Sleepyhead

[towbarron]

Can somebody take a look at my Sleepyhead results ?
Not really sure what it all means, maybe somebody can tell me what to adjust to get my leaks down.
I`m not really sure what is acceptable and what is high in my pattern.
I have looked on wiki but unsure what it all means

[caffeinatedcfo]

Can you post your results here, as well as your equipment (machine, mask, settings).

Pugsy's Pointers (see below in my signature block) walk you through how to do this if you are unfamiliar.

[towbarron]

Respironics Remstar Auto A-Flex
Mask- Mirage liberty
Settings A flex 2
5.0cm H20
humidifier C1

how do you want me to send the info from SD card ?

[caffeinatedcfo]

how do you want me to send the info from SD card ?

Open the image to full size so it is easily read.
I use Windows 7 snipping tool to create a screen shot and crop the image at the same time.
Prt/scr key will also take a screen shot.

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.
If you want to use Photobucket they provide a box with the various url addresses and you just choose the last one in the box.
Copy/paste that last line url address into the body of your post.
Use the preview button. If you can't see the image try again because if you can't see it we can't.

[towbarron]

Is this what need ??

[caffeinatedcfo]

Is this what need ??

It's a good start. Now do the same thing, but do it with the "Daily" tab which will display graphs of the evening so we can see your trends. You can turn graphs on/off in the File>Preferences menu. You will likely have to take multiple screen shots to get all the graphs.

[towbarron]

I don`t get a IMG link with this, only HTML or email

[towbarron]

http://s1318.photobucket.com/user/towba ... sort=3&o=0
http://s1318.photobucket.com/user/towba ... sort=3&o=1
http://s1318.photobucket.com/user/towba ... sort=3&o=2

is this what you need ?

[caffeinatedcfo]

It's not the worst data - but certainly not pretty. I'm not familiar with PR Systems so I'll let those experts chime in *cough* Pugsy!

What happened at 2:15am? Do you recall waking up? Did you take mask off or something?

AHI isn't horrible, but there does appear to be a ton of events. Sorry I'm not much help with that system.

Did you have a formal (titration) study to determine optimal pressure? The pressure seems to jump all over throughout the night (or am I just not reading the PR System data correctly)?

[Pugsy]

Next time try copying the last line in that box of 4 addresses on the right and pasting it into the body of your post. You will see the code for the image address until you either click on preview or submit. Then you should see the image below. This is the main one I look at. I don't really bother with all those graphs below the leak or snore graph...they don't tell us much in terms of therapy effectiveness.
Next time can you try to include the top Events graph? That is the top graph on the right above the flow rate graph. For some reason yours doesn't show up and the slider bar looks like it is all the way to the top...have you turned the Events graph off by some chance? Preferences/Graphs tab...make sure a check mark is in the box for the Events graph.
The graphs can be manipulated (made larger or smaller) so that you can include these graphs on one image.
Events graph...Flow rate graph...pressure line graph...leak graph.
Snore graph isn't needed because the snores are actually better seen on the Events graph.

First thing I see is at least 3 breaks in therapy line so you were awakened and turned the machine off at least 3 times. Do you remember why? 3 times...so there is a good chance that there were other awakenings where you maybe didn't turn the machine off....so is your sleep highly fragmented?

Your AHI is acceptable as under 5.0 AHI is considered acceptable. A good bit of the markers on the Flow rate graph are snores and RERAs and a few Flow limitations... so it looks a bit cluttered and maybe worse than things really were.
Please take a look at this thread of mine where I have some examples and some discussion about what we see on the reports.
viewtopic/t88983/Pugsys-PointersSleepyH ... nding.html
Pay special attention to my most recent post there that I just did today where I talked about some of my own reports and some "clutter" that I saw.

The snores and flow limitations...maybe your minimum pressure is not quite optimal. It's not a horrible report by any means but if you are waking often and/or having difficulty sleeping soundly there may be enough snores and flow limitations to cause some arousals.
Your clutter looks a lot like my clutter and even without seeing the top Events graph I can have a fairly good idea what it probably looks like.

Your leak line is fine...no where near large leak territory.
The pressure line...part of what concerned

The pressure seems to jump all over throughout the night (or am I just not reading the PR System data correctly)?

is just the way the the PR S1 machine does its thing. Every so often the machine does a little pressure probe for a very brief time so that it can sort of test the patency of the airway. Those end up looking sort of like a sawtooth pattern. Normal for your machine. Explained in greater detail here with examples that show it a little more clearly than what we see on your pressure line.
viewtopic/t80875/Respironics-APAP-press ... se-up.html

Your pressure doesn't really bounce around much at all. A couple of little test pressure probes hit 8 cm but that is it.
So really pretty much 5 to around 7.0.
Makes me wonder if the snores are real...that's where it would help if we could see the Events graph to see if the machine responded to them or the Flow limitations...or if the clutter we see is awake/semi awake breathing irregularities getting flagged and the machine doesn't want to respond to them because not real.

First thing I would do would be try to evaluate sleep quality and figure out the awakenings and what caused them.
I think a good bit of what is shown probably is awake/semi awake stuff.

[towbarron]

Would you recommend that I should adjust a setting or leave alone on the basis of what you see ?
The pauses are probably bathroom visits, so my machine is turned off

[towbarron]

Did you mean check event flags ? That is all I can see

[Pugsy]

Did you mean check event flags ? That is all I can see

Check sleep quality meant to see if you can spot a reason for the wake ups...you mentioned getting up to go to the bathroom.
Are you of an age where the male of the species has issues with the prostate gland which causes them to have to get up to urinate more frequently during the night?

I don't know if there are enough apneas and hyponeas happening to put the blame on need for frequent urination on the stress hormone putting the kidneys into over drive (common symptom of OSA is nocturia).

If you are a young man with no history of prostate issues...well maybe those few events are contributing to the nocturia.
Wouldn't hurt to maybe increase the pressure just a little to see if those few events reduce in number and the nocturia also reduces.
There is no urgent pressing need to those events but it might help.....so...I would probably do it if it was me just to see what happens. Up to you though. It isn't like the report is horrible by any means.

Some of what is seen could be related to simply being awake. The machine doesn't know if we are awake or not and sometimes it flags (as some sort of event) our awake breathing because when we are awake or semi awake our breathing is not nearly as regular as when we are asleep. If that is the case then increasing the pressure probably won't do anything. As long as there are awake/semi awake times the machine will likely flag some irregular breathing when it really isn't a problem.

Now if you do have some prostate issues...maybe talk to the doctor about what can be done to limit the nocturia and if that is reduced then some of the maybe awake/semi awake clutter (if that is what is going on here) will also reduce.
If you were sleeping straight through the night and had this "clutter" we would not have to try to worry so much about "was I awake or not" but when I see 3 breaks in therapy...there are at least 3 awakenings and associate awake time most likely while wearing the mask so it makes determining if those were real or not a little more difficult.

[caffeinatedcfo]

I thought I had prostate issues with nocturia, but immediately upon starting CPAP my middle-of-the-night bathroom breaks stopped.

[towbarron]

Well yes I do have meds for BHP, and if I drink a bit later in the evening I have to take a few bathroom visits in the night, How much would I increase the pressure ??