NewtoThis wrote:So all those little blue dots are hypopneas throughout the night? And the red bars are the apneas and the number on top is the length of the apnea?
Yes to all 3 questions.
Hyponeas didn't get a duration in seconds ...only the OAs.
S8 machines didn't give a flow rate (breathing) graph. S8 machines didn't give us anything to really monitor or look at in terms of what was really happening in terms breathing that be causing flags. All the good useful stuff was added with the S9 models and of course the subsequent AirSense models.
Your reports look pretty typical for what we used to see from S8 users bitching about the hyponea count.
If you notice the hyponeas also seem to increase when you have the OA cluster late in the night...probably you are either in REM sleep stage or are on your back when you see the OA cluster.
They do seem to reduce with the higher pressure so that makes me think they are "real" since they seem to respond and increase when OAs increase.
Personally I was never one to pooh pooh off a high hyponea count totally by the "cut it in half" theory because we had nothing to prove that it was okay to dismiss half those hyponeas just because we wanted more acceptable numbers. And we had zero way to evaluate how important they were with the S8 machines.
Hyponeas are flow reductions that aren't "bad" enough to earn an OA flag but they are important enough to be included in the AHI numbers AND for auto adjusting algorithms to try to increase the pressure in an effort to kill them. Somebody thought they were very important or they wouldn't be on the hit list or naming list. So I am not about to pooh pooh them off by cutting the "number" to just get a better number. I know some people did..but I wouldn't have done it if I had ever been using a S8 machine and I had only high hyponeas to worry about.
Now was this "high hyponea" count thing something because of the people with the flow reductions or was it from the sensitivity of the sensors and the machine's firmware algorithm for naming stuff? I don't know but I did see plenty of S8 reports where the hyponea count as nice and low....so not everyone had high hyponea counts. It's not something at was universally a problem with the Hyponea numbers. It was seen often though and often enough that people came up with the "cut them in half" thing in an effort to get some number they would wrap their brains around to prove to themselves the therapy was effective/acceptable enough.
Same people later reported nice much more reasonable Hyponea counts when they went to the S9 model machines and still using the same pressure.
Makes a person wonder what it was that caused the difference if the pressure was unchanged between the 2 machines. Was it a sensitivity issue?
Or a change in the way that ResMed defined hyponeas? We were never told what or why or even if there was a difference in that regard.
We know that a lot of things changed (for the better) with the change to the S9 machines. Different auto adjusting algorithm for one thing but we were never told if the definitions or sensitivity were changed.
The S8 machine was discontinued in 2010. It was one of the top dogs in its day but its day has long passed in terms of technology. It has its limitations and when compared to the newer models...the limitations were significant. It is what it is.
Now for you....about all you have available to you with this machine is "increase the pressure" and see if the hyponea count continues to reduce with more pressure. It seems to work with you but I know people who it didn't work with. Unfortunately it means you are using pressures near the maximum available with the S8 machine.
If you were reporting that you were feeling great and sleeping great then I don't know that I would worry so much about those hyponeas. They would probably still be in the back of my mind because I am not one of those people to so quickly dismiss the number without proof that it was okay to dismiss half of them and there was never any proof. Now maybe it was okay and didn't mean much but for me there was never any proof and I try to deal with provable facts whenever possible. It's not always clear cut even now but was even less clear cut with the S8 models.
Again I wish you had bought at least the S9 Elite and preferably the S9 AutoSet because I am betting that you only need the higher pressures some of the night and not all of the night.
My OSA is worse in REM...sometimes I need 8 cm more in REM and let me tell you it is much nicer to use 8 cm for 80% of the night and let the machine go to 16 if it wants to for the 20% of the night I am in REM...than to use 16 all night long.
I don't know if your clusters are REM related or supine related but for me I would prefer auto adjusting no matter what the reason and sleep however I wanted and let the machine sort it out. It's not always so easy to stay on one's side (if supine sleeping is the culprit) and we can't control REM so why not just cover both bases with a machine that will sort it out for you.
I may have to RISE but I refuse to SHINE.