In the initial days following diagnosis and after consultation with the sleep doc, I found this forum and began to read and investigate. I am deeply grateful for those who have helped me with my first few inquiries on the forum and have led me to a successful download of Sleepyhead 1.0 beta - 1 and the successful importation of my data. (Thank you, palerider.)
I have read and re-read the Beginner’s Guide to Sleepyhead, and have attempted to address the prompts for new users to set the preferences for use detailed there. That Guide is such a great help to new users with limited technical knowledge and computer skills, such as myself. I am also deeply grateful to those who took the time to share their skills and knowledge to develop Sleepyhead (jedimark, palerider), and to those who wrote the Guide for new users needing help and understanding with an OSA diagnosis.
Relying on information here, I began to understand that my AHI should have begun to decrease if my therapy was consistent, and to my dismay it was not declining. After revisiting the sleep center to select a second mask, and again visiting the DME for yet a third mask, my ahi began to stabilize in the low teens, but only dropped below the diagnosis AHI a few times. My post diagnosis followup visit at the Sleep Center is not until the 24th on March, so in desperation I contacted the Center, asked that they review my data, and increase my pressure sufficient to provide a therapeutic benefit to these mask wearing nights I have been enduring!
March 11 was my first night with a new pressure Rx of 8-12 cmH2O. While it was not a night of restful sleep due to several factors related to the pressure increase, my resultant AHI dropped to 4.63. Regrettably, if someone other than I had been monitoring my data, perhaps a resultant pressure increase could have occurred far sooner. You guys have taught me that I am to be my own advocate, as likely no one else will assume that role. I suspect my DME provider is only interested in my compliance so they can get paid, and sadly, the sleep doc with whom I am associated has demonstrated only that he has more pressing demands on his time than to follow up on newly diagnosed patients and the success of their early treatment. Perhaps I am expecting too much.
Anyway, the point to all this rambling is a question about the leak rate reflected on my March 11 Sleepyhead report. I am going to try to attach the report, but because of my limited skill level, I am not sure I have mastered those steps yet.
There are no markers for Large Leak in the Events screen, yet the Leak rate in Statistics shows Min. 9, Median 17, 95% 26, Max 33. If I understand the Guide discussion, and there is much there about leak rates, because my preferences for leak rate Redline default was set at 24L/min (ResMed Value) and my 95% rate was 26, it appears to mean that 95% of the time the leak rate from my Amara View FF mask from my Dream Station CPAP auto was at or below 26L/min, with a maximum leak of 33L/min that only lasted for a few moments. I have examined the LeakRate screen, and have expanded the data field to spot the peaks in leak values for when they occurred overnight, and have spotted the point at which leak rose to approximately 33 for a very brief period. Perhaps I still do not understand! If the default Redline value was 24L/min, why was there not a marker on the Events screen showing a large leak when the rate exceeded 24L/min? Also, I see no redline on the Leak Rate screen anywhere??? ( I have, today, changed the RedLine Option setting to 80L/min as I believe the Guide instructed for Phillips Respironics systems with a pressure setting of 8-12, which I now have. Did I misunderstand those instructions?
Wading through all that Leak discussion in the Guide was complicated, and perhaps I still need a tutorial, but given the March 11 data, can you advise if I had a leak rate for that date that is of concern? Previous leak rates at lower pressure are no longer relevant, but for the past 7 days Statistics shows a 90% leak rate at at 21 and at 20 for the last 30 days at 6-8 cmH2O.
I had a perceived leaks at both cheeks, at the bridge of the nose, and at the chin last night with the increase in the pressure, but this morning the DreamMapper App showed 100% mask fit with 0% leaks, and the Sleepyhead data appears to show no concern. Am I understanding these data correctly?
I know this is a long and rambling post, for which I apologize.
I would appreciate your responses to the above question, and to any other concerns visible regarding the SH data from March 11. Thank you for your help.
august silverbear
Some of my above remarks reference Guide language shown below.
A detailed look at the Show Leak Redline option
The default is to have this checked and the default value for the Redline is the ResMed value of 24 L/min.
Philips Respironics System One. The Philips Respironics machines report TOTAL leak, but Philips Respironics never tells us what the official definition of a Large Leak. SleepyHead 0.9.6 now flags the official Encore Large Leaks as gray bars over the Flow Rate graph. So if you get a lot of large leaks, you can use that data to help you decide where to draw a Large leak line. But until you get some data, here's a staring place to make some guesses about where to draw the Redline that are based on looking at a lot of Encore data from a lot of Philips Respironics users over the years:
New Series 60 System One machines. If you are using a pressure setting that is higher than 8-10cm, the Encore software usually does not flag Large Leaks until the Total Leak rate is up around 80 L/min.
So start by selecting a Redline of 80 L/min if you are using pressures above 8 cm and a Redline of 50 L/min if you are using pressures below 8 cm. Adjust if you see Gray Large Leak bars in your actual data.
