Jonathan's ongoing list of questions, comments, concerns...

[JonathanZK]

Hi All,

This is my first post... I've been on BiPAP for severe OSA for 9 nights. It's a Dreamstation with heated humidifier and the ComfortGel full mask.

And I'm wondering how accurate the sensors really are. The last few mornings I wake up and it FEELS like there's no pressure at all -- in comparison to when I turn it on at night -- although the machine is showing the normal settings. The Dreammapper app shows 100% mask fit and 0% leaks. Is it possible I just get used to it overnight, or can the sensors be malfunctioning?

Additionally, like many here I've been reading, I'm tracking my AHI. It seems to vary quite a bit night to night -- from <0.5 to around 5.5 (with one particularly troublesome night over 11). Can these figures be accurate without any sensors hooked up to me? How does the machine even know?

And one last question, if I may. I've read about a better app than Dreammapper called Encore. But I'm not a Windows user. Are there other similar apps that would be useful that can run on MacOS and/or Linux?

Thanks,

Jonathan

[Julie]

Encore's old - get Sleepyhead.

[Pugsy]

Welcome to the forum.

Encore is a PITA software even if you have Windows to use.

Use SleepyHead instead...there's a version available for your computer. It's Beta but fairly stable and what little bugs it has aren't usually a big deal.
https://sleepyhead.jedimark.net/

Read here for some how to information and what to look for.
http://www.apneaboard.com/wiki/index.ph ... SleepyHead

And here if you want to show us what you see
viewtopic/t158560/How-to-post-images-for-review.html

The last few mornings I wake up and it FEELS like there's no pressure at all -- in comparison to when I turn it on at night -- although the machine is showing the normal settings.

Common perception. The body just gets used to the pressure so that what seems so big at the beginning of the night is barely noticeable at the end of the night. I used to wake up in the middle of the night and have to pull the mask away from my face briefly just to confirm the machine was even on. Over time even the pressure at the beginning of the night won't seem so big anymore.

And yes, the sensors are fairly accurate in terms of air flow sensing.
What they have a problem with is awake breathing...they have no way to know if you are asleep or not and they can and will mistake awake breathing irregularities as some sort of apnea event and flag it as such. Our awake/semi awake breathing is much more irregular than our asleep breathing and we can sometimes have flagged events that are awake breathing flags by mistake.
The other night I had an AHI of 3 something and I went and looked at each event up close and I wasn't asleep for any of them. They weren't real.
It's very common for newbies to have this happen because newbies often simply don't sleep so great with this stuff attached to us.
Newbies get a lot of SWJ or sleep/wake/junk flagged events that aren't real.
In my recent case I had a bad night of sleep in general due to more back pain than usual....so I had a bunch of SWJ flagged events making it look like the AHI was a bit high (for me anyway).

Once you get SleepyHead and if you ever want to dig deeper into the validity of any flagged events...go here and read and watch the videos and you can learn how to zoom in and look closely at the flagged events to see if they look like you were asleep or not.
http://freecpapadvice.com/sleepyhead-free-software

[palerider]

And I'm wondering how accurate the sensors really are. The last few mornings I wake up and it FEELS like there's no pressure at all -- in comparison to when I turn it on at night -- although the machine is showing the normal settings.

Unless your machine is defective. (and it happens, but it's rare), the sensors are *very* accurate.

There are two, one measures the air flow, and the other measures the air pressure. Everything else is extrapolated from those two measurements.

The pressure sensor can measure the pressure it takes to push water down by less than a millimeter.

[JonathanZK]

Thank you, everybody, for your thoughtful responses. I appreciate all the kind words and valuable feedback.

I successfully installed Sleepyhead, and my goodness, this thing is collecting a LOT more data than the Dreammapper is reporting.

I will go through the documentation before asking more questions. But thank you all. I'm grateful for this community.

Jonathan

[JonathanZK]

My goodness, this thing has me convinced I'm gonna die. lol. I'm kidding, but only half...



I am noticing some discrepancies between this data and the results from my two sleep studies. For example, both of the studies -- untreated and with PAP -- showed no RERAs. While Sleepyhead is reporting 50 last night alone. Could this be a side effect of the machine; or an event that would otherwise have been an apnea that the machine weakened?

I'm also finding the snore data interesting... Is snoring with PAP common? What's considered a good/bad/normal? The documentation is helpful at understanding what the data is communicating, but it's not helpful in interpreting the value of the readings...

Thanks!

[palerider]

My goodness, this thing has me convinced I'm gonna die. lol. I'm kidding, but only half...



I am noticing some discrepancies between this data and the results from my two sleep studies. For example, both of the studies -- untreated and with PAP -- showed no RERAs. While Sleepyhead is reporting 50 last night alone. Could this be a side effect of the machine; or an event that would otherwise have been an apnea that the machine weakened?

I'm also finding the snore data interesting... Is snoring with PAP common? What's considered a good/bad/normal? The documentation is helpful at understanding what the data is communicating, but it's not helpful in interpreting the value of the readings...

Thanks!

Please read this:
viewtopic/t172378/Sticky--Newbies-PLEAS ... STING.html

Please don't use imgbb, the pics from it are terrible, fuzzy, unusable.

Your sleep study could have been a false negative because you were sleeping in an alien environment, or, it could be that the cpap's guessing at what is a RERA is over reporting.

Snoring with a cpap means the pressur eis too low.

Read the 'pugsys pointers' post in the announcements section for help in interpreting the sleepyhead data.

[zonker]

hey, jonathon.

pls see pugsy's post above on how the experts want to see the graphs.

it'll help them see how you're doing and garner you lots of helpful advice.

good luck!

[JonathanZK]

Please read this:
viewtopic/t172378/Sticky--Newbies-PLEAS ... STING.html

Please don't use imgbb, the pics from it are terrible, fuzzy, unusable.

Your sleep study could have been a false negative because you were sleeping in an alien environment, or, it could be that the cpap's guessing at what is a RERA is over reporting.

Snoring with a cpap means the pressur eis too low.

Read the 'pugsys pointers' post in the announcements section for help in interpreting the sleepyhead data.

I actually did read the sticky, but apparently not closely enough.

And I sent an email off to my doc about the pressure settings. I'm a little nervous about making changes myself because I've heard that doing things wrong can result in collapsed lungs, and I would very much prefer to avoid that. Plus with the bilevel, I'm not really sure if I should be adjusting IPAP and EPAP together (eg, +X for both, or keep them in a percentage).

hey, jonathon.

pls see pugsy's post above on how the experts want to see the graphs.

it'll help them see how you're doing and garner you lots of helpful advice.

good luck!

I made the requisite adjustments (I think). Might I trouble you for a Yay/Nay judgement on whether this is correct?

[Pugsy]

Nay on the adjusted image.
Way too many graphs...makes them all so tiny we can't evaluate anything.

Only graphs needed from Respironics machine
Events
Flow Rate
Leak
Pressure....only if using auto adjusting pressures which you aren't because your machine won't/can't auto adjust anything.

If you aren't comfortable doing any changes yourself that's up to you.

[palerider]

Technically, "nay"...

Getting rid of the Resp rate, AHI, Tidal Volume, Minute Vent charts would allow others to be larger...

However, it is *much* better, and good enough.

I'd like to see the flow rate, pressure and leak charts larger, those are the important ones.

I'd bump your epap and ipap up by one, see if that'll tame some of those events.

[JonathanZK]

Nay on the adjusted image.
Way too many graphs...makes them all so tiny we can't evaluate anything.

Only graphs needed from Respironics machine
Events
Flow Rate
Leak
Pressure....only if using auto adjusting pressures which you aren't because your machine won't/can't auto adjust anything.

If you aren't comfortable doing any changes yourself that's up to you.

Not sure what you mean here, "Pressure....only if using auto adjusting pressures which you aren't because your machine won't/can't auto adjust anything."

Technically, "nay"...

Getting rid of the Resp rate, AHI, Tidal Volume, Minute Vent charts would allow others to be larger...

However, it is *much* better, and good enough.

I'd like to see the flow rate, pressure and leak charts larger, those are the important ones.

I'd bump your epap and ipap up by one, see if that'll tame some of those events.

Thanks for hanging in there with me. Is this one a winner?

[Pugsy]

Not sure what you mean here, "Pressure....only if using auto adjusting pressures which you aren't because your machine won't/can't auto adjust anything."

There are machines that offer modes of operation where the pressure varies throughout the night depending on what the machine is sensing.
Your model machine doesn't offer this mode of operation.
Your machine is what we call a fixed pressure machine.
Whatever tiny changes you see in that pressure line is nothing more than the Flex exhale relief changes showing up.

Not the best example (see the image below) but all I have handy at the moment showing how the pressure varies when using bilevel...note both EPAP/exhale and IPAP/inhale can vary or not vary much depending on what the machine was sensing.

If you had a machine that would auto adjust...it would increase the pressure in your situation because of the snores and the other stuff going on. The snores, RERAs and the obstructive stuff showing on the events graph all point to your pressure settings not holding the airway open well enough to prevent the airway from collapsing. Hence the recommendation for more EPAP and IPAP...hold the airway open better and hopefully prevent the airway from trying to collapse.

[JonathanZK]

Not sure what you mean here, "Pressure....only if using auto adjusting pressures which you aren't because your machine won't/can't auto adjust anything."

There are machines that offer modes of operation where the pressure varies throughout the night depending on what the machine is sensing.
Your model machine doesn't offer this mode of operation.
Your machine is what we call a fixed pressure machine.
Whatever tiny changes you see in that pressure line is nothing more than the Flex exhale relief changes showing up.

Not the best example (see the image below) but all I have handy at the moment showing how the pressure varies when using bilevel...note both EPAP/exhale and IPAP/inhale can vary or not vary much depending on what the machine was sensing.

If you had a machine that would auto adjust...it would increase the pressure in your situation because of the snores and the other stuff going on. The snores, RERAs and the obstructive stuff showing on the events graph all point to your pressure settings not holding the airway open well enough to prevent the airway from collapsing. Hence the recommendation for more EPAP and IPAP...hold the airway open better and hopefully prevent the airway from trying to collapse.

Thank you for your detailed response.

I have a feeling the bruise on the bridge of my nose is about to get worse as I amp up the pressure and clamp down the mask.

Maybe some time next year I'll get a new machine if I land a good account. The auto adjustment feature seems like a very useful tool.

[Okie bipap]

For the bruise on your nose, get some moleskin at your local drugstore. It is found in with the foot care items. It is made for reducing blisters. I would place a piece of it over the bridge of my nose before putting on the mask. I learned about this from the RT I worked with when I first started treatment. She said her husband used it every night. It worked for me when I used the Suimplus mask.