What does a healthy Sleepy Head pie chart look like?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Nathan C. Morales
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What does a healthy Sleepy Head pie chart look like?

Post by Nathan C. Morales » Fri Apr 17, 2015 9:23 am

Hi,

I've been on my CPAP successfully for about 2 weeks. Last night was my longest sleep on the machine (almost 8 hours).

Is there anything on my event breakdown chart that suggests I still need to tweak my settings?
What does a healthy event breakdown chart look like?

I'm trying to optimize from here.

--Nathan

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hifiaudio
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Re: What does a healthy Sleepy Head pie chart look like?

Post by hifiaudio » Fri Apr 17, 2015 10:31 am

At an AHI of 3 I dont think it really matters (?)

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Pugsy
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Re: What does a healthy Sleepy Head pie chart look like?

Post by Pugsy » Fri Apr 17, 2015 10:46 am

I don't even bother looking at the pie chart because it's just a cursory overview breakdown of the types of events.
Doesn't really tell you much...if you only had 1 OA all night...the entire pie would be light blue OA.
If you had 1 apnea and 1 hyponea...half would be light blue and half would be dark blue.

Overall your report looks quite acceptable. For me personally there's a little more of what I call "clutter" than I would like to see but it isn't necessarily something critical.
The snores, RERAs and Flow Limitations aren't part of the AHI and there's a little more of them than I would want to see if it were my report especially since there seems to be some clustering of OAs and hyponeas.
If it were me I would increase the minimum either 0.5 cm or 1.0 cm and see how much of the clutter gets cleaned up.

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Re: What does a healthy Sleepy Head pie chart look like?

Post by palerider » Fri Apr 17, 2015 5:09 pm

I was going to suggest something similar to what pugsy says, working the minimum pressure up a bit at a time and see if it doesn't tame some of the clusters, having a higher baseline pressure may keep some of them from starting to happen.

go slow at this point.

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Re: What does a healthy Sleepy Head pie chart look like?

Post by SleepDisturbed » Fri Apr 17, 2015 7:51 pm

If I had reports like this I would work up to a minimum of 11. Max of 14.

Or even try a single pressure mode of 12.

But that is just me.

If this report is typical, I think your minimum is too low. Your median is 11 and max is 13.3, so I would move in that direction. Gradually! You seem to have a lot of activity when the pressure drops, then the machine is chasing you.

I have severe apnea, over 80 with deep desats. On Apap I consistently am below 1 and hit zero two or three times a week, so it is possible to get pretty low numbers.

However, the key is how do you feel? How is your sleep? If you are satisfied in that area, your numbers do NOT demand a change. But I am a geek and will always tweek stuff to get as close to perfect as I can get!

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Nathan C. Morales
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Re: What does a healthy Sleepy Head pie chart look like?

Post by Nathan C. Morales » Fri Apr 17, 2015 11:56 pm

I will make some adjustments tonight. I definitely feel better now that I am consistently on the machine, but I don't want to settle for passable if I can optimize my care to excellent.

Thanks for the recommendation.

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Re: What does a healthy Sleepy Head pie chart look like?

Post by Pugsy » Sat Apr 18, 2015 8:16 am

Let me share a little story with you so that you can maybe understand part of the "give it time" thing we talk about and how things can improve without changing anything.

I made the change from apap to bipap on my own and it took just a little bit of fiddling to come up with basic pressure settings to start with. I knew I had to choose something and stick with it and not go changing things nightly or even weekly. Something that is really hard for me to resist as I am not the most patient person in the world.
So I came up with settings that gave me a decent report at least once...so I chose those settings and decided to just stick with them for a period of time (to be determined by how long I could resist the desire to tweak things) and when I first started using them I really had more not quite so good nights as I did good nights but they weren't necessarily bad nights. At 3 weeks of using the same settings I started to notice a trend that the good nights were seeming to happen a little more often.
At 6 weeks I noticed a big change in overall reports when comparing the 6th week to the 1st week.
First week overall average AHI was between 3 and 4 with some "clutter"....6th week overall average AHI was between 1 and 2 and the clutter was less also. I didn't make any changes at all during those 6 weeks.

Now I have never been one to really notice any big change in how I feel when comparing AHI numbers by themselves...AHI of 1 or AHI of 3...I can't really tell any difference but when I have a lot of "clutter" I can seem to tell a difference. Now I don't know if the clutter is a by product of just a crappy night in general for reasons unrelated to sleep apnea or the crappy night is because of sleep apnea clutter. Chicken or the egg thing.
Since I have no way to know for sure I try to reduce "clutter" when I can if it seems to be a consistent thing.
I never worry about anything that is random and off the wall and doesn't happen often.
By reducing the clutter I am sort of covering my bases just in case the clutter is the cause of the crappy night..

Clutter being snores and flow limitations and RERAs on the Respironics reports...and is usually easily reduced with just a little bit more pressure overall if using cpap mode and minimum pressure if using apap mode if it is sleep apnea related clutter. If it is just a crappy night clutter because I had more pain than usual and didn't sleep so great because of the pain then more pressure won't fix it.

The moral of this story....don't go changing things often and chasing a bad night last night because a bad night last night might just be a fluke and random thing that just happens from time to time.

Pick a setting that seems to do a good job for at least sometimes and give it a fair trial to see how things trend over a period of time. There is a lot of truth to the "give your body time to adjust" thing.
Now of course when things are really ugly no amount of time can fix that but when things are maybe not quite as pretty as we want...then make small changes and give them time to work before deciding they aren't working as well as you want.

We as humans tend to want to evaluate success by numbers and while numbers are an important factor they are not the only factor and "perfect" numbers don't really guarantee anything except a nice math score.
Always keep in mind that how you feel is also very important..quality of sleep is very important.

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SleepDisturbed
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Re: What does a healthy Sleepy Head pie chart look like?

Post by SleepDisturbed » Sat Apr 18, 2015 9:10 am

I don't disagree with anything Pugsy wrote above.

But, I would never be able to wait six weeks! I am constitutionally unable to exhibit that much patience. You would have to put me in a straight jacket! :lol

A week maybe.

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Re: What does a healthy Sleepy Head pie chart look like?

Post by Pugsy » Sat Apr 18, 2015 9:42 am

SleepDisturbed wrote:But, I would never be able to wait six weeks! I am constitutionally unable to exhibit that much patience. You would have to put me in a straight jacket! :lol

A week maybe.
I totally understand...believe me I do.
What I did was 1 week at a time to get me through my urge to change something. I would look at the results and say to myself....it looked good for 2 nights and "okay for 3" and maybe not so nice for 2 nights...let's give it one more week and then maybe I see 3 really good nights..and so on.
Of course Murphy's Law intervenes and at some point I have a horrible night and obviously things didn't work well but we don't have a crystal ball to know what's going to happen later tonight that might need something extra ordinary to be done.

In all honesty I was really quite surprised when I compared the first week to the sixth. I really didn't expect to see that much difference. The changing was so gradual that I couldn't really see it until I stepped back and did some manual weekly averaging.
I also saw my time asleep gradually increase as well. I have since learned (of course I now have almost 6 years of this cpap thing to look at) that for me my main contributing factor in how I feel in general is hours of sleep and the overall quality of that sleep. If I get less than 7 hours of sleep I am pretty much guaranteed to want/need to nap around 4 PM no matter how good the sleep was or how pretty the report was. I have also learned that sometimes I just have "bad" nights for reasons unrelated to sleep apnea and if I wake up a lot then I will want to nap and my butt is dragging all day no matter how pretty the reports look. Some of my "best" days in terms of how I feel during the day follow so so reports but with good hours of minimally interrupted sleep. Heck, one of my "miracle" days followed a night with the AHI over 10. Go figure that one.

Right now I am battling sleep quality issues due to pain in one shoulder (I think I pulled something raking leaves) that just doesn't want to go away and of course it happens to be the shoulder that I normally lay on when side sleeping. Last night it just hurt too much to lay on it so I switched to the other side and it still hurt from sagging a little. So I often end up on my back which hurts even more so I wake up with back hurting and it hurts sometimes so much that turning onto my side is just extremely hard to do. So my nights suck and that makes my days suck and it's totally unrelated to sleep apnea but it still sucks.

Next week I will start tweaking and experimenting again...I have a 960 machine coming to me.
Going to compare it to the S9 Adapt that I have been using for the last 15 months. It has a lot more settings that I will need to fiddle with than the Adapt so it may be even more of a challenge to resist fiddling with things.

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Re: What does a healthy Sleepy Head pie chart look like?

Post by palerider » Sat Apr 18, 2015 11:16 am

SleepDisturbed wrote:I don't disagree with anything Pugsy wrote above.

But, I would never be able to wait six weeks! I am constitutionally unable to exhibit that much patience. You would have to put me in a straight jacket! :lol

A week maybe.
Pugsy offers GOOD advice, nobody ever said she offered EASY advice

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Re: What does a healthy Sleepy Head pie chart look like?

Post by SGearhart » Sat Apr 18, 2015 11:43 am

What does a healthy Sleepy Head pie chart look like?

It's a trick question. If you're healthy, you wouldn't be using a CPAP and Sleepyhead.

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Re: What does a healthy Sleepy Head pie chart look like?

Post by palerider » Sat Apr 18, 2015 12:07 pm

SGearhart wrote:What does a healthy Sleepy Head pie chart look like?

It's a trick question. If you're healthy, you wouldn't be using a CPAP and Sleepyhead.
a healthy sleepyhead pie chart looks like a smiley face *lol*

anything else is just *relative* information, that just lets you know what most of your stuff was last night.

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SleepDisturbed
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Re: What does a healthy Sleepy Head pie chart look like?

Post by SleepDisturbed » Sat Apr 18, 2015 7:05 pm

palerider wrote:
SleepDisturbed wrote:I don't disagree with anything Pugsy wrote above.

But, I would never be able to wait six weeks! I am constitutionally unable to exhibit that much patience. You would have to put me in a straight jacket! :lol

A week maybe.
Pugsy offers GOOD advice, nobody ever said she offered EASY advice
Let's see -- he can stick with a conservative, cautious approach recommended by the most respected and knowledgeable poster on the board (Pugsy), or he can strike out into the unknown, rashly going where no man has gone before!

No-brainer man!


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Nathan C. Morales
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Re: What does a healthy Sleepy Head pie chart look like?

Post by Nathan C. Morales » Sat Apr 18, 2015 8:53 pm

It's a win either way for me. I feel ten times better having been on the machine for 7 successful days in a row. I upped my minimum to 9. I still have clusters, but I'll toy around with it a bit.