Hubby's sleepyhead graphs self-titrating

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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Ogeo
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Hubby's sleepyhead graphs self-titrating

Post by Ogeo » Fri Feb 13, 2015 10:47 pm

Just a brief history - start date was 1/30/15. Pressure was 5-20. We changed it to 8-20 after first day per guidance on this site. He has now been using it for 14 days. His AHI is gradually coming down but he is still real tired to the point that when he sits down, he falls asleep.

I am posting several days graphs and would love some feedback and suggestions.

This was his worst night. Sleepyhead said to call the doctor. Most of his bad time was when he was awake as he had trouble sleeping this night. He is only on usual meds like HBP, Chlorestrol, aspirin.
Image

The rest of them are more typical of nights:

Image

and

Image

and

Image

Any changes we should do???? Why does he have those sharp peaks on his pressure? If you want a close up of his Flow Rate on any night, let me know what night and time of night.

Thanks for your help!

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Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments:  Max PS - 11; Max EPAP - 18; min PS - 7; Min EPAP - 14; rate auto; rise x2; pressure averages between 21 and 24.9
Hubby's equipment: PR System One REMstar Auto A-Flex model 560P. Doctor's orders left it open 5-20. We changed it to 8-20 after a couple nights. Start Date was 1/30/15. Oh, mask is the new nasal pico.

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palerider
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Re: Hubby's sleepyhead graphs self-titrating

Post by palerider » Fri Feb 13, 2015 11:06 pm

Ogeo wrote:Just a brief history - start date was 1/30/15. Pressure was 5-20. We changed it to 8-20 after first day per guidance on this site. He has now been using it for 14 days. His AHI is gradually coming down but he is still real tired to the point that when he sits down, he falls asleep.

I am posting several days graphs and would love some feedback and suggestions.

This was his worst night. Sleepyhead said to call the doctor. Most of his bad time was when he was awake as he had trouble sleeping this night.
well, in sleepyheads defense, the "call a doctor" is more a "those numbers are bad, do something"... but you already knew that most of it was something to be discounted, because he wasn't asleep, and if not asleep, then that long nasty stretch of centrals don't count.

perhaps go up another half if he's comfortable with the pressure, how's he resting (except for that bad night?)

also, I'd uncheck that box on the preferences that says "show unknown flags", because, they're cluttering things up, and nobody knows what, if anything, they mean. you'll need to tick the 'rebuild data' menu option after doing that.

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Pugsy
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Re: Hubby's sleepyhead graphs self-titrating

Post by Pugsy » Fri Feb 13, 2015 11:08 pm

I think the sharp spikes you are referring to are the pressure probes...looks sort of like a saw tooth pattern.
viewtopic/t80875/Respironics-APAP-press ... se-up.html
They are looking particularly spiky due to the scale of the graph.

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Ogeo
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Re: Hubby's sleepyhead graphs self-titrating

Post by Ogeo » Fri Feb 13, 2015 11:20 pm

Pugsy wrote:I think the sharp spikes you are referring to are the pressure probes...looks sort of like a saw tooth pattern.
viewtopic/t80875/Respironics-APAP-press ... se-up.html
They are looking particularly spiky due to the scale of the graph.
Thanks. I did not know that. He is still feeling tired almost every day so no change there. Is there anything we should tweak?

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments:  Max PS - 11; Max EPAP - 18; min PS - 7; Min EPAP - 14; rate auto; rise x2; pressure averages between 21 and 24.9
Hubby's equipment: PR System One REMstar Auto A-Flex model 560P. Doctor's orders left it open 5-20. We changed it to 8-20 after a couple nights. Start Date was 1/30/15. Oh, mask is the new nasal pico.

Discovering the world one geocache at a time!

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Ogeo
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Re: Hubby's sleepyhead graphs self-titrating

Post by Ogeo » Fri Feb 13, 2015 11:24 pm

palerider wrote:
perhaps go up another half if he's comfortable with the pressure, how's he resting (except for that bad night?)

He is very tired almost every day and sleeps alot during the day too.]

also, I'd uncheck that box on the preferences that says "show unknown flags", because, they're cluttering things up, and nobody knows what, if anything, they mean. you'll need to tick the 'rebuild data' menu option after doing that.
Will do for next time. Wish I knew what it means though since one of them is wild with marks.

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments:  Max PS - 11; Max EPAP - 18; min PS - 7; Min EPAP - 14; rate auto; rise x2; pressure averages between 21 and 24.9
Hubby's equipment: PR System One REMstar Auto A-Flex model 560P. Doctor's orders left it open 5-20. We changed it to 8-20 after a couple nights. Start Date was 1/30/15. Oh, mask is the new nasal pico.

Discovering the world one geocache at a time!

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Pugsy
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Re: Hubby's sleepyhead graphs self-titrating

Post by Pugsy » Fri Feb 13, 2015 11:36 pm

How is his sleep quality in general on the "good" nights...at least per the reports?
Does he often have sleep problems like the bad night?
I have no idea what those weird unknown files that look so ugly are.
Does he take any meds of any kind? If so, what are they?
On the good nights does he still wake often?
Only thing I can think of is maybe the pressure changes are a factor even though the range is relatively small.
Perhaps increase the minimum to 8.5 or 9.0 or maybe mimic cpap mode with minimum and maximum set to equal each other in apap mode...probably set around 9.0 or 9.5 maybe.

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palerider
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Re: Hubby's sleepyhead graphs self-titrating

Post by palerider » Fri Feb 13, 2015 11:51 pm

Ogeo wrote:Will do for next time. Wish I knew what it means though since one of them is wild with marks.
yeah.. it'd be nice to know what it means... could be anything... I turned it on at one point and tried to make sense of when they were flagged, and couldn't see anything that made any sense in the flow... maybe you can, if you zoom in on each one and look at a bunch of them.

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Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: S9 VPAP Auto
Get OSCAR

Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

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Ogeo
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Re: Hubby's sleepyhead graphs self-titrating

Post by Ogeo » Sat Feb 14, 2015 12:19 am

I'll try to answer both of your questions:
Yes, he is tired every day no matter what the AHI is.
His AHI started around 9 or 10 and gradually worked down and ranges between 1.5 to 4.5 if you subtract the CA when we know he is awake. That one night was his worst.
Meds are HBP, Chlolestrol, aspirin, typical old person meds. He does not take anything for sleeping except some Ibuprofin or Excedrin for pain on nights when his back is hurting.
Before APAP, he was getting up 2-3 times a night to go to the bathroom. Now he is getting up one or two times. He mostly sleeps on his side. He is not aware of waking up other than getting up to go to the bathroom.

When you zoom in on the flow rate, he has a lot of (for lack of better terminology) waxing and wanning. Could this be due to his feeling tired all the time?

Image

We will change his bottom pressure to 8.5 and see what he feels like in the next few days.

Thanks.

_________________
Mask: AirFit™ P10 For Her Nasal Pillow CPAP Mask with Headgear
Additional Comments:  Max PS - 11; Max EPAP - 18; min PS - 7; Min EPAP - 14; rate auto; rise x2; pressure averages between 21 and 24.9
Hubby's equipment: PR System One REMstar Auto A-Flex model 560P. Doctor's orders left it open 5-20. We changed it to 8-20 after a couple nights. Start Date was 1/30/15. Oh, mask is the new nasal pico.

Discovering the world one geocache at a time!

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Pugsy
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Re: Hubby's sleepyhead graphs self-titrating

Post by Pugsy » Sat Feb 14, 2015 8:31 am

Ogeo wrote:When you zoom in on the flow rate, he has a lot of (for lack of better terminology) waxing and wanning. Could this be due to his feeling tired all the time?
I don't know. It's kinda hard to really see it at this level of zooming in. You need to be zoomed in further to evaluate air flow.
See the one area of CSR/PB flagged breathing? Go to the events tab and find that category and click on one time CSR/PB event and see the scale level it goes to the breathing on the right side graphs.

Let's see what 8.5 minimum does.
I am wondering just how important the RERAs are in this situation.

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Drowsy Dancer
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Re: Hubby's sleepyhead graphs self-titrating

Post by Drowsy Dancer » Sat Feb 14, 2015 10:38 am

Ogeo wrote: Before APAP, he was getting up 2-3 times a night to go to the bathroom. Now he is getting up one or two times.
I'd take this, at least, as a sign that his treatment is becoming more effective, even if he's not all the way there.

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