New SH Data

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jweiner
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New SH Data

Post by jweiner » Sun Jun 25, 2017 7:58 am

So I upped my minimum pressure to 9 and last night my residual AHI was 7. Can someone tell me what might have happened? I was hoping that upping the minimum pressure would lower my residual AHI.
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Pugsy
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Re: New SH Data

Post by Pugsy » Sun Jun 25, 2017 8:15 am

Is there some reason you zoomed in on the time starting at around 23:40 instead of not zooming in at all and including the 22:20 start time?
Like was that a time you were awake and couldn't go to sleeping or something? This could cause a lot of SWJ events getting flagged.
Or A good chunk of your AHI is high because of what happened that first part of the night...sleeping position like on your back maybe?

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jweiner
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Re: New SH Data

Post by jweiner » Sun Jun 25, 2017 8:39 am

Pugsy wrote:Is there some reason you zoomed in on the time starting at around 23:40 instead of not zooming in at all and including the 22:20 start time?
Like was that a time you were awake and couldn't go to sleeping or something? This could cause a lot of SWJ events getting flagged.
Or A good chunk of your AHI is high because of what happened that first part of the night...sleeping position like on your back maybe?
The only reason that I must have zoomed in is because I'm clueless and keep doing that by accident. I did have a longer-than-usual sleep latency last night because my wife was watching tv when I was trying to fall asleep. I'll leave the settings alone tonight and see what happens. By the way, can using the "flex" feature cause an excessive residual AHI? I really like the feature. It almost feels like BiPAP with the exhalatory relief.

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Pugsy
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Re: New SH Data

Post by Pugsy » Sun Jun 25, 2017 9:25 am

In theory using the Flex exhale feature could let some obstructive in nature airway collapse happen due to the small drop during exhale.
It all depends if using that drop during exhale brings you down to a level where the airway isn't held open so well. Like how close you are to the threshold where the airway can collapse if you have any drop in pressure at all.

So it can happen that using Flex lets the AHI increase because a few obstructive events slip past the defenses. Easy fix if you don't want to give up the comfort of Flex...slight increase in that minimum pressure to offset the drop during exhale.

If you like Flex...by all means use it. Comfort is real important to being able to fall asleep and falling asleep and staying asleep is the name of the game.
I liked AFlex when I was using it...and yes it sort of feels like a bilevel because it sort if is creating 2 distinct pressures...one for inhale and one for exhale.
The timing of the drop is a little different with a real bilevel machine but not hugely different.
I always thought AFlex felt more "natural" to me and using a real bilevel was not quite as "natural" feeling but that's not to say that real bilevel with same about of difference between inhale and exhale was less comfortable. It's just a bit different and both are quite comfortable.
Things can be different but still both work out really well.
Did you use EPR on the ResMed you used? It's more like how bilevel feels than Flex feels bilevel.

About last night...The bulk of the ugliness was at the beginning of the night while you were admittedly likely awake. I suspect a good bit of the ugliness is SWJ ugliness. It's hard to document awake time though and it's hard for newbies to be able to eyeball the flow rate (you need to zoom way in) to get an idea when you fell asleep. To help document awake times when falling asleep is taking a long time you might reach over and turn the machine off and wait 10 or 15 seconds and turn it back on. You can then see the break in therapy line on your software graphs and will have a way to know for sure that you were awake during those times and thus can mentally remove the awake flagged events from the AHI evaluation.

You know the AHI for just the highlighted time (by accident or whatever) was just a little over 3.

Since you know that last night you had some prolonged time with the mask and machine on...and since we know that SWJ events can and will be flagged during awake/semi awake times...and you don't yet have the skills to identify for sure awake vs asleep status using the flow rate...we can't really formulate much of a definite evaluation about last night because there is a really good chance the numbers are skewed by SWJ.

So...this is why we say to use a setting for multiple nights to get an idea as to how the results trend. We just have nights that are "bad" for unknown reasons and we can't go changing things based on one outlier bad night....or shouldn't anyway. Now if you had told me that you went to sleep in 5 minutes and never really stirred much all night...I would be more concerned about that AHI.
But if we can explain some of the ugly as SWJ then it puts the quality of the data in question.

TV in the bedroom...wife watching it while you try to sleep...not a good mix because even if you fall asleep your subconscious will know the TV is on. You will spend more time in really light sleep ...if you sleep at all.
Bad sleep hygiene....and bad habit...and bad habits are notoriously easy to make and very difficult to break.

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jweiner
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Re: New SH Data

Post by jweiner » Sun Jun 25, 2017 10:46 am

Pugsy - you're awesome - thank you. By the way, I just got a discount coupon from CPAP.com for 15% of all orders over $175 so I might splurge and purchase the AirMini unit for traveling since I do travel quite a bit and I typically don't like taking my (big) machine with me. It looks like that unit works with the F20 full face mask, so I am seriously pondering it. Even with the coupon, it's still hard to justify close to $900 for a little tiny thing like that

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Pugsy
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Re: New SH Data

Post by Pugsy » Sun Jun 25, 2017 11:31 am

jweiner wrote:it's still hard to justify close to $900 for a little tiny thing like that
It doesn't interest me at all even if it was 1/3 the price. But then I travel infrequently and manage with my back up machine that I keep travel ready just in case. I also have some specific humidity needs and I am not sure the rebreather humidity exchange thing would do what my nose needs and I don't want to risk the side effects if the nose gets dried out and unhappy.

This type of thing is where a person has to come to terms with their own needs or preferences and are those needs and preferences worth the cost.
Stuff that come with huge YMMV stickers on them.

I like experimenting but not when the experiment costs me a lot of money out of my pocket. Heck I don't even pay anything near that amount for my ASV machines.

It's going to suit some people's needs and preferences quite well though and for those people I am happy that they are happy with it.
Goes back to what I always say about everything cpap......one man's treasure is another man's trash.

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palerider
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Re: New SH Data

Post by palerider » Sun Jun 25, 2017 1:30 pm

jweiner wrote: it's still hard to justify close to $900 for a little tiny thing like that
Ever price an iPhone?

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LSAT
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Re: New SH Data

Post by LSAT » Sun Jun 25, 2017 2:23 pm

Now that avatar makes sense....

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jweiner
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Re: New SH Data

Post by jweiner » Sun Jun 25, 2017 4:13 pm

palerider wrote:
jweiner wrote: it's still hard to justify close to $900 for a little tiny thing like that
Ever price an iPhone?
Of course, but no one actually pays full price for one.

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