SH Data Concerns

[Ivan101]

So I LOVE my new BiPAP machine! Cannot wait to get the one I will keep next week! However, I have noticed a few things and I need some help understanding them. First of all, since I got my new machine, I have been sleeping several extra hours. I am just getting over being sick, so I'm not sure if that's why, or if it's because my body is enjoying better sleep?

Second, I know my quality of sleep is WAY better, because my AHI is WAY down. The average is usually around 7-8 a night. Since the switch it's around 3-4. However, I've noticed a trend. Almost all of my events are Clear Airways, and most occur in the morning, typically I wake up around 7:30/8am, and then fall back asleep until sometime between 9 and 11:30. During that time, most of the Clear Airways take place. 43 out of 58 CA's happened between 7:30 when I woke up this morning, and noon when I woke back up. I only had 7 other events throughout the night from Hypopnea's (2 out of 3 were in the morning) and Obstructives (2 out of 4 were in the morning). That seems significant to me, especially since I'm pretty sure I did not wake up during that time. Any suggestions? My stats throughout the night are AWESOME now, but this morning trend isn't good...I'd hate to have to get up really early every morning if there's another way to help this?

I'm happy to post data, but when I press F12 or take screenshot...nothing happens?...the worse was the 10am hour...my AHI was like 34...

[Pugsy]

How to post images of reports explained in this thread
viewtopic.php?f=1&t=81072&p=737779#p737779

If most of your CA events are happening during that second period of sleep after 8 AM or so it's very possible that they are either awake or semi awake breathing irregularities by mistake. When you go back to sleep is it a deep sleep or fragmented or light sleep?

[Ivan101]

Typically, with my CPAP machine, I would wake up around 7:30 or 8am, remove my mask, and fall back to sleep, but wake back up about every 10-30 minutes rolling around until I get up - probably at least partly because I stop breathing, although never in my life have I been aware of a lapse in breathing over night. With the BiPAP, I wake up, am comfortable and feel rested, so I roll over to enjoy my bed, and fall back into sleep with the mask still on. I'm not aware of waking up until right before I get out of bed. I will monitor if this changes as I have the BiPAP longer (last night was night 3), but so far, this has happened each night with the BiPAP. It's great that I feel rested, and that when I do sleep after my early morning wake up that it's sound sleep instead of the fragmented I got with or without CPAP mask on, but I'm not sure it's worth the comfort if it's causing so many events...?

[Pugsy]

I'm not sure it's worth the comfort if it's causing so many events...?

If they aren't "real" events they don't count.
Please post an image of the detailed report so we can see what you are seeing.

Even if they were real...which way do you feel better...sleeping without the machine during that time and having all the known for sure events waking you up all the time?
Or using the machine and having some maybe events?
Are you wanting a nice math score?

Going back to sleep after being awake shortly often results in light sleep and not deep sleep...maybe lots of light sleep to a light arousal that you don't forget but then when go back into sleep stage you have a sleep onset central which is normal.
Naps are notorious for showing really high numbers because often during the nap we are awake a lot more than we realize.

[Ivan101]

I'm not looking for nice math numbers...I guess my question is if I should drag my butt out of bed when I first wake up...am I doing any harm or making myself more tired for the day by having all those "events" in the morning. I'm attaching my data from last night. FYI - I do hyperventilate in my sleep (it's obvious from my stats when that happened last night). I do tend to remember that I had dreams in which I was hyperventilating the next morning (I think I'm kind of in a twilight sleep when it happens). I'm almost positive it's not related to my sleep apnea. I have PTSD, and it happens when I have nightmares...I also tend to scream in my sleep at the end of said nightmares...I don't think I did that last night though...hopefully I have the settings so you can view the photos...

[Pugsy]

Your times on the graphs are absent and your events, flow, AHI and pressure graphs are missing the left axis stuff.

Scratching my head here...I see you are using version 0.9.3...can you go to the Help section and click on About SleepyHead and tell me which build you are using?

Are all your reports looking this way?
Try going to Preferences/Appearance tab and remove the check mark from "use pixmap caching" and restart SH and see if those values show up like they should.

Is your doctor aware of what you are seeing here? The last cluster might be blamed on some awake stuff but in general you are having more centrals than I would be comfortable with during the entire second half of the night if you see this often.
The first half of the night is unremarkable and looks quite decent.

Have you seen my SH reports? I have a couple of examples in the tutorial.
viewtopic/t88983/Pugsys-PointersSleepyH ... nding.html

[Ivan101]

Okay, the pixmap caching was what caused my axis markings to disappear. I also redownloaded SH to make sure it was the current build. (May 2013) My Dr. doesn't know about the first half of the night being so much better than the second. I usually track my data to watch for changes. I also have spent time trying to find trends and have never been able to find anything...until I started the BiPAP, and now it's blantantly obvious! Not sure how that works...I have sent about 15 messages to my dr. in the past 2 weeks, so I figured before I bothered her again, I'd see if there was a simple answer that someone on here knew. She does know that I monitor my stats and that I know how to alter my PAP settings/pressures if/when we want to tweak things, and she agrees that that's easier than trying to always go through the DME. That said, I'm still learning the software, so I guess I haven't been sending her the detailed graphs...only the statistics page. I just looked at the whole month of October...I don't see an over-arching trend of more events in the second half of the night...however because having my mask on was making me so gasy and nauseous, I was only 58% compliant the month before switching to BiPAP. Interestingly, I just went back through September, and the second half of the night trend is there...I guess I just always assumed that was normal as we spend more time in REM sleep as the night goes on? I never thought it was unusual...I'm also pretty sure that my DME reads my SD card and doesn't give my dr. a whole lot of stats...although I'm not sure...it could be that she also just looks at the overall statistics and not for any general trends? She's been great to work with and listens to me when I have a problem and gets it resolved. I know if I go to her about this if you think I should, she will be willing to listen and help. I never have felt that she feels undermined when I take suggestions from forums and mention them to her...I do it nicely

Could this be why I'm still always really tired??? Ugh, I was just beginning to think I was getting a handle on all of this...maybe not as much as I thought...

[Pugsy]

Snores are unexciting...Where is the flow limitation graph? All those other graphs below snore an FLs aren't really needed IMHO
Can you add the Flow Limitation graph to see if it is very active?

I don't know what to make of the centrals (real or not) maybe impacting sleep quality or are the centrals flagged just evidence of poor sleep quality. Don't know which came first.
Makes it difficult to come with an idea what to do because we don't know if the centrals are sleep onset or awake/semi awake breathing irregularities are simply real centrals deep in sleep.

What I do see is evidence "something" creating a situation where sleep quality is maybe less than optimal and in turn it's very possible that what we see could impact how you feel. But I don't know who came first...the sleep quality having a lot of arousals and thus the flagged centrals or the centrals maybe causing the arousals. Unfortunately it's extremely difficult to figure out which came first. You could zoom in on the individual events and maybe see if the actual flow rate looks like awake breathing but I am no so good with interpreting flow rate graphs unless the change is so obvious a blind man can see it.

Do you take any meds..OTC or RX?

[DoriC]

Can you post your pressure settings, Epap,Ipap, PS? I can't quite make it out on your graphs? And your settings on your previous machine? Thanks.

[Ivan101]

Okay, bear with me. I'm going to make a REALLY post. I will label each with what you are seeing. Here's the story: I was on CPAP ResMed S9 Autoset, pressure of 12, EPR off, then we tried switching to pressure 10 to help with the burping. The last two will be the night of the 8th (the data you've already seen, except with the flow limitation graph as well) and last night...I slept less last night and had much better results...so I thought I'd include a "good" night too...although there's still the trend of more towards morning. I got up as soon as I woke up this morning. So, here's my overview, my stats page so you can see my usage, and data from a day in September (the 10th) on 12 cm of CPAP.





Here's Sept. 24th at 10cm pressure:




Here's Nov. 8th...the night's data I have already sent...but this time with the flow limitation graph:




And Finally Last night:

[archangle]

Look at the airflow waveforms (flow rate) of the events you're concerned about and zoom in to see how long and how total they are.

If they don't last too long, or if you're still breathing fairly well, they aren't as worrisome as if they are long and you totally stop breathing.

BTW, some of your images aren't showing up for some reason, there's sort of a "do not enter" symbol.