Please help interpret sleepyhead report

[Vexations]

Here is a screenshot of a Daily report from sleepyhead. I'm not sure what to make of it. The AHI and Leak Rate numbers all look OK to me, but I wonder about the Mask Pressure.

[Nick Danger]

This actually looks pretty good. You may want to increase your minimum pressure a bit (the machine has to go a long way to get from 4 to 10 - 10 seems to be the pressure necessary to handle the events you are having). How are you feeling in the morning?

I'm sure Pugsy will be along shortly - she is very good at reading the graphs.

[Vexations]

This actually looks pretty good. You may want to increase your minimum pressure a bit (the machine has to go a long way to get from 4 to 10 - 10 seems to be the pressure necessary to handle the events you are having).

Pressure drops to 4 if the SensAwake feature detects that I'm awake. Looking at the graph, It seems to think I'm awake a lot. I've been wondering if those low pressure areas in the graph perhaps correspond to Stage 1 periods, rather than wakefulness.

How are you feeling in the morning?

Not great. I wake up with headaches that usually last about 3 hours, but sometimes an entire day. I have never felt rested in the 7 months that I have used the machine.

[Pugsy]

I can't read the report very well. Too many graphs that are unneeded making the graphs too tiny for my tired old eyes.
What is your pressure setting?

AHI of 3.33 is about all I can determine in regards to numbers. That AHI is of course well within acceptable limits.
I couldn't enlarge your image to make it so I could see the numbers better. Might be related to my desktop resolution...I don't know. I just know your image doesn't show up as clearly/cleanly as one of my reports.

Mask pressure graph just pretty much mimics the regular pressure line and doesn't really mean much. I turn that graph off..don't need it.
AHI graph is just a per hour AHI number. With the events graph at the top I can normally see what I need to see in terms of clustering already...so I turn the AHI graph off also.

The 4 main graphs on the left that I look at are...Events, Flow rate, Pressure and leak.
Don't bother trying to include all those other graphs..they are only useful in a case by case situation.
Having 4 graphs instead of so many makes it easier to see the main 4 graphs.

Some people are sensitive to pressure changes and the Sensawake thing could maybe be more of a problem than not using it would be. Most of us don't need or want a pressure reduction whenever we might wake up and there's also the possibility the machine is mistaken about your being awake and then it drops the pressure and then that disturbs you and wakes you up. Can you turn it off to see if that might be impacting your sleep quality?

I can't tell much from this graph...can't even see how long the sleep session is.

So since you report not feeling very good (or as good as the AHI says) maybe we look at the other usual suspects.
So you get the usual questions.....
Hours of sleep...how many are you averaging and be honest.
Are those hours of sleep fragmented with a lot of awakenings? If so, any idea why?
Do you have trouble with falling asleep either at the beginning of the night or middle of the night if you wake up?
Do you take any meds even OTC? If so what?
What are you main complaints when you say you don't ever feel rested? Is it just the headache or general fatigue or excessive drowsiness or what?

About the headaches...did you have them just like this prior to cpap therapy or have they changed?
Do you have any issues with whatever mask you are using with strap comfort....have to have the straps tight to control leaks?
Do you have any history of cervical spine issues...arthritis, old injury, etc?
What bed pillow are you using...same one as pre cpap?

[Vexations]

I can't read the report very well. Too many graphs that are unneeded making the graphs too tiny for my tired old eyes.

Sorry about that. I used a high screen resolutions for the screen capture. I'll upload a image that's easier to read with just the graphs you need.

What is your pressure setting?

10 cm H20

Some people are sensitive to pressure changes and the Sensawake thing could maybe be more of a problem than not using it would be. Most of us don't need or want a pressure reduction whenever we might wake up and there's also the possibility the machine is mistaken about your being awake and then it drops the pressure and then that disturbs you and wakes you up. Can you turn it off to see if that might be impacting your sleep quality?

I've tried turning it off once. I'm not sure whether it helps me or not. It's nice not to have to enable the ramp feature to get back to sleep. Trying to fall asleep with a pressure of 10 is difficult for me.

Hours of sleep...how many are you averaging and be honest.

No more than 6. Maybe 4 or 5. Hard to tell. I have no illuminated alarm clock. I couldn't read a clock without my glasses anyway, and finding them and putting them on over the old mask was such a hassle I never bothered to look at my watch. My new mask, the AirFit N10, is a bit easier. Do people keep notes? How?

Are those hours of sleep fragmented with a lot of awakenings? If so, any idea why?

Not as many as the SensaWake seems to indicate, and not as long. Recently, the headaches have been so bad they wake me up.

Do you have trouble with falling asleep either at the beginning of the night or middle of the night if you wake up?

No trouble. I usually fall asleep quickly, it sometimes doesn't take more than a minute or two. I tend to wake up once a night to go to the bathroom, usually around 4AM.

Do you take any meds even OTC? If so what?

None.

What are you main complaints when you say you don't ever feel rested? Is it just the headache or general fatigue or excessive drowsiness or what?

I've never thought of myself as exceptionally drowsy or sleepy. I have never fallen asleep while driving or anything like that. I never really gave it much thought until my sleep doctor asked if I felt rested in the morning that I realized that I don't find sleep restorative. I often just want to get up, preferably around 6AM, so that I don't have to sleep anymore. When I'm at my best, hiking in the wilderness, I go to bed at sunset and wake up before dawn. Then I do find sleep restorative. Maintaining that level of physical exertion is difficult when I'm back in town. I do feel "tired" around 10 PM and want to go to sleep, but it's not the same kind of tired that I feel after a good day of hard work.

About the headaches...did you have them just like this prior to cpap therapy or have they changed?

Headaches have never been a problem before. I do not have migraines. I only have them when I use the machine. I've tried quitting coffee/alcohol; it's not any of those. It is closely correlated to using the machine.

Do you have any issues with whatever mask you are using with strap comfort....have to have the straps tight to control leaks?

I switched to a new mask on Oct 3. The technician thought I fitted it too loose. I think I am trying to keep the mask on by not moving; I wake up stiff and with sore muscles. It's quite possible that the headaches are the result of tension in my neck.

Do you have any history of cervical spine issues...arthritis, old injury, etc?

None.

What bed pillow are you using...same one as pre cpap?

[/quote]
No, I have been using a CPAPmax pillow for about four months now.

[Pugsy]

Thanks for redoing the image...much easier.
What are your pressure settings? Are you in auto mode? That's what it looks like to me...auto (APAP) mode with pressure settings of 4 to 10. And you spend some time maxed out at 10 cm which means the machine wanted to likely to higher but couldn't...see the flat pressure line at 10 cm...the machine wanted to go higher but couldn't.

Did you have an sleep study in a lab to diagnose OSA and then another in lab to find optimal pressures? Do you have copies of those reports if you had in lab studies? If not, would be a good idea to get them. What was your diagnostic AHI?

Your AHI is not horribly high and while technically below 5.0 that is generally considered acceptable...it's pushing things a little especially with the clusters and you reporting not feeling so great. If your settings are indeed APAP mode with minimum 4 and max 10...that explains the weird look to the pressure line...I don't think that's sensawake going on there.
I am thinking a higher minimum would give you better results and maybe a higher maximum.

The headaches could be strap tension or just trying to hard to limit mask movement and sleeping in a position you are used to sleeping in. You should be able to sleep like you always sleep and not worry about it.
Talk to your doctor about the headaches...most likely related to the mask or straps or sleep position but at least alert your doctor and see what he says. I have a bad neck and if I sleep weird...I get what I call a neck headache. The neck may be stiff and maybe doesn't hurt much but the headache is nasty. I don't know that is your issue and since the headaches are new symptom....get it checked out. Straps or neck or both would be my first suspect though.

You can get a rough idea how many hours you are sleeping by the reports as long as you aren't spending much time awake with mask on. You can look back and see the averages. If you typically take a bit of time to fall asleep just mentally remove that time from the average.
The reason I ask is that most of the time with that question I get 7 to 8 hours but when I look at the overview section...those 7 to 8 hours a night are rare and the average is closer to 5 or 6 and that's simply not enough hours of sleep to expect much improvement.

Since you didn't seem to have the usual typical sleep apnea symptoms it is going to be more difficult for you to gauge improvement because not so easy to put a finger on symptoms.

People do keep a log sometimes...SleepyHead has a area for notes but the old pencil and paper works good too.

From what I see here...it looks like a little pressure adjustment is needed if you are indeed using APAP mode...it for sure isn't 10 cm all night long. I don't know if it will help your fatigue or not but it might and that makes it worth trying.
If you had a sleep study where they determined 10 cm pressure was needed...the machine isn't giving you that at all or anything near it.