rate this night :)

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Ghost754
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rate this night :)

Post by Ghost754 » Sat Apr 25, 2015 11:16 am

Hi guys, first off id like to thanks the people on this forum who helped me by suggesting raising my pressure to 7. my ahi is now between 2 and 4 instead of 6+

I recently found the hybrid mask, which seem to work well for my case. Im trying to improve my therapy by myself since it take forever to see a specialist where i live. I just dont know where to start with the sleepyhead graphic. id like to bring the AHI as low as possible.

Im asking you guys, what this graph tell you ? where should i start and look for in this report to improve my therapy ? thanks for you help

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grayghost4
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Re: rate this night :)

Post by grayghost4 » Sat Apr 25, 2015 1:09 pm

If this is a typical night .... You might be one of those people upset by changing pressure and since most of your number is made up of CA's .... it it were my graph I would change to cpap mode and set pressure at 7.5 and see what happens for a few nights.
If you're not part of the solution you're just scumming up the bottom of the beaker!

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Pugsy
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Re: rate this night :)

Post by Pugsy » Sat Apr 25, 2015 2:40 pm

Mentally remove the Clear Airway Index from your AHI because you aren't going to reduce them with any pressure tweaking. More pressure won't fix them using your machine and you aren't having enough of them to come close to needing a different machine.

So if you remove the Clear Airway Index your AHI is really getting down there and remember these machines sometimes flag awake/semi awake breathing irregularities as some sort of apnea event and so we can't do much about those either.
If you were thinking of trying to get that ever elusive 0.0 AHI...don't go there if that is all you are striving for.
If it happens it happens but it's hard to get 0.0 because it seems like we always have some sort of awake/semi awake thing or some random OA or hyponea that gets flagged.

How are you feeling and sleeping? That's the important thing right now.
If you are feeling decent and sleeping decent I don't see any need to change anything if most of your reports look this good.

The one period of time where the pressure went up for a little while...I suspect either REM or supine sleeping or maybe a little of both and unless the pressure changes are disturbing your sleep I don't know that I would do anything differently. Whatever it was that caused that pressure increase might happen again and the machine seemed to respond effectively since we don't see any clusters of apnea events that slipped past the defenses.

Unless you are having problems I don't see the need to change anything and if you are having problems we need to talk about what the problem is and options available to try to help.

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Ghost754
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Re: rate this night :)

Post by Ghost754 » Sun Apr 26, 2015 12:06 am

Pugsy wrote:Mentally remove the Clear Airway Index from your AHI because you aren't going to reduce them with any pressure tweaking. More pressure won't fix them using your machine and you aren't having enough of them to come close to needing a different machine.

So if you remove the Clear Airway Index your AHI is really getting down there and remember these machines sometimes flag awake/semi awake breathing irregularities as some sort of apnea event and so we can't do much about those either.
If you were thinking of trying to get that ever elusive 0.0 AHI...don't go there if that is all you are striving for.
If it happens it happens but it's hard to get 0.0 because it seems like we always have some sort of awake/semi awake thing or some random OA or hyponea that gets flagged.

How are you feeling and sleeping? That's the important thing right now.
If you are feeling decent and sleeping decent I don't see any need to change anything if most of your reports look this good.

The one period of time where the pressure went up for a little while...I suspect either REM or supine sleeping or maybe a little of both and unless the pressure changes are disturbing your sleep I don't know that I would do anything differently. Whatever it was that caused that pressure increase might happen again and the machine seemed to respond effectively since we don't see any clusters of apnea events that slipped past the defenses.

Unless you are having problems I don't see the need to change anything and if you are having problems we need to talk about what the problem is and options available to try to help.
thanks for your reply, to answer you question, ive droped from 5 to 2 AHI with the advice of some nice people here, but i dont see any difference in my life, i still wake up tired an dizzy. I dont know how to intepret those number, What does 2 AHI actually mean ? does the machine responded to these 2 ahi/hours, or it is the number of AHI that the machine could not prevent or negate.

if this graph look good to you and i should wake up fine and refreshed. then i will look elsewhere because sleep apnea might not be my only problem.

thank you !!

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Julie
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Re: rate this night :)

Post by Julie » Sun Apr 26, 2015 3:57 am

You said you wake up tired and dizzy - do you mean actual real dizziness vs fogginess, etc? Do you get lightheaded e.g. when sitting/standing?
Last edited by Julie on Sun Apr 26, 2015 5:14 am, edited 1 time in total.

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Jay Aitchsee
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Re: rate this night :)

Post by Jay Aitchsee » Sun Apr 26, 2015 4:58 am

Ghost754 wrote:What does 2 AHI actually mean ? does the machine responded to these 2 ahi/hours, or it is the number of AHI that the machine could not prevent or negate
The AHI as reported by the machine represents the average hourly number of events the machine did not prevent. It does not infer how many events the machine actually prevented.

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Pugsy
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Re: rate this night :)

Post by Pugsy » Sun Apr 26, 2015 10:51 am

AHI is the hourly average for the number of apnea events that slipped past the defenses...we have no way to know how many apnea events were prevented.

If you aren't feeling as good as your numbers on your report would seem to indicate then it's time to look at other potential factors.
First thing I would suggest would be to try either cpap mode or apap mode with extremely tight range of pressures.
In your case since you are using a Respironics machine I would suggest apap mode but set the minimum pressure to equal maximum pressure to mimic cpap mode. The reason I suggest this is that the Flow Limitation event flagging is turned off in cpap mode but turned on in apap mode and it would be helpful to have that added piece of data.

For some people the pressure changes (even tiny) in apap mode can be a disturbing factor to sleep quality.
So we suggest using a single pressure that doesn't change to see if that helps or not in terms of how well rested you feel. For some it helps a lot and for some it doesn't but it is at least something to try.

Also....take a hard look at any meds you take, even OTC meds for side effects that might be a factor...and look at other possible health issues too....like hormone levels and/or vitamin D levels.
It wouldn't be impossible for you to have more than just sleep apnea going on.

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Ghost754
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Re: rate this night :)

Post by Ghost754 » Sun Apr 26, 2015 11:15 am

Julie wrote:You said you wake up tired and dizzy - do you mean actual real dizziness vs fogginess, etc? Do you get lightheaded e.g. when sitting/standing?
after a night of 8-9 hours, i wake up like if i slept 30 minutes, headache, lightheaded, tired, stare blanky, i cant do major physic effort for hours. no mental awarness, i cant think clearly. Some morning are better than others, sometime i just wake up and i know its gonna take more than 6 hours until ill feel "normal" and this is with or without CPAP.

i had an AHI of 7 before using a CPAP, now im down to 2.. since i dont see any change and benefit, i was aiming for a better score. i thought the CPAP could negate all AHI event in a night.
Pugsy wrote:AHI is the hourly average for the number of apnea events that slipped past the defenses...we have no way to know how many apnea events were prevented.

If you aren't feeling as good as your numbers on your report would seem to indicate then it's time to look at other potential factors.
First thing I would suggest would be to try either cpap mode or apap mode with extremely tight range of pressures.
In your case since you are using a Respironics machine I would suggest apap mode but set the minimum pressure to equal maximum pressure to mimic cpap mode. The reason I suggest this is that the Flow Limitation event flagging is turned off in cpap mode but turned on in apap mode and it would be helpful to have that added piece of data.

For some people the pressure changes (even tiny) in apap mode can be a disturbing factor to sleep quality.
So we suggest using a single pressure that doesn't change to see if that helps or not in terms of how well rested you feel. For some it helps a lot and for some it doesn't but it is at least something to try.

Also....take a hard look at any meds you take, even OTC meds for side effects that might be a factor...and look at other possible health issues too....like hormone levels and/or vitamin D levels.
It wouldn't be impossible for you to have more than just sleep apnea going on.
ill try that ! im currently running at 7-12, what whould you think a good single pressure would be ?

thank alot for your time guys !

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Pugsy
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Re: rate this night :)

Post by Pugsy » Sun Apr 26, 2015 11:28 am

Ghost754 wrote: im currently running at 7-12, what whould you think a good single pressure would be ?
It's really hard to pull out a number based on 1 report. If it wasn't for that one brief pressure increase that you see then I would think 7.5 or 8.0 would probably be a good starting point but something changed during that time frame to cause a need for more pressure. We don't know what it was...like was it REM sleep (time frame would support it) or were you on your back that time. If you choose a lower number and whatever happened to cause the pressure increase to happen then happens again then it's possible for that period of time the therapy would be sub optimal...now would that be a major problem? unknown.

Your AHI pre cpap was only 7...so not all that horrible in numerical terms.
Makes me wonder if there is some sort of UARS component maybe also be a factor in your situation. Google Upper Airway Resistance Syndrome to see what I am talking about.
Now, I don't know that is what might be going on here but there's the possibility that it might.
CPAP therapy is still the treatment of choice if there is some UARS going on here.

I think I might try 9 cm if I were in your shoes based on what you have said so far. It's a little big bigger of an increase than I would usually consider as I usually like to go up in smaller increments but that one time where you need more pressure is likely to happen again and 9 cm would probably have a better chance of preventing whatever was going on at that time than 8 cm would.

Also you need to evaluate (besides meds and general health)...
How many wake ups during the night are you having? That's critical to sleep quality.
There's a big long list of stuff that can affect sleep quality and/or how we feel during the day...just have to start digging for potential culprits.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

Ghost754
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Joined: Sat Apr 04, 2015 1:05 pm

Re: rate this night :)

Post by Ghost754 » Mon Apr 27, 2015 12:59 am

Pugsy wrote: It's really hard to pull out a number based on 1 report. If it wasn't for that one brief pressure increase that you see then I would think 7.5 or 8.0 would probably be a good starting point but something changed during that time frame to cause a need for more pressure. We don't know what it was...like was it REM sleep (time frame would support it) or were you on your back that time. If you choose a lower number and whatever happened to cause the pressure increase to happen then happens again then it's possible for that period of time the therapy would be sub optimal...now would that be a major problem? unknown.

Your AHI pre cpap was only 7...so not all that horrible in numerical terms.
Makes me wonder if there is some sort of UARS component maybe also be a factor in your situation. Google Upper Airway Resistance Syndrome to see what I am talking about.
Now, I don't know that is what might be going on here but there's the possibility that it might.
CPAP therapy is still the treatment of choice if there is some UARS going on here.

I think I might try 9 cm if I were in your shoes based on what you have said so far. It's a little big bigger of an increase than I would usually consider as I usually like to go up in smaller increments but that one time where you need more pressure is likely to happen again and 9 cm would probably have a better chance of preventing whatever was going on at that time than 8 cm would.

Also you need to evaluate (besides meds and general health)...
How many wake ups during the night are you having? That's critical to sleep quality.
There's a big long list of stuff that can affect sleep quality and/or how we feel during the day...just have to start digging for potential culprits.
thank you! ill google what you said about UARS, for this week im gonna try 9-14 with a 30 min ramp at 6. if it dont work ill try simple pressure. i will keep you in touch

to answer your question, i dont wake up at all at night, even when the baby's crying and my girlfriend wake up to feed him and i dont even notice it.

i appreciate what you do guys, 29k post to help other people sleep and live better is very honorable.