Interpreting Detailed Graphs?

Can anyone point me to info re interpreting detailed graphs? I just figured out how to access them and am having trouble figuring out how the different categories relate: difference between "Flow Limitation" and "Leak" and "Minute Ventilation"?

Here's situation: Although my AHI for past month is very low and stable (0.1) and AP appears consistent (9.6/10.3/10.3), the Leak rate fluctuates a lot, both from night to night (14.4 / 21.6) and within a single night, when dips and rises appear pretty pronounced. I'm trying to figure out if these leaks are contributing to generally poor sleep: avg usage is 5.28, which includes at least 2 wakeups, the first generally after 3+ hrs of sleep, the second up to an hour before I actually get up and turn off machine. Those nights I get up to 5+ hrs sleep before first wakeup, I really feel the improvement during the day; rest of the time, I feel pretty wiped out much of the day. So, I'm trying to figure out what's triggering disruptions? In short, though I've drastically decreased apnea events, I'm still sleeping poorly.

One more question: what does "Oximetry State" measure, and how does one access it? Does it have to selected beforehand?

thanks for help,
tom

Doubtful Tom wrote:Although my AHI for past month is very low and stable (0.1) and AP appears consistent (9.6/10.3/10.3), the Leak rate fluctuates a lot, both from night to night (14.4 / 21.6) and within a single night, when dips and rises appear pretty pronounced. I'm trying to figure out if these leaks are contributing to generally poor sleep: avg usage is 5.28, which includes at least 2 wakeups, the first generally after 3+ hrs of sleep, the second up to an hour before I actually get up and turn off machine. Those nights I get up to 5+ hrs sleep before first wakeup, I really feel the improvement during the day; rest of the time, I feel pretty wiped out much of the day. So, I'm trying to figure out what's triggering disruptions? In short, though I've drastically decreased apnea events, I'm still sleeping poorly.

Leak fluctuations as you describe can definitely affect overall how you feel especially if they wake you up or just disturb you and you don't realize it may have caused you to awaken. Anything that causes awakenings will break the normal restorative sleep cycle and thus how we feel. The ResMed machine will subtract mask intentional vent rate before reporting the leak so all you see is excess leak and that 21.6 is very close the to 24 L/min that they say leaks can impact therapy and data.
I would suggest working on the leak rate and try to get it to be a straighter line under 10 would be much better.
I would suggest taking a hard look at other possible causes for awakenings. Sometimes the least little thing can make a huge impact.
Just because we get good numbers doesn't automatically give us those "aha days" where we feel awesome. Sometimes simply the number of hours of sleep that is "good" needs to be increased. In your case you are on the right track because you already know that you do better without the wake ups.
You are using APAP? If so at what settings? Sometimes people are sensitive to the pressure changes and that can disrupt sleep. If your machine is increasing pressure in response to leaks, that could also potentially be disrupting.

In general, I would concentrate on improving the leak or consider a different mask. See if that helps, look at the pressure line and see if it spikes very much because changes can impact sleep for some people. Maybe a narrow range if your range is wider or even straight cpap mode as a trial. Your overall AHI is great but as you already know more detective work is due to figure out what is disrupting sleep. As a side note, when I first started therapy after some tweaking I also got really good numbers but felt much less than optimal. Pain was part of my problem but another part was hours asleep. At 5 hours sort of blah, 6 hours better and 7 hours much better. Is it possible to increase the total hours using the machine?

Explaining flow limitations and minute ventilation I will leave to someone who can explain it better than me.

Oximetry state? I have no idea.

The S9 does not capture oximetry data on it's own. That requires a very expensive add-on - around $800 I think.

Thanks, Pugsy, for all the helpful suggestions.
I considered my apap range pretty narrow -- 8-10.4 -- without a lot movement, but since I've always been a light sleeper, even pre-apnea days, a bump from 9 to 10 could be significant for me.

And I suspect noise is problem, too. Dang thing sounds like a train passing through my room, whistle blowing, sometimes.

I'm just glad I finally figured out how to access the detailed data, which you recommended a while back.

*

Thanks, BernieRay for the $ tip re Oximetry app. Whatever it does, that's too steep for my budget!

tom

I wonder why the extreme difference in noise complaints with the S9. I don't even hear mine, just the vent if it's blowing against the covers. It's sits level with my bed, but one the other side of a queen. I think this is more than age related hearing loss.

Lizistired wrote:I wonder why the extreme difference in noise complaints with the S9. I don't even hear mine, just the vent if it's blowing against the covers. It's sits level with my bed, but one the other side of a queen. I think this is more than age related hearing loss.

I have wondered this also. Back when I got my M series machines (I have 2 APAPs, one with CFlex and one with AFlex) people used to complain all the time about how noisy the M series machines were and I didn't think they were noisy at all. Eventually had hearing tested for general thing and no hearing loss so can't blame it on that. I suppose the noise level could vary from machine to machine but to compare a machine to a train is more than just a little difference. I am starting to wonder if some people are more sensitive to certain tones that seem to amplify the sound a bit.

Only sound I hear is mask vent sound and my husband reports the same, he did comment that the vent noise is significantly less with the Swift FX than it was for the Swift LT. In fact things were so quiet that he once shook me to wake me up to tell me to turn the machine on because he thought it was off. I was indeed masked up and the machine was on. It was right after I changed to the Swift FX mask.

Being new one thing I noticed is if I have no leaks it is very quiet. If the seal is not good I hear whistling.

Speaking of the oximetry setup, does anyone know the cost of the oximetry setup for the Devilbiss Intellipap Autoadjust machine? I got an one of these machines recently on the auction site for an exceptionally good price. I have wanted to try this machine for quite a while and am using it regularly at the moment. I read about and researched the oximeter that can integrate with the data on the card. It uses, I understand, a Nonin XPOD Oximeter.

Anyone? Sorry if I am sort of highjacking this thread but the auxiliary oximetry was mentioned for the Resmed so wondered if anyone knew about the Intellipap setup.

Hawthorne wrote:Nonin XPOD Oximeter.

http://www.grasstechnologies.com/catalo ... cts_id=436
I found this $475, there may be other suppliers but didn't see any off hand.

Explanation but no price that I could see
http://www.braintronics.nl/pages/Produc ... nX-Pod.htm

Thanks Pugsy. I got such a good deal on the Intellipap, this MAY be a possible soon. It would be interesting and helpful to have all the data integrated like that.