Vibratory snore scores on Sleepyhead

[BIGsherm7272]

I seem to have a pretty good grasp of sleepyhead now, as in I can interpret all the data and it makes sense to me. My AHI has been excellent for quite some time, I have never had a major leak and my leak rate is very low most of the time, if any at all. I am having very few hypopneas/apneas, and if I do have an obstructive apnea event, they are almost always under 10 seconds, with the average one being 8. The length of my hypopneas (which were my main issue) has also gone down, and are averaging between 20-30 seconds, whereas I was having multiple apneas nightly that were over 40 seconds long, and have even had some longer than 1 minute. So I think I finally have found my sweet spot and am headed down the right path.

The only thing I still have a question on is the Vibratory snore count on sleepyhead. I do not know if they really matter since my AHI is so low, but my average snore index is usually around 5, and has gone as high as 10 before. I would assume this is similar to AHI scoring, meaning that all of my snores that met the criteria were added up and divided against the amount of hours I slept, as pretty much all the other scores are. At least that's how I think it works. Also, in Sleepyhead, when you go to the Daily tab and look at the events at the bottom left corner, your re able to see the length of each one. Correct me if I'm wrong, but the values in parenthesis next to the snore time is also the amount of seconds it lasted.

So could having a lot of vibratory snores effect the quality of your sleep, even though all my other numbers are stellar? For example, last night I had a VR2 snore count of 4.88, with the mean duration of each one about 2-3 seconds, with a low of 1 and high of 7. Is my snore count abnormally higher that some of the members on this forum? And could the amount of loud snoring I m still doing somehow be affecting my treatment and sleep? If so, what would help to reduce the mount of snores? I have already tried increasing the pressure, but if I go any higher than what I am now (10.5), my AHI score starts to rise, and other events that I normally do not have happen to me starting showing up, such as RERA, Cheyne-stokes breathing, Clear-airway, etc., so I have come to the conclusion that my current pressure setting is optimal.

Thank you in advance for any info on this.

[Pugsy]

The number in parentheses next to snores on the events tab is NOT snore duration.
We don't know what it reflects but it is some sort of marker. Respironics machines do not record snore duration at all.
The number in parentheses next to the other events..OA, CA, hyponea are a close approximation but again Respironics machines do not record event duration. Again it is some sort of marker and it is very close to event duration but it is not exact.
All the 3 main categories of events...OAs, Hyponeas and CAs have to be at least 10 seconds of duration to earn a flag. It's an important part of the criteria...those 8s you are seeing doesn't mean 8 seconds but it probably means 10 seconds as it probably barely met diagnosis. If you click on one of those events and zoom way in to the point you can count the seconds I imagine it will be barely 10 seconds. I spent the better part of a day counting seconds on various events from short to long and it was within a couple of seconds almost every time,

As far as how important are the snores...post one of your detailed reports so we can see what you are seeing. It's about the only way we can get a feel for figuring out if there are enough of them to be a concern.
Snores and flow limitations will drive the pressure up in auto mode though. They are usually considered warning signs that the airway is trying to collapse...now it may not go any further than a few snores or FLs and may not be anything to worry about but it is something the machine is designed to respond to with an increase in pressure to prevent further airway collapse.

If snores and FLs are a little too numerous they are usually easily reduced with just a little more minimum pressure.

[BIGsherm7272]

The number in parentheses next to snores on the events tab is NOT snore duration.
We don't know what it reflects but it is some sort of marker. Respironics machines do not record snore duration at all.
The number in parentheses next to the other events..OA, CA, hyponea are a close approximation but again Respironics machines do not record event duration. Again it is some sort of marker and it is very close to event duration but it is not exact.
All the 3 main categories of events...OAs, Hyponeas and CAs have to be at least 10 seconds of duration to earn a flag. It's an important part of the criteria...those 8s you are seeing doesn't mean 8 seconds but it probably means 10 seconds as it probably barely met diagnosis. If you click on one of those events and zoom way in to the point you can count the seconds I imagine it will be barely 10 seconds. I spent the better part of a day counting seconds on various events from short to long and it was within a couple of seconds almost every time,

As far as how important are the snores...post one of your detailed reports so we can see what you are seeing. It's about the only way we can get a feel for figuring out if there are enough of them to be a concern.
Snores and flow limitations will drive the pressure up in auto mode though. They are usually considered warning signs that the airway is trying to collapse...now it may not go any further than a few snores or FLs and may not be anything to worry about but it is something the machine is designed to respond to with an increase in pressure to prevent further airway collapse.

If snores and FLs are a little too numerous they are usually easily reduced with just a little more minimum pressure.

Interesting, would like to know what they actually represent, as seconds would seem to make perfect sense, but maybe it has more to due with severity? I just really just see what else it could be, especially since my main issues were Hypopneas (~160 during sleep study vs. only 12 obstructive, and various other centrals and what not, my total was around 190 events). I will do a little more investigating.

Anyways, below are the screen shots of my daily data, showing the VR2 event count for last night:

12/1/2015 -









If there are any other flags in the graphs you would like, please let me know. This is about an average snore event count for me. I have had it as low as ~25, and as high as nearly 100, but there are too many variables (sleep time, tiredness, sleeping position, sleeping medications, and many others), so I think this is an accurate representation of my current snoring habits. Thank you to all who view and give feedback.

This forum kicks some serious ass!

[Pugsy]

The "By Pressure" graph is useless...as is the AHI graph.
What is useful to see in terms of graphs on the right
the top Events graph
the Flow rate graph
the regular pressure graph when using apap mode
the leak graph

on the left side hide the calendar and pie chart on the daily detailed report...that brings AHI and statistics all into one nice image.
If you do this you have everything we usually need on one image and if we need something else we will ask for it.

I don't remember what those numbers in parentheses means (I see some 0s in mine)...
I think it might have to do with how many snores are recorded during a recording window which is 2 minutes I think but in all honesty I can't remember if that is what it was or what was being discussed.
Give me some time to wake up and get some coffee in me and I will try to find the discussion that I am thinking about. Unless someone beats me to it....it's in the vague corner of my mind because it really wasn't all that important for me to remember.
I do know it is NOT duration though.

I think you might need maybe a 0.5 to 1.0 cm increase in the minimum pressure and the snores should reduce. A look at the daily report in the format I mentioned above might help get a better idea.

[BIGsherm7272]

The "By Pressure" graph is useless...as is the AHI graph.
What is useful to see in terms of graphs on the right
the top Events graph
the Flow rate graph
the regular pressure graph when using apap mode
the leak graph

on the left side hide the calendar and pie chart on the daily detailed report...that brings AHI and statistics all into one nice image.
If you do this you have everything we usually need on one image and if we need something else we will ask for it.

I don't remember what those numbers in parentheses means (I see some 0s in mine)...
I think it might have to do with how many snores are recorded during a recording window which is 2 minutes I think but in all honesty I can't remember if that is what it was or what was being discussed.
Give me some time to wake up and get some coffee in me and I will try to find the discussion that I am thinking about. Unless someone beats me to it....it's in the vague corner of my mind because it really wasn't all that important for me to remember.
I do know it is NOT duration though.

I think you might need maybe a 0.5 to 1.0 cm increase in the minimum pressure and the snores should reduce. A look at the daily report in the format I mentioned above might help get a better idea.

Thank you for helping sort through what is actually useful in sleepyhead. I will try a short APAP trial, probably 3 days, and I will set my pressure at 12/7. I know for a fact that anything higher than 12 is not necessary from past trials. I am interested as to what the data will say on APAP this time around, now that I am mentally more stable and sleeping much better overall.

But when I have tinkered with my pressure settings in the past, if I went any higher than what it was set at (10), I usually had an increased AHI score, and several other flags that never show up, such as CA, CSR, and RERAs starting showing up, even they they are usually sparse. The only time my pressure stayed higher than 10 was after my auto-trial and I was in CPAP-check mode. The auto-trial determined that my 90% pressure was 11, so I left it in cpap-check mode for about a week. During that week in which the pressure was 11, my AHI was averaging nearly 1 point higher, and even had some nights that went above 3. I also was able to feel the difference, so I put the pressure back down to 10 and my scores and sleeping became better.

But all of that occurred when I was going through some very stressful events, as well as being in a major depressive episode, and also had very high levels of anxiety. I was also not trying to maintain good sleep hygiene habits, and was taking 2 heavy sleeping medications at the time, and was also going through a minor benzodiazepine withdrawal. So I think there were way too many variables to really know what was working and what wasn't, and why. Finally after 3 months of agony I finally got on the right medications and my mental state is much better, and my sleeping patterns are becoming slowly better. I was going to bed round 5-8am, and getting out of bed anywhere from 3-6pm. My sleep was also very fragmented, as I almost always would wake up 2-3 hours after falling asleep, and keep waking up almost every hour until I said screw it and get out of bed. Now I m going to bed between 2-4am, nd waking up between 1-2:30pm, and I am usually sleeping at least 5-6 hours before my first awakening, in which I am able to fall asleep right away with ease.

I still feel very fatigued/disoriented up awakening, but I believe that once I get some bloodwork done to rule out any of my health conditions exacerbating this, such as my hypothyroidism, and start to exercise more and lose some weight, that I will feel like a completely different person. Anyways, I attached my updated graphs with the graphs/setup that you said is optimal for you to look at. These are from last night: