First night with new machine - comments on Sleepyhead data?

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yaconsult
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First night with new machine - comments on Sleepyhead data?

Post by yaconsult » Thu Jan 29, 2015 10:46 am

I bought the practically new machine in my sig from craigslist yesterday and used it for the first time last night. I picked some initial settings based on years of 100% cpap usage.

I have never had access to this level of data before. Wow, the Sleephead software is impressive! I would be interested in feedback on my settings and results. I'm thinking that maybe I should lower the minimum pressure? Exhalation seems much easier with this machine on the a-flex x3 setting.

Image

Background - been on cpap for over seven years and sleep study just this month said:
RESPIRATORY ANALYSIS: (index = #/hr)
Apnea/Hypopnea Index (AHI): 80.2
*AHI 4% or greater: 62.4
NREM AHI: 80.2
REM AHI: -
Non-Supine AHI: 77.0
Supine AHI: 81.9
Respiratory Disturbance Index (RDI): 80.8
NREM RDI: 80.8
REM RDI: -

Apneas (index, #): 58.8 (96)
Obstructive Apneas (index, #): 47.1 (77)
Mixed Apneas (index, #): 0.0 (0)
Central Apneas (index, #): 11.6 (19)
Hypopneas (index, #): 21.4 (35)
RERAs (index, #): 0.6 (1)

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LSAT
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Re: First night with new machine - comments on Sleepyhead data?

Post by LSAT » Thu Jan 29, 2015 11:06 am

Looks great...leave everything alone for a week and then re-evaluate.

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Re: First night with new machine - comments on Sleepyhead data?

Post by Pugsy » Thu Jan 29, 2015 11:14 am

I also suggest leaving the settings alone for a week and then re-evaluate.
AHI is great at these but you are showing some snores and RERAs and they might increase if you lower the minimum. Snores and RERAs usually mean minor flow reductions that haven't grown up to be a full apnea sort of event.
So just be aware that if/when you might reduce the minimum pressure that those events might increase and even potentially grow up to be hyponeas or OAs.
You need more than one night's worth of data though. If last night was a fluke and the rest of the time you don't see those snores and RERAs then yeah...probably wouldn't hurt to try a little lower if you want to. Don't make changes based on one night....we never know if that one night represents a typical night or just a fluke night and we all have fluke nights on occasion.

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yaconsult
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Re: First night with new machine - comments on Sleepyhead data?

Post by yaconsult » Thu Jan 29, 2015 11:48 am

Great advice, LSAT and Pugsy - it makes perfect sense to wait and collect more data before making changes. I just chose the initial settings based on the 90,000 hours I have with my previous Remstar 510M machine.

While subjective, it feels "better" than the old machine, perhaps because I am using the a-flex 3 setting that was not available on the old system. I consider myself extremely fortunate to have gotten such a nice machine with only 90 hours on it for $100 on Craigslist. And the Sleepyhead software is just fantastic! I'm a happy camper right now.

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Re: First night with new machine - comments on Sleepyhead data?

Post by Sleeprider » Thu Jan 29, 2015 1:43 pm

Nice to see the new to you machine worked out so well. I agree the newer machines are nice enough, you'll never go back.

I agree with not changing a thing for now. If this continues, you nailed it right off. As I recall you were in the mid-3s on the other machine. It might be interesting to zoom in on the pressure wave form data in that time period marked as CSB. I'm always amazed at some of my breathing patterns. Were you fully asleep at that time?

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Re: First night with new machine - comments on Sleepyhead data?

Post by yaconsult » Thu Jan 29, 2015 5:32 pm

Did you mean CSR instead of CSB? If CSR, here are a couple of zooms:

Image
Image

Looking at all the data this thing records is fascinating!

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Re: First night with new machine - comments on Sleepyhead data?

Post by Pugsy » Thu Jan 29, 2015 6:43 pm

The "CSR" flagged time frames by SleepyHead aren't really (or necessarily always) true CSR or Cheyne Stokes Respiration pattern.
Instead the PR S1 flags what Encore and Respironics will call Periodic Breathing and by definition PB is simply a waxing and waning of the air flow that lasts for at least 2 minutes. CSR is a specific type of Periodic Breathing but it isn't the only type of PB.

Occasional time frames with PB isn't all that alarming unless we see lots of it accompanied by Clear Airway (central) events and then we sit up and take notice if we see a lot of it.

Your "CSR" doesn't really have any centrals associated with it and is really more of a general waxing and waning and sometimes can be associated with some awake or semi awake time. I used to see it show up when I know I was awake.

True CSR that is prominent and frequent and prolonged needs to be evaluated for potential health issues. Your "CSR" flagged time frames don't appear to look anything like true CSR ( I have an image somewhere that shows true CSR that I will try to find for you) and even if they were true CSR I wouldn't worry about it at this point unless I saw a lot more of it throughout the night especially if accompanied by a large number of centrals.

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Re: First night with new machine - comments on Sleepyhead data?

Post by Pugsy » Thu Jan 29, 2015 6:54 pm

Here's an image of CSR respiration from Resmed. Note the definitive flat line for the apnea along with the rounding of the breath.
Your respiration pattern barely has any waxing and waning or rounding and really to me yours looks more like maybe some SWJ...sleep/wake/junk. Like maybe you were awake or semi awake. Our awake or semi awake breathing is much more irregular than our asleep breathing even though we don't/can't notice the difference. The machine unfortunately cannot determine sleep status though, so it often will flag some awake/semi awake breathing as some sort of breathing that needs a flag but doesn't really mean there is a problem. Since it is hard to know for sure when it comes to this sort of awake vs sleep status we usually don't worry about this sort of stuff unless we start seeing a lot of it and specifically know that we were asleep when it happened...and we see it often.

I once had 17 centrals in 17 minutes and boy did it ever look like CSR at a first glance. It only happened once...I thought I was asleep as it happened about an hour before my awake time but I can't say for sure and since I have only seen it the one time I elected to not worry about it. That's when I start blaming the aliens....when I see weird stuff that I can't really explain. It's as good of a reason as any I suppose. We don't always get nice clear cut answers to our questions.

Image

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Re: First night with new machine - comments on Sleepyhead data?

Post by LSAT » Fri Jan 30, 2015 9:21 pm

yaconsult wrote:Great advice, LSAT and Pugsy - it makes perfect sense to wait and collect more data before making changes. I just chose the initial settings based on the 90,000 hours I have with my previous Remstar 510M machine.

While subjective, it feels "better" than the old machine, perhaps because I am using the a-flex 3 setting that was not available on the old system. I consider myself extremely fortunate to have gotten such a nice machine with only 90 hours on it for $100 on Craigslist. And the Sleepyhead software is just fantastic! I'm a happy camper right now.
90,000 hours on your previous machine???? That's over 30 years.............. .

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Re: First night with new machine - comments on Sleepyhead data?

Post by palerider » Fri Jan 30, 2015 9:24 pm

LSAT wrote:90,000 hours on your previous machine???? That's over 30 years.............. .
it's only 10 if the never turned it off.

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Re: First night with new machine - comments on Sleepyhead data?

Post by Tatooed Lady » Sat Jan 31, 2015 12:04 am

palerider wrote:
LSAT wrote:90,000 hours on your previous machine???? That's over 30 years.............. .
it's only 10 if the never turned it off.
Boot dryer working OT?

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Re: First night with new machine - comments on Sleepyhead data?

Post by Wulfman... » Sat Jan 31, 2015 12:18 am

If the user averages 8 hrs. per night, in one year that comes to 2920 hrs.
The first M Series machines were introduced in about mid 2006. That's almost nine years. 9 x 2920 = 26,280 hrs.

90,000 hrs. divided by 9 yrs. = 10,000 hrs. per year.

24 hrs. x 365 = 8760 hrs. in a year.

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palerider
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Re: First night with new machine - comments on Sleepyhead data?

Post by palerider » Sat Jan 31, 2015 12:56 am

Wulfman... wrote:If the user averages 8 hrs. per night, in one year that comes to 2920 hrs.
The first M Series machines were introduced in about mid 2006. That's almost nine years. 9 x 2920 = 26,280 hrs.

90,000 hrs. divided by 9 yrs. = 10,000 hrs. per year.

24 hrs. x 365 = 8760 hrs. in a year.

(in my Mr. Spock impersonation) "That's not logical, Captain".
you're close, sprok, but not exact, I'm surprised!

365.25 (gotta count them leapyears) * 24=8766, 10.266940452 years, approximately.

who knows, maybe it was a pre-production prototype model he got a year before they were released!

or, it coulda been a typo.

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Re: First night with new machine - comments on Sleepyhead data?

Post by yaconsult » Sat Jan 31, 2015 12:35 pm

Sorry - I meant 19,000 hours on the previous machine, not 90,000. It was well used as I can not sleep without it with my Apnea/Hypopnea Index (AHI): 80.2.

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