interest and who knows, if all fails I may be back and try a few different settings. (as long as my ticker can handle it     .

Regards, Nic***

[SarcasticDave94]

If you're able, request the ResMed machine if they follow through with replacement.

Not a doctor myself, but is it possible whatever your heart condition is might be the source of your sleep issue?

What do they expect to find or prove with a new sleep study at this point?

Also, do you recall your past sleep study data, such as how many CA you had on the diagnostic?

If we had the full screenshot of your chart that will show Events, Flow Rate, Mask Pressure, Leaks, with the left panel showing summary including settings, we can help try to make the ASV work better.

Take a look in Apnea Board. There's examples all over that doctors get settings wrong. And also many examples of patients controlling their settings, with feedback from other members to dial it in successful.

I used a ResMed AirCurve 10 ASV for 2 years successful. And I slept better until COPD hindered it. I know you can edit to make it better, if ASV is actually needed for you.

Final note, again your leaks must be controlled better. Your therapy effectiveness and accuracy demands it.