Help Interpreting SleepyHead Data

[jweiner]

I started using the Philips DreamStation Autoset a few weeks ago and downloaded the SH software at the beginning of this week. I am wondering why the machine is leaving me with a "residual AHI" in the 4-7 range. Originally, the unit was set to a minimum pressure of 4 cm H2O, but at the advice of a knowledgeable forum member, I upped it to 7 cm H2O. Unfortunately, my residual AHIs remain higher than I would like. Any additional thoughts/help would be most appreciated. Thank you!!

[LSAT]

Cannot open your link

[palerider]

I started using the Philips DreamStation Autoset a few weeks ago and downloaded the SH software at the beginning of this week. I am wondering why the machine is leaving me with a "residual AHI" in the 4-7 range. Originally, the unit was set to a minimum pressure of 4 cm H2O, but at the advice of a knowledgeable forum member, I upped it to 7 cm H2O. Unfortunately, my residual AHIs remain higher than I would like. Any additional thoughts/help would be most appreciated. Thank you!!

[url]https://www.flickr.com/photos/87099063@ ... 5x97WA/url]

https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

[jweiner]

I started using the Philips DreamStation Autoset a few weeks ago and downloaded the SH software at the beginning of this week. I am wondering why the machine is leaving me with a "residual AHI" in the 4-7 range. Originally, the unit was set to a minimum pressure of 4 cm H2O, but at the advice of a knowledgeable forum member, I upped it to 7 cm H2O. Unfortunately, my residual AHIs remain higher than I would like. Any additional thoughts/help would be most appreciated. Thank you!!

[url]https://www.flickr.com/photos/87099063@ ... 5x97WA/url]

https://sleep.tnet.com/resources/sleepyhead/shorganize
https://sleep.tnet.com/reference/tips/imgur

Fixed!! Thank you for the links. I thought people might want to see all the data as opposed to just a day's worth of data.

[jweiner]

Here is a snapshot of the daily data. I tried to organize the charts, but I don't have a graph entitled "Flow Limit."

[Pugsy]

DreamStation machines (or any Respironics mahcine) don't do flow limitation graphs. Instead they flag them as events in the Events graph but only in auto mode...not available in fixed (cpap) mode.

How come you zoomed in on one tiny section? It really doesn't tell us much.
Don't need snore graph (snores are flagged in the events graph) and don't need respiration rate either.

You can't fix the Clear Airway events with your machine...those are cessations of breathing but the airway is open and not blocked...in other words a central apnea.
You can only fix the Obstructive Apneas and Hyponeas with your machine and any pressure increases.

Your AHI on the report above was 6.25 and 2.50 of that was clear airway....so only 4.25 was obstructive. Still might be a little more than you would like to see.
I would try 8.0 minimum and see what happens.
Remember...as hard as it might be... you have to mentally remove the ClearAirway Index from any pressure evaluations and base any changes in pressure on what the Obstructive stuff is showing (OAs and hyponeas).

[jweiner]

DreamStation machines (or any Respironics mahcine) don't do flow limitation graphs. Instead they flag them as events in the Events graph but only in auto mode...not available in fixed (cpap) mode.

How come you zoomed in on one tiny section? It really doesn't tell us much.
Don't need snore graph (snores are flagged in the events graph) and don't need respiration rate either.

You can't fix the Clear Airway events with your machine...those are cessations of breathing but the airway is open and not blocked...in other words a central apnea.
You can only fix the Obstructive Apneas and Hyponeas with your machine and any pressure increases.

Your AHI on the report above was 6.25 and 2.50 of that was clear airway....so only 4.25 was obstructive. Still might be a little more than you would like to see.
I would try 8.0 minimum and see what happens.
Remember...as hard as it might be... you have to mentally remove the ClearAirway Index from any pressure evaluations and base any changes in pressure on what the Obstructive stuff is showing (OAs and hyponeas).

Thank you - I only put snore graph in there because a tutorial link another member posted had indicated to put that graph in. I put resp. rate graph in place of flow limitations graph since I couldn't find that one. I didn't realize that I had zoomed in on one part. I will raise my minimum to 8 and see what happens. Thanks again!!!

[Pugsy]

Might have been someone with a ResMed machine....it doesn't do the snores and FLs on the events graph but instead does the graph thing.
So sometimes those graphs are useful when it's a ResMed machine.

If you were using Encore (which is Respironics official software) it doesn't show any of that extra stuff like snore graphs and such. Don't ask me why the machine gathers the data if the official software doesn't even bother to report it...they didn't share their reasoning with me.

Here's what an Encore report will show in it's detailed section. This one is a good example of what I mean when I say that the 90% pressure doesn't always mean much. It's pretty obvious that for the bulk of the night I didn't need much in the way of pressure increases except for that last segment near the end of the night and things got a bit ugly. Probably REM related since that is where my OSA is so much worse. Some nights I would see this sort of stuff and some nights I wouldn't. Never could figure out why. Thought maybe it might be sleeping on my back so I rigged a wall to keep me on my side and I still saw dramatic pressure changes sometimes and not other times. So shrugged my shoulders and left the max open and let the machine sort it out.

[palerider]

Fixed!! Thank you for the links. I thought people might want to see all the data as opposed to just a day's worth of data.

summaries are pretty useless.

[palerider]

Here is a snapshot of the daily data. I tried to organize the charts, but I don't have a graph entitled "Flow Limit."

why did you only show 20 seconds of the night?

[Pugsy]

summaries are pretty useless.

Agreed.

The only time I will ask for a summary report is when I am wanting to see just how much they are using the machine because often they tell me 7 or 8 hours but the summary shows much less.

[jweiner]

Here is a snapshot of the daily data. I tried to organize the charts, but I don't have a graph entitled "Flow Limit."

why did you only show 20 seconds of the night?

Oops - I just noticed that. I didn't alter anything. I had only rearranged the graphs. I didn't realize that the default on the graphs was to only show 20 seconds. I'll know better next time.

[Pugsy]

I didn't realize that the default on the graphs was to only show 20 seconds.

It's not the default. The default is for full view with no zooming in. You probably inadvertently clicked on something that caused it to zoom in on the 20 seconds.

[jweiner]

Might have been someone with a ResMed machine....it doesn't do the snores and FLs on the events graph but instead does the graph thing.
So sometimes those graphs are useful when it's a ResMed machine.

If you were using Encore (which is Respironics official software) it doesn't show any of that extra stuff like snore graphs and such. Don't ask me why the machine gathers the data if the official software doesn't even bother to report it...they didn't share their reasoning with me.

Here's what an Encore report will show in it's detailed section. This one is a good example of what I mean when I say that the 90% pressure doesn't always mean much. It's pretty obvious that for the bulk of the night I didn't need much in the way of pressure increases except for that last segment near the end of the night and things got a bit ugly. Probably REM related since that is where my OSA is so much worse. Some nights I would see this sort of stuff and some nights I wouldn't. Never could figure out why. Thought maybe it might be sleeping on my back so I rigged a wall to keep me on my side and I still saw dramatic pressure changes sometimes and not other times. So shrugged my shoulders and left the max open and let the machine sort it out.

So should I be using the encore data or the SH data?

[Pugsy]

So should I be using the encore data or the SH data?

Encore is going to show you the exact same results as SleepyHead except it goes to 1 decimal point and SH goes to 2 decimal points.
Visually it looks different but the numbers are pretty much the same.
Only thing that I like better in Encore is the way the flow rate/wave form graphs are presented.

Encore is Windows only...and Encore Pro is what you would need with the DreamStation...and Pro is a bitch to install and use.
If you like pain, cussing, headaches and in general getting pissed off at software....send me a PM and I will tell you how to get it.
I have used it for years...way back before SleepyHead was even a thought in someone's brain. I keep Encore mainly to store my Respironics data (I own both brands in the bilevel models) That report was from back in 2011 when I was using a brand new (back then) PR System One Auto CPAP that I just had to get because I wanted one.

The only thing that Encore might make it easier to spot...Sleep/wake/junk because it gives you the breathing pattern already zoomed in and it makes comparing the pattern easier so it's easier to spot minor differences that could mean SWJ going on.
You can do the same thing with SH but it takes a lot more work zooming in on all the various areas.

Here's an example...not mine but one I have handy in imgur where there was a lot of Periodic Breathing going on (the green areas) and I think this guy was having some serious central issues.