Howdy, any tips much appreciated.

[savman]

Hi guys, well where do i start? Well i posted a topic earlier but i was at work and in a rush so ill start from the beginning. I was diagnosed with severe osa, 30 yrs of age. At the sleep study i was told i stop breathing 87 times an hour or something. And no, i do not have my original report.

The reason why im posting here is because after 4 months, i have found no improvement to my tiredness during the day. I will post the gear i have.

resmed s9 elite with a swift fx nasal thing. Pressure is at 9cm. my ahi is anywhere between 15 to 30 on some occasions. i installed sleepy head but i have no idea how to import the report on here for anyone to look at.

I have an appointment to go to the ppl who supplied my gear to trial another mask, but from what i can see my leakage rate on the machine was ok. i bought a chinstrap today to see how it goes.

The mask i thought was ok at the beginning but as soon as i roll over it comes out.

Sorry to bother anyone reading this but if this is as serious as ppl say then an ahi of over 15 a night is pretty scary

[kaiasgram]

Hi savman, you've come to the right place for help. You're right that your AHI is too high, no wonder you're so tired.

Before we can make suggestions we do need to see some of your SleepyHead reports. A change in pressure may be appropriate, but first we need to know what type of events make up those high AHI numbers. In some cases adjusting the pressure is not the answer.

Also some additional leak info would be good. If you're going by the smiley face on the machine, that's not enough info. You can get the smiley face but still be having enough leaks to cause disrupted sleep.

To post a screenshot of your SleepyHead report, first do a screen capture while in SleepyHead. Upload the image to a site like Photobucket. When you do that, you'll get the Image code for that image which you can copy and paste right into a post here. It will look like text, but if you click on Preview you should see the image -- that means we'll see it too.

It helps us to see the following graphs for any given night: Events (not the AHI graph, it's redundant), Flow Rate, Flow Limitation, Leaks and Snore. Here's an example. Do include those Statistics on the left-hand side under the Details tab. (This example shows a Pressure graph which you won't need since you have a fixed pressure machine.)



It also sounds like the fit of your Swift FX is not so great if it's popping out when you move. Have you watched one of the fitting videos for that mask? Sometimes the problem is an adjustment needed, and sometimes people start out with the wrong size for them (e.g., a person might think they have a "medium" size nose but they end up with a better fit with size Small nasal pillows.

[savman]

thanks ill do my photo bucket thing now...;ooking at the results are now worrying me hahah the osa isnt bad its saying my clear way apneas are bad..... ive fitted it correctly its just not that great of mask the intreveanous thingsx pop out too easily and sometimes when i tightened it up it was just too uncomfortanle

[kaiasgram]

thanks ill do my photo bucket thing now...;ooking at the results are now worrying me hahah the osa isnt bad its saying my clear way apneas are bad..... ive fitted it correctly its just not that great of mask the intreveanous thingsx pop out too easily and sometimes when i tightened it up it was just too uncomfortanle

Cool. It'll help when we look at a few typical nights for you. The clear airway events won't be helped by a change in pressure. I'm wondering if we'll see a pattern to your CA events. That information may help guide the next step.

As for your mask -- it may just not be the right mask for your face, but if you like the basic concept of a nasal pillow mask there are quite a few other NP masks you might try. You could also experiment with a size larger or a size smaller pillows to see if the darn things will stay put.

Will watch for your screenshots.

[savman]

wonder if this works hahah

[savman]

is there a particular part in the program you want me to screenshot?

[kaiasgram]

is there a particular part in the program you want me to screenshot?

Yes -- Get rid of the AHI graph because we can see the events in the top "AHI Flags" graph so the AHI graph is just a repeat we don't need. Add the Flow Limitation, Leak, and Snore graphs. On the left side of your screenshot, instead of the Events tab, click on the Details tab (see my above example). That will show us some important numbers.

[savman]

doe this help

[savman]

182 clear airway evets it said ....now im freaking out lol

[kaiasgram]

182 clear airway evets it said ....now im freaking out lol

Don't freak out, it's going to get straightened out. The screenshot is going to be really helpful when our resident experts see it (most likely in the morning since it's late for most folks now). If it's not too much trouble, can you get rid of the Pressure graph (since you're at a fixed pressure we don't really need to see it), and put in the Snore graph? There's a method to the madness of all this, I swear!

The night you're showing us -- is it pretty typical of the nights you've been having? Have the clear airways increased over the 4 months you've been using your machine or have your nights looked like this pretty much the whole time? Has your doctor seen any of your data since you started?

I'm only two years into this but I know that Pugsy and some of the other seasoned vets will see your graphs and give you some solid suggestions. It looks to me like you need to see your doc about all the clear airway events. It may be that a different machine is needed for your situation. One thing I'm wondering in the meantime is whether you might be able to reduce some of those clear airway events by lowering your pressure a little. Sometimes a person develops central apneas after starting on cpap -- the obstructive events are under control, but centrals start appearing in too-high numbers. Seems like you could afford to give that a try since your obstructive events (apneas and hypopneas) are so well controlled right now. Just a small decrease to see if it helps.

Your leaks are "acceptable" (the "do not cross" line is 24 for ResMed machines). But when I look at your leak graph during the night I wonder if all those little leak spikes are disturbing your sleep. Leaks can cause sleep arousals which can then be followed by 'post-arousal centrals' -- another possible scenario with your high central numbers. Centrals also occur during sleep-wake transitions.

Hang in there, help is on the way. You're a trooper to have stuck with this after four months of the kind of nights we're seeing in those SleepyHead reports!

[savman]

thank you so much will stick around for some of those experts hahahah but your kind words are much appreciated... ill take another screenshot too yeah i noticed that its mainly after 5 am im having a hell of a lot...anywhere between 90 and 182 a night. if i need a new machine that will be interesting as i only just bought this one for a small fortune hahah...hopefully ougs will get to have a look in the morning your time im in aus so its only evening here.....ill keep the post informed though on my progress

[savman]

my nights vary a lot...some times ahi is 11 others its 18 others its 21....now looking at this data though it seems as if it isnt the mask and its me. i have not seen my dr...i never really did..i went straight to the sleep clinic who just said i needed cpap so i bought one....here is the updated screencap

[kaiasgram]

You're welcome. All the info you've posted is a good start and will be helpful. Don't go anywhere (well, you can go to bed if you want, but check back in the a.m. ). It's late here in California so G'nite!

[Kennerly]

Savman wrote:

"At the sleep study i was told i stop breathing 87 times an hour or something. And no, i do not have my original report."

Welcome to the forum savman.

I suspect there will be interest in your recent sleep study report and the breakdown of your events - especially the CAs - during that pre-PAP night. Is that info available to you upon request?

[Sludge]

Can you copy all the files from the SD20 card and upload them to a third party server like DropBox or GoogleDocs?

That mess could also be Sleep Wake Junk, so a breath-by-breath review is needed.

The machine could be lying, and they're really obstructives.

CompSAS should have gotten a little better by now.

You need to get that sleep report to help look for clues (for instance, a pile of late night PLMs could drive a machine crazy like that (subset of SWJ)).

Any medications (prescription, OTC, street corner, etc.)(something could be wearing off as the night goes on)?

Is "tired" "sleepy" or "fatigue".

When/how much do you eat?