My First night with a CPAP machine numbers

[BG50]

A little background: did a take home test in 2015 and was diagnosed with severe sleep apnea with 65 AHI. I have gained about 100lbs in 11 years after getting married and definitely one of the reasons I have apnea has been my weight gain. I never experienced sleep apnea before in my life. Doctor gave me a Philip's machine back in 2015 and I couldn't even fall asleep with it. Tried on 10 different occasions to sleep with it and I couldn't even get to sleep. I angrily returned it to the medical company and I said I cannot use a cpap machine.

Fast forward to the pandemic and I really started to think about other options on treating my CPAP. Had a family trip with extended family and everyone was very upset when they heard me sleeping. I tried an oral appliance and to me thats even more invasive than a machine. Tried provent and provent seemed to help a little bit but it I was still stopping for long period of time with the provent. Provent is no longer in business so it doesn't seem to matter.

Went to my new doctor and saw a second one as a second opinion. The second opinion doctor told me I have large tonsils that can be removed but it would solve ONLY 20% of my problems. She also said it's probably not the way to go to solving my sleeping problems. Basically cpap is my only option. I am giving CPAP another shot and the doctor this time gave me an AirSense 10. I purchased it so I didn't have to go through the BS with the insurance company.

Last night was my first night with the machine and this is what the ResMed had to say:

USAGE hours: 5:58
Events per hour: 5.3
MASK seal:
Humidifier:
Pressure: 13 (my range is between 4 and 20)
Leak: 37L/min
AHI: 5.3
Total AI: 3.6
Central AI: 2.0

I woke up to go the bathroom and it was already 6AM. I normally used to go to the bathroom 2 to 4 times per night. I simply could not believe it. I have not had a sleep like this in years. Took my 10 tries to be able to fall asleep.

Makes me very optimistic I can do this.

Can someone help me with the numbers.....is the AHI high for a machine and what about the leakage?

Thanks everyone

[Pugsy]

Events per hour: 5.3
MASK seal:
Humidifier:
Pressure: 13 (my range is between 4 and 20)
Leak: 37L/min
AHI: 5.3
Total AI: 3.6
Central AI: 2.0

Can someone help me with the numbers.....is the AHI high for a machine and what about the leakage?

Makes me very optimistic I can do this.

I will explain those numbers seen on the machine in a bit.

First of all...lets get you prepared to see even more details that the machine can provide.

Get this software
OSCAR https://www.sleepfiles.com/OSCAR/
http://www.apneaboard.com/wiki/index.ph ... stallation
http://www.apneaboard.com/wiki/index.ph ... rpretation

and for optimal advice post the detailed report that shows more useful stuff
see this thread for formatting of the graphs. The machine gives you a lot more data than we need to see and OSCAR shows that data. It's a bit overwhelming. Let's start with the basics.
viewtopic/t158560/How-to-post-images-for-review.html

Pressure: 13 (my range is between 4 and 20)
Leak: 37L/min
The machine reports leaks and pressure in what we call 95% numbers and all that means is you were at OR BELOW that number of 95% of the night. It is NOT where you spent 95% of the night and it is NOT an overall average.
I have a good thread that explains why the 95% numbers don't always tell the whole story here. I had a 48 L/min 95% number but while the leak numbers themselves looked bad...the actual time in large leak wasn't really all that much compared to the rest of the night.
https://www.cpaptalk.com/viewtopic.php? ... t#p1036669

For your point of reference 24 L/min is ResMed's line in the sand where they start large leak territory flagging.
When you go into large leak territory they tell you that the machine's ability to sense, record and respond can be negatively impacted but up to 24 L/min they tell you they can easily compensate for leaks.
In real life the machine does a decent job up to around 35 L/min and then things start getting iffy...the deeper you go into large leak territory the iffier it gets.
Your machine reports only excess leaks. There are other brands that report different leaks including the mask's vent rate but ResMed machines remove the vent rate leak from what they report.

When it comes to leak evaluations I look at how deep did I go into large leak territory...how long was I there...and did the leaks wake me up or not. Large leak territory....your therapy isn't in the toilet at 30 L/min.....the machine will still do a fairly decent job. Now if you are deep into large leak territory with 50 or 60 L/min and stay there for 2 or 3 hours...we got a problem.

Actually for a first night.....I think you did quite well.

As for the AHI numbers

AHI: 5.3
Total AI: 3.6
Central AI: 2.0

Since I know what these mean I can see what the OSCAR report will show.
Central apnea (CA/clear airway on Oscar)...is 2.0 or 2 per hour average. Not going to worry about that number for a couple of reasons...one being there very likely is going to be some awake breathing false positives in there and two being we really can't do much about centrals...and three is the fact that there aren't enough of them to worry about anyway.
A few centrals are NORMAL to have and no cause for alarm.

Total AI...3.6 and since we know that AI is a total of central apneas and obstructive apneas that means 1.6 per hour of the AI (apnea index and index is hourly average) were obstructive apneas. 1.6 isn't a bad number at all especially for the first night but maybe a little higher than we would want to see every night. More on that later.

AHI is the apnea hyponea index and you don't see hyponea index on the LCD screen but it will be available on the OSCAR detailed report. It's going to be around 1.7 hyponea index because if we take the overall AHI of 5.6 and subtract the AI index the remaining is going to be hyponea index...or 5.3 minus the 3.6 AI index...leaves 1.7.

Once you post the detailed report I can explain further but really need to see that detailed report first.
I suspect that you need an upward adjustment in that minimum pressure but we need to first see the detailed report AND importantly you need to tell us if there is a period of time that you know you were awake. It's very likely there are some awake breathing false positive flagging that is going to muddy up the evaluations a bit.

Please don't assume that because your 95% pressure number is 13 that you need a minimum close to 13 because it simply doesn't work that way at all.

You did great for a first night. Better than I did on my first night...and you can for sure do this.
We like to see the AHI well below 5 in terms of the obstructive stuff (OAs and hyponeas) but we don't expect it the very first night or even the first week.

[BG50]

I appreciate the help and will get the OSCAR going

When I tried the dreamstation 6 years ago things were very different. I was very very angry that I had to sleep with a mask......thought my wife might make fun of me and think I was a loser......blah blah blah. I hated it and already was angry about it before even try it.

That definitely affected me in not being able to sleep with it.....deep down inside I didn't want it to work so I didn't have to use it

Fast forward six years and I know that it really is the best option.

Now that I have seen the other side and felt what sleeping all night with it can make me feel in the morning.....wearing the mask does not feel like a big deal at all. I completely have a new focus on using this after having one night of success.

[Pugsy]

Attitude, attitude, attitude.
The one thing that sometimes is really hard to fix when it is a negative attitude.
I predict you will do very well and eventually using the mask and machine will just be a routine part of your day/night.
If you look at the big picture it really is a rather benign way of taking care of a health problem. Certainly not nearly as invasive as if you were treating diabetes or some other 24/7 respiratory problem or whatever. No surgery is involved and you only need the assistance when asleep.

Understanding the detailed reports and what to do or not do...is a bit of a learning curve but nothing you can't handle.
It's really not rocket science at all.
Mostly it's common sense. Though I will admit that there is a fair share of people out there that are short on common sense.

Now does that mean that you will always have smooth sailing....of course not. We all have bumps in the road for various reasons from time to time and we don't even sleep the same each night.
I have been on cpap 12 plus years now and I still get a bumpy road night every now and then.
Accept it and move on and don't dwell on it and don't target just the numbers you see.
Always, always factor in how you sleep and how you feel in general. Remember that sleep itself is the critical component because without sleep the rest of this stuff doesn't really mean squat.

Nice low numbers don't equal perfection and sure don't guarantee feeling good and sleeping good.
Likewise higher numbers don't necessarily mean your therapy is in the toilet.
All this you will learn as you go.

It's all about progression much more than perfection.

And don't beat yourself up too much for your past failed attempt at cpap. That's water under the bridge and your feelings are very common. The important thing is you are here now.

When you have time could your edit your profile's signature line to reflect your model of machine and mask you are using?
It helps us if we can see at a glance what you are using.
See my signature line for an example.
We used to have the equipment profile thing that people used but it's broken and doesn't work and hasn't worked in a long time...I don't see it being fixed.
So we use the signature line instead.

[BG50]

Attitude, attitude, attitude.
The one thing that sometimes is really hard to fix when it is a negative attitude.
I predict you will do very well and eventually using the mask and machine will just be a routine part of your day/night.
If you look at the big picture it really is a rather benign way of taking care of a health problem. Certainly not nearly as invasive as if you were treating diabetes or some other 24/7 respiratory problem or whatever. No surgery is involved and you only need the assistance when asleep.

Understanding the detailed reports and what to do or not do...is a bit of a learning curve but nothing you can't handle.
It's really not rocket science at all.
Mostly it's common sense. Though I will admit that there is a fair share of people out there that are short on common sense.

Now does that mean that you will always have smooth sailing....of course not. We all have bumps in the road for various reasons from time to time and we don't even sleep the same each night.
I have been on cpap 12 plus years now and I still get a bumpy road night every now and then.
Accept it and move on and don't dwell on it and don't target just the numbers you see.
Always, always factor in how you sleep and how you feel in general. Remember that sleep itself is the critical component because without sleep the rest of this stuff doesn't really mean squat.

Nice low numbers don't equal perfection and sure don't guarantee feeling good and sleeping good.
Likewise higher numbers don't necessarily mean your therapy is in the toilet.
All this you will learn as you go.

It's all about progression much more than perfection.

And don't beat yourself up too much for your past failed attempt at cpap. That's water under the bridge and your feelings are very common. The important thing is you are here now.

When you have time could your edit your profile's signature line to reflect your model of machine and mask you are using?
It helps us if we can see at a glance what you are using.
See my signature line for an example.
We used to have the equipment profile thing that people used but it's broken and doesn't work and hasn't worked in a long time...I don't see it being fixed.
So we use the signature line instead.

I appreciate the help

I will get all that stuff uploaded on here