New to CPAP and Sleep Data Help

[Rhodesie]

Hi everyone,

Husband has been trailing for 2 weeks a ResMed Airsense 10 with a full face mask set on APAP with EPR and ramp both set to on. When I looked at the data via SleepyHead, I am wondering if the excessive CA events are "noise" from him waking up. He find the ramping up of pressure wakes him up. We met with our DME (respiratory therapist) and they weren't sure about the CA events. The tech dropped his upper max pressure today to try and see if he doesn't wake up as much. His OA events run about 1.2 AHI with a few of hyponeas.

I have attached one of his daily stats where he had the mask on for just over 7 hours.

[Pugsy]

Welcome to the forum.

Does he report spending a lot of time awake with mask and machine on during the night? Lots of wake ups with lots of time taking to go back to sleep????

I am not so sure that those centrals are related to pressure itself...if you look at the cluster of centrals right before the 05:00 time frame the pressure was very low.

[Rhodesie]

Welcome to the forum.

Does he report spending a lot of time awake with mask and machine on during the night? Lots of wake ups with lots of time taking to go back to sleep????

I am not so sure that those centrals are related to pressure itself...if you look at the cluster of centrals right before the 05:00 time frame the pressure was very low.

He does feel he wakes up during the night when the machine increases his pressure. When we look at what symptoms are associated with central apneas, he doesn't have any of them. Symptoms fit to traditional OA apnea.

Thanks

[Julie]

Can you get rid of the calendar and allow more of the results to show up at the bottom of that (left) column?

[Pugsy]

Those centrals might be awake breathing getting flagged by mistake and be more of a symptom of being awake and poor sleep than anything else.
Now if you had told me that he said he was sleeping soundly all night then we might worry a bit about those centrals.

Let's see if the tech reducing the pressure range (and maybe reducing awakenings related to the pressure changes) seems to help or not.
Frequent prolonged awakenings really mess with the data...can't trust it.
Remember the machine only measures air flow and it can't tell if a person is asleep or not.
When awake our breathing is much more irregular and can really cause some false positives to get flagged by the machine.

[Rhodesie]

Here are all of the graphs.

Bev

[Rhodesie]

Those centrals might be awake breathing getting flagged by mistake and be more of a symptom of being awake and poor sleep than anything else.
Now if you had told me that he said he was sleeping soundly all night then we might worry a bit about those centrals.

Let's see if the tech reducing the pressure range (and maybe reducing awakenings related to the pressure changes) seems to help or not.
Frequent prolonged awakenings really mess with the data...can't trust it.
Remember the machine only measures air flow and it can't tell if a person is asleep or not.
When awake our breathing is much more irregular and can really cause some false positives to get flagged by the machine.

We will see how things go for the next few nights. His sleep study had him at 37 AHI so even if the CA's are some portion real, he has improved with the use of APAP.

We talked today about whether the APAP is helping. He did realize that last night he only wore the mask for 4 hours and didn't feel good today. On days he keeps the mask for 7+ hours, he feels some what better. He is not sleeping soundly thru the night with it but it's only 2 weeks.

[Pugsy]

I think Julie wanted more of the stuff on the left side under the Statistics section than those extra graphs.

See this thread for how I hid the calendar and turned off the pie chart and let more statistics show up on that left side under the AHI graphs.
viewtopic/t158560/How-to-post-images-for-review.html

I didn't really care in this instance as I could see enough for right now but Julie wanted to see more and that's why she asked.

[Pugsy]

It doesn't help a person if they keep the mask on for 7 hours but they only sleep 4 hours of those 7 hours.
People have to get the sleep first before having any chance of feeling better.
We simply need more than 4 hours of sleep.

Now figuring out how to get more than those 4 hours...not always so easy.

[Ron AKA]

In SleepyHead just above the AHI orange bar is a set of tabs. Click on the Events tab and you will see a list of events. Double click on the obstructive events line. Then click on the event at about 3:18 AM. That should give you an expanded time scale view of what all those events around that time look like and should include both the open airway events as well as the obstructive. Then post that screen shot. Leave the flow rate and mask pressure where they are as they are the important ones to see in the expanded scale.

[Rhodesie]

Following Ron's instructions

[Ron AKA]

Yes, that is what I expected to see. You should also note that your machine has flagged 3 Cheyne-Stokes events. I would make some copies of the Cheyne-Stokes events, and the other events where there is a whole series of them, and take them to his doctor for discussion. I also have some events that look a lot like that, but not nearly so many. If he has just started CPAP treatment it is not unusual to see an increase in central apnea events, and they may reduce over the first 6-8 weeks to treatment. That said, he is starting with a lot. Needs to be reviewed by a doctor with expertise in the area. It can be a sign of heart or other associated issues. I plan to discuss my events with my doctor on the next regular visit.

[Pugsy]

And I think that those CAs/Centrals are probably SWJ and not real. Looks more like post arousal breathing to me.
I also suspect that the flagged OA might be SWJ also.
Especially with the history of a lot of known awake time in the middle of the night.
SWJ...sleep/wake/junk flagged events that are false positives and awake flagged events simply don't count in the evaluation process.

I would need to see what the machine flagged as CSR in terms of the flow rate before I got too worried about it.
Even if the real deal it's not usually something a doctor worries about unless there is an awful lot of it but if someone sees a lot of it or it bugs them...talk to your doctor about it.

[Rhodesie]

And I think that those CAs/Centrals are probably SWJ and not real. Looks more like post arousal breathing to me.
I also suspect that the flagged OA might be SWJ also.
Especially with the history of a lot of known awake time in the middle of the night.
SWJ...sleep/wake/junk flagged events that are false positives and awake flagged events simply don't count in the evaluation process.

I would need to see what the machine flagged as CSR in terms of the flow rate before I got too worried about it.
Even if the real deal it's not usually something a doctor worries about unless there is an awful lot of it but if someone sees a lot of it or it bugs them...talk to your doctor about it.

I am sorry about all of the question...but CSR?

[Ron AKA]

CSR is Cheyne-Stokes Respiration. Google it, check a credible medical link, and then decide how concerned you should be.