Help interpreting 1st numbers

[360]

Minimum pressure still 4 cm?
I would raise minimum to 5 or probably 6 depending on what you want to try.
Do the pressure variations bug your sleep? If so maybe a slight reduction in maximum but the machine wants to go up a bit for some reason and it wasn't a leak. The machine won't raise the pressure without thinking it has a reason to. I prefer to let the machine try to fight what it thinks it might need to fight and leave my max nearly wide open. Pressure changes never bothered me though.
If you choose to lower the maximum I would watch that pressure line closely to see if it gets maxed out often because if it does it can't fight the events effectively if it needs to. I would think more along the lines of around 12 as maximum. Tighter doesn't always mean better. Minimum is more critical. Now if the pressure variations seem to disturb sleep, by all means lower till you get a happy medium with less disruptions and event control. Sometimes an occasional event slipping past the defenses is less disrupting than the pressure changes for some people.

That large leak last night? Toss it out the window. It was brief and hasn't happened often and overall your leak is so much improved. We all have little blips or big blips from time to time.

Thanks again for the insight. Yes, min pressure is still on 4. I think I'll try 5 tonight and see what it does. I have no idea what happened on the large leak other than I've been trying different levels of pressure on the papcap strap and maybe I just had it too loose.

[avi123]

From what I've gathered here I think my numbers look pretty good. Biggest thing I'm looking at is the leak. I knew the number was huge so I made a makeshift chin strap last night and there was no mouth breathing. I don't quite understand how how the numbers can be that high when I know the mask isn't leaking either. Any help addressing this would be greatly appreciated and I'm open to any tweaks to my settings that could be made to further enhance my treatment.



Why use a CPAP with hardly any events?

I have what I would call severe apnea....I think my number was 52 when my study was done over 10 years ago.

Question:

If you have a severe OSA what do I have???:


See a FOT in the Flow graph at the end:


https://docs.google.com/viewer?a=v&pid= ... vxlw&pli=1


Statistics

3/16/2011 - 3/16/2011

Device Settings

Therapy Mode:

CPAP Set Pressure: 8.0 cmH2O EPR: Full_Time

EPR Level: 2.0 cmH2O

Leak - L/min
Median: 3.6 95th Percentile: 39.6 Maximum: 50.4

AHI & AI - Events/hr

Apnea index: 10.1
AHI: 12.2
Obstructive: 6.0
Central: 3.9
Unknown: 0.1
Hypopnea index: 2.1

Usage

Used Days >= 4 hrs : 1 Used Days < 4 hrs : 0 % Used Days >= 4 hrs :
100
Days not used: 0 Total days: 1 Median daily usage:
9:18
Total hours used: 9:18 Average daily usage: 9:18

Please don't blame me that I don't sleep enough!

I started CPAPING 4 months ago.


p.s. How did you use Google to post the above graphs?

[Pugsy]

If you have a severe OSA what do I have???:

The diagnosis of severe comes from the sleep study numbers and not the numbers with therapy.

I haven't read all your posts so I don't know what your sleep study AHI was.
Right now, your AHI of 12.2 still points to less than optimal therapy. If this were a sleep study AHI number it would still warrant therapy. BTW your leak numbers indicate that at times your leak is much more than optimal and likely will affect your overall numbers.

Posting images? You already know that they have to be hosted on a 3rd party site and linked to. Why don't you just do it?

I am posting this so that OP doesn't have to respond unless he just wants to and copy what I say. I suspect Avi may have me on his Foe list and chooses not to see what I say..

[Lizistired]

What was your prescribed pressure from your titration?

[360]

What was your prescribed pressure from your titration?

Is that question for me? If so, I have no clue...sleep study was 10+ years and 50+ pounds ago.

[360]

If you have a severe OSA what do I have???:

I'm not new to apnea but I am new to reading the numbers and dialing in treatment. That said your leak numbers are not good and if I were you I would call your DME and tell them you want an S9 Autoset...period. If they won't change you out, go see your Dr. and tell him/her you want an S9 Autoset. When he/she sees your numbers they would have to agree that your therapy is not good. I would start working on your leak numbers right away though as that has nothing to do really with your machine.

[robysue]

Why use a CPAP with hardly any events?

I have what I would call severe apnea....I think my number was 52 when my study was done over 10 years ago.

Question:

If you have a severe OSA what do I have???:

360 has severe apnea (AHI = 52 without CPAP) and his severe apnea is extremely well treated with CPAP (treated AHI = 0.1 in summary data, and under 2.0 on the night of 3/17/2011).

Avi, you have severe apnea (my guess is your AHI > 30 without CPAP), and your severe apnea is NOT effectively treated yet in spite of using CPAP the last four months since your treated AHI = 12.2 and your treated AI = 10.1. You really need to show your data to your sleep doctor and ask what you can do to try to get that treated AHI below 5.

Your leak data:

Leak - L/min
Median: 3.6 95th Percentile: 39.6 Maximum: 50.4

indicates that leaks MIGHT be part of your problem since that 95% leak rate (39.6) is WELL above the 24L/min line that the ResMed engineers indicates is high enough to compromise therapy (and the data) if it lasts long enough.

Median daily usage:
9:18
Total hours used: 9:18 Average daily usage: 9:18

Please don't blame me that I don't sleep enough!

Not sleeping enough? With average daily use of over 9 hours?

Lord, I'd love to be able to sleep 9 hours straight: With my insomnia, I'm averaging between 5 and 6 hours in bed, with the machine on the entire time. Getting between 4 1/2 and 5 1/2 hours of sleep most nights, but still have nights where my total sleep time is less than 4 hours.

[avi123]

Thanks Ms Butterfly. But by any chance have you considered my age in these comparisons. A problem on this board is that posters here are hiding their ages and sexes and ask for opinions on THEIR NUMBERS. Well, about to sex I can estimate that those who put a n/a on their sex are 80% females. As to age I can also tell from a recent POLL that most are between 45 and 55, and only two or three including myself are over 80.


Prevalence of OSA by age:

http://ajrccm.atsjournals.org/cgi/reprint/157/1/144

or

http://ajrccm.atsjournals.org/cgi/conte ... /157/1/144

Re-edited:

Deleted b/c not relavent

[360]

As to suggesting that I switch to S9 Autoset, sorry, I would not let a dumb CPAP decide on pressuring my lungs. Our CPAPS are very crude machines. To let a flow generator guess the the pressure and the air mixture at the alveoli, 6 to 7 feet away, is ludicrous.

Avi...you wonder why I'm treating my apnea because of the way my treated numbers look and then you say that you're happy where you're numbers are? The flow generator does not guess and it tracks your treatment just like your Elite does. If my numbers looked like yours I would be looking for additional solutions. If you try the APAP and your numbers and your health do not improve the turn it back on CPAP mode and continue on your current path, it's that simple. Anything else makes no sense. If someone other than Avi thinks I'm off base here please let me know.

[Pugsy]

If someone other than Avi thinks I'm off base here please let me know.

You are not off base at all. Let's just say that Avi has some different ideas on what he considers adequate treatment because his doctor tell hims so and so it must be so..... Been rehashed in several posts or attempts to explain things to Avi. Most of the time I ignore his ramblings unless he starts putting out potentially harmful or really misleading information. Save your fingers and don't try to argue with him. Some of the stuff he comes up with is so far out there I wonder.... but I quickly determined that he is unwilling to see things anyway but his way. Save yourself time, energy and probably a headache and try not to worry about getting through to him.

[avi123]

Thanks 360. After re-reading the article in my above posted link that the prevalence of OSA's numbers are peaking at the ages of 50 to 69 and then go down, and your suggestion of the S9 Autoset , I am going to check with my sleep DOC, if it is possible to lower my NUMBERS. BTW, this sleep DOC is not a Medicare provider meaning that I'll pay cash of $108 for the 15 min visit and then get reimbursement of $50. This is not an issue with me!

[scrapper]

You are not off base at all. Let's just say that Avi has some different ideas on what he considers adequate treatment because his doctor tell hims so and so it must be so..... Been rehashed in several posts or attempts to explain things to Avi. Most of the time I ignore his ramblings unless he starts putting out potentially harmful or really misleading information. Save your fingers and don't try to argue with him. Some of the stuff he comes up with is so far out there I wonder.... but I quickly determined that he is unwilling to see things anyway but his way. Save yourself time, energy and probably a headache and try not to worry about getting through to him.

Ditto, Ditto, Ditto

[360]

Thanks 360. After re-reading the article in my above posted link that the prevalence of OSA's numbers are peaking at the ages of 50 to 69 and then go down, and your suggestion of the S9 Autoset , I am going to check with my sleep DOC, if it is possible to lower my NUMBERS. BTW, this sleep DOC is not a Medicare provider meaning that I'll pay cash of $108 for the 15 min visit and then get reimbursement of $50. This is not an issue with me!

Hey Avi, let me know what the doc says. I'll be interested to see if he resists getting you an auto and what the logic is behind his resistance if there is any. For me I see no reason on earth a doc could deny your request when they look at your numbers. Again if the auto does a worse job than a constant pressure then one click of a button will put you back in cpap mode, but the charts won't lie and you will feel the difference. That would be my final point. So many times on here I see people arguing some of these points as if they are giving a lecture at a university, but this is not a exercise in debate or some type of cerebral gymnastics it's about how we FEEL when we wake up every morning and about how our sleep truly affects our bodies ability to function. For example I tweaked my bottom number last night to see what the affect was and this morning I woke up after 5.5 hours of sleep and could not go back to sleep because I am rested and FEEL 100% great. That's not a number, that's my life that I have back because I now have therapy that is becoming as dialed in as it can be. I've just went through a period of 10 years of never feeling this way I believe me I (and others around me as I'm cranky when I'm tired) notice the difference. Keep me posted.

[avi123]

Thanks 360.
My son and his family live in STL less than a mile from the recent tornado path.

[Pugsy]

So many times on here I see people arguing some of these points as if they are giving a lecture at a university, but this is not a exercise in debate or some type of cerebral gymnastics it's about how we FEEL when we wake up every morning and about how our sleep truly affects our bodies ability to function. For example I tweaked my bottom number last night to see what the affect was and this morning I woke up after 5.5 hours of sleep and could not go back to sleep because I am rested and FEEL 100% great. That's not a number, that's my life that I have back because I now have therapy that is becoming as dialed in as it can be.

Wise words, 360. All to often a small question blows up into a debate that involves such highly technical detail that only the most experienced people can follow it. Often way of the head of a newbie who is struggling with the most basic premises of cpap therapy. Also newbies sometime strive for numbers like they were taking a math test and forget that the whole idea behind cpap is to improve how we feel and limit the damage done by OSA. I see "my AHI is 3.3 is this good, can I do better?" with no mention of how they feel. It is all relative to how we feel. That's why we put up with all this work masking up, fiddling with leaks so that we feel better and in the process limit the damage done by OSA. It's a hard pill to swallow when we get "good" number and still don't feel so great. We need tangible rewards..Tis human nature.

I like Rooster's approach K.I.S.S. for newbies especially, keep it simple s..... Go into more intricate details if the person seems to need further explanation but start with simple first.

I am happy you can report feeling well rested today. Sometimes just a very small change can make a huge improvement. You now know why we work so hard at this and found that just tiny change was able to give you wonderful results. Your numbers were quite acceptable before the change but you still felt that something was maybe missing. Tiny change and numbers still good but big change in how you feel. That is the bottom line and your reward for all this work. Well done. Keep up the good work and it will only get easier. Will there be bumps along the way, sure but don't beat yourself up if they occur. We can't do much about what happened last night anyway except to maybe learn something.