First Data Report - Question

[monarch22]

I got my first data report today. Good news is I was 100% compliant! Bad news is that because my insurance doesn't require compliance, I wouldn't be contacted for them to check my data. The DME said I was doing good because my AHI was under 5. Overall, I'm pleased with the results so far (just under two months).

My question is if my pressure was originally set at 6 before I changed it to range from 6-12, and my 90th percentile shows mainly 8 and 9, does this mean when it was set for 6, my apneas would not have been controlled?

Also, if it shows the max reached at 12, does that mean that the pressure is going up to the maximum set and maybe I should increase the range?

I didn't feel confident in my sleep study results because I never reached REM. Also it showed that my low saturation on optimum pressure at 87%. Isn't that a little low?

[Lizistired]

Do you have software to view your data?
What did you base your first adjustment on?
I would not raise your max. I would probably set it at 6-9 or 7-9. If the range is too wide, the auto has to get there and it becomes less effective. You're just guessing if you can't see the data.

[Pugsy]

This is where it would be so nice to see the report.

If the maximum of 12 is stated as being reached then it was but apparently not for a very long time since your 90% only shows 8 or 9. The 90% number only means that you spent 90% of the time at that number or below. Sort of a weighted average but not a real average. The 90% number will be affected by the max that was reached but it is really can't be used as where the pressure should be all the time. I see this often with my auto. My minimum is 10 and my 90% will be maybe 13 or more depending on how high the max went though my overall average might be 11.

The maximum could have been reached due to a leak maybe once or twice... we don't know without looking at the reports. If the machine had spent a lot of time at 12 then your 90% number would be greater than 8 or 9.

Hard to put it into words without the pictures.

If you are feeling okay and maybe even a little better then I would say the 6 cm minimum is probably fine starting point since the reported AHI was less than 5. Maximum setting... the machine won't go where it doesn't think it should go. Just because a person has a higher max doesn't mean that the auto unit can't get to where it is needed to kill the event. If you had your machine set with a max of 20 and only a 6 or 7 or 8 is needed, then the machine won't ever go to 20 it will stop at 6 or 7 or 8. Time needed to respond to events is more critical to the minimum pressure. 6 cm to 7 or 8 or even 9 is likely well within the time constraints to respond to events and the max doesn't come into the picture unless something really wild happens.

Now if you did have a max of 20 and had a large leak or something to raise the pressure way up there then the pressures changes can be disturbing. So it is really your choice what is comfortable for you. I have a max of 20 and I rarely get above 12 from my 10 minimum. The pressure changes don't bother me. I have mine set this way because in the past I have had some "rogue"events that needed 15 to 18 cm of pressure.

I wouldn't change the minimum of 6 cm and the maximum is really up to you. Most new people seem to do better with a narrow range because leaks can drive up that maximum and that can be disturbing. This is why we usually suggest the narrow range but simply speaking from a mechanics point of view the machine won't go up there unless it thinks it should (but a leak could make it think so) so it doesn't really affect the treating of events at the lower numbers.

If you are comfortable with your settings and resting well I wouldn't change them, if you would feel better with a narrow range, then bring that max down. I see no need to increase the max from what you have reported.

Hope I haven't made things worse with my muddling.. It is real easy to see on a graph but hard to describe.

[monarch22]

Liz, no software. I've just been going with the info given on the screen. This is the first I've seen the details.

Pugsy, makes sense...although I had to read it twice for it to sink in, but that's normal for me! I wish I could post the reports, but I only have my printed copy from the DME. I can tell you that the time at max pressure was 17%. In looking at the graphs, the pressure went up to the max when I experienced several hypopneas in a row. That's another thing, sleep study showed no apneas, only hypopneas, which I doubted since my sleep was so poor and I never went into REM. This shows me that I'm having both.

The more I look at the report, the more it's making sense. I just wish my DME had reviewed it with me. I guess that's too much to ask. I'm happy my AHI is under 5, but I still think there is room for improvement.

[Pugsy]

I am so sorry but I tend to ramble when trying to explain things clearly and sometimes I make it worse.

When the max went to 12 and it showed the events at same time, was there a leak at the same time?
Sometimes a leak lets the little buggers in. If no leak to blame it on, maybe some rogue events, sort of in clusters?
I use to get them in certain cycles that corresponded to REM staged sleep. I didn't get much REM at the sleep study either. In that case I would for sure leave the max at 12 just in case they repeat. Remember it won't go up there unless it sees a reason to.

What information is available on screen? I am not familiar with its display.

How close to 5 AHI are you?

[monarch22]

Pugsy, you didn't ramble. You were very helpful! No, it doesn't look like the leaks went up at all during these events. My display shows what the humidifier is set for, AHI, leaks, total # of hours, and average hours/night. I've only had 2-3 nights where I have been over 5 on the AHI and it was 6 and 6.5 if I recall correctly. Now on the report, it's showing my AHI at 5 or under for the past 30 days. Each day varies anywhere from 1-5.

I guess what kind of hit me was to see the actual events on paper. Not that there are that many, but to see when they are happening through out the night. Makes me want the software even more!! The bottom line is that I am feeling better and I'm using the machine 100% of the time. Those first couple of weeks were pretty rough and I wasn't sure if I was going to get used to it. I'm glad that I pushed past that!

[Pugsy]

No leaks when the machine went after the events and maxed out. Hmmm.
Did this happen once, twice? Short period of time about 90 minutes to 2 hours into sleep...

The problem with the auto machines is that sometimes that the minimum pressure doesn't have enough time to get to the point that it prevents the events from happening. Sometimes a small increase in the minimum pressure is enough to ward them off. This is of course where software really helps.