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

[Kenwood]

Here's my 2nd night with my EPAP bumped up to 15.5 cm....

[Pugsy]

Doesn't look like the machine is wanting to kill those snores very badly.
They may not mean much. Up to you how bad you want to zap them I suppose. If you are sleeping well and feeling great they probably are not a huge deal. I sometimes have nights like that and then some nights with minimal to zero snores.
A few random snores may not be a problem unless they disturb sleep or you feel badly.
Leak line is awesome good once again. Is this with the Bella Loops? If so...I am pea green with envy..it took me a week to get there.

[Kenwood]

Doesn't look like the machine is wanting to kill those snores very badly. They may not mean much. Up to you how bad you want to zap them I suppose. If you are sleeping well and feeling great they probably are not a huge deal. I sometimes have nights like that and then some nights with minimal to zero snores. A few random snores may not be a problem unless they disturb sleep or you feel badly.

Leak line is awesome good once again. Is this with the Bella Loops? If so...I am pea green with envy..it took me a week to get there.

I'm sleeping and feeling great. Those snores do not bother me at all....they don't even bother the wifey. Personally, I think some of those could be my "internal snores" since I have a long uvula or maybe "sniffs".

My ears were bothering me all day yesterday, so I took off the Bella Loops and put back on the normal headgear until I get the Padacheek's Bella Loop covers from Karen in a couple days.

[Kenwood]

Here's my 3rd night with my EPAP bumped up to 15.5 cm....

Pressure wise....not a lot happened until 4:45am when the machine wanted to battle those snores...but those snores also occurred when my vents were partially blocked with a slight "spike down" that only went down 10 L/min.

[Pugsy]

Pretty boring report. If you hadn't had that little bit of snoring...nothing exciting after all.
The vent blocking...I don't know if that was a coincidence or not. In theory it should just affect the air that you are inhaling so I don't see how it might precipitate snores that the machine would want to fight. I could see it maybe creating some sound vibrations maybe but the machine wouldn't typically respond to those.

Isn't it nice to see such nice boring reports? And more importantly...the reflect your sleep and how you feel.
We like nice non eventful boring sleep because it means we have the best chance to feel better.

I tried a new bed pillow last night...the Mediflow with water in it. I don't have the water level optimal yet....woke up with a neck headache this morning to go with neck ache. Overall slept decently (I think for me) but haven't looked at the reports yet. Normally when I have extra discomfort I get more centrals from tossing and turning but from the looks of my bed head hair this morning...I didn't move around a whole lot. Hair is totally flat on left side...ugly bed head.

[Kenwood]

You think my pressures are good now? Boring reports are awesome!

A water pillow.....that is totally wild. And here I thought having a buckwheat pillow was weird.

[Pugsy]

I think your pressure settings are perfect.
Here's the deal...we don't sleep the same each night and sometimes your pressures will bounce around and sometimes they will barely move at all. We never know if we are going to have a really good boring night or an exciting night where the machine finds lots of stuff it wants to fight.

So what we do is find something that works well most of the time and stick with it. Yes there will still be an occasional not so great night but on a whole you will have a lot more boring reports than you will exciting reports.

There's probably a small range of pressures that most of us would do well at anyway. Remember my fixed bipap experiment a couple of weeks ago? I had a really ugly night the first night? I used the very same settings that night that I had been using on the model 750 machine in fixed bilevel mode for probably 4 months last year. The very same 9/13 settings that gave me AHI less than 1.0 a lot of nights last year. Heck, I even found a AHI 0.2 night with settings 8/12. That one was a fluke...most of the nights with 8/12 weren't so nice looking and that is why I ended up with 9/13.
It was just a coincidence that I had that really ugly night with lots of REM stage events pop up when I started the 660 machine at 9/13. I know from past history that 9/13 works quite well. I also know that 10/14 works quite well.
Which one works the "best"...well it depends on the night and we never know what the night might bring.

While I am probably a poster child for using auto adjusting pressures there are choices I have for using fixed pressures.
I could use that 9/13 and just allow an ugly report to slide by every now and then or I could increase the pressures a bit.
If I had aerophagia issues...I might let it slide if the 10/14 settings caused too much bloating. Fortunately I don't have those issues.

My point is this...you probably have several combinations of settings that will get the job done for you. You already know that you can get very decent reports on a fixed pressure machine...and now you probably have a little range with the auto adjust that would also do well. We pick one and stick with it and trust the machine to do its job. On the rare occasion where we have a really whacko night...well we shrug our shoulders and blame it on aliens and move on. Like my AHI 8.3 night...that's so whacko and so totally far from what I normally see that I simply am not going to worry about it.
I can't undo the night. I sure don't won't to use much higher pressures all the time just to prevent a once in 6 months bad night.

But now that you see the boring nights...this is how come I like to experiment...less boredom.
Pressures I don't experiment with so much anymore because I have learned the range where I know I will get the most consistent results. No dramatic changes. I don't chase the AHI 0.0 because I have learned that often it is a couple of lonely centrals that mess up the AHI...or maybe one lone OA. It just doesn't matter to me as long as I am sleeping decently and feeling decently.

[Kenwood]

I think your pressure settings are perfect.

...this about sums it up! Thanks Pugsy!!!
Pugsy....the "CPAP Poltergeist Cleaner" My job here is done!!

[Drowsy Dancer]

I would say that your reports are now exciting boring.

[Kenwood]

Wow....look at the flow rate increase when I blocked my vents last nite at 2:20am during that "spike down" I guess if it gets bad....my mouth should open at some point to breathe.

[Pugsy]

Wow, that's one crazy looking flow line there. I suppose it is your body trying harder and harder to get the needed good clean air and not the CO2O laden air. Yes, if it gets bad enough the brain should trigger the mouth to open and it might have in this situation and you not know about it. Not all mouth breathing shows up as a huge leak spike anyway.

Otherwise another boring report.

[SleepingBetty]

Just wanted to say thanks to you, Kenwood, for this thread and to Pugsy for all the explanations! It really helped me in understanding my own graphs. I hope it is helpful to lots of other newbies, too, so bumping it back to the top!

[Kenwood]

Just wanted to say thanks to you, Kenwood, for this thread and to Pugsy for all the explanations! It really helped me in understanding my own graphs. I hope it is helpful to lots of other newbies, too, so bumping it back to the top!

I'm so glad I could help you. That was my hope in creating this thread...to try and help others through my experience. I love looking and studying SH graphs in various threads. I wasn't expecting my first couple months on CPAP to be so challenging with factors like R/T's insisting that I cannot wear a Nasal Pillow mask with my high pressure, then to tell me I wasn't having any leak issues (when I was spending 1/3 of the night above the major leak line). Now....I'm sleeping back on my stomach, happy and feeling great. No leaks and low AHI. Just boring SH reports these days. Just an occasional night where I block my vents. Was any of that because of my sleep doctor or DME.....NO...it was because of the caring members of this forum (I like to call you all my "Support group") and PUGSY. She made a difference in my treatment.

[SleepingBetty]

That's awesome, Kenwood! I'm still plugging along. Last night was better again, but I'm not sure I'm at my final settings yet. We'll see.

I enjoy looking at the graphs, too. At first, it was very confusing, but little by little, I began to understand what they meant. There are still many things I don't understand, but that will come in time.

I've been pointing people to this forum and all the wonderful help that is here. I haven't actually talked to my brother yet, but my mom has tried without success. He is in bad shape, narrowly averting a major stroke recently, and they believe he may have had a series of smaller strokes in the past that have left him with Parkinson-like symptoms, but it isn't PD. Yet, he won't use his CPAP! Then, a nephew that would wake up and find his mask across the room, but has no desire to try again. It's sad, really, when such awesome help is available. Well, one at a time! I do feel the crusader stirring inside me, though!

[Kenwood]

Ugly 30 minute cluster (zoomed in view) right after I fell asleep on Friday night. Haven't had one of these in awhile....Damn aliens!