Encouraging APAP progress so far...

[jmaziarz]

I've been using my M-Series APAP w/A-Flex machine for over a week and it has been going well. My compliance is nearly 100% and I am sleeping through the entire night without ripping the mask off in frustration. I also have the card reader with the EncoreViewer software and have been looking at my data each morning. I still have a lot to learn. I found some basic information on what the various data points mean and how the machine handles them at http://sleepapnea.respironics.com/technology/.

Where do I go from here? Should I start posting my data so others can see how I am doing?

[bdp522]

Sure you can post data for comment. The big question is how are you feeling?

Brenda

[gasp]

Sounds like you're off to a good start. I learned a lot about my data by posting my numbers for forum members.

[jmaziarz]

Here is my data from last night. Comments are greatly appreciated.

- My leak does not look bad but I am still having quite a few OA's and FL's, what should I be change to fix this?
- My VS's are clustered towards the beginning of the night (I don't use ramp), what could cause this?
- Should I reduce my minimum pressure?

[Wulfman]

Here is my data from last night. Comments are greatly appreciated.

- My leak does not look bad but I am still having quite a few OA's and FL's, what should I be change to fix this?
- My VS's are clustered towards the beginning of the night (I don't use ramp), what could cause this?
- Should I reduce my minimum pressure?

First question is what is your normal sleeping position?

You might try moving your minimum pressure up and see if the OA's diminish.
If you sleep on your back, that could explain some of them.
It looks like the OA's are happening quickly.....some with a leading snore......and the machine doesn't have time to respond, so I'm guessing the apneas are of short duration.

Look at your leak line and see if the VS's line up with the leakage.

Den

[jmaziarz]

I am a side sleeper. Even though my AHI was 3.1 last night I still feel a bit groggy today.

So I should raise my minimum pressure to say 10.5?

[Wulfman]

I am a side sleeper. Even though my AHI was 3.1 last night I still feel a bit groggy today.

So I should raise my minimum pressure to say 10.5?

If you were at 10, I'd go to 11.

Den

[jmaziarz]

Should I stay on a minimum pressure of 11 for a while or will I start to see results after the first night? Also, can you explain why I would want to increase my pressure so I can understand? Thanks for your input.

[Wulfman]

Should I stay on a minimum pressure of 11 for a while or will I start to see results after the first night? Also, can you explain why I would want to increase my pressure so I can understand? Thanks for your input.

Typically, you want to give yourself a few nights to adjust to a new/different pressure setting.......so I would say at least 3 nights.
If the minimum pressure on an Auto/APAP is too low, it has further to go to take care of the "events"......Autos move slowly and cautiously......and that allows too many events to take place if and when it finally gets there. It's ideal to get the minimum pressure up to where it would take care of almost all of those apneas, hypopneas, etc. If you continue to move your minimum pressure up and the events in the reports keep decreasing, you know you're going in the right direction.

Den

[gasp]

I have only been interpreting my numbers for a year and have not buckled down and learned how to do it well. So my comments have limited value.

-When I see the increased snores at the beginning of the night, I wondered if you begin by sleeping on your back or other position that increases snoring for you.
-A 0.4 FL doesn't seem high to me.
-It looks like your machine is set for a 10 to 20 range - is this the range you were prescribed?
-Some masks have an inherent higher leak rate than others. Look at your masks booklet to see what the 'normal' leak rate is.
Helpful link: viewtopic/t13839/Normal-Leak-Rate.html

In addition to Encore Pro software reports, I enjoy and get useful information from Skinner's Encore Pro Analyzer software. In particular, I use the line chart pressure comparisons such as flow limitations vs pressure, AHI vs pressure, and more.
http://james.istop.com/EncoreProAnalyzer/

[jmaziarz]

-When I see the increased snores at the beginning of the night, I wondered if you begin by sleeping on your back or other position that increases snoring for you.

Nope. I always sleep on my side.

-It looks like your machine is set for a 10 to 20 range - is this the range you were prescribed?

Yes, I am currently using a 10 to 20 range. I was prescribed 4 to 20. My sleep doctor doctor admitted to not being familiar with APAP which is why it took almost 5-weeks for me to get the machine. My DME kept asking him for a "range" and he kept giving them my titrated CPAP pressure of 12. Pretty frustrating. I set my range at 10 to 20 based on advise from RestedGal.

-Some masks have an inherent higher leak rate than others. Look at your masks booklet to see what the 'normal' leak rate is.
Helpful link: viewtopic/t13839/Normal-Leak-Rate.html

The normal leak rate for the Mirage Liberty at 12 cms (my 90%) is 41. That is exactly what I have been getting.

In addition to Encore Pro software reports, I enjoy and get useful information from Skinner's Encore Pro Analyzer software. In particular, I use the line chart pressure comparisons such as flow limitations vs pressure, AHI vs pressure, and more.
http://james.istop.com/EncoreProAnalyzer/

Will that work with EncoreViewer too?

[Snoredog]

my opinion:

Your obstructions that cause the apnea appear related to the tongue getting lodged into the back of the throat. Vibratory snore seen supports that. When you snore it is the soft palate fluttering against the base of the tongue, then on inhale it suddenly slams shut resulting in the Obstructive apnea you see on the report.

IF you look in front of each of your OA's (obstructive apnea) they are proceeded by snore. Your 90% pressure seen is 12 cm. If you are going to increase pressure from current 10 you should increase it to 12 cm. That should eliminate the snoring (may not but should reduce it) and lower the frequency of residual apnea seen. Keep in mind all those apnea you are looking at on the report are "residual" meaning the machine did not eliminate them.

So if it was me, I would:

1. Increase Minimum pressure from current 10 cm to 12 cm.
2. Setup a Auto:Ramp pressure lower at say 7 cm for 30 minutes. Having it pre-configured for Ramp means it is available and you can use it when ever you want, probably won't impact your AHI any.

Way it would work:

1. Get in bed turn on machine, it goes to 12 cm pressure, may be a bit too high to fall asleep against, so you hit the Ramp button and pressure drops from 12 cm to 7 cm where it is much easier to exhale against, every 5 minutes it will increase up by .5 cm, by the time the 30 minutes has elapsed you will be at your ideal pressure of 12 cm.

Make things easy for yourself, use the features available on that machine.

[jmaziarz]

Thanks Snoredog. I'll try your suggestions tonight and post my data in the morning.

[rested gal]

I set my range at 10 to 20 based on advise from RestedGal.

And that wasn't a bad place to start. Now that you've got data from that setting and the data shows you're still having quite a few Obstructive Apneas, I'd raise the minimum to Den's suggested 11 or Snoredog's suggested 12. I'd keep the 20 in place for the max.

You're doing great, jmaziarz! Beautiful low leak line.

You asked if James' Encore Pro Analyzer will work with Encore Viewer. I don't think so.

[Poppy]

Hi. I don't have a card reader yet and just brought my card to my doctor's office to see how I am doing with my new apap. I'm wondering, though, my apap has a cflex. What's the difference between a cflex and an aflex?
poppy