SleepyHead Results ~ Thoughts?

[CPAPLowspark]

I'm interested in you all taking a look at my past two nights of results...
http://imgur.com/6D56uJy


Last nights...

http://imgur.com/L32evJU



I haven't seen that blue line in any of my results since starting therapy on 4/5...

[Julie]

Did you really read all the pgs in those links? You don't really have things laid out properly and a lot is missing.

[palerider]

signs point to "no".

[robysue]

Here's what immediately catches my eyes:

Night of 4/25 (http://imgur.com/6D56uJy)
Looks like you were in bed for about 6.5 hours. There's a usage gap of about usage gap of about 15-20 minutes around 0:30, and a couple of shorter gaps a bit earlier. The leak graph is a bit noisy, but the leaks stay well below the Resmed RedLine for Large Leaks of 24 L/min. The leaks are at their worst right before you turned the machine off for good around 5:30. Did you get up then? Or did you go back to bed without the mask on for more sleep?

The handful of events right before you turn the machine off around 5:30 are not particularly significant in my opinion since they may represent sleep-wake-junk. However, they are responsible sudden 7-8cm increase in pressure that happens right after 5:00. If the pressure increase woke you up, you may want to either set the min pressure setting a bit higher, or the max pressure setting a bit lower, or both. (Be aware that setting the max pressure setting a bit lower may lead to some clustering of events in REM, so you will need to watch your data pretty carefully.)


Night of 4/26 (http://imgur.com/L32evJU)
Looks like you went in bed for the first time around 9:00pm. You used the mask for a bit more than an hour and then you took the mask off for about 40 minutes. What did you do in those 40 minutes? Get out of bed because you weren't sleeping? Got up after a wake and did something before returning to bed? Or did you take the mask off and try to sleep for 40 minutes or so without the mask?

In any case, you turned machine back on around 10:40 and you turned the machine off for good around 4:30. There are two additional gaps in usage: A 15 minute gap just before 1:00 and a 20-25 minute gap just before 1:40. Any ideas on what was going on between 12:30AM and 1:40AM? And what happened after 4:30? Did you get up for the morning? Or did you take the mask off and go back to bed and sleep some more?

Leaks are more problematic on this night, but they're still below the RedLine. Nonetheless, it's worth asking: Did you notice any leaking---particularly 23:20 and 23:40?

There's also a dense cluster of OAs scored right around 0:30 that trigger a 5-6cm increase in your pressure. Given that the cluster starts about 110 minutes after you turned the machine back on at 22:45ish, there's a reasonable chance that cluster could be REM related.

Do you remember what was going on when you woke up and turned the machine off around 0:40ish? That might tease out whether that cluster was REM related or not.

Overall observations
Your leaks could be a bit better, but they're not yet so bad that they are affecting the efficacy of your therapy. But they could be bad enough to be affecting the quality of your sleep. If you remember waking up being bothered by leaks or if you feel like you were tossing and turning fighting with leaks on one or both of these nights, then you ought to do some work in tracking down the source of the leaks and figuring out what to do about them.

If you are still feeling lousy, the big question is the usage pattern: What are you doing in the middle of the night when the machine is not on? How often are you waking up during the night? Are you spending a lot of time out of the bed settling yourself back down to try to go to sleep again? Or are you just taking some lengthy bathroom breaks? Or are you taking the mask off and going back to sleep?

What's your desired sleep schedule? Do you want or need to get up around 4:30 or 5:30 most mornings? Or are you turning the machine off a lot earlier than you want to get up? Finally are you looking for ideas on what to tweak at this point?

[robysue]

Did you really read all the pgs in those links? You don't really have things laid out properly and a lot is missing.

I'm not quite sure what you and PaleRider are reacting to. The images that I saw when I clicked on the OP's post had the following graphs, which are exactly the graphs we tell newbies we want to see AND in the order that I personally prefer to see them in:

The event table
The flow rate graph
The pressure graph
The leak rate graph

The left sidebar stuff could have been better organized, but quite frankly the main problem is that the poster doesn't know how to turn the pie chart off. He's trying to show the Session Data---which IS interesting in this case---along with the statistical summary data that appears below the pie chart. Yes, the big AHI number and the breakdown into OAI, HI, CAI, is missing---but with the event table you can clearly see the AHI is quite low both nights. Looking carefully at the Flow Rate graph, you can even pick up the missing total AHI number.

[CPAPLowspark]

Thank you for the insight. A few responses:

1) I am only a month into therapy and still getting use to the machine/mask/pressure. So those "breaks" are usually caused due to a simple wake up, then I realize I need to pee so I remove the mask and take care of all that stuff. Then I usually put the tv on and get mentally prepared to put the mask back on and try it again.

2) I have woken up several times in the past month and taken off my mask and fallen back to sleep for 15 - 20 minutes. I am sure during that time I am having episodes and I wake up, realize that I don't have the mask on and put it back on.

3) Leaks - I started with a FF mask and it didn't work for me. After 4 nights of use I switched to a nasal mask and I really like it. I don't notice much leaking except when I am waking up in the middle of the night and I feel high pressure...I feel a small air leak on my right upper cheek area. I move around and fix it and go back to sleep.

Even with the waking up and those other newbie struggles with the mask and machine...I feel much better than before therapy...even 4 or 5 hours of choppy sleep on the machine is still better than the 80 AHI I have lived with for several years...

[robysue]

Thank you for the insight. A few responses:

1) I am only a month into therapy and still getting use to the machine/mask/pressure. So those "breaks" are usually caused due to a simple wake up, then I realize I need to pee so I remove the mask and take care of all that stuff. Then I usually put the tv on and get mentally prepared to put the mask back on and try it again.

You've got a good strategy for learning how to sleep well with the mask. That's important. Once you are waking up less frequently, you should start to feel better.

2) I have woken up several times in the past month and taken off my mask and fallen back to sleep for 15 - 20 minutes. I am sure during that time I am having episodes and I wake up, realize that I don't have the mask on and put it back on.

It is important to try to train yourself to not fall asleep without the mask. But when it happens and you wake up a bit later and realize it, the right thing to do is what you're doing: Put the mask back on and go back to sleep. Again, as long as you consistently put the mask back on, things will get better.

3) Leaks - I started with a FF mask and it didn't work for me. After 4 nights of use I switched to a nasal mask and I really like it. I don't notice much leaking except when I am waking up in the middle of the night and I feel high pressure...I feel a small air leak on my right upper cheek area. I move around and fix it and go back to sleep.

Your leaks are NOT large enough to worry about on the nights you posted a long as they're not leading to frustration on your part. It sounds to me like you're doing the right thing in regards to the small leaks that you do detect in the middle of the night. Mask comfort is more important that eliminating the last bit of leaking, so stick with the nasal mask you like rather than going back to a FFM.

Even with the waking up and those other newbie struggles with the mask and machine...I feel much better than before therapy...even 4 or 5 hours of choppy sleep on the machine is still better than the 80 AHI I have lived with for several years...

I'm glad to hear that you're already noticing improvement!

As your sleep settles down and you have fewer night time wakes, you should continue to notice additional improvement in how you feel during the daytime.

It sounds and looks like you are off to a good start!

[CPAPLowspark]

Thanks for the reply and encouragement! I will provide some updated information soon as I am sure I will have more questions.

Thx!