palmer1121 wrote: Also what is the event flags graph for? How would I use this?
The event graph gives an overall view of the night. it lets you see when each kind of events occurred and how many there were (roughly speaking). It also allows you to quickly select a portion of the wave flow to zoom in on to study more closely, and it tells you where the zoomed in portion of the wave flow and other graphs is in relation the whole night, which is important for the rest of us if you asking us for help analyzing some data.
I have reviewed my AHI and not bad. question: at what point should I be concerned if a like and AHI is ok and I don't feel like i am waking up due to a leak.
When using a Resmed S9, the official Large Leak line is at 24 L/min. As Pusgy says a few
short-lived leaks beyond that are nothing to worry about if they're not waking you up. But prolonged leaking above 24 L/min can make the AHI data unreliable. And the larger the Large Leaks, the more likely the AHI data is UNRELIABLE
Of the two nights of detailed data you post, the data in Graph 2 (with the Bella loops?) shows the leaks are way out of control. The MEDIAN leak rate in the side bar is equal to 32.40 L/min, which is well above 24 L/min. A MEDIAN leak rate of 32.40 says your leaks were AT or BELOW 32.4 L/min for 50% of the night, and a MEDIAN leak rate of 32.4 also says the leaks were AT or ABOVE 32.4 L/min for 50% of the night. So we already know that leaks were a significant problem for at least 50% of the night. (Clearly Mr. Red Frowny should have showed up the next morning on short version of the Sleep Quality Report on the S9's LCD.)
We look at the leak graph to find out WHEN the leaking happened, how long each leak was, and how BAD each leak wase. On this night the first long Large Leak lasts almost 2 hours (from roughly 2:45 to not quite 4:35), and it was over 45 L/min for over an hour. That's a really long and really large leak. The second long Large Leak lasts about 45 minutes (from roughly 5:15 to 6:00), and there's a 10-15 minute Large Leak from roughly 4:45 to 5:00. In other words, it looks to me like you were in Large Leak territory for about 3
hours on this night and your usage was only 5:20. So you were in Large Leak territory for about 56% of the night.
The leaks on Graph 3 are much less out of control. The median leak rate is 0.0 L/min, so there was no leaking at all for at least 50% of the night. There are still two official Large Leaks, but they are not quite so large and they are less long. The first one lasts about 45 minutes, but most of this time you are barely in Large Leak territory. The second one is larger, but only lasts about 15-20 minutes. All in all, there's a bit more than one hour of large leaks during the night. My guess is Mr. Green Smiley face showed up the next morning.
Your summary data shows that Leaks have been an issue since around April 10. Between Jan 20 (or so) and April 10 your summary leak data shows the leaks were pretty well controlled. During this period, the 95% leaks are pretty consistently below 20 L/min, and the median leak rate is usually less than 10 L/min. In December and January, the summary data indicates that on many nights leaks may have been unacceptably large for significant periods of time.
Will sleepyhead show when I awake?
No. SleepyHead can't tell when you are awake and when you are asleep.
I have read so much about cpap and analysis of the data, but I am unsure of how to analyze the data if cpap is improving my quality of sleep and sleep experience.
My take:
If the leaks are NOT under control, you can't trust the AHI data. So if the leaks are out of control, you have to work on that issue FIRST. You don't need a perfect leak line, but you do need to get to where the MEDIAN leak rate is always WELL under the Resmed Redline of 24 L/min---a good target is to try to keep the MEDIAN leaks under 5-10 L/min. You need Mr. Green Smiley showing up every day on the Sleep Quality report on the machine. It would be good if you can get to where the 95% leaks are consistently under 24 L/min since that would limit the large leaks to no more than 5% of the entire night.
If the leaks ARE under control, then the AHI data is critical for determining whether the PAP is doing its job of keeping your throat open when you are asleep. If the AHI is NOT consistently below 5.0, then there's something that needs to be tweaked in the pressure settings and it's a good idea to keep the sleep doc informed of the fact that the AHI is not yet where it should be. What kind of "tweaking" should be done depends on exactly what part of the AHI remains too high on therapy: Large numbers of OAs and Hs probably indicate that more pressure is needed, but large numbers of CAs can't be fixed by increasing the pressure.
Having the leaks under control and the AHI consistently < 5.0 may or may not lead to you feeling better in the daytime. And ultimately that's the real goal. Optimized PAP therapy will allow your body to get restful sleep uninterrupted by apnea events, but it won't magically fix any other problems with your sleep. If you are still feeling tired, fatigued, or sleepy even though you are consistently using the machine AND the leaks are under control AND the AHI is low, then there's a certain amount of "sleuthing" that has to be done to find out what the remaining problems are. Sometimes it's easy enough to identify (insomnia, fractured sleep, pain issues, etc) and sometimes it's not so easy. And once the additional problems are identified, sometimes what to do seems straightforward, and sometimes it's not. Sometimes it's just a matter of time: It takes time to heal the damage from the years of untreated OSA. And unfortunately there are a few unfortunate people who never really seem to feel much better on PAP than before; perhaps the damage the untreated OSA is severe enough where the body never manages to fully heal.
