My CPAP experience and this site

[BlackBag52]

I think it is time to introduce myself to this very helpful community.

I was diagnosed with extreme sleep apnea (AHI=110) about 2-1/2 years ago. My sleep doctor chose a F&P Icon for my machine and a Quatro FX full face mask (large) with a pressure of 13cm. One month later they decided since my leaks were very excessive that I needed a size Medium mask. Unfortunately my insurance paid for NOTHING, mostly since I had not met my deductible yet. I did seem to feel better initially but gradually my fight with mask leaks seemed to make my therapy and generally well being gradually move to sub-optimal levels.

I tried to get the data from my machine into sleepyhead which worked initially but then I kept getting glitches. Finally (about last Spring), I started "lurking" here and reading the posts most every day. I discovered that the memory stick in the icon was getting new (extra) files written to it by my macbook air and the Icon didn't like that.

Since I now had new/different insurance and PCP, I decided to try a new machine and had my Dr. prescribe the ResMed AirSet 10. However, insurance was again not going to pay for anything due to a $6,000 deductible. So, I began a search for a nice data capable machine based on the posts I've read here kind of focusing on the S9 autoset or a PR model 560. I finally found a very low hour PR model 560 off of Craigslist and boy what a difference in the data and Sleepyhead!

While my initial experience with the Sleepyhead software and the F&P Icon was less than desirable, my experience with Sleepyhead and the PR model 560 is AMAZING. A big thank you to Mark and the others who have provided feedback to Mark to make this software so good. I will be contributing to Mark shortly.

The first two years of therapy my AHI reading seemed to be in the neighborhood of 8 to about 13 with a lot around 10. In addition I was back to being very sleepy at various times throughout the day. I was convinced that I could do better but also convinced that I was going to have to it by myself with the great advice I've read in this community. I got my AHI's consistently down to around 3 to 5 or lower with the PR 560 but noticed that my pressures were going pretty high during the night (>19). I've recently found a PR model 760 auto bi-pap machine cheap and started using that about a week ago. Much easier to breath with but a LOT of settings to figure out which I'm still working on. I've changed my mask to the AirFit F-10 and my AHI's are down even more. I'll post my Sleepyhead data here later today to see if there are any recommendations for changing any setting. I did notice that I may need to raise my lower pressure as I have a great deal of snores happening.

Anyway, I just wanted to say a BIG THANK YOU to the people here for their help. There is absolutely, definitely no way I could do this by myself without the vast amount of information and great advice from this forum.

Jack

[chunkyfrog]

Welcome to the forum. I am dismayed that anyone's deductible is six thousand dollars.
--I would die with that sorry a plan.
I would hope for very cheap premiums.

[BlackBag52]

Well, I don't consider them cheap. About $500 per month for just me...

[chunkyfrog]

Yikes! I feel for you. I don't understand the logic.

[BlackBag52]

Ok, lets see it I can show some of my SleepyHead data:

[BlackBag52]

Well my Tuesday data seems to have been cut off on the right side so lets try this for my Wed data:

[BlackBag52]

Arrrgggg,

Well, still cut-off but it seems that it will at least allow one to click on the image to see them in Imgur. Here is my Thursday data:

[BlackBag52]

And here is last night's data:

[BlackBag52]

I had the "flex" on for Tue with a level of 2 but shut it off for the rest of the week as I don't really understand it much. In addition, I don't really understand the "PS" which I think goes from 2 to 8 right now. It seems to be the difference between my inhale pressure and my exhale pressure.

Any advice for those two settings? Any advice for my Min/Max EPAP or IPAP settings?

I also do not have the "ramp" setting on nor am I using my humidifier right now.

I guess that I'll go back and find Pugsy's pointers about posting the data to see if I can get some nice pics showing the whole night and not cut-off on the right side..

Any and all advice is greatly appreciate

[Pugsy]

Don't worry about the images. Mine do that sometimes too. We all know that all we have to do is right click the mouse and choose view image to see the total image. I don't know why mine does that sometimes and sometimes it doesn't and I don't change anything with the way I do the screen shots.

PS Pressure support is just the difference between inhale and exhale pressure. I haven't been able to find out in what situation it might be better to have a smaller vs large range for PS. The most commonly used PS setting is around 4.

In general we look at EPAP for obstructive apnea stuff...like the snores, flow limitations or OAs and IPAP for hyponeas.
You've already got IPAP max wide open.

You start the night with PS of 2 because that is what is going to be provided while awake and then the machine will decide what it wants to do once you get to sleep and the apnea events drive the changes.
I personally found that PS of 4 was much more comfortable. Your machine has a min and max PS...right now you have it set to min 2 and max 8 which might be the default settings...I don't remember.
Technically your reports aren't horrible but some nights are a bit uglier than others and the pressure is going all over the place. Something is driving the pressure changes and when we see times where the pressure doesn't do anything (and we can't blame it on big leaks...which I will talk about in a minute) and the 2 usual culprits for pressure increases are either REM stage sleep or supine sleeping or a combination of both. Your pressure line is so wild I can't get any sense for what it might be. If you tell me you never sleep on your back then we know it's REM driving the pressures.

Leaks....you are showing some time in large leak territory...those gray areas on the graphs...and the leaks are so big that the machine's pressures are flat lined which means the machine is unable to sense what is going on due to the massive leaks. Leaks over 100 L/min will do that...so that flat line during the grayed out area doesn't mean no events were driving the pressures. It means that during the large leak the leak was so bad the machine was clueless as to what might have been happening.

So...how are you sleeping? Soundly or having a lot of wake ups? How are you feeling in general?
If you feel less than optimal there maybe a couple of little tweaks we can do to maybe improve things. The reports aren't horribly horrible by any means....but they look a bit wild and inconsistent and we can't get any sense for any trends or patterns. I suspect that the really high pressures could be feeding the leak monster. When pressures vary so wildly it makes it really difficult to anticipate the fit for seal needed at those really high pressures.
Do leaks wake you?
I have a couple of ideas to maybe start with in terms of settings...
But I prefer to do one change at a time and see what happens...in this case change PS from 2 to 8 range to 4 to 5 range. See what happens in terms of your sleep quality and what the reports show.

Let me show you a little bit about what I mean in regards to pressures being more stable in general. Here's on of my reports below that shows my 760 and it's pressure graph. My OSA is worse in REM stage sleep...documented on the sleep study and the first REM stage normally occurs around 90 minutes after sleep onset.
I think you can spot mine with this report. I don't always need more pressure in REM but usually at least once a night I will see a good sized jump in pressure. You may have to right click mouse to see the full image.

[BlackBag52]

So...how are you sleeping? Soundly or having a lot of wake ups? How are you feeling in general?
If you feel less than optimal there maybe a couple of little tweaks we can do to maybe improve things. The reports aren't horribly horrible by any means....but they look a bit wild and inconsistent and we can't get any sense for any trends or patterns. I suspect that the really high pressures could be feeding the leak monster. When pressures vary so wildly it makes it really difficult to anticipate the fit for seal needed at those really high pressures.
Do leaks wake you?
I have a couple of ideas to maybe start with in terms of settings...
But I prefer to do one change at a time and see what happens...in this case change PS from 2 to 8 range to 4 to 5 range. See what happens in terms of your sleep quality and what the reports show.

Well, I wake up one or two times every night usually due to the leaks. Sometimes, it is hard to get back to sleep so I'll see breaks in the data for several minutes or more. In general I feel much, much better with either of the PR auto machines (560 or 760) than I ever did with the Icon at a static 13cm. I see that my screen shots for Thur and Friday are missing the flow data and by reading the Sleepyhead owners manual I just figured out that the machine does not record flow data if the card is out. My card was out the last two day. I'll do better now that I know it affects my reports..

I will change the PS from 2-8 to 4-5 this evening and see if it helps.

Thanks
Jack

[palerider]

Arrrgggg,

Well, still cut-off but it seems that it will at least allow one to click on the image to see them in Imgur. Here is my

I'm cribing this from a post I just made in another thread

you can have a large thumbnail that you can click to get the full detail by doing sometihng like this:

Code: Select all

[url=http://imgur.com/1TScxYz.png][img]http://i.imgur.com/1TScxYzl.png[/img][/url]

to do that, upload your image, and copy the 'linked bbcode' link, then make the following changes:

Code: Select all

change this:
[url=http://imgur.com/1TScxYz][img]http://i.imgur.com/1TScxYz.png[/img][/url]
to this:
[url=http://imgur.com/1TScxYz.png][img]http://i.imgur.com/1TScxYzl.png[/img][/url]
(add .png after the first link, and change the second one by adding a l *before* the .png)

good on you taking charge of your sleep and making changes you need to get better than 'what the doctor ordered'

[BlackBag52]

Just a quick test to see if I can get the proper image into my thread..

[BlackBag52]

(add .png after the first link, and change the second one by adding a l *before* the .png)
[/code]

good on you taking charge of your sleep and making changes you need to get better than 'what the doctor ordered'

Thanks Palerider,

Jack

[BlackBag52]

Ok, modifying the image code by adding .png and adding l


Jack

Is this the same thing as selecting "large thumbnail"?