AHI 131 !! - Help me understand my SleepStudy & CPAP results

[Pugsy]

Respironics says when using a non Respironics masks to turn Mask Resistance control to 0 which is off.
I don't think it really matters though. It doesn't affect the leak reporting like mask choice in the ResMed machines do.
Resistance is not the same as vent rate. To get an exact or semi exact approximation you would need to compare the resistance number of a similar Respironics product to the nasal pillow you use that is non Respironics.

I have played with all the settings with my nasal pillow mask...couldn't tell any difference...so I turned it off.

http://www.healthcare.philips.com/us_en ... ontrol.wpd

[caffeinatedcfo]

Lookin good buddy! This is awewsome news!

[Kenwood]

Pugsy...Looks like the 1cm addition to my EPAP (now at 17cm seems) to have fixed those snores I was having. This is my 4th night using EPAP 17cm with no snores and my average AHI during that time has been 1.05 AHI. Before bed last night, the wifey asked me if I wanted her to wake me up when she heard me having leaks as Tuesday night she woke up to the sounds of air leaks. I told her if it's bothering her - sure; if it's not bothering her - let me sleep as its not really hurting my treatment like the massive major leaks from the FFM. Unless its a "whine sound" like I'm blocking my vent with my arm or pillow. Last night also bumped the humidity setting from 3 to 4 (Classic mode).

Might go back to the Aloha and see if these occasional leaks are more mask or mouth. As the leak lines on the Aloha were near perfect straight lines. Hmmmm

Wednesday night's data - Night #6 using Swift FX Nasal Pillow:

[Pugsy]

Another awesome good (and now thankfully boring) report.

The Aloha is a bit more stable. The back strap on the Swift FX does like to "ride" up the back of the head a bit.
It never bothered me all that much but it did happen occasionally.

What it comes down to is which mask seems to let you sleep the best overall...not the leak line itself unless leaks wake you up or leaks are massive and prolonged which you have considerable experience with seeing with the FFM.
Which mask lets you feel a bit better about things in general. Better quality sleep in general...fewer wake ups from little mask issues.
It may be a toss up. Between the Swift FX and the Aloha for me it was a toss up. The Swift FX won out barely because I have this deep seated preference for having a little on my face and head as possible.

Now I have the toss up between the Tap Pap and the Swift FX. Therapy part is a toss up. Again my preference for "less on my face" takes center stage with my own personal wants.

Here's the great part. You get to decide what your own wants are...if a flatter leak line is part of your wants...that's fine.
Whatever makes you feel the best, be it leak lines or feeling in general or sleep quality. The mind is a powerful tool and sometimes it likes or needs the validation from nice nearly perfect reports.

I used to be a lot more worried about leaks and AHI numbers than I am now. I have discovered that how I feel during the day is not always reflected by what I see on my reports. Last night was a perfect example and if I have time I will post again in my Poster Child thread. Coyote ugly report but I slept extremely well last night and feel awesome good today. I have some thoughts on it but no time to go into it in great detail right now..maybe later. Lots to do today.

[Kenwood]

Another awesome good (and now thankfully boring) report.

The Aloha is a bit more stable. The back strap on the Swift FX does like to "ride" up the back of the head a bit.
It never bothered me all that much but it did happen occasionally.

What it comes down to is which mask seems to let you sleep the best overall...not the leak line itself unless leaks wake you up or leaks are massive and prolonged which you have considerable experience with seeing with the FFM.
Which mask lets you feel a bit better about things in general. Better quality sleep in general...fewer wake ups from little mask issues.
It may be a toss up. Between the Swift FX and the Aloha for me it was a toss up. The Swift FX won out barely because I have this deep seated preference for having a little on my face and head as possible.

I sure do love seeing boring reports too!
The masks are a toss up, I agree. I like the fit of the nasal pillow part of the Swift FX under my nose...but not the headgear fit.
Would "Bella Loops" headgear be a better for me on the Swift FX?

[Pugsy]

Would "Bella Loops" headgear be a better for me on the Swift FX?

Bella Loops...it took me about a week to get the fit just perfect. Main issue was the ear thing. Once I got it fitted just right..awesome mask but even then I sometimes would have my left ear getting pinched when the loop slid out of the groove. I have a nice groove for the loop but tiny ears in general so it was easy for the loop to slide out of the groove and pinch the ear lobe. Always my left ear..never my right ear. I think I have lop sided ears. When I was using the Swift FX I pretty much split the time using the Loops and the traditional headgear.

Being a male..you probably have larger ears so maybe less chance of that happening. If they look interesting to you..might be worth a shot. I gave my step sister a set of the Bella Loops (along with the traditional headgear) when we changed her from over 5 years of using an over the nose mask and she took to them like a duck to water. Loves them...never uses the traditional headgear. Fitting has to be perfect though...too tight and it hurts like a SOB and too loose they come out of the nose too easily. Do the final fitting laying in bed and not sitting up...the weight of the short hose pulls on the loops a little and just right sitting up is likely to be too tight laying down.

They don't cost a lot to try. $25 on EBay with free shipping or about the same at cpap.com when they have their free shipping or purchase $99 worth of free stuff and everything is free shipping. Often if you hang around in check out lane a little pop up will show up offering free shipping.
Or DME might have it and insurance might cover it. It is considered a headgear.
I think I gave away my last set but will go look later.

[Kenwood]

Wooohooo!!!! - I finally got my BiPap Auto
....after a month long battle with my DME!



BiPap Auto Settings:
EPAP-15 / IPAP-22 / PS-4

Looks like it had a little over a month's worth of use (278 hours)...but I don't even care.
I'm sending my old BiPAP Pro back to them with 395 hours.

[Pugsy]

Hey... you're swapping for a less hours of use machine. It will be fine. So "newer" in a sense with less hours then the one you you gave them.

Now ( crossing my fingers this fight was worth it )
Well.... it is any way you look at it really...you now have 3 machines in one. Win win...all bases covered.

Now you get to titrate all over again. Always something. Good luck tonight.

[Kenwood]

Okay Pugsy, time to titrate all over again with the new PR S1 750 BiPap Auto.
Settings: EPAP-15 / IPAP-22

I definitely noticed the pressure difference right away when I turned it on. It took me a couple minutes to get used to the different feel between pressures. I switched back to the Aloha nasal pillows too - you sure can tell in the leak line. I moved the SH pressure chart up and the snore chart down. I had a several of those super brief one quick loop snores but only one reached a 2.0 level on the chart. I woke up very refreshed this morning and did not notice anything the machine did last night - including the mask vent block at 2:30am to 3:00am. Take a look at the settings to the left and make sure I set everything correct. Thanks Pugsy....you rock!

Thursday night's data - Night #1 using new BiPAP AUTO with Aloha Nasal Pillow:

[Pugsy]

SleepyHead is messing up the EPAP pressure line. It's not showing movement and I don't believe SH. Can you get an Encore report?

You know this report is certainly acceptable...and we don't sleep the same way each night and ......you already know that speech.
I don't know that we really NEED to change anything base on one night. I was on the fence about the 15 EPAP....I am still on the fence.
Maybe I will get off the fence if I see the EPAP pressure line from Encore.

That said a 0.5 cm increase in EPAP wouldn't hurt but that is all I would do IF I were to get off the fence.

Your choice really. You've changed treatment modality and sort of have to let the body adjust to things again.
It is far from being a horrible report where we obviously would need to make a change.
I know from past experience... the AHI can range quite a bit without changing a thing.
Given your past reports once EPAP was at 17....if me...probably would make the 0.5 EPAP change and then sit back and watch it but that can also be said of leaving EPAP alone. There's no urgent need to make the change. I am a big fan of using as little pressure as possible and not worrying about 0.0 AHI thing. But that's me and you are you. For some people it's a mental reassurance thing.

You've had your chance to look at things...what are your feelings? What would you tell someone to do if you saw this report from someone else...with only one night under the belt? It's not black and white...of course you probably wouldn't have seen those nice boring reports with EPAP at 17 either.

[Kenwood]

SleepyHead is messing up the EPAP pressure line. It's not showing movement and I don't believe SH. Can you get an Encore report?

[Pugsy]

Well...I'll be darned... SH was right. EPAP didn't want to move except for that little period right after 4 mark.
Hmm.

In theory...EPAP could be reduced and no need to go up based on it's inactivity...but I am not so sure I would want to do it right now .

I think I would sit back and watch things for a few nights. Not change a thing.

[Kenwood]

Well...I'll be darned... SH was right. EPAP didn't want to move except for that little period right after 4 mark.
Hmm.

In theory...EPAP could be reduced and no need to go up based on it's inactivity...but I am not so sure I would want to do it right now .

I think I would sit back and watch things for a few nights. Not change a thing.

Yeah...let's give it the weekend and see how things work out.

I thought for a second the machine wasn't working right or I had messed up the settings somehow maybe the PS?

[Pugsy]

No you didn't mess anything up. Probably we would see movement if EPAP was lower. It didn't move because it found no need to alter EPAP...not much to fight.
Which in theory means probably could get by with less EPAP.
EPAP for obstructives
IPAP for hyponeas
is the usual way we look at things.

If you look at the only real cluster of OAs...right at that 4 hour mark or so where EPAP responded a little. That makes sense. EPAP at 15 is doing a superb job of holding the OAs off. Is it too good of a job? Don't know yet. Don't know if it matters either at this point. Need more nights to get a better feel for what is going on. You are in great shape...now it just comes down to what minor tweaking you want to under take. There's no rush.

Your AHI wasn't horrible at 15 or 16 EPAP..we only raised it to 17 to see if it would kill the snores...which it did.
The machine didn't seem to want to use EPAP for the few snores you had last night. Don't ask me why...I don't know but I would assume that the machine didn't think it was enough of an issue or didn't meet some other criteria that we aren't privy to.

This may be why original RX for EPAP and IPAP was so much lower...hard to say what went on during the titration study.
Hard to believe that the snores at the lower EPAP were so totally ignored though...unless there was a reason that we don't know about.

Gotta run...going to lunch with my mom and then some errands.

[Kenwood]

Would "Bella Loops" headgear be a better for me on the Swift FX?

Bella Loops...it took me about a week to get the fit just perfect. Main issue was the ear thing. Once I got it fitted just right..awesome mask but even then I sometimes would have my left ear getting pinched when the loop slid out of the groove. I have a nice groove for the loop but tiny ears in general so it was easy for the loop to slide out of the groove and pinch the ear lobe. Always my left ear..never my right ear. I think I have lop sided ears. When I was using the Swift FX I pretty much split the time using the Loops and the traditional headgear.

Being a male..you probably have larger ears so maybe less chance of that happening. If they look interesting to you..might be worth a shot. I gave my step sister a set of the Bella Loops (along with the traditional headgear) when we changed her from over 5 years of using an over the nose mask and she took to them like a duck to water. Loves them...never uses the traditional headgear. Fitting has to be perfect though...too tight and it hurts like a SOB and too loose they come out of the nose too easily. Do the final fitting laying in bed and not sitting up...the weight of the short hose pulls on the loops a little and just right sitting up is likely to be too tight laying down.

They don't cost a lot to try. $25 on EBay with free shipping or about the same at cpap.com when they have their free shipping or purchase $99 worth of free stuff and everything is free shipping. Often if you hang around in check out lane a little pop up will show up offering free shipping.
Or DME might have it and insurance might cover it. It is considered a headgear.
I think I gave away my last set but will go look later.

Purchased a set of Bella Loops on CPAP.com today.