screen shot help

[Pugsy]

Your leak numbers are well within the accepted range that we would expect to see with your pressures. Remember your machine reports total leaks which include the intentional vent/leak rate and the higher the pressures the higher the vent rate.
Most the minor ups and downs with your leak line is associated with the up and down of the pressure itself. So really not much if any excess leak is going on here.
No where near large leak territory which is going to be around 90 L/min anyway.

My first thought was after the ramp that the minimum EPAP could maybe be increased a little to better prevent the snores and hyponeas (assuming they are obstructive in nature) along with the OAs.
But then I looked at the bulk of the rest of the night and several reports and for the most part your EPAP stays way up there and still isn't preventing the snores and stuff. So it's doubtful that changing minimum EPAP 1 cm or so (which would be all I would be comfortable with doing anyway) is going to make any impact because for the most part EPAP is well into the teens anyway.

That's when I thought maybe sleep position might be a factor. If you are on your back a lot that might explain some of what we are seeing. It's hard to break that habit though and I don't know if it would help or not.
Plus we don't know how much of your fatigue is related to maybe less than optimal sleep quality because not all fatigue is related to sleep issues anyway. You know the drill...meds, other health issues, etc.

Do you remember waking often during the night?

[JDS74]

Glad you are going to a new good guy.

I use the CMS50F wrist pulse-oximeter - the older white face model.
Here is a link to where I got mine.
CMS50 Oximeters

Some folks use other models that are clip on style like the CMS50D model.
The F model costs more but is much more comfortable and much easier to keep on your finger.

When I first started, my EPAP min was 9 cm H2O and, after talking to my doc, changed it to 10 cm H2O and the obstructive went away. I also increased the Pressure support just slightly at the same time. Your number of obstructives seems to be hovering on being eliminated altogether at your current pressure - 2 per hour.

Along the lines that pugsy mentioned, here are some links on sleep hygiene.
Links for information about Sleep Hygiene. Something in there may be of help.

Info on Sleep Hygiene
Sleep Hygiene Recommendations
Sleep Hygiene Tips

[exhausted1]

this is the best one EVER !

how can i repeat this over and over ??!!

[exhausted1]

my routines suck because of work schedule and stress

i try to be in bed by 11 and does not take me long to fall asleep

that pulse ox meter JD says not compatible with sleepy head software , i sent them an email

do i try setting the epap pressure up one ?

i am up for trying anything

thank you thank you !!!

[exhausted1]

health is pretty good , a little overweight not much

stress is up there , take my vitamins daily , using d3 for a few months as it was a suggestion

i only wake in the middle of the night every so often , not much at all

epap question i see you answered, leaks you feel not an issue

i just feel a tweek here or there may help ...but which one

all is appreciated !!

[JDS74]

Loading the data into SleepyHead is a two stage process. Load into SpO2 software, then point SleepyHead to the data and it loads. The Blue Face CMS50F is not compatible, the Whiteface one is.

[Pugsy]

this is the best one EVER !

how can i repeat this over and over ??!!

Sleep like you did that night. It is a very nice report.
It just goes to show you that the settings can work sometimes. We don't know why some nights are better or worse than others. It just happens.
I don't think that increasing EPAP 1 cm is going to do much but I suppose it wouldn't hurt anything. See the thing is.... once you go to sleep you don't seem to spend very much time anywhere near that minimum EPAP so changing it is unlikely to matter all that much unless you have a lot of reports where you spend a lot of time at minimum EPAP.

[exhausted1]

i will look at the white one ...thank you

i wish i could !! ...i reread your email and that is what i saw you were getting at

i had a 1.89 night in may and i was like what was that ??!!

that's also what i thought ...it seems to work , so what else could i do ???

with the old machine i was at 12 , 15 as high as 29 +

so what to work on next to keep it low ? hmmmm

thank you !!

[JDS74]

Loading the data into SleepyHead is a two stage process. Load into SpO2 software, then point SleepyHead to the data and it loads. The Blue Face CMS50F is not compatible, the Whiteface one is.

Mea Culpa.
In a previous version of SleepyHead, this process worked. Now with the current version, it doesn't.
I haven't tried to import into SleepyHead in over a year. SleepyHead has had problems in the past synchronizing with SpO2 files and their time stamps. Sleepy Head does read the file and display a graph but doesn't link to the Respironics data.

[JDS74]

my routines suck because of work schedule and stress
i try to be in bed by 11 and does not take me long to fall asleep
...

do i try setting the epap pressure up one ?
i am up for trying anything
thank you thank you !!!

Do you have a copy of one of the Encore reports that got made at the doctor's office.
On the last page of the detailed report, is a list of your settings.
Can you post just those settings?

Stress and a bad work schedule can mess with your sleep quite a bit.
Can you see if trying to improve your sleep hygiene helps?
The August 30th posting shows only a little less than 2 hours. Is that right for that night?
What happened that you didn't continue with the machine?
Even if you have excellent AHI numbers, the total therapy time is not sufficient.
If you get many days like that, the next day will be really sub par - tired, sleepy, etc.

From that post, your EPAP min seems to be 5 cm H20. That seems to be fairly low.
The real pressure boost comes when first you have an OSA event followed quickly by a CA event.
It may be that your doctor thinks the relatively low rates don't merit increasing the pressure to catch them.

Have you gotten your sleep study reports yet? What do they say about your pressures?

[palerider]

sleepyhead 0.9.6 supports direct import from the cms50 D+ E and older F models, as well as the files from them.

0.9.7 testing supports direct import from those, plus the new f, and I, (and probably H) models.

just plug them in and go, you may need to load a usb<>serial driver for windows, though that may be loaded when you install the program.
http://www.silabs.com/products/mcu/page ... ivers.aspx

you will need the mac driver for macs.

I like the CMS50I, it's wrist mounted, has time stamps, and records multiple sessions.

[JDS74]

Reviewing your September 13 statistics post, it is interesting that the 95% EPAP number is up around 15 cm H2O and that the individual charts show the machine hovering at or around that level.

When I first started with the Auto BiPap 750 machine, it was set wide open and I got crappy rest because of the time it took the machine to detect obstructive events and to respond to them - my AHI hovered between 10 and 20 for a long time.
Your data shows the machine popping pressure up and down as it tracks your events.

It is just speculation but it may be that that kind of oscillating change by itself is disturbing your sleep.
Some folks find that on bi-level machines they get better sleep if they set the machine to single pressure CPAP mode just because of the pressure changes.

Since you spend a lot of time up at the 15 cm H2O pressure level anyway, you might ask your doctor is an increase in the EPAP min to 10 or so would be harmful. I certainly would not suggest you do a change like that on your own. Setting the pressure higher would help stabilize the pressure variations you are seeing in the data.

So, a two pronged approach:
1st See if you can improve on sleep hygiene - perhaps doing something very relaxing for the hour or so before bed time.
Do you do anything in bed before masking up and trying to go to sleep? My drill is in bed, mask on, machine on, lights out.
Following my pulse rate during this time, I see a rate in the 85 to 100 range as I get to bed dropping down below 70 within two minutes. That's my body getting ready to sleep.
2nd Talk to your doctor to see if an increase in pressure will be harmful and might be helpful.

I hope all gets better over time.

[exhausted1]

this is what i don't see, where is the 2hrs indicated ?
never would be able to function

i haven't changed anything since i got this machine in march, i pushed for this last test and to get this machine and the numbers are what the center and doc used

the numbers are what i thought i posted with the summary page from sleepyhead , let me know if that is not the case

i do not understand all the numbers and that is why i appreciate all the help , i just know there has to be a min and a max , sorry

i have tried being consistent with alot of things but it is tough , like going to the gym , it's all time , and i hate that feeling , have a tough time waking up in the am but falling asleep is not a problem and staying there really isn't . I just want to be able to feel better and feel awake and enjoy things that i haven't done in years

divorce , kids , work ...what came first , ex was an issue and no help anyway

i am trying to get all the help and advice i can to change and fix this

pale , so the newer version will work ?

thanks again everyone !!

[exhausted1]

thanks JD

i feel the same way with the ups and downs and i will reach out to him when i send him the reports as he asked

so that setting would go from 5 to 10 ?

i would never do such a change myself and i do understand

my routine at bedtime is mask on and i fall asleep .. i wish i could go to bet at 10 every night but that is impossible

i will get that meter , but again i don't understand the numbers and will post them , could not even tell you rates at all , i put the mask on , sleep and do what the doc says when i see him
that's why i wish i could change things myself and test them out ...nothing drastic though of course

[exhausted1]

i am going to sleep...i hope

thank you all !!