[Self Diagnosis] Interpreting SH Data

[Subspace]

Hello,

This is my first post so please bare with me. A bit of background about me, I'm 31 years of age, male, not overweight, and I've had some sleep issues for nearly a decade. I've spent thousands of dollars on supplements, exercised, etc but nothing would or could solve my fatigue. I've been to my doctor(s) many times and it's the same result every time. They report that nothing is wrong with me even though I'm fatigued and have anxiety/depression issues.

I then read about CPAP and how it has been the holy grail for many users who has been suffering from sleep apnea and other related sleep issues. I've read up on the symptoms/issues and it all seems to correlate with what I've been going through. I decided to go to my sleep doctor to get tested. This is where things went wrong. This sleep doctor of mine would not stop talking about nonsense, such as their children, their daily lives, what they ate for breakfast, etc. I thought the doctor was just being nice until I received a hefty bill after insurance for the full "consultation" time. I also came to the realization that it would cost ~$2000+ just to get tested.

Therefore, I decided to take matters into my own hands (self diagnose) and do a bit a research. After spending many hours of research, I finally decided to purchase a new Resmed Airsense 10 Autoset that came with a N10 and a Mirage FX nasal mask.

The first two nights were horrible. I couldn't sleep properly and it felt awkward with having the N10 mask on my face. I kept getting leaks here and there too.

The third night (last night) went really well after switching to the Mirage FX nasal mask. It felt lighter, formed to my face really well, and it just felt natural. I fell asleep with it fairly fast. Still getting some leaks here and there and I do believe that there were certain occasions where I would try to breathe through my mouth.

With that being said, here is my data from last night. Hoping that I could get some insight into what's being shown VIA SH.

Thank you.

Symptoms that I have are,
- Constant fatigue and sleepiness during the day
- Constant need to take a nap
- Noticing on occasion that I'm waking up in the middle of the night trying to catch my breath.
- Headache upon waking up but not always
- Swollen uvula (that my sleep doctor pointed out)

Medications and other,
I don't take any medication other than Claritin for allergies. I rarely drink alcohol, maybe once every 2-3 months but nothing heavy. I do use e-cigarettes (low nicotine) and have been off of cigarettes for over 10 years.

[Pugsy]

Welcome to the forum.

Don't need all those tiny graphs...makes it hard to evaluate.
See this thread
viewtopic/t158560/How-to-post-images-for-review.html
No need to redo these though. I can see well enough.
Just mentioning this in case you post future reports. You can get all we need on one image and the graphs big enough for evaluation.

Your primary job right now is getting comfortable with the mask and actually getting some sleep.

From the way the pressure graph is moving....it's wanting to fight to keep the airway open so I think you pretty much have your diagnosis there. If no OSA....usually no pressure movement.
We have no way to know how many airway collapses it prevented though...only see the ones it didn't prevent.

The CA/Central flagged events make up the bulk of your AHI and may or may not even be real. You may have been awake when they got flagged. Ignore them for now until you are sleeping more soundly to eliminate the chance of them being awake pauses in breathing that are being flagged. The machine only measures air flow...it doesn't know if you are asleep or awake and it can and will flag awake breathing irregularities by mistake.

How did you come up with the 8 cm minimum starting point?

[Subspace]

Thank you for the quick reply! And sorry about the graphs. I'll make sure to correct them in the future.

I started with the standard 4-20 range but it quickly became apparent that I was struggling to breathe at 4cm. I tested out breathing through various minimum pressures and found 8cm to be the most comfortable. I also had two previous results that I went by that showed that my Median was around ~7.57.

What I've noticed last night (the result shown in my original post),

- Had several occasions where I opened my mouth, causing me to wake up. I'm thinking of purchasing a F20 FF mask to counter this. I also want to try out a P10 in the near future.
- Woke up maybe 3 times at some point and noticed that I was breathe fast and shallow.

With that being said, should I continue to do what I'm doing and post daily results?

Thank you Pugsy

[Pugsy]

Yep, continue with these settings and work on mask comfort, fit, leaks and primary job is sleep itself.
Any leak that wakes you up....unwanted even if it is a tiny leak...anything that disturbs our sleep is unwanted.
Remember the primary goal....good sleep. Without good sleep the numbers don't mean much do they?

I have always felt like the mask was the hardest part of all this cpap stuff. Finding just the right one that suits our own preferences, wants and needs isn't always so easy to do.

We can't fix those centrals with more pressure...whether real or not. So we set them on the back burner for now.
If you get bored and want to learn how to dig deep into things and figure out awake vs asleep flagged events...go here and read and watch all the videos. http://freecpapadvice.com/sleepyhead-free-software

Finally even if all your centrals were "real" and none were sleep/wake/junk SWJ...you aren't having enough of them to worry about at this time.
And I can pretty much bank on a substantial number of your as being SWJ. Comes with the newbie territory thing.
Heck...even veterans sometimes. Not long ago I had a night where the AHI was over 3 and every single one of the flagged events wasn't real. I just had a bad crappy night's sleep with lots of tossing and turning, etc because of some back pain stuff going on. My AHI was over 3 and nice mixture of all 3 event categories and every single one of them I wasn't really asleep when it got flagged.

You are already so far ahead of where I was at this stage of things...you are doing quite well.
Pressure settings are fine....now just get used to having the alien on your face.
Play with new masks as you have time/money and are interested. Just wanting to try something is a good enough reason.

[Subspace]

You're right. The mask is definitely the hardest part so far. And as you've stated, my primary goal at the moment is to get a good sleep and in due time I'll hopefully find the break that I've been searching for a very long time.

I'll check those videos out as soon as possible.

Lastly, I'll post more results as time goes by.

Thanks Pugsy!

[palerider]

This is my first post so please bare with me

I only bare with people I know very well.
That said, I think I'd bump the min up to 9 and see if that smooths things out any more.

[Subspace]

This is my first post so please bare with me

I only bare with people I know very well.
That said, I think I'd bump the min up to 9 and see if that smooths things out any more.

Didn't notice the misspell until now.

I shall bump it to 9 tonight. Thank you for the input

[Subspace]

Update,

So I had two nights that went horrible. On one of the nights, I just couldn't sleep with this mask on my face. Anxiety was through the roof and the thought of working the next day without sleep didn't help. After about roughly two hours, I finally fell asleep and woke up feeling really crappy. Another aspect that went wrong with this session was that somehow the data on my SD card got corrupted. If you are wondering, I make sure to eject my SD card reader (and SD card itself) before unplugging.

The following day, I was so tired from the previous failure that I went to sleep almost instantly. At some point during the night, I somehow woke up and seemingly turned off the machine. In the morning, the mask was off my face and the machine was off. I don't remember doing this at all. I did manage to format my SD card and resolve the corruption issue. It fully recorded the two and a half hours that my machine was on and working before I turned it off unconsciously.

With that being said, I can't handle this mask any longer it seems. I decided to buy the F20 mask along with the P10 mask after hours of research yesterday (overnight shipping). Both masks arrived today.

Tried on the F20 mask and did a 5-minute session with it. During those few minutes, it felt absolutely great. No leaks, felt secure, and it is a lot quieter than the Mirage FX nasal mask I've been using up to this point. It's a lot more comfortable and the feeling of not having to worry about mouth breathing during my sleep is a plus.

Can't wait to try it on tonight and will post results tomorrow with this new mask. As for the P10, i'll try out this mask sometime in the future (or sooner if the F20 doesn't pan out).

[Subspace]

Here is a graph of my first night with the F20 Mask. I'm a side sleeper and the mask started to leak a few times during the night. It was fairly tight against my face too. Going to have to adjust it a bit.

For now, I'm going keep using the F20 Mask and see if I adapt to it over time.

Should I raise my minimum to 10? Or should I stay at 9?

[palerider]

I'd try 10.

[Subspace]

Second night with F20. Keep getting leaks around the bridge and chin area depending on how I move my face during the night. Tried adjusting the tightness and position of the mask but to no avail.

I do notice that my breathing starts to get shallow and shorter as I get more relaxed.

[Jas_williams]

Your leaks aren’t huge and your numbers are good, as you use the machine more I expect the CA count to gradually diminish as you get used to sleeping with the mask on

[Pugsy]

If you are still having some little wake ups during the night from the mask or leaks....very likely would explain the centrals or the biggest part of the centrals/CAs.
If that's the case as you get things sorted out so not so many wake ups due to mask fit/leaks whatever...some of those centrals will go away.

Even if they are the real deal though...not enough to worry about and should reduce a bit with time like Jas says.

Right now you are experiencing what I think is the most difficult part of this therapy...finding the right mask for you and getting it fitted so it is comfortable and doesn't leak and doesn't wake you up a gazillion times during the night.
In all honesty probably something that never totally goes away but with time and experience we learn to deal with it effectively and not let it affect our sleep quality so much.
I know even now I have some nights where leaks were a problem...and this morning I woke up mouth breathing and the mouth as dry as the Sahara (very unusual for me)...so my leak report might not be real pretty. Haven't had time or inclination to download yet to look at it...and I can wait..it won't change. And no matter what it might show I probably won't do anything more the shrug my shoulders anyway. No sense in getting in a rush.

[Subspace]

Thanks guys/gals. I'll keep pushing to make this work. I know that things like this take time. You guys/gals have been more helpful than most of my doctors and I'm very grateful for that.

Some of the centrals/CAs might be the leaks. I do notice that sometimes I will exhale and won't inhale for a few seconds. I don't know why this happens. It is like my brain is forgetting to complete the breathing process.

Thanks again

[Pugsy]

Some of the centrals/CAs might be the leaks. I do notice that sometimes I will exhale and won't inhale for a few seconds. I don't know why this happens. It is like my brain is forgetting to complete the breathing process.

If you notice that you don't inhale and exhale...you are awake and any events flagged then are SWJ events and to be ignored.
As to why we sometimes "forget" to breathe...our awake breathing is irregular and sometimes we just don't "need" to breathe so we don't. No big deal. We pause our breathing all day long and never notice it...we notice it at night because that's really all there is to notice. We are thinking about our breathing more. Common for cpap newbies to target breathing as something they notice more.
We don't have the daytime distractions to cover up the pauses in breathing.
Eventually with time...the brain learns that the breathing is boring and we no longer will tend to focus our thoughts on the breathing.
At that point it becomes a non issue.