My first cpap charts

[monica4patience]

I'm hoping I did this correctly. I started CPAP on 12/7/10. These are just the 3 most recent charts. How do they look?




Those large leaks are when I took off the mask to, uhm....use the bathroom...or otherwise get up. The DME said to just leave the machine running. Last night (12/12) I decided to just turn it off when I got up; therefore no large leaks as before. I was up lots last night due to the major snowstorm and worrying whether DS10 had school or DS18 had to work snowblowing.

[robysue]

In my humble opinion, these are pretty good graphs for someone just starting out.

My guess is that those leak lines are right around the intentional leak rate for your mask at your pressure and that would indicate that you don't have any real serious leak problems---particularly since you know what actually caused the couple of (short-lived) large leaks.

The AHI numbers are between 4 and 5. So technically, it looks like the CPAP is treating the apneas ok. But another important question is: How do you feel? If you are starting to feel better with CPAP than you did without CPAP, then the therapy is treating your daytime symptoms effectively as well as effectively treating the apnea itself.

In the long term your doctor probably wants them to stay consistently below 5.0 and you might feel better if they go down closer to 0. But there's no real reason to worry about chasing lower AHI's yet: They may come down naturally as your body starts to get used to the machine. So my advice is watch them but don't worry too much unless they start to creep up and stay above 5.0 on several nights every week. In that case, I'd report the problem to the sleep doctor.

So overall, I'd say you've had a really good start to your therapy. Good luck and here's hoping that your numbers continue to look good and improve!

[jules]

I have a hard time reading them but I do see your VS is high.

Is the hose rubbing against something like a headboard? Do you have rainout? These can both cause artificially high VS numbers.

[jweeks]

I have a hard time reading them but I do see your VS is high. Is the hose rubbing against something like a headboard? Do you have rainout? These can both cause artificially high VS numbers.

Hi,

That is a good question. If these VS really are snores, they could be disrupting her sleep. Since these were my plots, I'd give it another week or 10 days to see how it sorts itself out. If the VS stays high, I'd be tempted to tweak the pressure up a little. I had some VS events when I first started, and raising the pressure by 1 cm took care of it, and I noticed an improvement in my sleep. A pressure of 7 is pretty low, so it should be too difficult for someone to move up a little, especially if they are running CFLEX.

-john-

[jules]

if these were mine, I would make sure the hose wasn't moving during the night first and insulate it with a homemade cover (tube socks work in a bind if you have a bunch of ones already destined for rags but a towel or piece of blanket or mattress pad works too with cable ties or rubber bands to hold things in place)

[mayondair]

I agree with insulating, and or hanging the hose, let things go a few nights, hyponeas look a little high, if the snores are not machine artifact, they may be precursors to hypopneas, and a small pressure increase may help. JMHO, I'm not a doc, and you may want to discuss this with yours, but for the first few nights it looks good! So good luck, hope you are feeling good!

[monica4patience]

Last night I hung a towel over the headboard to see if that would help with VB...the score climbed to 216.8. I had some congestion when I woke, so wonder if there is a true snore problem. DH says he hasn't noticed any snoring, but then he's says he was asleep!I slept for a solid 9 hours last night; no bathroom breaks until DH's alarm went off.


As far as how I feel....it's just a very subtle difference that I can't quite identify yet. Maybe it's the lifting a little of the brain fog? Maybe it's a little bit more energy? I'm still ready to go to bed after dinner.

[mayondair]

If you were congested, that may have made the VS go up, still maybe try hanging the hose, but a nice long sleep Woo HOO! The Mach may be sensing just some vibrations , not loud snoring, but enough for RERA to go up and disturb your sleep a bit.

[monica4patience]

what is RERA? I can't find a definition for it.

[robysue]

RERA stands for "Respiratory Effort Related Arousal". In a sleep study, a RERA is scored by looking at the data gathered from the belts, which measure increased effort to breath; the nasal flow monitors (or the flow data from the titration machine), which measure the air flow going into your body; and the EEG, which detects the arousal. Apparently a RERA may not have to last a full 10 seconds. Or maybe it doesn't have enough desaturation to count as a hypopnea. I've read the definitions I've found on line, but they are not clear to me and in my humble opinion seem to be a bit inconsistent. But (from the OSA point of view), the arousals from RERAs can disrupt the sleep architechure if you have enough of them. If/when a sleep lab scores them, they are added to the RDI, but not the AHI. And a diagnosis of moderate obstructive sleep apnea can be based on an RDI being above 15, if I recall correctly.

Now PR's System One machines score something that is labeled as a RERA. But I have no idea what criteria must be met in the flow data for the PR S1 to score a event as RERA. I've spent a bit of time on Resprionics's web pages, but have not come up with any links that contain genuine information about how PR's algorithms determine any of the "sleep event flags" that show up in the Encore Viewer/Pro software. All I can find is what I think of as advertising copy---the claims of what the machine can detect and how it reacts to the various events if the machine is running in Auto mode. If anybody out there knows of a link to more detailed and technical information about the PR algorithms, can they post them to the forum?

[rested gal]

Monica, you have a beautifully low leak rate -- to be envied!

If it were me, and I were looking at the other areas of the data, I'd raise the CPAP pressure from the 7 it's currently set for. I'd set the pressure on 8 or 9. I'd want to see if another cm or two of pressure could prevent more of the VS (vibratory snores) and the hypopneas. I'm not a doctor. That's simply what I'd try for a week or two, just to see.

You might not be as inclined to "tweak." And it isn't necessary since you're getting good treatment as is.

[monica4patience]

I was really surprised at my numbers this morning. I had a very restless night; felt like I was awake the whole night. My AHI was down to 2.6 which leads me to think I should not change the pressure. But I am more sleepy and exhausted than I have been since starting treatment. I know DH's snoring woke me several times, so it was a very light sleep.

Would my AHI level be lower if I wasn't sleeping as well? Should I try experimenting with the pressure?

I made a hose cover last night. Found a perfect royal blue fleece in the discount bin (1 yard for $1.30). Course I had to clean all the clutter off the sewing machine, relearn how to thread it; make one hose cover too narrow; but had success with the second one. I also hung the hose over the bed with a Command hook and hairband. The VS was down to 91.4 from a high of 216 the day before.

[mayondair]

I'd try what Rested Gal suggested( Id always listen to her advice!) it seems some VS numbers may have been taken care of by hanging and insulating the hose, but it is still high, how about RERA?. You may sleep better with less disturbances, aside from AHI numbers. Give whatever you try more than 1 or 2 nights. Sleep well

[Laurie1041]

Question: How do I post my data from my S9 to the forum? I would like to have some input on my data as well. Thanks, Laurie

[monica4patience]

Okay, I changed the pressure from 7 to 8. My numbers look much better but I still woke about 7 times throughout the night. I was mostly able to get back to sleep. Here's the numbers:
CA: 0.2
OA: 0.9
H: 0.9
FL: 0.0
VS: 28.7
FE: 3.6
AHI: 2.0

Wonder whether the machine can pick up DH's snoring? I know that's partly what is waking me. I'd been wearing earplugs to block his snoring, as well as mine! But I just can't stand to use them with the machine. I "hear" too much noise!!!

Not feeling much better, despite the consistent 11-12 hours of sleep. Could also be the season and feeling overwhelmed to get it all done!