Sleepy head data questions

[danjfoley]

I have data for 5 days now. I'm concerned about the events list. Should i be having events? My overall AHI is under 3 all days. but i have a lot of events..

Last night:

13 - Clear Airway Apnea
3 - Flow Limitations
4- Hyponea
14 - Obstructive Apnea
108 - Pressure Pulse
1 - Resp. Related Arousal
3 - Vibratory Snore

[robysue]

I have data for 5 days now. I'm concerned about the events list. Should i be having events? My overall AHI is under 3 all days. but i have a lot of events..

Last night:

13 - Clear Airway Apnea
3 - Flow Limitations
4- Hyponea
14 - Obstructive Apnea
108 - Pressure Pulse
1 - Resp. Related Arousal
3 - Vibratory Snore

1)If your treated AHI < 5, then CPAP is considered "effective" managing your OSA. And so if your AHI < 5 AND you are feeling better, then you don't need to worry too much about anything else with regard to the CPAP and OSA.

2) CPAPs are not perfect: They do not prevent every single apnea or hypopnea from occurring. Rather, they work by making it much more difficult (but not impossible) for our airways to collapse, and that, in turn, minimizes or reduces the number of events down to the "normal" range less than 5. In practice, some folks manage get their AHI below 1.0 on a consistent basis, but almost no one sees night after night of AHI = 0.0 (No events). Many of us do tend to feel better when our AHI is on the low side of 2.5 versus on the high side of 2.5. But there's more to feeling good than having a perfect AHI = 0.0.

3) "A lot of events" is relative. How much mask time (sleep) did you get last night? You say the AHI < 3 and there are a total of 13+14+4 = 31 apneas + hypopneas. That means you got at least 10 hours of mask time?? But to put those 31 events for the whole night in perspective, consider this: If you were diagnosed with moderate OSA on your diagnostic sleep test, you had at least 15 apneas + hypopneas PER HOUR of sleep without a PAP machine. And so if you slept for 6 hours on the sleep study and had an AHI > 15, then you had at least 90 apneas + hyponeas during the 6 hours of 9ntreated sleep.

So overall, your numbers for the events are NOT THAT HIGH---particularly if your AHI < 3 for the night. But you still might want to look at the distribution of the events and their lengths.

4 hypopneas for the night is nothing to worry about.
1 RERA is nothing to worry about
3 Vibratory snores means you are NOT really snoring at all--just three snorts or clearing throats or isolated snores for the whole night.

13 CAs---probably nothing to worry about since the total AHI < 3. But are there clusters of events?
14 OAs---probably nothing to worry about since the total AHI < 3. But are there clusters of events?

In other words, there are enough CAs and OAs that if they are piled up in clusters, you could still be having some real daytime problems in terms of how you are feeling and potential problems with O2 desats at night. But if they are spread out and your overall AHI < 3 as you state, then these numbers are "acceptable". You might also want to look at the events themselves. Are they short---barely 10 seconds long? Or are a lot of them longer than 20 or 30 seconds in length? If so, then there might be a problem---particularly if you still don't feel particularly well.

108 Pressure Pulses---look at the data. The System One sends out PPs when it tests the patency of your airway. Typically the S1 will send out a PP about 6 seconds after the last exhale ended if it has not detected an inhalation. So you can get PPs if you tend to pause frequently between your exhales and inhales. You can also get PPs when you airway collapses momentarily, but you manage to get it opened back up before you've missed more than one breath. And typically when the S1 detects an apnea, there will be one or more PPs. Typically during a long apnea, the S1 will continue to send out a PP about every 5 or 6 seconds. So a 30 second apnea may account for 5 PPs. The S1 can also send out a bunch of PPs in a row if it's not sure its detecting your breathing correctly. In other words, if the machine can't tell whether there's at person at the other end of the hose, it will send out a whole bunch of PPs in an effort to try to reestablish what your breathing pattern is. This can happen when there is a very large leak. It can also happen when are breathing very shallowly, but the reduction in air volume going into/out of your lungs was gradual enough that a hypopnea could not be flagged. So 108 PP may mean nothing interesting or it could be very relevant. You have base its relevance on what's triggering the PPs and how you are feeling.

[Otter]

I have data for 5 days now. I'm concerned about the events list. Should i be having events?

Yes. Even someone who doesn't have sleep apnea would score a few events if for some reason they tried CPAP.

If you're concerned, post some screenshots of ResScan or SleepyHead, and people here will be glad to apply the points robysue discussed to your data and help you learn how to interpret it yourself. This really isn't a bad idea even if nothing is wrong with your therapy, because if anything does go wrong down the line, you might be too brain fogged to figure it out easily. Better to learn about your therapy while you're still with it enough to be curious.

[peterg]

I might just add one major , though perhaps not breadly concerning (for most cases) qualification. An AHI under 5 is medically thought to be a good result (to live with), but the question is how long is each event and how low does your Oxygen level go down to (and what ill effects does this have on your health). hence the advice to, at least occasionally, marry your CPAP machine results up to a pulse oximeter to get an idea of correlation of events to O2 desaturation events. (with another provisio that pulse oximeters are inaccurate for some people whos hemoglobin is screwy - see Wikipeadia page on Puse Oximeters).

dreamtime/wishlist - a pulse oximeter that works off skin rather than nails, that can be built into the CPAP mask that the CPAP machine can use. might even sttle for a nano pinprick thingy that goes in and out of the skin, painlessly, as you move around.