perplexing Sleepyhead data

[NYCzzz]

A little background about me:

I was diagnosed with OSA 6 years ago, with an AHI of 28. For the first 5 years I used a dental device bc i was mortified at having a CPAP, and found them unbearable. Last year I gave CPAP a try and have been happy with it... mainly because the Swift FX and, now, AirFit P10 are so much better for me than previous masks.

As I've become educated on this site I demanded a switch from my S9 Escape Auto to the S9 Autoset, which I miraculously after one year of use was able to accomplish.

I just downloaded Sleephead, and here's my first full night. Note that the data looks strange because I'm traveling and it's a time zone thing... I slept until past noon the day before and them until about 11am today....

The data on my S9 Escape was showing average Pressures per night around 10. Now with the Autoset in APAP mode set at min 4, max 20 pressure, I am perplexed at how most of my night is spent at the minimum pressure around 4.0 and there are very few events. I do recall the original sleep study showing that for me, my AHI shoots up during REM. But the only clusters I see are CA's!

The CA's are toward the end of my sleep ( the graph above shows the end of the night before as well due to the clock timing issue). I'm wondering if the higher pressure I used to get on the Escape was due to the algorithm not realizing that my apneas were central, not obstructive, whereas the Autoset knows not to ramp up the pressure for centrals.

This of course begs the question of whether my Sleep Apnea is even OSA. I will follow up with more charts as I get some more nights of data, but for now I'm trying to understand:

A) given the low pressures seen on my report, is it possible that if my pressure were zero (i.e. no CPAP) I would also have fine results? Or is there some compelling evidence in this report that I have OSA... I am not doubting my original diagnosis, I'm just perplexed by this data

B) What's up with the CA's? I was never diagnosed with CA when I got the sleep study... Maybe just noise around the time when I wake up....

Can't thank you all enough for your help.

[Julie]

Looks to me like most of the time you're not at 4, but between 7.5 and 8.5 (95% of the time anyway).

Many of us have a few centrals both when going to sleep and awakening - unless you get large clusters during the night, they're not something to worry about.

However, most of us cannot breathe properly at all at a low pressure of 4, and I would certainly raise that to at least 6 for a few nights and higher if you find it changes how you feel and how your numbers look. 4 is just the machine's low default setting (and 20 the high) and some doctors seem to think it's ok to just leave them there rather than prescribing an actual range (i.e. 8-12), but it makes it hard for the machine to catch apneas at higher levels in time to effectively block them when it's only set at 4.

[palerider]

The data on my S9 Escape was showing average Pressures per night around 10. Now with the Autoset in APAP mode set at min 4, max 20 pressure, I am perplexed at how most of my night is spent at the minimum pressure around 4.0 and there are very few events. I do recall the original sleep study showing that for me, my AHI shoots up during REM. But the only clusters I see are CA's!

the escape doesn't really *have* data, and I'm not sure what that 10cm reading you were getting actually *means* maybe it was the 95% pressure, not the average pressure.

The CA's are toward the end of my sleep ( the graph above shows the end of the night before as well due to the clock timing issue). I'm wondering if the higher pressure I used to get on the Escape was due to the algorithm not realizing that my apneas were central, not obstructive, whereas the Autoset knows not to ramp up the pressure for centrals.

the escape uses an older algorythm than the autoset does, not only does it not log meaingful data, it isn't as smart.

This of course begs the question of whether my Sleep Apnea is even OSA. I will follow up with more charts as I get some more nights of data, but for now I'm trying to understand:

A) given the low pressures seen on my report, is it possible that if my pressure were zero (i.e. no CPAP) I would also have fine results? Or is there some compelling evidence in this report that I have OSA... I am not doubting my original diagnosis, I'm just perplexed by this data

B) What's up with the CA's? I was never diagnosed with CA when I got the sleep study... Maybe just noise around the time when I wake up....

sleep/wake junk can certainly look to the machine like centrals, so it's something to keep in mind as you get more data.

I'd suggest bumping the lower pressure up to 5, since half the measurements were below 4.88 and half above, so it'd be a good starting point, you can go into the preferences menu and change the graph scales, no need to have it go to 25 on the pressure when you're looking at less than 10 max.

you're working in a different setup, give it a couple of days and see what comes up.

[palerider]

Looks to me like most of the time you're not at 4, but between 7.5 and 8.5 (95% of the time anyway).

actually, according to the stats, he spent 95% of the night at, or below 7.64, and half of the night below 4.88. the *max* was 8.36, and there was only 5% of the night that it was between 7.64 and 8.36

[robysue]

Looks to me like most of the time you're not at 4, but between 7.5 and 8.5 (95% of the time anyway).

actually, according to the stats, he spent 95% of the night at, or below 7.64, and half of the night below 4.88. the *max* was 8.36, and there was only 5% of the night that it was between 7.64 and 8.36

Palerider, thanks for pointing this out. So many people (including Julie here) misinterpret the meaning of the 95%, and it's nice that I'm not the one pointing it out for once.

[NYCzzz]

I had similar results last night... very few OAs or H's, the bulk of my events were CAs which seem to get worse as pressure increases.

Wow. This data is making me question whether I even have OSA, or whether my results were CA's misdiagnosed as OSA.

I'm going to try sleeping with my machine in CPAP mode tonight at the lowest setting 4,0 and see how I do. I need to figure this out!

[palerider]

Looks to me like most of the time you're not at 4, but between 7.5 and 8.5 (95% of the time anyway).

actually, according to the stats, he spent 95% of the night at, or below 7.64, and half of the night below 4.88. the *max* was 8.36, and there was only 5% of the night that it was between 7.64 and 8.36

Palerider, thanks for pointing this out. So many people (including Julie here) misinterpret the meaning of the 95%, and it's nice that I'm not the one pointing it out for once.

hey, I read your remdial stats blog post I knew the *meanings* of the terms, but your explanation made it very clear WHY the numbers work that way.

I are trainable!

for those that would like a well written, easy to understand refresher course on how the numbers go into the basic machine stats work... read this: http://adventures-in-hosehead-land.blog ... de-to.html

[palerider]

I had similar results last night... very few OAs or H's, the bulk of my events were CAs which seem to get worse as pressure increases.

Wow. This data is making me question whether I even have OSA, or whether my results were CA's misdiagnosed as OSA.

I'm going to try sleeping with my machine in CPAP mode tonight at the lowest setting 4,0 and see how I do. I need to figure this out!

your CAs are after your pressure goes down. you don't have a lot of pressure in the first place.

you might try cutting back on the EPR and see if that has an effect.

the pressure is going up for some reason, perhaps pre-emptive strikes due to snoring?

[archangle]

the escape doesn't really *have* data, and I'm not sure what that 10cm reading you were getting actually *means* maybe it was the 95% pressure, not the average pressure.

We really need to be clearer about that. Even the S9 Escape records some data, such as pressure. The S9 Escape Auto records pressure and AHI.

I'm not quite sure how much data the S9 Escape Auto records. It records something about pressure and apneas, but I don't know if that's just one number per night, or if it's a nightly graph of pressure, AHI event types and times.

[NYCzzz]

Based on my charts here, with only a couple H's and 1 OA during this period, I'm trying to understand why the pressure remained above the minimum 4.0 for most of the period and even reached my maximum of 8.0... Could the Flow Limitations be a factor? Does my S9 Autoset actually respond to Flow Limitations in the .1 area? I thought that was insignificant? There was essentially no snoring so i didn't include that...

thanks