Help with Latest Sleep Numbers, Could it be Leaks?

[LookingEast]

Keep us posted. We do care.

I will, thanks.



I'm very interested in what the doctor's office has to say. My "average" AHI is about 8 from all the day's usage so that in itself doesn't look ominous at all.
When I told the Resp Therapist from the DME I could see my OAs, Hs, etc. she wanted to know...HOW?
That said, I wonder, if all the doctor sees is AHIs and an average, what can he do without a complete picture.

Do you know if the PR machine I have offers complete reports to the clinicians?


Sue

[palerider]

Do you know if the PR machine I have offers complete reports to the clinicians?
Sue

your clinician can see as much data as you're looking at with sleepyhead

the problem is that many of them don't care to look.

[Pugsy]

Respironics has a software product that DMEs and doctors offices use....that's Encore in some version and thus they can see the same thing you can see using SleepyHead...if they bother to look.
SleepyHead is showing you what Encore would show you if you could use Encore but it is a Windows only software.
Sleepyhead shows it visually a little differently but the data it presents is the exact same data.

Here's a detailed report from my BiPap using Encore. Incidentally it shows one of my classic probable REM stage sleep clusters. Now this particular cluster is uncharacteristically ugly for me. A rarity so I wouldn't do anything except chuckle and shrug my shoulders and probably blame it on my alien friends messing with me again. Below it I have included what would be a more typical night for me on my BiPap just so you can see the difference. The really ugly nights are rare so I wouldn't try to change the settings but if I saw more ugly nights than good nights then I would change the pressures a little. I don't have a SleepyHead image handy of these but if you want to see them to compare just let me know and I will see if I can still get a screen shot of those nights to compare to but I think you will see what I mean with these.

Also note that while the leak line got up there...no large leak flags and the bulk of the increase was because the pressures went so high.



and same night using Sleepyhead



and a more typical night for me.

[LookingEast]

Thanks for posting these. How did you get the BIPap report? Do I need windows for that or can a dr send me that? I can get access to a PC...
I'd like to see my BiPap report if possible, and hope my doctor is going to look at it very soon as well.

You wrote:

Also note that while the leak line got up there...no large leak flags and the bulk of the increase was because the pressures went so high.

Why does the higher pressure prohibit the leak from being flagged?

Here's my data from last night. One of my longest nights sleep in the history of mankind, haha. Guess my body and mind finally said, NO MORE!!! Wish that would continue...
I remember waking up around 10:15 am and the nasal pillows were on my chin or neck, and I can see now where a break in data occurs when this happens vs "ugly" stuff. I'm pleased to see I put the mask back on instead of taking it off/turning off the machine. It's becoming instinctual, I don't remember doing that.

I feel like I got a pretty decent night's sleep, partly I think since it was (a lot) more 4-5 hours.

Also, I changed my "auto-off" setting to "ON." But when I played around with it last night while awake, taking off the nasal pillows mask, the blowing didn't stop. I tried disconnecting the tube and it still was blowing. How does the "auto-off" feature work?

In response to an earlier question, yes, I did fiddle with the BiFlex settings, and had settled on 2. But last night 1 felt more unrestrictive when breathing.





Thanks,
Sue

[Pugsy]

How did you get the BIPap report? Do I need windows for that or can a dr send me that? I can get access to a PC...

Encore is strictly Windows software. You would need some sort of virtual Windows on your Mac to use your Mac...some sore of Windows environment like BootCamp or Parallels.
If you have access to a PC with Windows...tell me which version of Windows and I can get you the software so you can generate your own reports.

Why does the higher pressure prohibit the leak from being flagged?

It doesn't prohibit large leaks from being flagged. If I had a large leak it would get flagged.
Vent rates vary by pressure...more pressure means more vent rate and since Encore is showing total leak (vent rate plus excess leak) when my pressure increase so much the vent rate also increase so not all that mountain of a leak is related excess leak..a good bit of it is the vent rate driving the vent numbers up.
From past experience...I don't ever get a large leak flag until I hit 90 L/min at my pressures and my mask.

Also, I changed my "auto-off" setting to "ON." But when I played around with it last night while awake, taking off the nasal pillows mask, the blowing didn't stop. I tried disconnecting the tube and it still was blowing. How does the "auto-off" feature work?

It will blow for about 60 seconds before it shuts off. It's not an immediate reaction...with Auto Off set to "On" just give it about a minute or so and it will shut off.

Your report from last night...quite decent and if you could keep this up...no need to do anything. Makes me again wonder why so ugly sometimes and so nice other times. Something changed to cause the ugliness at times. If you can have a report like last night's....why can't you do that all the time? Scratching my head here. Maybe you do just need more time.

[LookingEast]

Encore is showing total leak (vent rate plus excess leak)

So the "leak rate" on Sleepyhead is vent and the "total leak" is vent plus excess?

I have a friend who uses PC and I"ll find out what version of Windows she has and let you know, thanks.

Last night was my best AHI ever at 2.95 with 6.46 hours sleep. This time mask was intact when I woke up.
I notice I had the most "snore" events to date as well -- does this indicate deeper/better sleep or maybe they're just "snorts" associated with events.

In any case, I'm happy with the way things are going these past two days.

I also received the replacement mask yesterday, the Res Med AirFit P10 and I have to say I LOVE this mask so far....!

It's so easy to assemble, clean and most of all it's comfortable and basically completely quiet, and - no air blows on me at all.

I also went back to the chin strap the last two days so I think that's taking a big part in helping the air get to where it needs to be. I played around with BiFlex settings again without looking at what number it was dem-ing and came back to 1 every time, so yep, I'm not changing anything at this point.

Here's last night's data.

[Pugsy]

Leak in SleepyHead is an approximate of excess leak only.
Total leak is excess leak plus vent rate.
Nothing in SH shows vent rate all by itself. Vent rate varies by mask time and pressure and will increase or decrease as the pressures increase or decrease.

If the good reports continue and you weren't using a chin strap when you had the bad nights then maybe mouth breathing was a factor in there somewhere. Maybe while not technically horrible mouth breathing maybe something else.

[LookingEast]

Hi,

Just wanted to report that my AHI continues to be under 3.0 for the past 5 days. I'm pretty thrilled.
I'm loving the AirFit P10 mask. The fit and comfort and quietness are amazing.

Also, I talked to my doctor's office (finally) yesterday and his nurse told me this about my numbers, the "uglies", all the Hs, and all:

1. My AHI was 10 during initial sleep study
2. With treatment it was 7, and that' what they based the Rx on.
3. They are completely fine with these numbers.
4. If I'm not happy, I can come in and discuss it in person but there won't be a change to the Rx.

Here's hoping the mask did the trick, cuz the treatment does seem to be working now....!

SUe

[robysue]

You don't have Encore...it won't work on a Mac anyway.
That's okay I was just wanting to see if it flagged any of those borderline up around 80 L/min leaks as large and if it says 0% on the LCD screen then it didn't.

Just for information, SH 0.9.6 on the mac DOES show the Encore Large Leak Flags!

It's also a bit more stable than SH 0.9.5. So if LookingEast is really concerned about whether she's got official Large Leaks with her PR machine, upgrading to SH 0.9.6 just might be a good idea.

The SH 0.9.6 for Mac download link is: http://sourceforge.net/projects/sleepyh ... g/download

[Pugsy]

Just for information, SH 0.9.6 on the mac DOES show the Encore Large Leak Flags!

Yep.. I saw that on someone's report the other day. I think it is supposed to be added to the Windows version at some time also. I was pleasantly surprised to see that little bit of added detail.
It will make for much easier evaluation of those leaks that are pushing close to what we think LL territory is.
If we had still been wondering exactly for sure about LL territory with the OP here I was going to suggest getting the latest Mac version of SH but things seemed to settle down (and the machine was reporting 0% of time in large leak)and not become so much of a potential question mark so I just didn't mention it.

Oh....S9 users haven't been left out...there's now a red line on the leak graph where 24 L/min is...so easier to eyeball the time spent above 24 L/min.

[robysue]

Oh....S9 users haven't been left out...there's now a red line on the leak graph where 24 L/min is...so easier to eyeball the time spent above 24 L/min.

And that Redline can be moved from 24 L/min to where ever you want. So the folks using Icons and IntelliPAPs can set the Redline at the appropriate numbers for their machines, which I don't remember right off the top of my head. Do you know what those numbers are?

[Pugsy]

So the folks using Icons and IntelliPAPs can set the Redline at the appropriate numbers for their machines, which I don't remember right off the top of my head. Do you know what those numbers are?

For the F & P Icon....60 L/min is the beginning of large leak territory.
For the Devilbiss IntelliPaps...it's quite generous if I remember correctly..up around 90 L/min or in that neighborhood and might be a little higher.

[LookingEast]

Roby Sue wrote:
It's also a bit more stable than SH 0.9.5. So if LookingEast is really concerned about whether she's got official Large Leaks with her PR machine, upgrading to SH 0.9.6 just might be a good idea.

Hi there, yes, I updated the day it was released and my latest data graph upload was using SH 9.5. WHere are the Large Leaks indicated? I still see "leaks" and "total leaks."

Also, you can call me Sue.


Sue

[Pugsy]

WHere are the Large Leaks indicated?

If you don't have any large leaks then they may not show up on the graphs but if they do it is on the very top of the events graph...top right and called LL.

Let me see if I can find an example for you. I saw one the other day. Give me a bit.

[Pugsy]

See Bassbunny's image of her report in this thread for an example of how LL shows up. This is the same way it shows up in the Encore report except LL is on the very top in the leak graph and here it shows up in the events graph right under PB.
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