anyone can interpret reports

[gogailg5]

hi my name is Gail. I am a seasoned CPAP user. over 10 years. I've watched these machines evolve from the size of a phone book and sounding like a freight train, to
hand-size portable units. I can self adjust my Res S9 and have tried lots and lots of mask. my problem. I still do not sleep well. Each night I awaken 3 - 4 times.
I had 7 sleep studies and each time the rx is set to 7.0 pressure. On my last sleep study I convinced the tech to share with me what was going on. He stated well you stop
having apnea events at 9.0 and you stop snoring at 11.0. When I explain this to the doctor, he stated that looking at the 'big picture' my setting should be 7.0. 7.0 is a disaster
for me...my AHI is 6.0 at this setting. anyway...my QUESTION is does anyone knows how to read and interpret these SleepHead reports...the doctors don't..haha.
if so I will more then gladly upload the data to you maybe in an email of some platform....thanks Gail

[zoocrewphoto]

hi my name is Gail. I am a seasoned CPAP user. over 10 years. I've watched these machines evolve from the size of a phone book and sounding like a freight train, to
hand-size portable units. I can self adjust my Res S9 and have tried lots and lots of mask. my problem. I still do not sleep well. Each night I awaken 3 - 4 times.
I had 7 sleep studies and each time the rx is set to 7.0 pressure. On my last sleep study I convinced the tech to share with me what was going on. He stated well you stop
having apnea events at 9.0 and you stop snoring at 11.0. When I explain this to the doctor, he stated that looking at the 'big picture' my setting should be 7.0. 7.0 is a disaster
for me...my AHI is 6.0 at this setting. anyway...my QUESTION is does anyone knows how to read and interpret these SleepHead reports...the doctors don't..haha.
if so I will more then gladly upload the data to you maybe in an email of some platform....thanks Gail

Many people here will gladly look over your graphs. It does sound like you need a higher minimum based on what the tech said. Post a typical night of graphs here. As long as the events are obstructive, then raising the pressure should help. I would go ahead and raise it to 9 and see how you sleep and feel.

[Julie]

http://sleep.tnet.com/resources/sleepyhead

http://sleep.tnet.com/resources/sleepyhead/shorganize

[gogailg5]

I have a screen shot....is there a way to upload it in this post?

[zoocrewphoto]

I have a screen shot....is there a way to upload it in this post?

You need to have it on a website somewhere. Some people upload to photo sites. I use my own website. Then you just add the link or image here with the tools right above the edit box where you type.

[Julie]

Read the links given - the answers are all there.

[chunkyfrog]

Gail, you need a new doctor.
Fire this one, before he kills you.

[gogailg5]

haha...I've don't know. I live in the south. so we do not have a great selection of sleep specialist. most of them do it on the side for the money it brings in.
anyway, I uploaded my report....can you guys help interpret it? also, I am sorry for the long delay in replying. I am currently serving in the Peace Corp living in
Ukraine. This whole CPAP issue really limits my traveling within Peace Corps. but I might see if the doctor here in Ukraine are any better?

thanks
https://youtu.be/WxnQWuRMpXY

[Pugsy]

I can't enlarge the image to see any numbers but from what I could see nothing just stands out screaming to be fixed.
I did seen to obvious breaks in therapy where you turned the machine off and back on again.
Is this common for you...is your sleep fragmented by even more wake ups where you don't turn the machine off and back on again.

You do have some OAs scattered about but not not a hugely large number of them. Would you feel better if they didn't happen...maybe but maybe not. Some people need an AHI below 1.0 to feel the difference and others can't tell any difference in how they feel between and AHI of 0.0 or 1.0 or 5.0.

If you want to reduce the OAs...a little more pressure is needed if using fixed mode or if you want to use auto adjusting (apap) mode then you need to change modes and allow the machine to increase if it feels it needs to. I doubt that you would need a lot more than your current pressure to better prevent those OAs so probably setting the minimum to what you are using now and setting the max to 3 or 4 above that would get the job done.
Would you feel better? Don't know but it's worth trying.

Alternately if you are having a lot of wake ups then those alone could be playing a major factor in how well rested you end up feeling.
You can have an AHI of 0.0 and still feel like total crap if your sleep quality is trashed from numerous wake ups.
So it's not all about the AHI...there's a big picture that needs to be looked at when we don't feel as good as we would like or the numbers seem to tell us we should feel.

Now as to why a person might not sleep well and have a lot of wake ups....any number of reasons for that and cpap can only fix the sleep apnea reason. Cpap can't fix bad sleep if the bad sleep is caused by something other than sleep apnea no matter how much we want to dump all our problems in the sleep apnea basket.

So....any idea why the wake ups? How long does it take you to get back to sleep? Take any medications that might impact sleep architecture?
It's normal to have a few wake ups but most of the time we go right back to sleep and don't remember them. Like at the end of each REM stage...it's normal to wake up briefly. If you remember 3 or 4 wake ups there's probably a good chance that you are having more that you don't remember but it's hard to evaluate.

You might try turning the machine off and back on with each wake up (if your mind is alert enough) so that you can see the time it was off and look to see if anything happened apnea event wise on the reports that might explain the arousal. Is it possible and apnea event caused the awakening...sure, it's possible but without being able to pinpoint exactly when the awakening occurred and thus being able to evaluate the flow rate immediately before the awakening we just have no way of knowing for sure.

[gogailg5]

ok, so great. I really never consider setting the CPAP to auto but on a small range. I was think it had to go from 4 to some high number. But I noticed that
auto would drop as low as my next event and then jump up high, which didn't seem to be a good resolution. I will set it to auto with a range of 8.6 to 11.0
thanks...I will provide feedback. Sometimes, you really need to hear confirmation that the numbers AHI, are not the true indicators of how you feel.

[Pugsy]

I wish all it took was getting a nice low pretty AHI and we would all feel like supermen and superwomen.
Getting a nice low AHI is usually fairly easy with the proper machine and correct diagnosis....just a matter of a little tweaking of the settings.
Now feeling those good numbers is a whole different ball game.
I have first hand experience in that myself. I can get really nice 0.0 AHI numbers and still feel like crap but the crap feeling isn't from poorly treated sleep apnea but instead comes from poor sleep brought on by arthritis pain causing a lot of wake ups. I would still feel like crap even without OSA diagnosis and no cpap use because my sleep would still be crappy from the pain.

Sleep maintenance insomnia....read up on it. That's where we can usually go to sleep fairly quickly but wake up more than we want to during the night and/or stay awake with those wake ups more than we want.
There's a long list of potential culprits and sleep apnea is but one on that very long list.
I get a double dose...my pain meds cause insomnia...so if I don't take a pain med I hurt all night and wake up often with the pain and if I take my usual pain meds then I wake up after about 2 hours of sleep wide awake and cleaning house at 2 AM. Damned if I do and damned if I don't.

[gogailg5]

thanks so much....not sure why I waited so long to reach out for help. The doctors here in SC are trained in Sleep disorder but their medical field is else where.
They know that there's lots of money and low processes. They send you for a study, go by the report, write an order for a CPAP and hope to charge you for adjusting it.

But I set the CPAP to Auto min 8.4 and max 11.0 my numbers were much better at AHI 2.2 and I slept much better. My mouth was still dry, but not completely dried out as in the past.
I got a real scare a few weeks ago when my OSA event was lasting for 35 to 45 second. I had one event that was off the charge at 51 seconds and living in Ukraine, there not much I can do.

I am so glad and grateful for all of your help.

Gail

[ajack]

If snore when to 11, I would have min 8 max 15 and get some charts up to look at. the resmed adjusts ok over that range. you can then fine tune in on the right pressure

correct pressure for a fixed cpap would have been 11, going by your test. they continue to raise pressure till the snores are also controlled and use that pressure.

[gogailg5]

that's what I would have thought as well. I have tried a setting of 11.0 however, I don't sleep well. I have dreams about being chased.
I think that my pressure is mixed. that towards the 4am timeframe I need 11.0...but in the beginning it's lower around 8.6.
but I will give it a try.

thanks

[Pugsy]

I think that my pressure is mixed. that towards the 4am timeframe I need 11.0...but in the beginning it's lower around 8.6.

I suspect the reason why you are sometimes needing more pressure in the wee hours of the morning (those 4 AM pressure increases) is related to REM stage sleep.
It's quite common for our OSA to be worse in REM stage sleep and it's common to need more pressure during REM than non REM and in those wee hours of the morning is when we tend to have more frequent REM cycles and they last longer.

From the one report you posted I can't tell if snores are a problem or not. If they aren't a problem I wouldn't be trying to kill them with more pressure (higher max) if more pressure seems to cause a problem. Sometimes the cure is worse than the disease.
A few snores here and there that don't cause you to wake up aren't the end of the world.

Google "sleep stages" and look at the hypnograms to get an idea about REM stage sleep in those wee hours of the morning.
The same can be said about sleeping on your back assuming that supine sleeping makes your OSA worse...it's common but it doesn't necessarily affect everyone.
I know first hand about OSA being made worse in REM sleep...during my sleep studies it was determined that my OSA is worse in REM...in fact about 5 times worse and it was very common for me to see marked pressure changes upwards during probable REM stage sleep time. It's fairly easy to spot once you get an idea when REM normally happens.
I would sometimes need 5 to 8 cm more pressure during REM. Supine sleeping for me didn't seem to make my OSA worse (did a month long experiment where I built a wall to force me to stay on my side). I still had the marked pressure increases show up in my report.

Letting the machine go higher to deal with the REM needed pressure changes didn't cause me any problems but if they had then I would have likely made a compromise to eliminate the problem...maybe let a few events slip past the defenses.

You don't want your already fragile sleep made worse by trying to totally eradicate something that might not be that big of a problem and a few snores here and there isn't that big of a problem...if using higher pressures causes a bigger problem with your sleep than the snores might be causing.