Please help me to get better ! ( Attn: Pugsy )

[palerider]

Thanks Pugsy , Pale Rider and Zonker :

This time I'm going to stick at this with my new Air Sense 10 -Autoset (Resmed) - day by day - until I get the AHI down .

Once you get Oscar installed and post a couple screenshots, we can start helping you tweak your settings for the best possible treatment of your Sleep Disturbed Breathing.

https://www.youtube.com/watch?v=-gie2dhqP2c

[PPP]

Hi Pugsy and team :

Unfortunately a poor night last night and an AHI of 19 and therefore 19 " events per hour ". On the CPAP machine there is a happy face for " mask seal " but when I checked " My Air" ( RESMED- APP ) I see that for mask seal its - poor . The reading is 28 whereas when 6.5 AHI was scored on Jan 1 , the seal was a high of 5 . I'm entirely unsure of why as I had actually tightened the mask straps a bit after the first two nights . This is a disappointing result from three recent score of AHI : 9.6, 9.4 and 8.9 .Not the best I've ever had ( 6.5 ) but way better than 19. I must say I tossed and turned all night for some unknown reason and just slept poorly overall - feels like I had no sleep at all even though I was in bed for 8.36 hours .The only change I made was for pressure - turned up to 10-18 from 7-18. Is Ambien recommended ?

Do you have any suggestions respecting better use of the mask . I wear a chin strap under the mask to keep my mouth shut - but that was no problem on Jan 1 when the score was 6.5 AHI .This is a bit disappointing but I'm determined not to regress and I recall in your note to t newbies that some nights for everyone are just "poor'"- No apparent reason . Maybe this was one of those for me - hope so . Anyway any comments or suggestions .?

I"m continuing to make effort to get OSCAR in place . It loads at first as I have MAC OS of 10.15.02 and therefore it can be downloaded . Thanks to Dog Slobber and Bristolman for this suggestions re the Mac- that saved a trip to the Apple store . But then it asks for a " profile " and I enter that . After that Im unsure what to do and how to do it . I expect for most its easy and intuitive but I have no tech skills and am out to sea at that point . Is there a written set of instructions for setting up and using OSCAR ? If so can you advise on that .

Thanks a lot for any replies . Much Obliged for sure !

pat

[babydinosnoreless]

Making mask straps too tight may be why your leak rate went up. Sometimes leaks are caused if the straps are too tight and the mask can't properly inflate.

Also if you didn't sleep well a big part of the AHI could be sleep wake junk but without Oscar we can't tell if they were real or just from you tossing and turning.

I'm not good with the technical side of things (my husband helped me with the software) but did you put your sd card into the computer so you can import data ?

[PPP]

Thanks Babydinosnorless :

I did not insert the card as I'm too uninformed ( and simple minded ) to appreciate that I had to do that . I'll try that next .
Thanks a lot !

pat

[zonker]

Hi Pugsy and team :

good day, ppp. two things to say re: your first paragraph. try not to get discouraged. we sleep differently every night, so you can expect hiccups along the road. having said THAT, may i suggest you search youtube for mask fitting videos specific to your mask?

next as to oscar itself. as baby asked, have you taken the smartcard out of your cpap machine and put it in the smartcard reader of your machine? i'll assume yes and continue.

you should be set. try it again from fresh. do you get to the screen that looks like this-

Screenshot (1).png

i'll stop there until i hear back from you.

i don't know if there is a written set of instructions. let's wait and see if one of those knowledgeable persons like dog slobber or palerider come along.

[Pugsy]

The only installation instructions I know of are here
http://www.apneaboard.com/wiki/index.ph ... stallation

I have no idea why the AHI is higher...maybe you are in the minority and don't need more pressure.
Maybe you are having primarily central apneas and not obstructive apneas and if that's the case more pressure isn't the answer and could potentially make things worse. It does happen in a small percent of people and that's why I wanted to see your data before you go changing anything.
It's also possible that you slept poorly simply because of the new pressure minimum and there were some false positive awake breathing events being flagged.

I really, really need to know the event category breakdown of the AHI.....and you can get that off the machine LCD screen itself.
The software is better but what you can get off the machine is better than nothing. I explained this yesterday earlier in the thread here. There's a reason I didn't advise blindly increasing the pressure without knowing what kind of events you are having.

Look on the MyAir results page....it will also give you the number of events in each category and the average I think. If it doesn't give you an average/index....I can figure it myself if I know total number of events in each category and how many hours the machine was on.

As far as the leak situation. On the machine itself you won't get a bad leak management message unless you spend more than 30% of the night over 24 L/min. If your MyAir is reporting 28 L/min...that's a 95% number which means at OR BELOW that number for 95 % of the time. Actually...I would put leaks on the back burner for now unless leaks woke you often last night.
The machine still does a more than acceptable job with leaks up to 30 L/min....doesn't really start getting iffy until above 35 L/min.

I need to know
Central Index
Apnea Index
Hyponea Index
and those should be available on the machine LCD screen and at the MyAir web page.

[squid13]

Do like my dad did when he got to simple minded like you say, carry a note pad with you and write things down on it for things to do.

[Pugsy]

Are you using EPR....exhale pressure relief? If you are...at what setting and full time or ramp only?

[PPP]

Hi Pugsy :


First of all thanks for all this effort. And its true -I got ahead of myself and put the pressure up to 10-18 from 7-18 and this without you recommending it - for sure you did not say "do it" ! I'm perhaps over focused and in a foolish rush to get best results and I see thats not helpful . From here on I'm not going to take any initiatives . I'll follow your lead exactly from here on IN !

I'll look now and send the data -right away . More to follow .

pat

[PPP]

Hi Pugsy :

Here is the data I can access :

Resmed Air sense 10 AutoSet , and MY AIr

_______________

EPR - On

EPT Type- Full Time

EPR Level - 3

HL 4

Essential - Plus

Smart Start - On

----------

Usage 8.36 hrs

Events AHI 19

Pressure 9.8

Leak 12L/min

AHI 12.0

Total AI 11.6

Central AI - 10.9
_______________________


From MY Air ( Resmed )

Time 8.36 Score 70/70

Mask Seal Score 13/20

19 Events Score 0/5

2 Mask off Score 5/5

Total Score 88/100

Thats all from My Air ? !


I spoke to the vendor this afternoon she also advised that the " Obstructive Apnea " was at a level of 0.4 - I could not read that from the CPAP data on screen .
You asked specifically for Central Index ,Apnea Index and Hyponea Index . Central seems to be at 10.9 - and AHI as well - but not others . They do not show in MYAir nor on the CPAP AirSense screens .Is this sufficient ?

Again, thanks for your very considerable your assistance .

Pat

[Pugsy]

Go back to the 7 minimum pressure tonight and turn off EPR or at least reduce it to 1 (or if you can't do without it change it to ramp only and make use of the ramp time)...and let's see what the results are tomorrow after tonight.

I understand the MyAir way of reporting AI and AHI...the hyponea index is hidden but can be figured out.....and as I expected a lot of central apneas...that Central apnea index (central AI).

You really, really need to get the software stuff figured out because while the data from the machine/MyAir is sort of helpful....we really need to be able to see the details ASAP.

I want to first concentrate on the central apnea numbers....let's see if turning off EPR helps or not...sometimes it works miracles...sometimes not but worth trying since it is easy, fast and cheap experiment.

Also turning off EPR effectively increases the baseline pressure a little which is what the obstructive apneas need...so trying to kill 2 birds with one stone here.

[PPP]

Thanks -you Pugsy :

I will do as you say - exactly !

And now I'm quite frightened as it appears I have Central Sleep Apnea and not OSA ? And I just looked at the various med literature on the difference and that CSA is usually connected to other serious illnesses . Up to now I thought I had typical OSA ! When I saw a sleep Doc 2 years ago nothing at all was noted or stated stated about this . My brother has advanced Parkinsons and this may be related .

Again I getting ahead of myself . Do I need a bi-pap machine - that seems what CSA requires???. N o need to answer this .

Sorry I'm going on here - I will try to get OSCAR up and running - My Air will not give me the data you have asked for or at least I do not know how to get at a it .

I'll report tomorrow . What a great help you have offered Pugsy . Many Blessings !

Pat

[Pugsy]

Take a deep breath, settle down....there are many causes for central apneas and they don't all mean you are at death's door and at this point we don't know if you are going to need a different machine or some other sort of intervention.

You do still have OSA but for some reason you also have some central apneas in a number that we sit up and take notice on (a few are normal and we ignore but you are having more than a few)....so for now it's called complex sleep apnea. That's where people have both obstructive apneas and central apneas.

There's a very small subset of people who use some form of exhale relief that find when they do (any exhale relief creates a bilevel pressure situation) central apneas pop up. Just a weird breathing reaction for a short explanation.
You may or may not be a part of that very small minority and it's easy to check out...just turn off EPR or reduce it and see what the centrals do or don't do.

I will explain in more detail later but it is very possible that all we have to do to reduce your centrals to a more normal/acceptable level by just turning off EPR or reducing it. If it doesn't work out then we chat about other options.

Did you ever get OSCAR actually installed or still having trouble with the installation process?
You do have to take the SD card out of your machine and put it in your computer to use the software. Does your Mac have a SD slot?
Does your cpap machine have a SD card in it?

[PPP]

Yes - - no point catatstrophising - which is my personal default setting .

AM Trying to get OSCAR up .

SD card from CPAP fits into slot of Mac for download - trying that .

But cannot get beyond profile .

I'll keep at it or will get help before I reply further . Will write tomorrow .

Much Obliged Pugsy !!

pat

[Jas_williams]

When you get to the profile try clicking the word welcome at the top to get to the welcome tab from there you can import your data