Numbers are trending down, but can you help me clean up these hypopneas?

[billypilgrim]

Hello! This forum has been super helpful as I've gotten settled into to using CPAP this past week. After a tough first night, where my Dreamstation auto was set to wide open, I've increased the pressure minimums (from 4 to 7 to and have seen my AHI decline from 11 the first night to just under 4 last night. Based on the Sleepyhead data, I was down to just one clear airway and one obstructive apena last night, but I still clocked 20+ hypopneas. Based on The Lanky Lefty's Sleepyhead interpretation video, I think it's safe to toss about five of those, bringing the total to 18 and my AHI down to about 3.2 or so.

The data is below. I'm going to soldier on at a minimum pressure of 8 for a few more nights to see if it will help and then try increasing at .5 increments. Does that sound like a sensible plan, or do you see anything in the data below that would tell you otherwise? I'm definitely feeling different than I have in the past, but it doesn't seem to be a dramatic shift yet (my home sleep study RDI was 9.1).

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[Pugsy]

Sounds like a sensible plan.

Once you get to the point of perhaps trying 0.5 cm increments I would suggest giving the setting change a one week trial to establish patterns and trends and not go changing things too quickly. There is some truth to the "give it time" thing. The body and brain does need a chance to adjust and establish a new norm.

[billypilgrim]

Sounds like a sensible plan.

Once you get to the point of perhaps trying 0.5 cm increments I would suggest giving the setting change a one week trial to establish patterns and trends and not go changing things too quickly. There is some truth to the "give it time" thing. The body and brain does need a chance to adjust and establish a new norm.

Thanks, Pugsy. I've learned a heck of a lot from you so far. It's much appreciated.

[HoseCrusher]

Another thing to consider...

Hypopneas are usually scored in conjunction with a drop in oxygen levels in the blood. Without that data, the machine makes a wild ass guess about what is going on and if anything looks a bit shaky it marks a hypopnea.

You may want to read up on what a hypopnea actually is and then zoom on on each hypopnea marked in your data and see if it is really an hypopnea or a wild guess by the machine. I use a ResMed machine and they seem to be heavy handed with hypopneas and tend to score them when there isn't real support for the score.

Here is a typical case...

You roll over and take a deep breath and sigh. After this your breathing is a little shallow and when it finally settles into sleep breathing the machine notes the change in flow and immediately scores a hypopnea. The machine doesn't know you changed positions and had a sigh, it strictly looks at air flow and scores accordingly.

A quick look at your data shows hypopneas occurring during changes in flow rate. When you were stable, no hypopneas were scored. Look at the data from around 01:30 to about 02:10... no events recorded.

If you change pressure and that eliminates them, fantastic. However, if they aren't real it may not be worth worrying about.

[billypilgrim]

You may want to read up on what a hypopnea actually is and then zoom on on each hypopnea marked in your data and see if it is really an hypopnea or a wild guess by the machine. I use a ResMed machine and they seem to be heavy handed with hypopneas and tend to score them when there isn't real support for the score.

Thanks, HoseCrusher. I've done some reading on it and found The Lanky Lefy's Sleepyhead interpretation video particularly helpful. There are definitely a number of them that can be tossed. I often see them in the data when I know that I'm awake, too.