Sleepyhead question

Lou Cypher wrote: ↑

Mon Feb 19, 2018 4:35 pm

Time over leak redline 1.300%

Geez....that's what I mean about SH making a mountain out of a mole hill. 1.3% of 6 hours and 22 minutes...that's all of a little less than 5 minutes above 24 L/min. Not worth looking at.
5 minutes out of over 6 hours in large leak that you slept through....don't give it a second though.

As far as the pressure graph...it's better if you include everything like I did on my report so I can get the overall big picture of what the pressure did and why.
But I can see enough with this snippet...out of the entire night you had about 1 hour where the pressure wanted to kiss that 20 cm line. The bulk of the night you were well below that 20 cm. You don't need more max pressure and I am not sure that you need more minimum.
I would need to see the entire big picture....like I did mine.....to get a better feel for the events and the pressure relationship.
It's important to know what the AHI is composed of in each category before we go down the "more pressure" road anyway.
Also need to see when they happened.

I tried to duplicate what you did as well as I could...If I still need something , please let me know and I will try to fix it for you to be able to see what is going on.

[IMG]http://i68.tinypic.com/24xdfv8.png[/IMG]

No need to redo this image but next time a couple of hints.
Turn off the Pie Chart so that we can see the AHI numbers....Preferences/Appearance tab and remove the check mark for "show pie chart". Now sometimes this sticks and sometimes it doesn't. If it doesn't don't worry about scrolling down to include the machine settings below the statistics..the settings thing isn't all that helpful but seeing the AHI is.
Also..when you use imgur....copy the last line in the box of addresses..the BBC link code...using that address lets us click on the image and zoom in for easier reading. I can't read all of your numbers (but I can see enough for now) and I can't make it bigger with the link you have chosen.

When you had that clustering of OAs were you on your back by chance?
You need more pressure minimum for part of the night and not for other parts. The usual culprits when that happens is either sleeping on your back or REM sleep or maybe a combination of both.
First REM cycle doesn't normally last for nearly 2 hours which is why my first suspect would be sleeping on your back.

Can you grab a screen shot of the Flow Limitation graph for this night? I suspect that it will be more active at the time of the OA clustering.

So you need more minimum pressure for some parts of the night and not others. How much more I can't really and it also depends on just how often you get reports like this one and the why of the clustering. Is this pretty typical for what you see night after night or is this a one off "bad" night?
If this is pretty much what you see every night then a little increase in that minimum would probably clean it up. 1 or 2 cm probably.

OK I will try to answer your questions...

Remember I am trying to use a new Full Face mask and having difficulty getting used to it. I have only been at this particular model and size the last week.... so I have no standard to match to... I am trying to establish the standard now.....Having said that, I KNOW nothing about much of which everyone speaks here....... Everything had been working fine for me for almost 18 years and now everything is upside down....( but I appreciate your help very very very much and I am learning as we proceed) so here goes........

How to turn off pie chart..

I can't seem to find a preferences / appearances tab....

I have absolutely no idea what you mean or are talking about when you say "when you use " imgur " so obviously all the lines that follow are oatmeal to me... sorry

Next where are you seeing the clustering of OA's ???? if it was at the beginning of sleep then probably YES it was on my back.....I have grown accustomed to sleeping entirely on my back. As a matter of fact I go to sleep within seconds on my back and wake up the next morning in the exact same spot.....]
Now all that happened with the nose pillows.. now with full face, I am still starting off laying on my back but I am waking up during the night , some times a couple of times ,,, sometimes only once..... and then I go back to sleep usually on my back..... that is if I can get back to sleep.... the last few days have been getting better with that ability to do so. Twice in the last 5 days I have been able to move over to my side and go back to sleep...... So Am I to understand that I should be trying to side sleep and stay away from the back as much as possible ?

I hope this is the a pic of the chart you wanted....not sure4 how to make it bigger or better at this time..... but I am taking copious notes on all this.....

[IMG]http://i68.tinypic.com/rlyzcm.png[/IMG]

Open SleepyHead...upper left corner you will see "File"...click on it and in that drop down menu you will see Preferences and when you click on Preferences the windows open up and you see the various tabs and the one on the far right is "appearance".
this isn't a critical thing.

Clustering of OAs between 00:40 and roughly 2:20. I can't see the numbers well enough to know for sure.

Forget what I said about imgur. No wonder you are confused...I see now that you aren't using imgur.
I don't know if you can read the tiny numbers on your side of your image but I can't. I have no idea what you did when you made it smaller so that you could get the image to show up but I can't do anything with it. I can't see it very well and I have no way to make it larger. If I "view your image" it's still too small for me to read the numbers and if I try to zoom in I lose detail so can't read because it's blurry.

Okay...now I have a better understanding of things. You used to use a nasal mask and now you are using a full face mask and also using a new machine. Lots of new things.
Sometimes with full face masks people need a little more pressure than if they were using a nasal mask.
It's common. We don't know why for sure but I suspect that the lower straps on full face masks pull the lower jaw back just a little and change the airway just enough to sort of compromise the opening a bit or make it a little harder to hold open.

So since you are trying lots of new things I don't know that I would change anything with the pressure until you are more used to all the new stuff and you see if last night ends up being a typical night for you or if it is a random bad night that doesn't duplicate itself.

Busy with doc appointments today.... I made a change to the pic of last nights data. don't have much time to write at this point. I will be back on later to explain more... I found out along with all the changes here I had a bad sinus infection that was unlike any other I have ever had.. bad timing huh? Today is the last day on the Antibiotics and predsone.

If you can't see this chart good enough, click on it and choose view, I am hoping that will work for you on this board because of the way I loaded the pic and change it to a JPG.

I know I am a pain but Thank You for helping me soooo much try work out these problems and give me knowledge.... plus a good nights sleep.... I really do appreciate it...

Let me know if you need different charts in the pic and if it worked for you to be able to read it....please

Talk back later with more info on what is going on here....

Sorry for some reason this info didn't come over in the pic,,, guess I still have more to learn with all this software stuff.....

Total time in apnea 00:05:16
Time over leak redline 15.709%


[IMG]http://i67.tinypic.com/102s6mf.jpg[/IMG]

Yes, thank you. I can now read things very well.

Didn't know you have been sick with the sinus stuff. Let's back up and not do any changes until the sinus stuff is not potentially impacting your results.

I have one rule...no changes to settings when a person is sick with any sort of upper respiratory issue because being sick can cloud the data.

Which mask would you rather use? Full face or nasal? Just from a comfort perspective in terms of comfort and sleep quality?

Well today is the last of the 10 days on meds... and I am feeling fine now.... no dripage and sleeping is better.........

I don't believe I have a choice, I have to use the Full Face and I think I have settled on the Air Touch 20 - I believe that is the one with the memory foam..... in terms of comfort I would love to have my Swift LT back but it just can't happen.....

Even though I keep getting messages like from last night "Your mask is leaking way too much.. Talk to your CPAP advisor."

I have talked to her and after two different appointments and trying different things... the answer I got was,,,, things won't be like they were and you will just have to adjust to what sleep will be like now......

Glad you can at least read the numbers now.......

PS... I will say that I sleep on my back more than my side....

Are you waking up when those leaks are happening?
Or are you sleeping decently for the most part?
15% of the night in large leak and the bulk of that 15% isn't horribly horrible so much that the machine can't sense what is going on.
Unclassified apneas are minimal....that's when the machine doesn't know exactly what is happening...just that something is happening.

Since you aren't having a lot of sinus/nasal symptoms....how about increasing that minimum pressure 1 cm...and see if it will help with the obstructive stuff and maybe let you dial in the seal a bit better so that if the machine goes higher it maybe won't leak quite so much.

I am waking now and then,,, which never happened until the horrible mouth leaks got so bad even the tape couldn't stop them.....

I would say I am waking at least once a night now,,, the second time is get up time ..LOL

My problem is when I wake up during the night, I find a reason to take off the mask... thirsty, bathroom, or currently just curious to check the numbers etc......

Then my crazy mind won't let me just jump right back into bed and sleep.. I start to think about what woke me up, check the numbers ,,,, see if there is a leak I can stop before sleeping ... I usually wind up anything from 30 minutes to an hour before I can settle back down and try to sleep again..

Just my crazy brain..been like that all my life... hard for me to stop thinking and analyzing ....

In this case it is hard for me to analyze because I know not of this CPAP stuff.....LOL

I will give the 1cm a try tonight....and let you know tomorrow.....

Does most everything else seem ok........ By that I mean nothing that needs tending to.....

One wake up during the night wouldn't be so bad if you just could turn the brain off and go back to sleep.....but then you already know that.
If I only woke up once during the night I would be dancing a jig. But then I normally can go right back to sleep and I don't get up often to go pee or whatever. If I get up then I am usually prime for not being able to go back to sleep so I don't do it unless I just have to.

Since the big leaks aren't waking you...and I know that SH says they are horrible...there are degrees of bad and 15% isn't horribly bad IMHO.
Heck, even ResMed won't give you Mr Frowny face until you hit 30% or more of the night in large leak.
You are trying to dial in a new mask...it takes time so I wouldn't worry so much about that leak right now despite what SH says.

Sleep maintenance insomnia...that's when we wake up during the night too many times or can't go back to sleep if we do.

Oh...the prednisone..it can mess with sleep and cause insomnia to be worse....so while I know you have been fighting it most of your life the prednisone isn't doing you any favors. It takes some time for it to get totally out of your system so I know you are through with it or getting close but it takes time to wash out of the body.
Also take a hard look at any other meds you might be taking. You might be surprised with what some of them might do in terms of messing with sleep.
I take a pain medication during the day that comes with a big "may cause drowsiness" sticker but if I take it in the evening it causes insomnia to me. It does that for a small percentage of people...wakes them up instead of putting them to sleep and I drew the short straw on that one.

Overall I think you are doing well for a new mask and new machine and new way of doing things.
Just in the minor tweaking stage to see if things can improve just a bit on both the leaks and the AHI.
Leaks are a war we never truly win...sometimes the mask wins the battle and sometimes we win the battle but it's a war we always have to fight. Even me...sometimes the mask wins. I just shrug my shoulders and tell the mask "I will get the next battle" and I usually do.
I win more times than it wins. Now if you reporting multiple wake ups because of the leak..then we have a different discussion because any leak that wakes us up is unwanted. We have to get the sleep first and foremost. Without the sleep the rest of this stuff doesn't really matter much.

Busy day for me today and crazy night last night....

First I forgot to put the chip back into my CPAP,,,, so I don't have all the info today.... I am hoping after waking up tomorrow I will have everything up to date and you can maybe figure out What %%$@ is happening.......

I bumped up the minimum pressure 1 cm and went to bed hoping for some better results.... but I got the usual 2 hours or so later wake up with leaks.... Did my usual thing and went back into bed hoping to finish the night ........

About 45 minutes or so later I woke up with air flying out of the mask everywhere with lots of pressure.... I was tired and just tried to reach up and twist or turn the mask to stop the leaks .... didn't work just like water flying out of a fire hydrant.. I have never seen anything like that before....

I did a lot of thinking and wondering to no avail for a long time..... Put the mask back on and thought I would try it again..... I had quite a few of periods where I woke up slightly with leaks and I managed to reach and stop them a bit,,, then back to what I have been calling sleep........hour or so later another AIR EXPLOSION......... scared me so much I jumped up in bed..... I reached up with both hands and pulled the mask as tight as I could to my face just to see if I could stop the blowing and I could not... I took a quick look at the cpap guage and saw 19. some thing numbers looking back at me... I turned the mask off for the third time and decided I would stay up and see if I could gain any knowledge on this....

I put the mask back on and turned the cpap on, trying to learn how to stop the little leaks that were there at this time...... eventually\y I did learn how to stop most of those....

I really wanted to post those charts to see if you can figure what the heck is going on with all that air litterally blowing my mask almost off and why it does that.....

Of course my brain wonders if the machine is OK but it probably is we just need to work out the issues........

I have the chip back into my cpap and plan to put the minimum pressure back to where it was unless I hear from before I go to bed a bit later......

I am wondering if you ever even heard of something like that happening,,,let alone 3 times in one night..............
Oh yeah, I have a history ---- if something is going to happen it is going to happen to me,,that is for sure and for certain..... Wish me well, I am off to watch some TV and then head to bed again later... needless to say I AM TIRED... AS most of the people on this board are tonight , I am sure..

Well here is the story from last night and chart

I moved the pressure back down 1 cm as we hadn't talked and i wasn't sure what to do....... I didn't think going back to the original setting would hurt anything.

I laid down and fell right to sleep... slept straight through for almost 6 hours and then woke up fine.....

Now here is the wording from SH./.

The last time you used your ResMed AutoSet...
was last night (on Thursday, February 22, 2018)
You had an AHI of 6.16, which is considered not very good
You machine was on for 5 hours, 41 minutes and 0 seconds.
You had significant periods of major mask leakage.
Your pressure was under 19.02cmH2O for 95% of the time.

If I look at MyAir I am told I have a great score " 87 "

Mask Seal 20
6.3 events per hour
Total Air Score 87

now the chart.....


Needless to say I am still a bit confused....... between what SH says and Myair and how I slept and feel......

I am leaning toward what you were saying the other day,,,,,,,,, no big deal and SH can confuse with their wording......

With all that said.... and in light of last night... do we move the pressure again or stay as is...... and what are your thoughts moving forward.....

I don't want to keep tyng you up day after day but I sure do appreciate your help here..... it lets my mind rest knowing someone who knows something about this stuff is looking into what is gong on.....

A big THANK YOU

Ignore SleepyHead's leak warning...your leaks weren't bad enough to worry about.

The bulk of your problems happened within the first hour of the night. I can't enlarge this image...I tried.
But I can see well enough.
Something caused the machine to want to do the more pressure thing that first hour. We know you were probably on your back which is your usual position and most likely you were on your back the rest of the night where the machine didn't find much to fight.
So what makes that first hour different? Dunno....maybe chin/neck/airway position related because of the full face mask lower straps.
Something changed but we just don't know what and we really don't know have any way of knowing what it was.

If it were me...I would just try more minimum pressure like we already talked about.
I think you just need a little more minimum pressure with this full face mask to better cover the whatever thing it is that is changing that affects the pressure needs.

You could use a lot more minimum all night and cover all bases but I look at that like using the atomic bomb to kill a fly. You don't need a lot more pressure all night just to cover maybe 1 hour of whatever.

How about going back to adding 1.0 cm to your starting pressure and see what happens?

Now some might suggest that you add a cervical collar...and yeah you could try that but that's just more "stuff" on you that might mess with sleep and the problem might easily be fixed with just a little more minimum pressure.
I like to start low with the increases instead of starting with big increases. Sometimes we can get by with less than we think we need and going up slowly is an easier adjustment.

And don't let anyone tell you that you need your minimum up near that 90/95% number...you don't. That's like nuking the fly when a fly swatter will work just fine.

I think I fixed the chart...I need to make notes I got scraps of paper everywhere ....LOL

OK, will put the pressure back tonight and see how it goes.... each day is one more day with the prednisone leaving the body.... today is the second day I haven't taken any....

Thanks again.......