2 weeks and struggle seems to be easing

[neallo]

I have been a hose head for only two weeks. I am still struggling with leaks 95% at 25 max at 134, butt that was for a few seconds but finally got min to 0.0.

I have a few questions about sleepyhead.
Does any one know how are snores recorded and scaled?
What is meant by flow limitation
A non sleepyhead question
I woke up middle of night and felt nothing coming out of my machine, but when I moved the masks I felt and heard high pressure, is this natural or should I be concerned.

[MitzyG]

After I got used to my machine, it felt like the mask/air wasn't there. I had to feel the exhale vent to know that air was still coming through.

[robysue]

I have a few questions about sleepyhead.
Does any one know how are snores recorded and scaled?
What is meant by flow limitation

Snoring
No-one really knows for sure how either the Resmed S9 or the PR System One machines record snoring. We do know this much: Snoring is picked up by analyzing the wave flow data and not through a microphone. In other words, when you are snoring, there are certain tell-tale signs that show up in the wave flow data. Mostly these are small oscillations in the wave flow during the inhalation part of the breath. Sometimes they're visible when looking at the wave flow in SleepyHead and sometimes they're not.

On the S9 the snoring data is recorded as a continuous function of time. In other words, you get a "snore graph" where the horizontal position is the time of night and the vertical position is supposed to be the "loudness" of the snoring. I'm making an educated guess on the vertical dimension of the graph because ResScan uses icons instead of numbers for the vertical scale. Here's a picture of a Snore Graph in the Resmed ResScan Data interpretation guide available at http://www.apneaboard.com/ResScan_Inter ... -Guide.pdf


Note the icons used for the vertical axis: They are icons depicting stylized speakers with the top speaker indicating "very loud" and the bottom one indicating "no sound". The note about interpreting the graph is clear: Higher means the individual snoring is worse. The length of time spent snoring is determined by the horizontal distance of the bump on the snore graph.

When JediMark wrote the code for displaying the Resmed S9 snore data, he opted for a numerical score. How the numerical scores in SH relate to the three icons used in ResScan is something I don't know. I only used an S9 for a few months three years ago, so I have limited data to try to figure this out. Perhaps JediMark will stop by and explain how SH picks the numbers for the vertical axis of its snore graph.

An important note to PR System One users: The PR System One machine records snore data in a very different way and comparing the vertical axis of the SH snore graph for an S9 to the vertical axis of the SH snore graph for a System One is like comparing apples and oranges. I wrote a long post here about the way snore data for PR machines is presented in both SH and Encore


Flow limitations
Loosely a flow limitation is a change in the shape of the inhalation part of the breath that indicates the upper airway may be beginning to collapse. They are thought to be possible precursors to apneas and hypopneas, but it is possible for an apnea or a hypopnea to just occur out of the blue without any flow limitation warning. Resmed S9 AutoSets and PR System One Autos both respond to flow limitations by increasing the pressure so as to make it more difficult for the airway to actually collapse.

The way that S9s and System Ones record flow limitation data is quite different. The S9 records flow limitations is as a continuous function of time. The vertical height of the graph gives an indication of how severe the flow limitation is and the horizontal length of the bumps gives an indication of how long the flow limitation lasts. Again, ResScan does not use numbers on the vertical axis for the Flow Limitation graph:



From bottom to top, the icons on this graph are stylized representations of how non flow restricted inhalations look, how moderately flow restricted inhalations look, and how severely flow restricted inhalations look. Hence, the higher a bump on the Flow limitation curve, the more severe the flow limitation. When JediMark was writing the code for to display the S9 flow limitation data, he chose to use a 0 to 1 scale, where the number represents the "percentage" of "flow limitation." In other words, if the flow limitation graph hits .60, that means that the height of the flow limitation is 60% of the maximum height of the flow limitation in ResScan.

An important note to PR System One users: The PR System One machine records flow limitation data in a very different way. If you are using a PR System One in fixed pressure mode, NO flow limitation data is recorded. If you are using a PR System One in Auto mode, flow limitations are scored as discrete events with tick marks in the wave flow (flow rate) graph showing where the flow limited breaths occur. But it is not clear what specific criteria are used to earmark a section of the flow rate graph as "flow limited" breathing. You can get an idea of how long the flow limited breathing lasts by looking for series of FL tick marks. On the PR machines there is not a graph that shows how severe the flow limited breathing actually is other than zooming in on the flow rate graph and looking at the individual inhalations.

[neallo]

Thanks for the responses, I now have a little more information. My snoring seems to be quieter, but I thought that cpap would eliminate snoring, but atleast my fiancee is reporting much quieter snoring so she is sleeping much better. I guess I need to compare snore graph to flow limitation to do if there is a problem.

While I was awake with machine on I recorded snore information and flow limitations. What would that indicate? I know I wasn't snoring while awake the only limitation flow wise was the machine itself, don't use ramp because I don't normally last awake for any amount of time. Fiancee laid awake and watched tv, which hindered my sleep a little, but no real problem because I have no wake up time on weekends.
Another thing, I noticed a couple of times that my leak graph and my snore graph were pretty similar in that I could put one over the other and not see a lot off differences. Weird?

[robysue]

While I was awake with machine on I recorded snore information and flow limitations. What would that indicate?

That would indicate the machine is misinterpreting WAKE breathing patterns as possible sleep disordered breathing patterns. The machine has no way to tell when you are awake or asleep and it assumes that you are asleep the whole time you are using it.

WAKE breathing is much more ragged and much more irregular than SLEEP breathing is. And hence when you are awake and breathing with the machine on, the machine is apt to look at normal WAKE breathing patterns and (more than occasionally) score them as CAs, Hs, OAs, or FLs. The fact that the machine also scored some snoring when you were awake may either indicate that you do have some vibrations (that may not be audible) when you are breathing while awake OR it could be the machine is picking up vibrations from elsewhere and that's being imposed on the wave flow and the machine is recording false snores. I don't know how sensitive the Resmed snore detection algorithm is, but the PR snore detection algorithm is particularly sensitive and can be fooled into recording snoring when the hose is rubbing on a sharp corner of the bedside table or (in the case of pugsy) when a snoring dog sleeps next to the person wearing the mask.

Another thing, I noticed a couple of times that my leak graph and my snore graph were pretty similar in that I could put one over the other and not see a lot off differences. Weird?

Snores are one (special) form of flow limitations. If you have little else going on in the way of flow limitations, then the snore graph and the FL would indeed be very similar to each other.

[chunkyfrog]

The easiest way to check if the machine is running is to hold your hand in front by the exhaust vent and feel the air stream.
Once you know where it is, it's very easy to check.

[neallo]

Thanks for the helpful hints, it's hard for me to remember the exhaust vent in my half asleep state. My does the pressure really feel that low when you are acclimated to the cpap and pressure.
I am trying to get my mask leaks under control. My median leak last night was 12.5, my 95% was 25. So I might be thinking that my flip flop kicking sleep style might be raising these leak numbers.
Hmm how to slow down my sleep dancing without going to a doctor? Idk heard someone state the naproxen could hinder sleep, not good because my choices are naproxen Orr ibuprofen. Ibuprofen is lower dose, but naproxen is doctor prescribed. Guys I will start trying ibuprofen maybe it will help with the plmd and leg and back pain.

[jencat824]

Hmm how to slow down my sleep dancing without going to a doctor? Idk heard someone state the naproxen could hinder sleep, not good because my choices are naproxen Orr ibuprofen. Ibuprofen is lower dose, but naproxen is doctor prescribed. Guys I will start trying ibuprofen maybe it will help with the plmd and leg and back pain.

I would caution you to be careful with these NSAIDS, use one but not both. I have kidney failure because a Dr mixed 2 of these drugs & I didn't question him.

Now for restless legs & plmd, there are drugs specifically for that, without using NSAIDS, but if one of these works for your legs + pain that's great. I take Mirapex for rls & plmd and that works for me. There are many drugs to treat these, but the mildest is always best IMHO.

Just my two cents worth,
Jen

[neallo]

I don't take both at same time, because my mother read about these issues and when I told her about the naproxen she freaked, but I am glad you pointed this out to me for me and anyone else who reads these things need to be told often and point blankly. Sorry your doctor has made your life tougher than it should be. All I can say is sorry.
Who knew that I suffered from so many sleep problems. Osa, plmd, possibly rls, pre arthritic knees, a sore back do to yrs of abuse playing sports and manual labor in my career choice. I might discuss those medication therapies with my sleep doctor when I have my follow up at end of month. I only take the naproxen in the morning before work of my knee hurts, which it does in the winter. I promise I will only take ibuprofen at night to help with back and other pains. I understand your concern and I truthfully an thankful you pointed it out to me. I hope someone who reads this sees what you are going through and stops taken both at one time.

[John from Brookston]

I have been a hose head for only two weeks. I am still struggling with leaks 95% at 25 max at 134, butt that was for a few seconds but finally got min to 0.0.

I woke up middle of night and felt nothing coming out of my machine, but when I moved the masks I felt and heard high pressure, is this natural or should I be concerned.

I think that's typical. When i first started sleeping all night I'd wake up in the morning to get up and the hose would bring me up short. I wasn't aware of the mask, blower, pressure, nothing. It's an enjoyable sensation, actually. Congratulations! You're adapting to The Hose!