last night's sleep report--why so many events?

[svh]

SO, last night my AHI was 1.6, which is high for me--I tend to average around .5, but have been higher the last few days, and have been tired and headachy. I'm wondering if I've got my machine set optimally, and hoped some of you might have suggestions.

Here are the pages from last night's reports:







Thanks very much to anyone who has advice!

---Sarah

[KatieW]

An AHI of 1.6 is very good, but if there is an upward trend, you might want to do some analysis. But, if it's an isolated "bad night", and it gets better the next night, don't worry about it. I used to get those once a week, now its once a month.

Your reports are difficult to read. I find that seeing the data on the Detailed Report, it's much easier to correlate the events. How to do this is: do a screen shot of your Detailed Report, zooming in for a 30 minute view of the apneas in the bottom screen. Then save it as a jpg. Upload it to a Photo Bucket account, then paste the link into your post. The report will show up as part of your post--click the Preview Button before posting to check this.

What is your current pressure and EPR setting? And what is your 95 percentile? (on the Statistics Page).

Your increase in apneas could be: positional (sleeping on your back, or dropping your chin), having more REM sleep requiring a pressure adjustment. Or it could be non-cpap related, such as stress, diet, exercise, sleep hygiene.

[svh]

Sorry the reports were hard to read. I'll try to do what you suggested tonight, when I get off work. I really appreciate the help!

[Emilia]

Actually, using Picasa provides a url for the image. I grabbed the image url and posted the event page here:

[dave21]

Looking at your graphs the Apneas aren't related to leaks, so it looks like as Katie suggested it's probably positional related, maybe sleeping on your back.

Around the big cluster of obstructive apneas along with the central apneas between 3am and 4am you can see you went into snore mode, so it's quite possibly your pressure isn't high enough.

What is your titration pressure supposed to be set at? The pressure graphs suggest you're using the S9 at the base requirement of 4cm which seems to me a little low. If you're titration is say 10cm then you would be better to up the minimum pressure closer to 10cm to keep the apneas at bay. You might want to talk to a doctor though before changing these unless you're confident.

If you're usually at AHI=0.5 and it's only 1 night at AHI=1.6 then I wouldn't worry too much, we all have nights like this. You differ from the norm/average from time to time. If you find it consistently stays at 1.6 or goes higher, e.g. above AHI=5 then you need to take a greater look.

Thanks
Dave

[svh]

I've set my machine to run from a minimum pressure of 6 to a maximum of 12. Last night, I got these results:

AHI 1.1
Pressure: Median 6.4, 95% 9.0, Maximum 10.6

So, do you think 6-12 is the right range? I've never had an autoset before.....

Thanks!

--Sarah

[Emilia]

And AHI of 1.1 is great! Congratulations!! It appears that is a good range. I have mine set at 6.5 - 10 and I usually have a 90th %tile of 7-8. Last two nights, my AHI was 0.95 and 1.1. As long as you keep monitoring your data you should be good to go!!

[dave21]

I've set my machine to run from a minimum pressure of 6 to a maximum of 12. Last night, I got these results:

AHI 1.1
Pressure: Median 6.4, 95% 9.0, Maximum 10.6

This would suggest that for 95% of the time the pressure is at 9cm and at some point through the night the machine ramped up the pressure due to you having apneas up to 10.6cm. If you wanted to reduce the likelihood of getting obstructive apneas then it might be better to increase the minimum pressure to something like 8.5cm so it has a quicker response time to increasing the pressure to respond and reduce the time in an obstructive apnea.

So, do you think 6-12 is the right range? I've never had an autoset before.....

You should leave the maximum range at 20cm unless you have been told to reduce this. Many people misunderstand the maximum figure, its there as a maximum. So by reducing it to 12cm you are limiting the maximum ceiling. If you have apneas that require a pressure greater than 12cm to assist and reduce the time you are in an apnea then the machine will not be able to respond by increasing the pressure as you have set a fixed upper limit to the machine. The only time when you would want to reduce the maximum is if a sleep doctor has prescribed it, e.g. you suffer from pressure induced central apneas, or physically cannot stomach a pressure above a certain limit, e.g. As it cause problems with your lungs or you end up swallowing the oxygen instead.

Note that playing with the pressure on a large scale can in some people induce more central apneas. If you find this then you should reduce the pressure. Ultimately it's best to talk to the sleep doctor but not all of us have good sleep doctors.

Hope this helps!

Thanks
Dave

[svh]

Thanks VERY much! I really appreciate the guidance. I'll up the minimum, and let the max go to 20 tonight.

[dave21]

Thanks VERY much! I really appreciate the guidance. I'll up the minimum, and let the max go to 20 tonight.

Just remember that if the AHI is under 5 then the treatment you are getting is working to keep most of your apneas at bay. You can keep tweaking the pressure to on average reduce the AHI even further but make subtle changes and try it for a week at a time to get a good baseline. Each night figures can change for other reasons like rolling onto back or just having your muscles relax more so you need to try changes over a longer period of time.

You might also find the info I have put together at http://www.osahelp.com useful on changing pressures and examining graphs. Good luck!

Thanks
Dave

[svh]

Thanks SO much--what a great compilation of information! I've saved it for further reference.....

[LoQ]

Thanks SO much--what a great compilation of information! I've saved it for further reference.....

I know, I think it's a great page and have passed it on to other people, too.

Thanks, Dave, for that information. While it's not exactly Lab Rat material, it deserves some sort of award, at least for generosity of sharing your time and effort to help others. For that, I commend you.

[dave21]

Thanks LoQ, that made me smile this morning!

[kaluchka]

How is it possible to get such a nice report?! Do you have to make any changes to the software? (using 3.10)

[LoQ]

Thanks LoQ, that made me smile this morning!

You deserve it. That's a wonderful page, and it's clear that you put a lot of effort into it, and you've organized the information in a way that is very helpful.