Bad AH1's screenshots

[sherryrose]

I have been on bipap for about three months, went through the VA and felt like they just gave me the machine and fitted the mask and let me go. I didn't know anything, I came here and read everything I could and downloaded sleepyhead, and finally was able to see my AH1, but as far as the rest I am still not sure what it all means. It looks like I am having some major leaks, I am going to tighten up my mask tonight see if that helps. I haven't touched the masked since they fitted on me, scared I will screw it up. Any help and advice would be welcome, just know I am still learning.

[Pugsy]

What makes you think your are having large leaks that need tightening of the mask.
From these 2 reports I don't see large leaks.

For some reason your events aren't showing up on the Events graph on the night where the AHI was 10ish.
Not showing up on the flow rate graph either...and they should....plus the AHI 10ish night was only with a very short period of sleep time reported so I don't know how much faith I would have in that result.
And the other night with AHI of 6 ish is showing 0.0.
Something is wrong with the reporting.
You can't have 0.0 at the same time as 6.69.

The data shown doesn't compute...and is incomplete.

But leak numbers as shown don't point to any large leaks. The worse it ever got to was about 70 total leak and that would barely make it in to large leak territory (if it even made it there).
If you are going by the statistic on the left side below all the other statistics where it says some sort of % of time above the red line threshold...that calculation is based on the ResMed 24 L/min number and since you are using a Respironics machine that number won't work for you.
To change it go to Preferences/Cpap tab and either turn it off (remove the check mark for the red line threshold) or change the 24 to something more along the lines of where your large leak territory would begin and that would be up around 75 to 90 L/min for your machine at your pressures.

[palerider]

make your charts look much like this: https://sleep.tnet.com/resources/sleepyhead/shorganize

turn all the flags back on. (lower left corner of the charts)

[sherryrose]

Is this a little better I am still learning so I am a little slow I read the page but still get confused as to how to set up the page.

[Pugsy]

On the left side we need the AHI and the breakdown into each category making up that AHI..
and we need the statistics.
Hide the calendar and the pie chart and those things on the left will easily fit.

On the right side need these graphs.
Events graph....if you have an AHI number there will be something here.
Flow rate graph...events are also flagged here
Pressure graph
Leak graph

[Pugsy]

You are using imgur. Follow these steps and your image won't be so huge and we can click on it to make it larger if we need to.

Be sure you are signed in to your imgur account.
Click on the image you wish to share and on the right side is a box with a bunch of addresses in it.
Below the addresses you will see the various thumbnail sizes available.
Click "Large Thumbnail" and the copy the last/bottom line of addresses in that box of addresses and paste that address into the body of your text here.
When you do a large thumbnail the image will still be fairly large but not huge and it might be large enough we can see what we want to see but if it isn't then we can click on the image to make it full size.
That's what I did with the image I just posted.

[sherryrose]

I think I got it finally thanks for all your help

[Pugsy]

You got the image sharing down.
Now you need to get your image itself so that it shows what is needed.
We don't need snore, respiration rate or tidal volume on the right side graphs.
And your AHI is still only showing the overall total and not the breakdown into each colored bar graph for each event category.

And I have no idea why the smiley face is showing up.

You need to click on the lower left corner down below the graphs....see the Flags arrow pointing up...
expand that area and click on any items you have showing red/black...so that they are showing green/black.
It looks like you have the flags all turned off and they need to be turned on.

If you can't get things to show up properly...go create another profile and download to it and this time don't go turning stuff off except the calendar and pie chart.

[sherryrose]

I tried again I tried to arrange them so you could see what is going on, not sure if I did it right, thanks again for all of your help.

[Pugsy]

Go down to the Flags on the lower left right below the Time at pressure graph and expand it...I see the PB flag is red...it's turned off and I bet a bunch of the others is turned off and...click on the up arrow so the rest of the flags show up and see how many are red...they need to be green.

You are including stuff that isn't needed and not including stuff that is needed.

Look at the items that I showed in the example I posted. Those are what we need to see from your report.

It might be easier to go back and just create another user profile and start totally fresh because you have turned a lot of stuff off that need to be on. Plus this latest image is just a tiny segment of the whole sleep session.

[sherryrose]

ok I put up new screenshots from last night and I noticed that my chart doesn't look like the one on the web page that tells me how to line it all up,
Suggested Support Order for your charts
Event Flags
Flow Rate
Pressure
Leak Rate
Snore
Flow Limit
I have all of them but the flow limit, not sure why and when you tell me about,

Go down to the Flags on the lower left right below the Time at pressure graph and expand it...I see the PB flag is red...it's turned off and I bet a bunch of the others is turned off and...click on the up arrow so the rest of the flags show up and see how many are red...they need to be green.

I am not sure what you are talking about I did go to a little thing that said flags and clicked on it and the color changed to green, not sure if that is what you are talking about.
Sorry to keep bothering you but I really want to understand this whole thing. I got a call from the sleep clinic and I have to go in next week to have my pressures adjusted because of my data.
Here are the new screenshots I hope they show better information.

[Pugsy]

Your most recent bottom image is the one with the most useful information on it.
That's the one that shows 2.66 AHI...you don't need to include the snore graph (that's on the bottom and tiny) because snores are also included on the Events graph on the top.

For some reason that image is blurry and I can't click on it to enlarge it or make it any clearer. I think you copied the wrong link from the box of addresses.

At any rate. You had 2 episodes of large leak. The first one at around 23:40 wasn't all that prolonged and if that was all there was then I wouldn't worry about it but the last large leak started around 1:15 and lasted for much longer and it looks like it might have caused you to wake up since the sleep session reporting stops there.

On the AHI of 2.66 night roughly 50% of the events were clear airway/central events and they either were SWJ (sleep/wake/junk) or real and even if they were all real there's not enough of them to worry about. We can't fix centrals with your machine so we have to just ignore them. Mentally remove them from the evaluation process.

All in all the time frame shown on the graphs points to acceptable therapy. We don't see what happened after 2 AM but at least for this segment with the exception of that prolonged large leak (which is maybe a little less than 1 hour duration) things are actually pretty good at least on paper.
22:40 to roughly 2:00
That last large leak time frame...when it's over 100 L/min so the machine's recording and response is going to be severely limited during that time frame. The rest of the time frame though is going to be fairly accurate.

What is your primary complaint or problem? Leaks waking you up? Waking often during the night for whatever reason?

[sherryrose]

Thank you so much for looking at my charts, my problem is waking up and removing my mask and going back to sleep. Sometimes I don't remember even taking it off, is this a common problem?

[Pugsy]

Yeah, taking the mask off and not realizing it is a fairly common problem. Seems especially to affect new cpap users fairly often.
I did it a few times myself when I first started therapy and even had a few nights where it looked like I took it off for a couple of hours and then put it back on and I never remembered doing either event.

The general thinking is if you eliminate mask discomfort itself as being a reason for taking it off and what is left is just that the brain doesn't want the alien thing on its human's face because it's "new" then eventually the brain will come to accept this new alien as its best friend and quit prompting the body to remove it.
Until that happens we usually suggest that the person maybe apply a little bit of tape in a couple of places (like the strap area on the cheek) so that the discomfort associated with the pulling off of the tape will wake the person up enough so they stop the unwanted behavior.

So if you aren't having any real comfort issues that you can associate the removal with then maybe just tape it down in a couple of places. Now if the mask is uncomfortable then obviously you need to try to fix the comfort side of the problem first.

With time and experience the "removing the mask and not realizing it" thing usually fades away and happens less and less as the brain comes to realize that the alien plastered on the face is a good thing and not a bad thing.