Graphs...Charts..Data...Oh My!

[SnoozyQ]

Can someone help me with my S9 Elite data? What does it all mean?!?!

Started use in Sept? but bottom chart shows 2 weeks, per my selection.

[Roman Hokie]

Several people here will be able to help. It would be beneficial if you uploaded screen shots to a post. However...

Since the forum doesn't permit images to be uploaded, you'll have to put them online somwhere and link to them. If you don't have another area in which to do it, I suggest http://www.dropbox.com (you can put public images there for linking) or http://www.picasa.com (or any other image-hosting site).

[SnoozyQ]

Hmm...I uploaded to Flickr and used the IMG tag....are they not showing up? They are for me

[Julie]

Hi, they do show up and it looks like you're doing great - the AHI (top pg) is consistently very low and it's the most important number. Otherwise, what I saw is that it looks like your pressure is set at a straight "10", but I wonder if you had an Apap (auto vs cpap) machine if the numbers wouldn't go higher on some nights because there are only a few that are just a bit lower, and using Apap allows the pressure to be more flexible in catching apneas higher than the scripted pressure when necessary. As well, an auto machine lets you set it to 'only' cpap if you want, but gives the option to use the 'auto', where your machine only uses cpap. Have you talked to your MD about a change?

[robysue]

Here's some help in interpreting the summary data you posted SnoozyQ.

First, the graphic summaries give you visual data for each day in your summary period, which is Sept. 14 to Nov. 5 in this screen shot.

The orange data is "compliance" data. The length of each orange bar indicates how long you used the machine each day. Days with mulitple orange bars are the days where you turned the machine on and off more than once. Sometimes if a given "mask event" is too short, it will show up as a thick black line.

The bars in the next chart represent your daily AHI and AI numbers, where the AHI and AI are computed on a noon-to-noon basis. The red sub-bar is your daily AI number: The S9 counts the number of apneas it detected and divides by the total number of hours the machine was run. The S9 tends to truncate fractions at the first decimal instead of rounding to the first decimal. So for example, if the S9 detected 10 apneas on a day the machine was run for a total of 6 hours, the AI would be listed as 1.6 even though 10/6 = 1.666667 = 1.7 if you round like you learned in grade school. The length of the white sub-bar on top of the red one represents the HI for the day---the number of detected hypopneas divided by the time the machine is run. So the total length of the red+white bar is the AHI for the day. Again, the AHI is the total number of apneas + hypopneas detected divided by the time the machine was run. The days where there is no red or white bar are the days where the S9 detected either no events, or so few events that the computed AHI and AI were both 0.0.

The blue bars in the next chart are for the pressure the S9 was running at. Since you're S9 is an Elite, which is straight CPAP, I don't really understand why a few of the bars are indicating that your median, 95%, and max pressures are not all equal to your prescribed pressure setting of 10cm. Maybe on those days, you were using the ramp really frequently?

The green bars in the last chart are for your leak data each day. Since there is NO dark, dark, green bar at the bottom of any of these bars, that indicates that your median leak rate on all the days shown is either equal to 0.0 or so close to it, that I can't see the dark green bar. The medium green bar represents your 95 percentile leak rate for each day. To my not very experienced eyes, your 95% leak data looks pretty decent---there's only one day where your 95% leak rate] is over 10 L/min. The light green bars represent your maiximum leak rate for each day. They're all over the place. Looks like some days you have at least one or two really bad (but short) leaks and other days you don't. The days where there is NO green bar at all are days where you hit a grand slam homerun in the leak department: You're median, 95%, and maximum leak rates are all 0.0 on those days---such as Nov. 2 and 5.

The numerical data in the second screen shot gives you summary data (averages) for the entire two week period that you selected. It's not yet clear to me if ResScan simply averages the daily numbers [i.e. adds up each of the daily numbers and divides by the number of days] or if ResScan does something more sophisticated in order to take into account the differing number of hours the machine is run each day.

[SnoozyQ]

Thanks I appreciate the help!!!

So....why don't I feel any better???

[robysue]

Thanks I appreciate the help!!!

So....why don't I feel any better???

There are several of us here on cpaptalk.com who started CPAP around the same time you did give or take a month or so who are wondering the exact same thing, including me.

In trying to answer this question, it might help to know what kind of symptoms you were experiencing before starting CPAP and how you're feeling now as well. Any small improvement in any of your pre-CPAP symptoms? Any new symptoms since starting CPAP? Any obvious problems with starting CPAP---other than some occasional problems with nasty leaks?

[SnoozyQ]

Previous symptoms:

Difficulty staying asleep/waking up many times during night
difficulty falling asleep
severe fatigue
severe daytime sleepiness
non restorative sleep

Symptoms are the same now, EXCEPT that I sleep at night--so I can fall asleep and stay asleep. But I don't wake up feeling like I've rested. I wake up to the alarm and I'm thinking "No!No!No! I can't be done....I just can't". Sometimes I can get up and go, sometimes I can't.
I think I may ask for more sleep now than I did prior to treatment....I can wake up after 12 hours, and need a nap an hour or 2 later. I never feel better afterwards though.
I'd say my ability to function has decreased....I want to stay home and sleep.

[robysue]

SnoozyQ,

Have you mentioned the fact your symptoms other than not being able to sleep through the night have not gotten any better to your doctor? Have you had a follow-up meeting with either the doctor or his/her PA or nurse to talk about how therapy is going? If not, then try to set up an appointment. Call the office and tell the receptionist that you're have some serious problems adjusting to CPAP and that you need to talk to the doctor or a PA or a nurse about your problems.

There are a couple of widely circulated hypotheses here on cpaptalk concerning sleep debt and REM rebound that many posters say might explain why it takes some of us so much longer to start feeling better on CPAP. For me, I actually felt much WORSE during my first month of CPAP. I still have many more problems with day time sleepiness and inablity to concentrate during the day than I had before CPAP. So I'm not sure I buy completely into the sleep debt/REM rebound theories, but they may have something to them.

And then there's the need to make sure that there is not a second medical reason that you're still tired in spite of CPAP. There's nothing that prevents a particular patient from having more than one medical condition that can interfere with getting enough sleep. Have you been tested recently for thyroid problems? Anemia? Vitamin D deficiency? Any of them could lead to additional problems with fatigue and daytime sleepiness problems.

Good luck

[robysue]

SnoozyQ,

Another thing that I noticed about the data you posted that might be relevant to why you're not yet feeling any better.

On the vast majority of days, the usage data seems to indicate that you're taking the mask off in the wee hours of the morning (say between midnight and 5 AM). On many days you didn't seem to put it back on and many other days you put it on after a long multiple hour break.

Are you pulling your mask off in your sleep? Or are you waking up and taking the mask off in order to get back to sleep? And what time does your alarm go off?

In either case, maybe you'll start to feel better when you are more frequently putting on the mask on at bedtime and not taking it off until your alarm goes off.

[SnoozyQ]

When I told my reg doc about not feeling better, she said she doesn't know what else to do and referred me to Neuro--which I see on the 18th.
Other than that, I don't know what to do. I don't have any medical support really and I feel like they gave me the equipment and left me to figure it out. To make myself better.I don't know who to check with and no one is checking on me. Neuro doesn't know me yet so I don't see how they would help before seeing me later this month.

Its really frustrating--aside from the medical aspect--bc everyone at work expected a 'different me' as soon as I got the machine. So now its like I must like to sleep and that's it! At this point I'm tired of sleeping! I want to be awake and LIVE without being exhausted bc I've been up for a few hours!

Thanks for letting me vent and thanks for the help--good luck to you too.

Edited to add:Early on I knowingly did out of discomfort, but no, I don't take the mask off. Strange that it reads that way bc I put it on at bedtime and take it off when I wake up at 6.Confusing??

[idamtnboy]

Thanks I appreciate the help!!!

So....why don't I feel any better???

I started on CPAP 3 months ago. The first thing I noticed was I didn't need quite so long a nap in the afternoon. I had been napping ~1 hr most every day. After about 3 or 4 weeks I was down to about a 1/2 hr nap. Now I'm getting to the point where at my usual nap time, about 2 to 3 PM, I'm lying in the recliner for about 15 min and not going to sleep, or if I fall asleep I'm only sleeping about 10 to 15 min. I can stay awake later into the evening, but I am sleeping more hours during the night than before, i.e., my sleep pattern is changing!

[robysue]

SnoozyQ,

It's a shame that you're not getting more support from your medical team. Have you been tested for thyroid and anemia recently? As in the last couple of months, not the last couple of years? These are simple, straightforward blood tests and if they haven't been done since you started CPAP, tell your doctor that you'd like to have a full thyroid panel and tests for anemia done to find out whether either of those might be causing your extreme exhaustion.

but no I don't take the mask off. Strange that it reads that way bc I put it on at bedtime and take it off when I wake up at 6.Confusing??

This is really peculiar because the posted data shows that the S9 was turned off before 4 AM on 11 of the last 14 days of data you posted. Is the time entered correctly in the S9's settings?

[SnoozyQ]

Oh no...from what you are telling me, there's no way the time is set correctly. It goes on my face from bedtime(around 10:30pm)to wake up(around 6 am) every day (that I am able to go to work!!).
And I don't know how to set the time--didn't know there was an option! My RT didn't explain much to me about the machine, other than how to put the (wrong!)mask on, turn it on,change a filter and mail the card when asked.

I feel like such a moron! Now it's going to show completely flawed data and I didn't even know....

I feel like I'm kicking my own butt!

[Emilia]

I started on cpap on Aug. 31, and I have some improvement, but not as much as I expected to have by now. I sleep through the night, have incredible AHI data....most nights below 1.5, headaches are pretty much gone, dizziness is almost gone, BUT I don't feel energy yet.... at least not enough to want to start exercising. I have some bursts of energy ... enough to clean the bathroom or vacuum a couple of rooms or run some errands. I have a very low vitamin D level that I am working to correct, but that takes time. I would suggest, if you have not had blood work done recently, to have a full thyroid panel done as well as a 25 hydroxy vitamin D test. These two thing may be culprits in your lack of restfulness or energy. I also take a B12 sublingual tab each day. It is worth investigating these avenues. Together with cpap, it may be the ticket!