HELP! New Remstar Auto Report interpretation

Fifi · Post by **Fifi** » Thu Jul 21, 2005 7:20 pm

I have been on fixed cpap pressure 13 for many years I forget how many possibly 7.

I have never seen my original sleep study results (because I never had one done!)

Can anybody help me interpret my encore pro results?

I am not sure if they are good or bad and how I can improve on them.

Or if they are spot on and I should be celebrating for having such wonderful results. ( I have a bottle of red wine on stand by just in case).

The result summery for one night are as follows:
Summary:
Treatment mode: APAP 8.0-18 cm.H2O
AHI 4.5 events per hr
Usage 7.8hrs

Sleep disturbance details:
Total Obstructive Apneas: 30
OAI: 3.76
Total Hypoapneas: 5
HI: 0.63
Total NR Apnoeas: 1
NRAI: 0.13
Total Snores: 54
SI: 6.8
Total Flow Limitations: 9
FLI: 1.13
Total Time in Apnoea: 348 Sec. Average Apnoea Duration: 11.2 sec
Fraction of night in variable breathing: 19.6%

APAP Pressures:
Average Pressure:11.5 cm/H2O 90 percentile pressure: 13.9 cm/H2O

Any feedback would be greatly appreciated

Fifi · Post by **Fifi** » Thu Jul 21, 2005 8:09 pm

Hello

Is any body able to offer any interpretations?

wading thru the muck! · Post by **wading thru the muck!** » Thu Jul 21, 2005 8:46 pm

Your AHI results are higher than I find for myself, but they are within the "good" range of under five. The most important thing is how did you sleep and how do you feel in the morning.

Fifi · Post by **Fifi** » Fri Jul 22, 2005 5:10 am

Thanks for taking the time to respond wading thru.

I have only just received my new Remstar Auto with C-Flex and I am trying to get used to it.

C-flex feels really weird, even set on 1 it is making me feel sea sick. I have been using the c-flex for 6 days and have not become used to it yet so last night i switched it off and I think i slept better, so I think I will give it a miss for a while.

How I feel in myself is a really difficult question to answer. For 20 years my apnea has gone undiagnosed doctors were just baffled and it has steadily destroyed my life.

Since on Cpap things have greatly improved and I have slowly started picking up the pieces, however things are still not right.

I think I suffer hugely from 'brain fog', whether that is permanent damage from the brain being starved of oxygen for so many years but i am hoping possibly that with this new machine I could attempt to improve things.

Docs are all too busy to take any notice, I have been there done that and it does not work! I have been on Cpap roughly seven years. I have never had a proper sleep study. I was just given a machine and told try that and see how it goes.

At the end of the day, I suppose I need to consider myself lucky, that one doc by sheer chance, who had just done a course on which sleep apnea was mentioned, thought it might possibly be apnea.So it was finally picked it up after 20 years of doctors failing to diagnose.

It could easily have killed me, as I was so ill for so many years, and life had been reduced to a struggle to survive, living a day at a time.

I need to learn how to monitor and improve things for myself. Hope fully i will find the info that i need from these boards, as I really have nowhere else to turn to for help, that I can think of.

JL · Post by JL » Fri Jul 22, 2005 8:07 am

Fifi

As Wading said your results (AHI) are below 5 so you are in the good range... but since you have the capability to download and monitor your own data you could try tweaking the settings for even better results and hopefully to feel better as well. Many find that narrowing the range of pressure settings on APAP's gives them better results (less apneas/hyponeas). You could for example start with settings at 10-16 cm or even 11-15 cm and then check the results. In effect your doing your own ongoing sleep study to provide the best treatment settings for yourself.

To help you interpret the data you could also download Derek's MyEncore software which uses the EncorePro database to present your data in a much more understandable and useful manner...especially the AHI vs. Pressure chart. The software makes it much easier to do your own tweaking to establish the best settings for you. The software is now available through the first topic on this forum.

Hope this helps

Jim

Fifi · Post by **Fifi** » Fri Jul 22, 2005 8:18 am

Thanks jim

I have already downloaded dereks software which provides very useful info.

I will start by narrowing down the range as you suggest 10-16 tonight and see what happens.

Many thanks for your input it is greatly appreciated.

Simply Sue · Post by **Simply Sue** » Fri Jul 22, 2005 9:29 am

FiFi,
I learned alot about understanding Sleep Apnea results by reading the CPAPopedia at the top of the screen.
Susan

Fifi · Post by **Fifi** » Fri Jul 22, 2005 2:39 pm

Sue

I have been there before, however in the excitement of receiving my new machine I completely forgot of its existence.

There is some very useful info there, thank you for pointing me in that direction.

rested gal · Post by **rested gal** » Sat Jul 23, 2005 3:01 am

Fifi, I agree with JL that narrowing the range - especially by raising the lower pressure - might be helpful. JL's suggestion of putting the lower pressure up to 10 for awhile (as you indicated you plan to do) sounds good to me.

There's nothing wrong with turning off C-Flex if you sleep better without it. That's the beauty of that particular autopap - C-Flex is there if you want it, but can be turned off if you don't do well with it.

Fifi · Post by **Fifi** » Sat Jul 23, 2005 3:22 am

Thanks Rested Gal

I turned my pressure range down to 11-16 cm H2O
My AHI has gone down to 1.9 events hr, which I guess is good.

However my Hypopneas have increased from 5 to 8
So HI index has gone from 63 to 96

I do not have much info on Hypopneas. Is there an ideal range does any one know?

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): AHI

rested gal · Post by **rested gal** » Sat Jul 23, 2005 4:12 am

Fifi, an AHI of 1.9 is not just "good"...it's great!

You can expect variations from night to night, so don't worry if tomorrow night the AHI is 3.something, and the next night something else. As long as the AHI is staying below 5, you're doing wonderfully well.

I also wouldn't worry about hypopneas being 8 vs 5 , or 10 or any other numbers of them on any given night...if the total AHI stays 5 or below. The hypopneas are counted into the total AHI (Apnea/Hypopnea Index) and your total AHI was excellent at 1.9.

I used to get worried if the AHI went up a point or two. I'd think, "OMG, I need to TWEAK something for the NEXT night". You can end up like a dog chasing its tail, and worrying over nothing. It probably would go back down on another night even if you did nothing different to the settings. There will be variations in the AHI from night to night - sometimes by several full points. That "just happens". Some nights it might just reflect more time spent in one sleep position or another. The variations are normal. Not to worry if it stays 5 or below.

There can also be variations in the data depending on what mask you use. Again, no need to worry as long as the AHI is staying decent.

The main thing is, how do you feel in the morning, before you even look at the data. I feel the same (good) whether my AHI from the night before was under 1.0 or was 4.something (rare for me - mine's usually under 3.0.) I always see more hypopneas and/or limited flows than anything else on my charts. I don't really worry about which type of events were showing up in a decent AHI - as long as I feel good.

Also, we can get very hung up on "what's the AHI?". There are soooo many other things than just apneas/hypopneas and limited flow that can disrupt sleep. Sometimes we forget about making our entire sleep environment restful - including a good mattress, comfortable room temperature, etc. And then there's always a squirrel to run across the roof, a dog barking, a car starting, a door slamming, possible aches/pains from other ailments...many things to disturb sleep that have nothing to do with OSA. Lots of pieces to the puzzle.

Guest · Post by **Guest** » Sat Jul 23, 2005 5:55 am

Get an integrated humidifier. The humidifier that you are presently using requires an extra 3 foot hose connector. An auto machine will NOT function accurately with that type of humidifier. The 3 foot hose causes pressure in the water chamber which, in turn, causes movement of the water. The movement is interpreted, by sound, as a snore in the Auto machine and you will get incorrectly elevated pressures. The Remstar has also recently added a baffle to the inside of their humidifier....not on the original integrated humidifier. The baffle is to "prevent water from backing up into the unit." At least, that was the reason given. However, it could also be used to deaden the noise in the humidifier chamber just as an acoustical barrier does on other electronic equipment. I was using the same humidifier as you and my levels kept spiking no matter what mask I used or what I did. After over a year of this, I accidentally mentioned to the doctor that I kept knocking the humidifier on the floor or yanking it around.He had me write down exactly what my equipment was and compared it to his original prescription. The prescription had NOT been followed and the DME had substituted the humidifier. He point blank told me that to get accurate readings with an auto, it is extremely important to use the compatible equipment. An extra 3 foot hose will make a difference, as will ambient noise, as will condensation in the hose. An easy way to check it out is to simply remove the humidifier and extra hose and connect your interface directly to the machine. Do this for several nights and then compare your results. After a rather heated conversation with the DME, I received a new integrated humidifier.....my levels are now running between 5-6, with a high around 8. The snore index dropped from in the 20s to 7. The Auto CAN be a good machine if used properly. Leave the CFLEX off if it is bothering you......sometimes it is just annoying until you can get used to it. I am presently involved in a study to see if changes in CFLEX level affect pressure levels. That is a topic that is being quite heatedly disputed. But one thing is certain with an auto.....ambient noise will affect the readings. Also, even minor amounts of condensation in the hose can cause drops in the pressure.....the actual reading on your machine will not change but the pressure inside your mask or nasal interface can drop up to 6 points. It is a quandry, with no easy solution. Just learn to experiment by adding, changing, removing, altering equipment and document on your downloads what changes were done on any specific night. Also, do not make a change based on 1 night.......you need to use the same equipment for at least a week to compare the variances before making any further adjustments. It takes a while but eventually you will get the combination you need. It does not happen magically overnight in a sleep lab either. Good Luck!

JL · Post by JL » Sat Jul 23, 2005 6:15 am

Fifi

Appears the range adjustment may have helped your overall AHI but like Rested Gal said many things can cause day to day variations. I'd give it a few days at that setting to see if you have a consistent AHI before you do any additional minor tweaks to settings. Again zero in on the AHI vs. Pressure setting chart in MyEncore to see what range gives you the lowest overall apneas/hyponeas.

Congrats

Jim

Fifi · Post by **Fifi** » Sat Jul 23, 2005 7:01 am

Thank you guest.

I bought the machine with the integrated humidifier, however I love my fisher and paykel stand alone humidifier. The humidifier is fixed to a Fisher and paykel tray which sits under the auto pap and the humidifier.

So the humidifier does not move or budge in any way, as it is screwed to the tray.It uses an additional two foot connecting hose.

With the integrated humidifier, it is not possible to use the additional respironics hepa anti bacterial filter that I currently use with my fisher and paykel. I have severe dust and pollen allergies and the hepa filter helps.

I hear from the boards that the integrated humidifier gives off a lot of moisture and I am not sure if it can be regulated. (I have not even looked at the instructions of how to use the integrated humidifier as yet).

The thought had crossed my mind that the separate humidifier may affect the readings. So I will soon start to use the integrated, but I just want to get used to the new machine before I do that.

Many thanks for your imput.

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CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, humidifier, fisher and paykel, auto

Boomer · Post by **Boomer** » Sat Jul 23, 2005 7:18 am

C-flex feels really weird, even set on 1 it is making me feel sea sick.

Just fyi...I misundersood this in the manual when I first read it. A setting of 1 does not directly relate to a pressure, but is actually the least amount of relief on exhalation, 3 being the most amount of relief.

Boomer

Mask	Humidifier

HELP! New Remstar Auto Report interpretation

HELP! New Remstar Auto Report interpretation

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