How does one get consistent results?

[GuestStar]

Note, I'm not the one using the machine.

He got his lowest AHI yet (using the machine 8th time, now 9th) at 1.40. Today his machine display read an AHI of 7.6. However when I analyzed with Sleepyhead the AHI reads 5.10. This is the first time there has been a conflict in reports. He did nap earlier that day, with the SD card out (it must keep results in RAM, as the result is on my Sleepyehead now) but I have not factored the nap into the data (which is much better than last night's sleep).

Is it normal at first to keep getting nights with high AHIs? I just don't know how to go about reducing the number. 5-7 every couple of nights does not sound good enough. And the nights it is good it is still mostly 2.5-3.

[Julie]

You haven't mentioned leak data (among others), whether mask leak or mouth breathing, and those could make a difference, as could supine vs side sleeping and other factors. Can you DL the reports (Sleepyhead?) to Imgur.com and leave a link in this thread so we can see what's what. Consistency comes with good sleep hygiene, finding the ideal pressure settings, dealing with mask issues, no alcohol before bed, etc. etc. Every situation's different so you'd have to look at each person on their own. Every night is unlikely to give the exact same AHI, but if it stays within a couple of cms most of the time (as long as they're on the low side) and he feels rested, then things should be fine.

[HoseCrusher]

Why not back up a step...?

Does he feel more refreshed from sleep now?

9 data points is interesting but it looks like you have a large deviation in the numbers. You can start to speculate on a trend in the numbers but until you have more data you are guessing. Continue to track but start looking seriously after 50 - 100 data points.

Also keep in mind that we are not machines. There is variability to the way the body works and when we measure data from the body that variability shows up in the data.

[ChicagoGranny]

I just don't know how to go about reducing the number. 5-7 every couple of nights does not sound good enough. And the nights it is good it is still mostly 2.5-3.

Post Sleepyhead detail graph of a typical night in this thread. See Pugsy's formatting instructions - viewtopic.php?f=1&t=111910

You'll need an imgur.com account to host the image.

Members will give you advice. So far, they are just guessing.

[ChicagoGranny]

You can start to speculate on a trend in the numbers but until you have more data you are guessing. Continue to track but start looking seriously after 50 - 100 data points.

That is BS. If his pressure is too low, or his leaks too high, it's ridiculous to wait 50 - 100 days to make appropriate corrections.

[GuestStar]

Sleepyhead Data Here

Yes, he has told me he feels like things were worse when I inform him his AHI was high. But I cannot tell you if this is a biased analysis because I told him it was bad that day. Same when it is low, he tells me he can tell it was better sleep. From now on I will ask him to evaluate his sleep before I tell him his "score". His untreated AHI is nearly 30.

Most nights he says he feels much better. He always sleeps on his back. Since getting the machine he basically just falls asleep and doesn't seem to move the entire night.

[Jay Aitchsee]

A couple of things:

First, when the card is not inserted or used the numbers that SleepyHead reports will be different than the summary data reported by the machine. We had a discussion about this a while back and concluded that SleepyHead uses the detail data recorded on the card to calculate the results. If the detail data is not present, the summary data as reported by SleepyHead is in error (at least for ResMed machines). It is consistently higher or lower, but I don't remember which right now.

It is normal to experience some variation night to night.

It looks like the majority of the AHI is H, hypopnea. Usually, this is treated by raising the minimum pressure. You could raise the minimum pressure directly, or by decreasing Flex.

It is good not to let the numbers influence how one feels by answering that first and then looking at the numbers to determine if there is correlation.

[HoseCrusher]

Granny you missed my point...

When tracking a number that varies a lot, you need lots of data points to get a proper feel for it.

The point was that rather than focus on AHI perhaps a focus on restful sleep assessment would be better.

Originally we only had AHI data over a very short time to evaluate. With the addition of more data I would suggest raising the minimum from 8 to 9 and see if that helps.

I still wouldn't pay a lot of attention to AHI until there is more data available.

[Julie]

Another thing - IF his numbers and how he feels are the same on his back as on his sides, then all is ok in that respect, but as apneas increase a lot on your back, and if his being able to be on a side changes the figures, it might be worthwhile his trying to side sleep more often.

[ChicagoGranny]

Since getting the machine he basically just falls asleep and doesn't seem to move the entire night.

Has he mentioned the CPAP exhalation relief? His pressure is mostly under 10.0, and he may not need exhalation relief. If it were me, as a first step, I would drop the relief one notch and see what happens. That gives him a little more pressure on exhale and might help prevent some hypopneas. If you try it one night, and it causes a problem, you can always revert to the original setting the next night.

Personally, I never liked exhalation relief. Pressure cycling up and down on every breath was a bit annoying. A straight, solid pressure gives me a confident feeling that the process will protect me when I fall asleep.

... doesn't seem to move the entire night.

Or, you sleep so well you don't notice.

[GuestStar]

I've set his minimum from 8 to 9 as suggested. But, uhm, will his doctor be notified that a setting such as this was altered? I just now realized this.

Has he mentioned the CPAP exhalation relief? His pressure is mostly under 10.0, and he may not need exhalation relief. If it were me, as a first step, I would drop the relief one notch and see what happens. That gives him a little more pressure on exhale and might help prevent some hypopneas. If you try it one night, and it causes a problem, you can always revert to the original setting the next night.

Would this be the "flex" setting on the device?

[GuestStar]

Or, you sleep so well you don't notice.

Haha maybe! I actually slept worse at first because my brain was so used to no noise meaning no breathing. I was always on the alert and slept way better when I heard him snoring or making noises, because I knew it meant he was still breathing. I'm doing better now, but if I wake up I feel like I have to check to make sure he is still alive.

[ChicagoGranny]

I've set his minimum from 8 to 9 as suggested.

+1

But, uhm, will his doctor be notified that a setting such as this was altered?

Who cares? Do the right thing. If you change settings and get a very good therapy going, tell the doctor on the next visit and dare him to mess with what you are doing.

Would this be the "flex" setting on the device?

Yes. But, since you changed the minimum, don't change the flex yet. In this case, it's best to change just one variable at a time. If you changed both on the same day, you might not be able to tell which change gave you the change in results you observe.

[Julie]

Yes it would be the flex...

Don't worry about the doctor - it's not his therapy, but yours (or your ? friend, family members) and while occasional old fashioned doctors get grumpy when patients tweak pressures based on software and education, most of the time because they're ignorant themselves of how the machines work, most should be happy that you're taking charge. And if they're adamant in their paternalism, change doctors.

[ChicagoGranny]

if I wake up I feel like I have to check to make sure he is still alive.

Oh, that was before. Now, CPAP will keep him alive for a long time.