Need help with CPAP Stats

[tazmania]

Thank you for the tips RobySue. Most appreciated.

I'll follow your advice and use the CPAP setting with my current pressure and C-flex setting. Once that appears to work to my satisfaction I'll try switching to Auto Mode. Just need to decide when I incorporate the cervical collar.

[Julie]

Why wait?

[robysue]

Why wait?

Changing more than one thing at a time can make it hard to figure out which of the changes are useful and which are not.

Also making too many changes at one time can create problems of its own. For me, if I make more than one substantial change at a time, it usually winds up distracting me from getting decent quality sleep because too many things are "different" from what I'm used to.

[Julie]

Good points... I think I was hoping the collar would solve many things at once.

[tazmania]

Update:

I've been using the new machine for the last 5 nights using the same settings I was using on my older Respironics device. No real significant improvement in the quality of sleep. I still wake up around 3 or 4am with the extreme dry mouth and at that point I sleep for a couple more hours without CPAP.

Tonight I'll be installing Sleepyhead and extracting the data from the last 5 nights of sleep. I'll share that information with you all here looking for feedback and an education on what I'm reading.

I'm ready to start the next step which will be to use the cervical collar to see if that makes a difference. I believe I will try it tonight for the first time.

[ChicagoGranny]

Tonight I'll be installing Sleepyhead and extracting the data from the last 5 nights of sleep. I'll share that information with you all here looking for feedback and an education on what I'm reading.

This is a step in the right direction.

I'm ready to start the next step which will be to use the cervical collar to see if that makes a difference. I believe I will try it tonight for the first time.

You should do this because ...

I still wake up around 3 or 4am with the extreme dry mouth

... this is a clear indication that you are mouthbreathing and the collar might prevent this.

[tazmania]

Thanks Granny,

I'm hopeful that this is going to make a difference. I figure if I can get just another hour or two each night I'll feel about 250% better than I do today.

[tazmania]

Alright Newbie here taking a first stab at presenting SH screenshot.

Hope this works.

I'm interested to hear what others see in these graphs.

http://imgur.com/EdfTpGs

[palerider]

Hope this works.

I'm interested to hear what others see in these graphs.

if it hadn't, hit the 'edit' button and try again.

I don't see much of anything in that graph, it's very boring, other than a period of large leak.

boring is good.

[tazmania]

Hope this works.

I'm interested to hear what others see in these graphs.

if it hadn't, hit the 'edit' button and try again.

I don't see much of anything in that graph, it's very boring, other than a period of large leak.

boring is good.

I'll take "good" news anyway I can get it.

[tazmania]

Bummer, day one wearing the collar didn't net me any different results.

Went to bed at 10:15, awoke at 3:30am, uncomfortable. Took off the collar and shut down the CPAP.

Hopefully Day Two nets me some additional sleep time.

[tazmania]

I was doing a little research on Sleepyhead and saw this:

IMPORTANT NOTES about Philips Respironics System One machines:

1) The Philips Respironics System One machines record two kinds of Snore Data. In SleepyHead they are referred to as VS1 and VS2 data.
In SleepyHead 0.9.6, The Vibratory Snore index shown in the Left Sidebar data is the average number of VS2 per hour. In other words:
Vibratory Snore (index) = (number of VS2 scored)/(run time) In SleepyHead 0.9.3, The Vibratory Snore index shown in the Left Sidebar data is the average number of VS1 per hour. In other words:
Vibratory Snore (index) = (number of VS1 scored)/(run time) The thing is: VS1 snores are scored on a Philips Respironics machine only if the machine is running in Auto mode. If you are using a Philips Respironics machine in fixed pressure mode, the SleepyHead 0.9.3 Vibratory Snore index will always be 0.0; but that does NOT imply that you are not snoring.

2) The Flow Limitation data is recorded on a Philips Respironics machine only if the machine is running in Auto mode. If you are using a Philips Respironics machine in fixed pressure mode, the Flow Limitation index will be 0.0; but you can't assume that means you are not having any flow limitations.

My current steps are to ensure I'm not introducing too many new aspects to my sleep habits. As such I am using the new CPAP in continuous pressure mode with the same C-flex setting of 3. Looking at my daily detailed stats I noticed a lot of zeros thinking the machine was working really well for me. But after reading this I realize I don't have data and was misunderstanding some of the stats. I've shared my Sunday night daily stats in a post above.

Last night I incorporated the cervical collar to no great effect. How long before I should start to use the machine in Auto mode?

[robysue]

You asked about the Snore Data and Flow Limitations:

I was doing a little research on Sleepyhead and saw this:

IMPORTANT NOTES about Philips Respironics System One machines:

1) The Philips Respironics System One machines record two kinds of Snore Data. In SleepyHead they are referred to as VS1 and VS2 data.
In SleepyHead 0.9.6, The Vibratory Snore index shown in the Left Sidebar data is the average number of VS2 per hour. In other words:
Vibratory Snore (index) = (number of VS2 scored)/(run time) In SleepyHead 0.9.3, The Vibratory Snore index shown in the Left Sidebar data is the average number of VS1 per hour. In other words:
Vibratory Snore (index) = (number of VS1 scored)/(run time) The thing is: VS1 snores are scored on a Philips Respironics machine only if the machine is running in Auto mode. If you are using a Philips Respironics machine in fixed pressure mode, the SleepyHead 0.9.3 Vibratory Snore index will always be 0.0; but that does NOT imply that you are not snoring.

2) The Flow Limitation data is recorded on a Philips Respironics machine only if the machine is running in Auto mode. If you are using a Philips Respironics machine in fixed pressure mode, the Flow Limitation index will be 0.0; but you can't assume that means you are not having any flow limitations.

If you want to see the VS snores and FLs but still want to have a fixed pressure setting, then what you need to do is simple:

Set the machine in APAP mode and set both the min Pressure and max Pressure to your current pressure setting of 11cm. When min Pressure = max Pressure, the machine can't change the pressure, but at the same time it records the VS and FL data so you get a fuller picture of what's going on each night.

My current steps are to ensure I'm not introducing too many new aspects to my sleep habits. As such I am using the new CPAP in continuous pressure mode with the same C-flex setting of 3. Looking at my daily detailed stats I noticed a lot of zeros thinking the machine was working really well for me. But after reading this I realize I don't have data and was misunderstanding some of the stats. I've shared my Sunday night daily stats in a post above.

All the stats except for FL and VS are correct. And while there is some extensive leaking going on most of the night, the leaks are not large enough to be flagged as Official Large Leaks most of the time, and that means the efficacy data recorded is accurate enough to be trusted. So in terms of therapy, it looks like your machine is doing an excellent job of managing your OSA. Also your machine does record VS2 data, and if you were doing a lot of snoring, it would show up in the VS2 data: In other words, if snoring were a problem, the VS2 Index would not be 0.0, even though the VSI = 0.0.

As for flow limitations: They may or may not be an issue. Switching to APAP with min Pressure = max Pressure = 11cm will allow you to continue sleeping with a fixed pressure setting, but will also allow you to record the FL data. My guess is that there won't be a whole lot of issues with FL in your data, however.

What is interesting in this data is the overall variability that's evident in the flow rate graph at three distinct periods of time:

• first between 23:30 and 0:30 (when the leaks are at their worst)
• second between 1:30 and 2:10 (leaks are higher than they should be)
• third between 3:20 and 3:45, when you turned the machine off and gave up for the night after what appears to be waking up because of large leaks

Any ideas on what might be going on during those time frames?

Were you very restless, tossing and turning in bed trying to get comfortable and back to sleep after waking up and having trouble getting back to sleep? If so, what do you think woke you up? The leaks? The collar? Something else? In this case, there's some evidence that you really need to work on the leaks even though they're usually not flagged as Official Large Leaks. And there's evidence that the collar might not be working as intended. (Or it could be you just need to give the collar more time.)

Or were you sound asleep and dead to the world? In this case, it could be that the irregular breathing might be an indication of REM sleep. And that in REM your mouth opens and your tongue drops off the roof of the mouth and air goes in through your nose and out through the open mouth. And the collar didn't prevent this from happening.

Last night I incorporated the cervical collar to no great effect. How long before I should start to use the machine in Auto mode?

It depends on what problem you are trying to solve by switching to Auto.

Switching to full Auto mode (where min Pressure is not equal to max Pressure) is not likely to reduce the number of events since they're already so close to 0.0. It's not likely to do a better job in preventing snoring since the VS2 I = 0.0 (i.e. you're not snoring enough to matter.)

If the goal is to try to fix the leaks, switching to APAP is not likely to do that. Moreover, if you wind up having some significant pressure swings in Auto mode, that could aggravate the leaks. And because switching to Auto might aggravate the leaks, you may find yourself waking up even more frequently to deal with leaks than you are now.

[ChicagoGranny]

awoke at 3:30am, uncomfortable

What type of discomfort? Still getting "extreme dry mouth"?

[tazmania]

Thanks for the feedback RobySue. I'll answer your question too CG.

First off, thank you for the helpful hint of setting the machine to Auto using min and max pressure as the same value. I'll do that tonight so I can track some more statistics.

Second, the collar isn't any new culprit as I used it last night for the first time and this set of dailies was from Sunday night's sleep. I don't know what is waking me. To answer you CG, yes the discomfort is always a dry mouth, every morning and almost always I awake around 3-4am with this occurring. And every morning I do the same thing, turn off the machine and try to relieve myself of the dryness, then fall back to sleep without CPAP. Mind you prior to waking and shutting it down I really don't recall waking. I always sleep on my back and don't turn to my side as I can never seem to keep a good seal on the nasal pillows if I try side sleeping. Once the machine is off I always sleep on my side ... and I toss and turn several times during that last hour or two of restless, (most likely apnea filled sleep).

One might suggest I get up and take care of the dry mouth then try to sleep with the machine but I fear getting up. Normally once I'm up, I'm up and have a lot of difficulty getting back to sleep. So I don't even try getting up. I simply shut off the machine, try to work out the dryness naturally and then fade back to sleep.

This Sunday graph shows a large leak around the time that I shut the machine off but looking at the 4 days prior to that it doesn't show the leak happening just prior to me waking and shutting it down. I'll do some more analysis with each passing day to see if it is really the norm or the exception. There ARE large leak signs every night though. Just randomly throughout the night.

The collar isn't too bad. As Granny says it doesn't interfere with the mask. I slept last night like I always do except for a brief stint where a dream woke me around midnight. FYI I don't really dream much while I'm using the machine (that I can recall). Is that a sign of anything? I do dream but if I recall correctly that usually happens after I've turned off the machine.