Please Interperet My Data

Sean19 · Post by **Sean19** » Wed Apr 25, 2018 5:21 pm

Hello, after years of nagging from my caring Wife I finally went to seek help for my sleep troubles. I'm a 36yo male. It took nearly 3 months from first DR visit to get a machine. The first few days were uncomfortable as expected but I felt surprisingly better rested. My ResMed Air #s are ok but my SH data isnt sugar coated as such. Lately I've been feeling no more rested that before beginning the cpap treatment. I can see my leaks are huge, I am a mouth breather and have been training myself to breath through the nose.

Pugsy · Post by **Pugsy** » Wed Apr 25, 2018 5:39 pm

Welcome to the forum
When you have time please add your equipment to your profile like I have mine
wiki/index.php/Registering_Equipment_in_User_Profile

The bulk of that AHI is central/clear airway apneas.
How many times do you think you are waking up during the night?
How many hours of real solid sleep do you think you are getting on average?
Do you take any medications of any kind and if so, what?
Any other mental or physical health issues going on?

How long have you been on cpap therapy?

And yes..the leaks are ugly and some of them so bad the machine might be missing some events but for sure the leaks could be messing with sleep quality and anything that messes with sleep quality messes with how we feel during the day.
You might want to try a chin strap of some sort or even taping your mouth to see if the leaks reduce to a more manageable level.

prodigyplace · Post by **prodigyplace** » Wed Apr 25, 2018 5:40 pm

I am still rather new at this.
I find it curious that the doctors prescribe an Auto CPAP machine but it is locked in Continuous CPAP mode at a constant pressure. For instance, your machine is set to 9 cm pressure continuous,
I have the same machine but the pressure can vary between 5 & 12 as needed.

You have quite a few large leaks. As you stated, that may be due to mouth opening and a chin strap may help.

I think if the machine were in auto mode with a little higher maximum pressure, the Obstructive Apneas and possibly the Unclassified ones could be reduced.

EDIT: Pugsy has much more experience & training than I do.

TedVPAP · Post by **TedVPAP** » Wed Apr 25, 2018 5:50 pm

Until you get your mouth leaking/breathing problem tamed, there is no reason worrying about your data. Your pressure is low enough such that a chin strap may be effective.

Sean19 · Post by **Sean19** » Wed Apr 25, 2018 5:52 pm

Pugsy wrote: ↑
Wed Apr 25, 2018 5:39 pm
Welcome to the forum
When you have time please add your equipment to your profile like I have mine
wiki/index.php/Registering_Equipment_in_User_Profile

The bulk of that AHI is central/clear airway apneas.
How many times do you think you are waking up during the night?
How many hours of real solid sleep do you think you are getting on average?
Do you take any medications of any kind and if so, what?
Any other mental or physical health issues going on?

How long have you been on cpap therapy?

And yes..the leaks are ugly and some of them so bad the machine might be missing some events but for sure the leaks could be messing with sleep quality and anything that messes with sleep quality messes with how we feel during the day.
You might want to try a chin strap of some sort or even taping your mouth to see if the leaks reduce to a more manageable level.

Thank you for the quick reply Pugsy.
Yes, the CAs concern me.
Most nights I feel like a wake up 5 times or less.
Solid sleep?? HA! I'm 36 years old I thought I was sleeping "solid" my entire life until I started researching SA and the associated symptoms/risks. I was under the assumption i was sleeping approx 7 hrs a night.
No meds, eat pretty well, minimum junk food, no soda, some beer on weekends.
No mental or physical issues. 5'10" - 185lbs, I don't exercise but am very active all day (construction).

Today makes 3 wks on the CPAP.

Pugsy · Post by **Pugsy** » Wed Apr 25, 2018 5:57 pm

The unclassified apneas are because of the large leak. The machine is having trouble deciding what to call the whatever it is sensing.
It knows something has happened but can't figure out what to call it because the large leak is so bad it is affecting the machine's ability to sense things.
They might be central and they might be obstructive...we just don't know because the machine doesn't know.

More pressure won't help with the centrals and until we know if you spent much time awake we don't know if we even need to worry about the centrals. If you are spending much time awake with the machine on then those centrals might not even be real.

So before I offer anything more than "fix the leaks"...I need answers to the above questions I asked.

You might want to go watch the videos here with special attention to the bottom video.
http://freecpapadvice.com/sleepyhead-free-software
It will help you figure out if those events are real or SWJ...sleep/wake/junk.

Sean19 · Post by **Sean19** » Wed Apr 25, 2018 5:58 pm

TedVPAP wrote: ↑
Wed Apr 25, 2018 5:50 pm
Until you get your mouth leaking/breathing problem tamed, there is no reason worrying about your data. Your pressure is low enough such that a chin strap may be effective.

Hi Ted,
I was hoping I could train myself to keep my mouth closed during the night. It was very hard for me to admit there was a problem (sleeping) and swallow the fact that i now need to rely on a machine to better my health... I will tell you my nose breathing is getting better and I know that only because I am noticing scents around me that I hadn't in the past.

Sean19 · Post by **Sean19** » Wed Apr 25, 2018 6:07 pm

Pugsy wrote: ↑
Wed Apr 25, 2018 5:57 pm

So before I offer anything more than "fix the leaks"...I need answers to the above questions I asked.

I think those questions were answered, no? Am I being unreasonable for believing I can train myself to nose breath?

Pugsy · Post by **Pugsy** » Wed Apr 25, 2018 6:10 pm

FWIW...I also had to train the mouth to stay shut. I was in the habit of mouth breathing more from gasping for air during the apnea events than it was nasal congestion causing the mouth breathing.
I tried chin straps and tape and eventually settled on tape for about 2 months I guess. Eventually I broke the habit of mouth breathing and it's rare that I mouth breathe now...and if I do doesn't last long so I don't really care.

Whatever your leaks are from....either mouth or mask movement...they are pretty bad and you can't really ignore them.
15 to 30 minutes isn't the end of the world but a couple of hours worth...that's pretty bad.
Especially when it's deep enough into large leak territory to affect the machine's sensors.
Usually we don't see unclassifieds until large leak is over 30 L/min.

Sean19 · Post by **Sean19** » Wed Apr 25, 2018 6:14 pm

10-4. I will work on correcting the leaks and will revisit with new data. Thank you to all who replied.

Pugsy · Post by **Pugsy** » Wed Apr 25, 2018 6:20 pm

You were replying at the same time I was waiting on the answers to the questions.

Thank you for answering.

I am not sure why you initially felt marked improvement and not experiencing it now unless the honeymoon is over. Sometimes that happens.

Or perhaps the machine is missing flagging some events because of the leak situation and the AHI is worse than reported.

Do watch the videos and see if you can figure out if you were asleep when those centrals were flagged...or if you were awake and they can be ignored.

One thing to try...turn off EPR and see if that makes any difference in the number of centrals. EPR can cause centrals in a very small percentage of people. So if they look real...turn off EPR. If they don't look real and instead look like post arousal or SWJ then we work on trying to fix the cause of the arousal first.

You aren't being unreasonable with wanting to try to keep a nasal mask and not go to a full face mask just yet.
I don't blame you...I was in your shoes about 9 years ago.
It took me about 2 months or so of taping my mouth to get to a point where the mouth started to stay shut. Have no idea how long it might take you. Chin straps slid around a lot on my face so I found them more annoying than helping but you might do well with a chin strap.
You will find that there is a big YMMV sticker on everything pertaining to cpap therapy. What works well for one person will be a dismal failure for the next person. So you just have to keep trying different stuff until you figure out what works well for you.

TedVPAP · Post by **TedVPAP** » Wed Apr 25, 2018 6:23 pm

Sean19 wrote: ↑
Wed Apr 25, 2018 5:58 pm

TedVPAP wrote: ↑
Wed Apr 25, 2018 5:50 pm
Until you get your mouth leaking/breathing problem tamed, there is no reason worrying about your data. Your pressure is low enough such that a chin strap may be effective.
Hi Ted,
I was hoping I could train myself to keep my mouth closed during the night. It was very hard for me to admit there was a problem (sleeping) and swallow the fact that i now need to rely on a machine to better my health... I will tell you my nose breathing is getting better and I know that only because I am noticing scents around me that I hadn't in the past.

I have been in training for 8 years. LOL
At some point, you should try nasal pillows. Since the air is directed into the nose, I find I can breath entirely through my nose even when I have congestion. No need to mouth breath when sleeping.
Mouth leaking is a different story. I use a chin strap to keep the mouth closed. This helps many people. But some will still leak air out of their lips so I use a chin strap that resists mouth leaking.

No hurry on trying different approaches but at somepoint you should.

Pugsy · Post by **Pugsy** » Wed Apr 25, 2018 6:24 pm

Oh...the reason I suggest taping the mouth...because mask movement leaks look exactly like mouth breathing leaks on the leak graphs and we don't know for sure which it is unless the mouth is taped.

A little while back I was testing a new nasal mask and I was getting some really bad leaks so I taped my mouth to make sure what the leaks were from.
This was with my mouth taped...so all this is mask movement leak.

prodigyplace · Post by **prodigyplace** » Wed Apr 25, 2018 6:29 pm

Does Sleepyhead interpret the Nasal Mask setting as pillows?
I notice Pugsy’s and the original screens show Pillows instead of Nasal Mask.

Pugsy · Post by **Pugsy** » Wed Apr 25, 2018 6:37 pm

prodigyplace wrote: ↑
Wed Apr 25, 2018 6:29 pm
Does Sleepyhead interpret the Nasal Mask setting as pillows?
I notice Pugsy’s and the original screens show Pillows instead of Nasal Mask.

Good catch. I missed that.

SleepyHead might have it wrong or he might have the wrong mask choice in the clinical setup menu.

OP needs to go into the clinical menu setup area and confirm the mask type selection...and it should be "nasal" for the N20.
It may affect the leak graph...and might be part of the reason for the elevated leak numbers.
I don't think it will make all the large leaks go away but it should help reduce them just a bit with the calculations it does prior to reporting excess leak.
From past experience when I have had the wrong mask type selection in the menu...maybe 3 L/min difference.
https://sleep.tnet.com/home/files/resme ... -guide.pdf
Sean...if you don't know how to change the mask type.....this manual will explain how.
I suggest you download it anyway because it has more info in it than the typical user manual.

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