Newbie stumped by night 19 data readings?

[Eddie B]

Ok veterans; I need some help. My AHI numbers have steadily dropped from night one of 18 down to 2 or 3 the last five days. Last night for the first 5 hours AHI was between 1-3 and then in the beginning of hour 5 my AHI steadily ramped during the hour up to 42. The AHI then dropped back to 1immediately and then during the next hour ramped up to 32 where it stayed for about 20 minutes??? Minute Ventilation had averaged 7 during the first 5 hours and then was moving back and forth to 19 or 20 during the 2 hours of high AHIs. Any thoughts or ideas?

[Lizistired]

What do your leak line, flow limitation, and snore line look like?
Can you post a screenshot?

[Pugsy]

To have any idea what happened we need to see the report in question. Don't know how to insert report here, instructions below.



How to insert image/report

Open the image to full size so it is easily read.
I use Vista snipping tool to create a screen shot and crop the image at the same time.
Prt/scr key will also take a screen shot if using XP. If laptop is used sometimes the Fn key has to be pushed at the same time as the prt/scr key
I think windows 7 has the snipping tool.
Once the screen shot is created save it in jpg format.
Upload the image to a host site. I use Photobucket it is free, there are others.
Once the image is uploaded then copy the ENTIRE IMG address. Be sure to include the opening and closing IMG in brackets. Paste that copied address into a post here.
Use the preview button. If you can't see the image try again because if you can't see it we can't.




To take a screenshot on the Mac, hold CMD+SHIFT+4

Click and hold on the upper-left corner of the area you want to capture
Drag to the lower-right corner and release

The screenshot will show up on your desktop.

[Eddie B]

My screen shots at Photobucket - http://s1238.photobucket.com/albums/ff4 ... =slideshow

[Eddie B]

What do your leak line, flow limitation, and snore line look like?
Can you post a screenshot?

I have a link out there now - http://s1238.photobucket.com/albums/ff4 ... =slideshow

[Pugsy]

Brief history question.
Do you have copies of your sleep study? If so what does it say in regards to number of events in each position and/or REM vs nonREM staged sleep?

Could that last hour or so of ugly groupings of events be related to sleeping on your back?

[Eddie B]

I don't have a copy of my original Sleep Study; I'll be getting it next week. I always sleep on my back; confused as to where those large #'s were coming from..have not seen anything like them during my treatment so far. Question - did the information I posted provide anything that could cause the large # of AHI's?

[Pugsy]

Leak wasn't bad enough to account for all those events. Flow limitations go hand in hand with events so not surprised by those.

Was this the only night that showed such an awful grouping? Rest of the nights pretty standard? You say this one is unique then maybe just could have been a fluke maybe. I didn't see anything that we could blame those events on.
I was thinking positional maybe (on your back). Didn't really look like REM pattern but hard to tell. It is like everything went to hell that last couple of hours for some reason.

Just keep a watchful eye out for repeat. Make note of anything unusual that might account for it. Were you awake by any chance during that time frame?

When you get sleep study next week it may point to positional quirk or REM maybe, both are common though. Maybe you just got lucky last night and they made a guest appearance.

Obviously if this happens often then something needs to be done but for one night out of 19, I wouldn't do anything different.

[Eddie B]

Leak wasn't bad enough to account for all those events. Flow limitations go hand in hand with events so not surprised by those.

Was this the only night that showed such an awful grouping? Rest of the nights pretty standard? You say this one is unique then maybe just could have been a fluke maybe. I didn't see anything that we could blame those events on.
I was thinking positional maybe (on your back). Didn't really look like REM pattern but hard to tell. It is like everything went to hell that last couple of hours for some reason.

Just keep a watchful eye out for repeat. Make note of anything unusual that might account for it. Were you awake by any chance during that time frame?

When you get sleep study next week it may point to positional quirk or REM maybe, both are common though. Maybe you just got lucky last night and they made a guest appearance.

Obviously if this happens often then something needs to be done but for one night out of 19, I wouldn't do anything different.

I'm curious, what would REM have to do with those numbers? thx

[Pugsy]

I'm curious, what would REM have to do with those numbers?

Some people have many more events during REM. It is very common.

On my sleep study I had 11 AHI events in non REM sleep but when I finally got to REM I was clocked at 53 AHI and Oxygen level went to 73%. While the machines don't score sleep stages I can get a rough idea where I was in REM by the time pattern for the events that I do have.
Always goes along the normal cycle for REM sleep. I use APAP because of this. I prefer to stay at lower pressure for the bulk of the night when I have minimal events and let the machine pressure increase to deal with REM events that are stubborn. Otherwise I would need straight cpap of 15 cm.. Don't want to do that. Pressure changes don't bug me so I do well with it in APAP range.

Your event pattern didn't really look like a REM pattern but I always ask, just in case because not everyone has a normal pattern.

[Pugsy]

Update
Eddie may have stumbled on an explanation for the unexpected anomaly. I will let him tell it if it proves to be true.

[idamtnboy]

Eddie, you have to look carefully at the AHI graph. First, notice that it climbs up a notch every time you have an event, then stays there until the next event. But since the graph is events per hour it counts events for one hour, and then resets to zero, and counts events for the next hour, and so on. So when it topped out at 32 and stayed there for 20 minutes that means you had 32 events during the first 40 minutes of that one hour period and no events in the remaining 20 minutes of that hour. Your AHI number for the entire night will the total of all events during the night divided by the number of hours the S9 was on. It will always be less than the number for any hour of the night when you have events.

Now, as to why you had so many in those two hours, others have given plausible explanations.

[idamtnboy]

Eddie, how about posting the flow graph for part of the first hour of the high AHI? Set it to 5 or 10 minute scale factor.

[Eddie B]

Eddie, you have to look carefully at the AHI graph. First, notice that it climbs up a notch every time you have an event, then stays there until the next event. But since the graph is events per hour it counts events for one hour, and then resets to zero, and counts events for the next hour, and so on. So when it topped out at 32 and stayed there for 20 minutes that means you had 32 events during the first 40 minutes of that one hour period and no events in the remaining 20 minutes of that hour. Your AHI number for the entire night will the total of all events during the night divided by the number of hours the S9 was on. It will always be less than the number for any hour of the night when you have events.

Now, as to why you had so many in those two hours, others have given plausible explanations.

Last night my data looked in line with where I have been over the last week - http://s1238.photobucket.com/albums/ff4 ... epdata.jpg I had heard that Melatonin could help create a faster and deeper sleep, on the night of the event I took 5MG of Melatonin before going to bed. 5 hours later my AHI's and Events were much higher than in the previous two weeks. I did not take Melatonin last night and I will not take it for at least another week, then I will try it again and see if I get those very high events/AHI's during a 2 hour window. One of the side effects of Melatonin is "vivid dreams" during REM and that is perhaps what I experienced. After 7 years of having all the signs of Sleep Apnea and not being diagnosed, I'm looking forward to restorative benefits of stage 4/5 sleep. If I have similar results with high AHI's/Events with the 5MG dose of Melatonin the next step will be to wait I week and go on a 3MG dose. Any thoughts on this?

[Pugsy]

I tried small dose of melatonin and within 30 minutes I had extreme vertigo (dizziness) that had me bouncing off the walls when trying to walk. It lasted till mid day the next day. Never took it again. If it can alter sleep patterns and mess with dreams, it might be possible explanation as to that weird 2 hours of events.


Common side effects listed below

Reported melatonin side effects include headaches, nausea, depression, nightmares and vivid dreams, irritability, abdominal cramps and dizziness.

Melatonin facts also point to negative effects on the reproductive system as well as decreased sex drive in both men and women.

Above copied in part from this link.
http://www.herbal-supplements-guide.com ... fects.html

more info here
http://www.mayoclinic.com/health/melato ... ts/AN01717


and copied in part from this link below
The most common Melatonin side-effect is headache and/or an altered sleep pattern. Mental or mood changes may also occur as well as itching, fast heartbeat or heavy headedness. Melatonin may cause lowering of the body temperature. Vivid dream is also associated with melatonin use. Melatonin side-effects are usually temporary and can be relieved by reducing the melatonin dosage.

http://www.melatoninfaq.com/