No more OSA? 250 to 215 lbs.

[Maxman190]

Can you help me understand the leak graph? The leak, leak 95% and leak max, what does each of it mean?


What pressure setting should I try tonight? I will upload the data of tonight's sleep tomorrow.

[RandyJ]

I don't find that leak graph, showing multiple days, very useful. You want to look at your leak graph for one night. Post one night's leak graph...

[Maxman190]

This is from June 3rd.


This is from June 4th, I didn't use my machine yesterday.


Is there any way to export data instead of screenshooting?

[Maxman190]

What pressure setting should I try tonight? I'm planning to sleep soon.

[RandyJ]

Those leak graphs look pretty constant, and unintentional leak is less than 24L/min. In my opinion, you're fine.

As far as pressure goes, I don't see evidence to warrant changes. Your last AHI of 2.13 is not bad. maybe you could post the breakdown of those events. You should do at least a week with the same settings every night before considering a change. Maybe after 7 days data you could post what's going on and I and others could offer feedback.

[Maxman190]

Alright, I'll keep it at 16/14 for now. Thanks for all your help everyone.

[Pugsy]

Large leak territory for the BiPap Pro PR S1 model 650 is going to be around 90 L/min.
That 24 L/min number is for ResMed users...though it doesn't hurt to use it for PR S1 evaluation...the leak allowance for PR S1 machines is normally more generous than 24 L/min and if one wants to use the 24 L/min as a personal threshold it will provide an extra layer of security.

Go to this thread of mine.
viewtopic.php?f=1&t=89894&p=826177#p826177
and note how I have shown the images of my reports. If you could do the same then we can see those snores or RERAs and be able to better evaluate things. That AHI graph below the flow rate graph is unneeded. You can turn it off in AH at the Preferences/Graph tab.
I have a thread where we explain most of the basic data that is shown on the reports.
viewtopic/t88983/Pugsys-PointersSleepyH ... nding.html
See if that helps to clear up some of your questions...if it doesn't take care of things...post back here again with questions and I will try to answer in more specific terms.

I can't tell a thing about your therapy with the graphs you have shown. Need to see the whole picture to better determine what is going on. It's much easier for us to evaluate if you present the entire detailed nightly report that represents the majority of your nights.

RERAs are maybe important if you are having a lot of them because they could point to a lot of minor arousals from some cause and a lot of arousals will disturb sleep quality. Anything that disturbs sleep quality also has the potential to mess with how we feel the next day...this includes snores because they are indications of some sort of flow reduction and those flow reductions could also cause arousals. This is why sometimes people go ahead and use xpap therapy to try to reduce snores when the AHI is not maybe all that horrible. The snores can disrupt sleep. They don't have to come paired with a full grown obstructive apnea (or hyponea) to be a disruptive agent to sleep quality and mess with how a person feels the next day. Never mind what snores do to the sleep quality of a bed partner. My husband rarely snores very much but when he does...I can't get good sleep.

Based on AHI your pressure settings are working but there is often more than AHI involved.
If you have a lot of "clutter" as in snores or RERAs showing up on your reports...those aren't part of the AHI equation so we have to look at those data points separate from the AHI.

So let's get you educated on what you are seeing on your software reports and get you comfortable assessing things.
Then we can evaluate the RERAs and snores to see if they are maybe a factor for you.
It's normal to have a few of each scattered around the night. We aren't ever given an acceptable number range for those data points like we are with the AHI (with okay being under 5.0 per hour). Instead we have to sort of figure out if what we are seeing is a potential problem on an individual basis. In my "clutter" thread above....I really didn't think that the snores or RERAs or Flow limitations were impacting my sleep quality but in general I don't like clusters of anything on my reports. Especially when they are happening every night. Random "bad" nights will happen but not night after night.

[Maxman190]

[Pugsy]

Don't need the AHI graph...turn it off.
Instead can you get an image of the report including the Events graph at the top and the Flow rate graph?
Don't really need the pressure graph because you are using fixed dual pressure...it isn't going to vary.
Looks like from what I see here that you didn't really have any snores and the RERAs were minimal.
Looks like maybe a little "clustering" of events at certain points during the night...normal suspects...supine sleeping or REM stage sleep or both. I can't tell from this report how much clustering is going on though.
See this thread for some good examples of "clusters" of OAs in my case. I think you will see what I mean.
viewtopic.php?f=1&t=88508&p=811640&hili ... ro#p811640

You can resize the graphs so that they are a bit smaller and then you can get more graphs on a single screen shot.
Make sure SleepyHead is opened to maximum size and then hover the mouse along the bottom line of each graph section until you see a little short double line..then click and drag to resize the box. SH will remember the resizing.

In the end you will come up with a report that looks like the one above I include my pressure graph because usually I am using auto adjusting pressures. This one above just happened to be using a new machine that I just got. The Events graph and the Flow rate graph are more important than the AHI graph...we already have AHI on the left side.

[Maxman190]

Wasn't sure which one you guys needed, so I just posted the whole thing.





Sorry Pugsy, I could only read one paragraph of your thread, it is very helpful. But, thanks to my excessive daytime sleepiness, I can barely concentrate or read anything without falling asleep. I did learn a lot from it though.

[Pugsy]

But, thanks to my excessive daytime sleepiness, I can barely concentrate or read anything without falling asleep. I did learn a lot from it though.

Okay...this answers my question about how do you feel?
Your reports don't look that bad. Based on that Events graph there is no real urgent need to change anything. But if you want to see if things change and it might affect how you feel...maybe 0.5 increase in EPAP...that's the only change I would make at this point.
Maybe you are having some low level arousals that we can't see that might impact how you feel. The report isn't horrible and doesn't point to anything screaming "fix me".

How is the sleep quality? Do you wake up often for some reason? Have trouble getting to sleep or staying asleep.
Do you take any meds..even OTC? If so what, when and what dosage.

[Maxman190]

Is this better?

[Maxman190]

Sleep quality is okay, I don't wake up in the middle of the night. No trouble falling asleep. I take a few medication... Lexapro 20mg, Wellbutrin XL 300mg, Buspar 15mg, Fish Oil 2400mg, Vitamin E 40iu. First three medication is for my anxiety disorder and depression. Last two are just supplements that my doctor told me to take.

[Pugsy]

Yes, thank you...that last image makes it so much easier to see the whole picture.

You know that your RX meds could be impacting how you feel during the day.
I don't have time to research them thoroughly but for sure the 3 RX meds all have known side effects for causing fatigue, drowsiness, and get this...I just spotted with a quick look at Buspar because I wasn't real familiar with it...depression is also a known side effect.
http://en.wikipedia.org/wiki/Buspirone

Damned if you do and damned if you don't.

I don't know how much of an impact the drugs are making but I am sure there is some impact there and with the really pretty decent software reports (at least on paper) I don't know that making any changes in regards to xpap therapy is going to make that big of a difference.
Doesn't hurt to try...maybe a little more EPAP but very little.

I think the biggest issue are the potential side effects from the meds.
I would think a really good discussion with the doctor about the meds...dosage and especially time of day dosage would be first on my list of things to do if it were me.
I know you can't just up and quit taking them..and we also know that depression itself presents with fatigue issues...so really caught between a rock and a hard place. The problem that the meds are supposed to be fighting and the meds themselves can cause problems.

I know we all want to see all our symptoms go away with optimal cpap therapy but sometimes the problems aren't totally related to sleep apnea or a sleep disordered breathing issue...and the machine can't fix problems unrelated to sleep disordered breathing.

[RandyJ]

I think the biggest issue are the potential side effects from the meds.
I would think a really good discussion with the doctor about the meds...dosage and especially time of day dosage would be first on my list of things to do if it were me.
I know you can't just up and quit taking them..and we also know that depression itself presents with fatigue issues...so really caught between a rock and a hard place. The problem that the meds are supposed to be fighting and the meds themselves can cause problems.

I agree with Pugsy 100% Those particular meds are known to cause daytime drowsiness, a feeling of sedation, etc. Even just one of them can cause it alone, and you are taking THREE which can have that effect. These drugs can also have an effect on decreased time spent in REM sleep, so you might seem to sleep well but are not getting all the REM sleep that you need.

It might be a long road, and working with a doctor who really cares and can be with you on this, to tweak dosage/change and or eliminate some of these meds to find a balance that deals with both the condition (anxiety/depression) and the side effects from the medications (fatigue/sedation).

At least you know that you are getting good therapy with cpap, and though you might make minor changes to pressure, it's unlikely that it is related in any way to how you are feeling during the day.