Higher AHI but feel better?

[bipap3800]

How was your sleep quality? Did you wake very many times and/or spend much time awake with machine and mask on? I see one time where you turned the machine off...were there other awake times and you didn't turn it off?
How do you feel today?

Yes, slightly increased CA average when compared to what you got with initial settings but significantly reduced from the night where your AHI was 10 and 2/3 of it was central/CA.

Oh...where's the Events graph from last night? We need to see it also.
Always on the right there graphs
Events
Flow rate
Pressure
Leak.

It's been about 6 hrs since I woke up and I am feeling fine, not sleepy. But will have to see how is it like after lunch. One thing to mention is that I am having slight headache. Not sure if it is due to posture. I woke up once about 5am and spent maybe 15-20 mins to fall asleep again. There isn't other instances I woke up but had mask on.

I don't have the data now, can only provide tonight when I get home. Should I stay with these settings tonight or you can only advise after seeing the event graph?

Thanks Pugsy!

[Pugsy]

It's not a horrible report and I never make changes based solely on one night's results unless the results are a disaster which yours clearly aren't. We don't sleep the same each night and if people continually try to fix things based on last night's results they never get a chance for the body to adjust to the new settings. You can't do a thing about what happened last night anyway.

Seeing the Events graphs let's me get a better understanding when those various events happened. I can't really tell much by the colored lines on the Flow Rate graph.

My general suggestions are to give any new settings at least 4 or 5 nights unless the results are a disaster.
We can't fix centrals (assuming they are real) with more pressure anyway.
The obstructive component of your AHI is actually fairly low so you don't need more EPAP.

I wanted to see the Events graph to see how many of those centrals might be SWJ or sleep/wake/junk or were maybe clustered around known awake times. If they aren't real then they don't count. Only asleep events count.

You probably should take a crash course in learning how to distinguish awake vs asleep events.
Watch all the videos here.
http://freecpapadvice.com/sleepyhead-free-software

[bipap3800]

It's not a horrible report and I never make changes based solely on one night's results unless the results are a disaster which yours clearly aren't. We don't sleep the same each night and if people continually try to fix things based on last night's results they never get a chance for the body to adjust to the new settings. You can't do a thing about what happened last night anyway.

Seeing the Events graphs let's me get a better understanding when those various events happened. I can't really tell much by the colored lines on the Flow Rate graph.

My general suggestions are to give any new settings at least 4 or 5 nights unless the results are a disaster.
We can't fix centrals (assuming they are real) with more pressure anyway.
The obstructive component of your AHI is actually fairly low so you don't need more EPAP.

I wanted to see the Events graph to see how many of those centrals might be SWJ or sleep/wake/junk or were maybe clustered around known awake times. If they aren't real then they don't count. Only asleep events count.

You probably should take a crash course in learning how to distinguish awake vs asleep events.
Watch all the videos here.
http://freecpapadvice.com/sleepyhead-free-software

Yes, my obstructive has been fairly low compared to hypopnea. Wonder what impact does high hypopnea has, and how to reduce it.

Here's the screenshot with events:

[Pugsy]

The general rule when using bilevel is EPAP for OAs and IPAP for hyponeas.
More IPAP can be accomplished in 2 ways...simply a higher EPAP because more EPAP forces the IPAP up if a person doesn't reduce the PS. More IPAP can also be accomplished by increasing PS only.
The problem with more PS only is that sometimes it can trigger central apneas in some people which of course we don't want.
Hyponeas are just as important as the other apnea events in the grand scheme of things. If they weren't important they wouldn't be included in the AHI and they wouldn't be part of the criteria for the auto adjusting algorithm to want to go killing them.
Sometimes there's a fine balancing act that people have to do to keep something reduced but not cause some other something that creates a problem. Sometimes compromises have to be made when a change in something ends up causing more problems than it fixes.

You could try just a little more PS but watch the centrals carefully and remember science 101 ....keep your variables to a minimum whenever possible so that you can better evaluate your results.
Do allow at least 3 nights at a setting (preferably a week) to give the body a chance to adjust to any changes unless the results are a total disaster.

[bipap3800]

Ok I will stay with these settings for a few more days and monitor. I didn’t feel sleepy today.

I notice when I first start the machine, epap = min epap; ipap = min epap + min ps. Assuming a tight ps range, Is it correct to say that along the night the machine will increase ipap and as a result might push up the epap? Or does the machine adjust epap and might pull down the ipap?

Does my event graph shows a lot of SWJ?

[Pugsy]

I have zero way to identify SWJ events at this level of zooming in. Simply can't see each individual breath to look at the pattern.

I am not sure what triggers are involved when PS can change within a range which might impact EPAP vs IPAP.

I had a thread not long ago where I gave a crash course in figuring out asleep events vs awake/post arousal events.
Let me see if I can find it.

Did you watch the videos at Jason's website about using SleepyHead? He explains it so much better than I do.

[bipap3800]

Is there any thing I can do so that you could identify it? Should I zoom in at one of the CA event? Or zoom in at a few individual CA event?

No I have not watched yet

[Pugsy]

Watch all the videos. They will explain what you need to do to zoom in to see the breaths and have an idea if the breathing is awake vs asleep.

Also see this thread where I have some examples from someone whose AHI is pretty much all SWJ.
viewtopic.php?f=1&t=171979&p=1261265#p1261265

[palerider]

Wonder what impact does high hypopnea has,

Poor rest and oxygen desaturation: https://www.youtube.com/watch?v=-gie2dhqP2c

[bipap3800]

Watch all the videos. They will explain what you need to do to zoom in to see the breaths and have an idea if the breathing is awake vs asleep.

Also see this thread where I have some examples from someone whose AHI is pretty much all SWJ.
viewtopic.php?f=1&t=171979&p=1261265#p1261265

Wonder what impact does high hypopnea has,

Poor rest and oxygen desaturation: https://www.youtube.com/watch?v=-gie2dhqP2c

Thanks Pugsy and palerider for sharing the video links. Will watch it when I have the time.

Anyway here's my graph for last night. seems pretty good!

screenshot-20180815-085605.png (101.93 KiB) Viewed 14863 times

[Pugsy]

You may want a little more minimum EPAP but give these settings another 2 or 3 nights to get a little more used to it.
There's just a little more snores and FLs going along with those OAs and hyponeas than I would want to see.

The Clear Airway/Centrals...we ignore as long as they stay random.....we can't fix them with this machine anyway.
2 or 3 per hour doesn't need fixing anyway even if they were all real which I doubt that all of those flagged centrals are real.

[bipap3800]

Will continue with these settings for a few more days before increasing the min epap to 7. By increasing the min epap are you targeting the OAs or hypopneas?

[Pugsy]

Targeting mainly the snores, FLs and OAs but as a by product of more EPAP you also get a little more IPAP (when the PS is unchanged) which should also help reduce the hyponeas. There's more than one way to get more EPAP than just cranking up PS.
The snores and FLs aren't part of the AHI but they are signs that the airway is trying to collapse and the pressure is not quite optimal.

[bipap3800]

Is the snore real snore or just vibrations? My wife says i don’t snore anymore.

FL.. I know it’s something about the machine detecting air flow restriction but how is it different from OA or hypopnea event?

[Pugsy]

Is your wife awake all night to listen for snores?

The machine can pick up vibrations from outside forces and mislabel them as snores. Like hose rubbing on something and making a bit of noise. Or like when my little pug dog (who snores something awful) sleeps with his chin on my shoulder and my machine picks up the vibrations from his snores and flags them.
If you think that some of your snores are the hose rubbing on something you can use a hose cozy and eliminate that chance to see if it helps or not.

Flow limitations are a bit complicated to explain but think of them as OAs or hyponeas that didn't grow up to earn an OA or hyponea flag. They are the early signs that the airway is trying to collapse and one of primary factors that auto adjusting algorithms use to determine if more pressure is needed.
So Fls might be the shape of the air flow or it might be simply the reduction in air flow didn't last long enough or reduce enough to earn a grown up OA or hyponea flag. They are important because they can grow up and become full grown OAs or hyponeas.

Example...
With the OA to earn a flag there has to be at least 80% air flow reduction (doesn't have to be 100% blockage) that last for at least 10 seconds.
Withe the hyponea to earn a flag there has to be at least 40 % (sometimes 50 depending on brand criteria) up 79% air flow reduction that lasts at least 10 seconds.

Now what do you think happens to an air flow reduction of say 35% that lasts 30 seconds? It doesn't meet criteria for the OA or hyponea flag but it certainly is doing something....so it might earn a FL flag.
Or a 95% reduction in air flow that lasts only 9 seconds? Same thing...doesn't meet criteria for the OA or hyponea flag but it sure is doing something and if you have enough of them it can sure mess with sleep quality.

Snores and FLs are the early warning signs that the airway is trying to collapse...that's why they are so important and one of the driving forces behind the auto adjusting algorithms. Want to nip them in the bud before they get a chance to continue to grow up and end up with a full grown OA or hyponea flag.