Good, Bad or Ugly?

[onceceltic]

Hi

Looking for some help understanding the SH data and what I should be looking for. Is this data good, bad or ugly?

I had my Sleep Study done 3 weeks ago and Doc told be the result was “positive” for OSA. He said I rated as a severe case as the score was 77 ( I take that to mean my AHI)

This week I have been issued with my Philips Respironics System One 551P RemStar Auto with A-Flex Mode: APAP 4-20cmH2O and ResMed full face mask which I am told I am to use for 2 weeks. I am then to return the device to the clinic and they will then issue me a permanent fixed pressure CPAP that will be calibrated to my requirements.

I am looking at the graphs and am confused as the AHI is now only around 2, dose this mean that the original Sleep Study was wrong or does it mean that the machine has reduced my AHI from 77 to 2 ?

There is some old data on the card ( I presume from previous patients) which looks very different from mine.

My wife says I am still snoring, is this because of the leaks that are happening

Will two weeks be a long enough period to gather sufficient data to set up the fixed pressure machine?

Any help will be appreciated

Regards

[Ruinednose]

im not the ebst at this but it all looks good , the leak rate is high i think

[Julie]

Of COURSE the machine has reduced your AHI - that's what it's supposed to do. And it's normal to do it that fast and well, even if some people don't get that lucky so fast.

Btw - I take it you do have the Phillips machine, or do you have a Resmed Remstar... has to be one or the other, not both.

Your leaks are high, so I wonder if they bothered helping you to fit the mask properly, in your size, or figured it didn't matter as you might not keep it after the trial period. Are you wearing it very tightly fastened? Shouldn't do that... counterproductive if anything and the soft silicone 'cushion' of the mask that touches you needs to inflate to be effective, so if it's squished too tightly down, it won't work well. And maybe (like most of us) you need to experiment with various masks to find the right one for you.

[zoocrewphoto]

Btw - I take it you do have the Phillips machine, or do you have a Resmed Remstar... has to be one or the other, not both.

Actually, Phillips Respiropnics is Remstar. Resmed is not related to Remstar. It can be very confusing.

[Bill44133]

oh my God you are snoring like crazy... You need more pressure... Your not supposed to snore...

[Julie]

Zoo Crew -

[SleepyToo2]

A pressure of 4 cm is too low for most people to be able to breathe normally. If you are using some kind of pressure relief in addition to that, it is no wonder that you are still snoring like crazy. The wide-open pressure setting can mean that the poor machine will take too long to respond to the need for more pressure, and you will get events. I would be arguing with my DME to get some adjustments to the pressure made so that you can be sure that the value the CPAP is set at will be closer to your actual needs than you can possibly get with the current information. You do need to get those leaks under control, but if you are starting off at a pressure of 2 cm, it is highly likely you are opening your mouth to try and get more air - that can break the seals on the full face mask, hence the leaks.

[chunkyfrog]

Since your pressures vary so much from one night to the next, I would push for an auto cpap (full data, of course)
Any auto can be used in straight cpap mode, but it is better to have and not need than to need and be SOL.
Show your numbers to your doctor, and ask for the auto

[Bill44133]

A pressure of 4 cm is too low for most people to be able to breathe normally. If you are using some kind of pressure relief in addition to that, it is no wonder that you are still snoring like crazy. The wide-open pressure setting can mean that the poor machine will take too long to respond to the need for more pressure, and you will get events. I would be arguing with my DME to get some adjustments to the pressure made so that you can be sure that the value the CPAP is set at will be closer to your actual needs than you can possibly get with the current information. You do need to get those leaks under control, but if youLuck are starting off at a pressure of 2 cm, it is highly likely you are opening your mouth to try and get more air - that can break the seals on the full face mask, hence the leaks.

Since you are diagnosed severe 4 is way to low.. I would change that to about 10 and see how that goes.

I am also diagnosed severe and I have bi-level-cpap of 23 and 19.

Good Luck..

[Pugsy]

SleepyHead's graph numbers don't jive with statistics. Makes it hard to evaluate the pressures and the leaks.

Let's see if we can fix them...go to Preferences...Appearance tab and remove check mark from "use pixmap caching" and restart SleepyHead...
While in Preferences go to the graphs tab and remove check mark from the AHI graph.

I suspect all you need to reduce the snores is a little more minimum pressure but with all the graphs looking whacko it's hard to see where it is going to need to go.


Look at your axis numbers for leak and pressure... Here's a normal looking graph numbers.

[ems]

A pressure of 4 cm is too low for most people to be able to breathe normally. If you are using some kind of pressure relief in addition to that, it is no wonder that you are still snoring like crazy. The wide-open pressure setting can mean that the poor machine will take too long to respond to the need for more pressure, and you will get events. I would be arguing with my DME to get some adjustments to the pressure made so that you can be sure that the value the CPAP is set at will be closer to your actual needs than you can possibly get with the current information. You do need to get those leaks under control, but if youLuck are starting off at a pressure of 2 cm, it is highly likely you are opening your mouth to try and get more air - that can break the seals on the full face mask, hence the leaks.

Since you are diagnosed severe 4 is way to low.. I would change that to about 10 and see how that goes.

I am also diagnosed severe and I have bi-level-cpap of 23 and 19.

Good Luck..

I think 4 is low also but personally, I wouldn't jump from 4 to 10. Maybe try 6 for a week or so. Then go up a bit from there if that isn't enough. I'm on bipap and my pressure is 6/9. We are all individual and our needs are different. I was diagnosed as severe also - no centrals.

[SleepyToo2]

I agree with ems - I would not jump to 10 in one go. Definitely try 6, then 8, before getting to 10. Remember that the CPAP will be set to a fixed pressure, so you want to find out what that should be as quickly as possible. However, it may take longer than is available unless more time is politely demanded!

[zoocrewphoto]

A pressure of 4 cm is too low for most people to be able to breathe normally. If you are using some kind of pressure relief in addition to that, it is no wonder that you are still snoring like crazy. The wide-open pressure setting can mean that the poor machine will take too long to respond to the need for more pressure, and you will get events. I would be arguing with my DME to get some adjustments to the pressure made so that you can be sure that the value the CPAP is set at will be closer to your actual needs than you can possibly get with the current information. You do need to get those leaks under control, but if youLuck are starting off at a pressure of 2 cm, it is highly likely you are opening your mouth to try and get more air - that can break the seals on the full face mask, hence the leaks.

Since you are diagnosed severe 4 is way to low.. I would change that to about 10 and see how that goes.

I am also diagnosed severe and I have bi-level-cpap of 23 and 19.

Good Luck..

AHI severity does not have any direct relationship to pressure needed. If you look at the graph, the machine is set wide open 4-20, but never goes up to 10, because it doesn't need to. It does need to have a higher minimum, probably in the 6 or 7 range.

Don't assume that a high untreated ahi means that the person needs a high pressure. Or even worse, don't assume that somebody with mild sleep apnea needs only a low pressure. They may not get any treatment at all if they need 10 or 15, and their machine was set to a straight 6.

[YDNAM]

Hi, am curious (and probably a bit dopey...) but how do you get the graphs from your machine? do you just take the chip and load it intyo your computer?

[zoocrewphoto]

Hi, am curious (and probably a bit dopey...) but how do you get the graphs from your machine? do you just take the chip and load it intyo your computer?

As long as your machine does more than compliance data, you put the card into your computer and use the software. Both Respironics and Resmed machines have their own individual software (Encore and ResScan) and both can be used with Sleepyhead. All 3 programs are available for free. If you post the machine model number that is on the bottom of your machine, somebody will send the info for the correct versions. Also, make sure you fully signup so that you can receive private messages.