1st Night - Gonna call it a success...2nd night update...

[SharkBait]

Stuff showed up yesterday, hooked her up, ate dinner, watched some TV, and went to bed early...

Sleep clinic showed an AHI of 74 (didn't break down AI/HI, but tech at the lab said AI ~60...) and blood oxygen saturation as low as 81%. These numbers were a concern to my Dr. I was titrated to 10 cm h2o, so I set apap at 8-12, Aflex at 2, Humid set to 2.

My usage shows 12 hrs 20 minutes, but I read a bit so I'd say I slept a little over 10 1/2 hours. I was a tired puppy. Had a bit of a sore throat (usually indicative of sinus infection for me...) yesterday so I took some Benadryl around 6:00 PM and also woke up at around 1:00 AM and took another dose.

Here are the #'s...

Avg 90% Pressure = 10.0
Avg Pressure = 8.9
Non-Responsive AHI = 0.0
Avg AI = 1.0
Avg HI = 1.9
Avg AHI = 2.9
Avg Flow Limitation Index = 1.0
Avg Vibratory Snore = 5.0
Avg Max Leak = 56.0 LPM
Avg 90% Leak = 32.0
Avg Leak = 26.2
Avg Large Leak = 0

These Leak rates seem high. Can't argue with the results, but do these leak rates need attention? I put the mask on with medium size pillows. As I feel around the mask I don't feel any air escaping, but there is a vent right on the front and it's just a constant air flow. I can certainly see that flow of air coming out of the vents filling 26 LPM, so maybe that's just the nature of my mask.

Mask was very comfortable. I kept the hose pointing down instead of running it up over my head. I had some strap marks on my face and my nose had a bit of tenderness, but nothing severe on either front. At the clinic I used a nasal mask that was leaking out the top resulting in my eyes burning from all that air. In comparison, I loved this nasal pillow mask. I'm sure with use my nares will toughen up. They aren't sore per se, but there was a bit of tenderness when I first got up that is going away as the morning wears on...

I'm guessing about half the night supine, half on my side. I consider myself a mouth breather when I sleep (every morning I wake up with very dry mouth), but it seemed like my mouth stayed closed all night (same as at the sleep clinic). When I did open my mouth, the air flow would awaken me and I would shut it and quickly fall back asleep. This only happened a couple times at the clinic and maybe once last night (that I remember). My mouth wasn't dry this morning like it usually is...

Should I be concerned with the leak rate? (Never mind, I found the flow rate chart ~26 is right in line...)

What is the Vibratory Snore Index? I don't see a unit of measure for that figure.

Was 10 cm an accurate titration or is this showing that it is closer to 9? Either way I'm happy with my auto setting of 8-12 and was thrilled with the exhale relief!


P.S. Thanks for everything you guys do!!! I was able to order my stuff with confidence (form apap.com) and was armed with tons of info on how to proceed.

[elader]

as a relative new guy who has been watching his numbers for a while and who had sleep study numbers almost identical to yours, I can safely say "WAY TO GO GUY!"

Your numbers look very nice... actually really really nice. You can consider buying the card reader so you can actually see events and leaks. The vibratory snore is supposed to be a prelude to an event, but can also be caused by leaks or mouth breathing. Live with your settings for a while.

You can find the leak rate for your mask and pressure with the docs that came with the mask or on the mfg web site.

[Gerald]

Shark.......

You've hit the ground running......and you'll do well.

Congratulations!

[SharkBait]

as a relative new guy who has been watching his numbers for a while and who had sleep study numbers almost identical to yours, I can safely say "WAY TO GO GUY!"

Your numbers look very nice... actually really really nice. You can consider buying the card reader so you can actually see events and leaks. The vibratory snore is supposed to be a prelude to an event, but can also be caused by leaks or mouth breathing. Live with your settings for a while.

You can find the leak rate for your mask and pressure with the docs that came with the mask or on the mfg web site.

Thanks elader,

I've got the card reader and the Encore Pro 1.8.49. Nice benefit to the software: it encourages me to stay compliant so I can see a good report the next morning. Although I gotta admit I wasn't in any danger of not complying. My mask was VERY comfortable especially considering 1st time use, and my APAP was treating me right. I have no idea what I was using at the clinic when being titrated, but it had basically no exhale relief and that was quite disturbing.

Okay, found the leak rates and it looks like the mask is rated a tad over 30 LPM @10 so I'd say I'm right where I need to be on that. I could have sworn I've seen < 1 leak rates reported, but I guess that's after doing the math...

[Georgio]

Congratulations, that was a very good first night.

I come up with the following:

Your avg. pressure is 8.9
Your avg. leak is 26.2
From the vent chart: vent rate at 8.9 is about 29.

This would mean that your actual leak rate is less than the mask vent rate, which should be very good.
This is consistant with my results with the same mask.

Someone please correct me if I'm wrong.

[SharkBait]

Shark.......

You've hit the ground running......and you'll do well.

Congratulations!

Thanks Gerald,

I think I'm blessed with the ability to sleep. The blue lights are no problem to me (eyes are closed anyway...). The mask on my head, while not ideal (I'd prefer nothing...) doesn't present a huge problem for me. And the noise from the CPAP is basically white noise as far as I'm concerned.

I'm not thrilled with the idea of sleeping with this thing for the rest of my life, but it is what it is. I want to see my kids have kids, so xPAP it is for me...

[SharkBait]

Congratulations, that was a very good first night.

I come up with the following:

Your avg. pressure is 8.9
Your avg. leak is 26.2
From the vent chart: vent rate at 8.9 is about 29.

This would mean that your actual leak rate is less than the mask vent rate, which should be very good.
This is consistant with my results with the same mask.

Someone please correct me if I'm wrong.

Thanks Georgio,

From what I've seen this morning I think you're absolutely right. I kept feeling around the edges for air because I was thinking, "this can't be right. It feels too comfortable.".

[BeanMeScot]

I have the exact same set up. The mask is very comfortable. You are off to a great start. Definately keep everything the same for a while.

[Gerald]

Shark.....

Your sub-conscious mind (the one that's in charge while you're asleep) has agreed to this project.....and that makes all the difference.

Looking at it in a "mechanical" way instead of an "emotional" way....will guarantee your success.

When I first started out, the "tech" gave me a cheap mask....which bloodied the bridge of my nose (after about a week).

I immediately changed masks....and that allowed me to continue.

So....be careful of fitting your mask too tightly. If you have a red spot, that's a "caution flag".

Because I use a nasal mask that's different from yours, I can't offer much advice.

There are others on the forum who'll help you, though.

[Georgio]

A lot of that comfort is provided by your M-series. Sometimes I think it's not even on. The swift LT mask is my third try and most comfortable, maybe it will be your favorite mask too!

[SharkBait]

Shark.....

So....be careful of fitting your mask too tightly. If you have a red spot, that's a "caution flag".

I'm going to loosen it just a tad. I had virtually zero leakage so I can probably afford to loosen up...

[SharkBait]

I had an observation. My "snores" seem to have mostly occurred while I was reading. I'm having a bit of a cough, so I'm guessing those coughs will register as snores?

Also, can someone give me an idea of what Flow Limitation Index is and what an ideal/acceptable/bad score would be? I found a paper on this index, but it was like asking what time it is and someone telling you how to build a watch...

[Gerald]

Shark....

I'm not using the same mask as yours....but, my "nasal pillows" look almost the same as yours.

I "grease up" my nares with Lansenoh Lanolin evern night.....It comes out of a tube.....and I use about a 3/8" ribbon to do both nares.

Lanseoh is for "nursing moms"....so, if it's safe for mommies.....it certainly won't hurt my nares! You'll find it in the "supplies for nursing moms" section of the drugstore.

The benefit is....that the lanolin helps make the pillows seal better.

Also....I don't wipe the residue off in the morning....I spread it all over my morning beard stubble....and find that it makes my electric razor do a better job.

I've been using it for a couple of years......and I wouldn't want to do without it.

[rested gal]

I could have sworn I've seen < 1 leak rates reported, but I guess that's after doing the math...

That would have been with ResMed machines, for which 0 is an ideal leak rate. They report "leak" differently than Respironics machines do.

I had an observation. My "snores" seem to have mostly occurred while I was reading. I'm having a bit of a cough, so I'm guessing those coughs will register as snores?

They could, yes.

Also, can someone give me an idea of what Flow Limitation Index is and what an ideal/acceptable/bad score would be? I found a paper on this index, but it was like asking what time it is and someone telling you how to build a watch...

I personally wouldn't worry about that index at all. "Ideal" would be none, but I don't think there is any particular number that's considered "bad" or whatever. I wouldn't worry about the FL's no matter how many were "counted."

Flow limitations could be described as hypopnea wannabes. Some restriction of airflow, but not bad enough to warrant calling them hypopneas. The threshold for "hypopnea" in most cpap machines is a 50% reduction of airflow, I think (might be wrong) for x number of seconds. I don't know how much restriction there has to be for the machine to call it a "flow limitation", but not a hypopnea. At any rate, I'd think you're still getting plenty enough air through with what the machine calls a "flow limitation" to not need to be concerned about those. If I saw them clumped all across the session on the Daily Details graph, I'd probably raise the min pressure another cm. Nights with nasal congestion might show up more "flow limitations" than usual. No big deal, imho.

Your numbers look extremely good, Shark Bait. You're off to a very good start!

[Sleeptech010110]

Incredible first night, congrats:-)

Your sleep tech would be proud:-D