6 weeks in... how am I doing?

[amybeth]

Well, I've been doing my therapy for 6 weeks now. Been through 3 different masks and finally feeling like I'm getting used to this. I have downloaded my detailed info and have no idea what I'm looking at to know if I have my settings right or if anything needs to be tweaked. Thank goodness I can come here and know someone will help me.

Here are the numbers I get from the screen on my machine...

Large leak and Periodic breathing are both 0

AHI - 1 day: 8.6, 7 day: 5.5, 30 day: 5.1

90% Pressure - 1 day: 12, 7 day: 9.8, 30 day: 9.7

I'm sorry I'm so clueless Any thoughts/insights will be greatly appreciated! Also, is there something specific I look for on the detailed reports?

Thanks in advance,
Amy

[Pugsy]

AHI break down into event categories??? How much of that AHI is Clear airway, hyponea and Obstructive apnea...this has to come from the software reports....see any clusters of anything?
Which software are you using?

How are you feeling? How is your sleep quality?

Have you read my little tutorial on understanding your data? If not I have links for it in my signature line or it is at the top of the announcement section on the main forum page.

[amybeth]

Thanks for the reply. I will read your pointers.

Encore Viewer 2.0 is the software I have.

[amybeth]

Ok.... learning a lot from your tutorial! Thanks!!

What I'm seeing is that my CA is always low...less than 1 and often 0. Don't see a single day with it being greater than 1.
Hyponea averages 1.5 - 3
OA is around 1-3

These are the averages I can figure. I forgot to stick my SD card back in for the last 5 days. ARGHHH! At least I caught it before a month went by I guess.

Does that help?

As far as how am I feeling... I think it's getting better considering I'm not waking up so often because of the newness of having a mask on my face or a tube under me when I try to roll over or a leak sprouting and such. But that has just started the last few nights. Hopefully it continues and I reap the benefits of feeling more rested long-term.

[Pugsy]

EncoreGuide link this will show you examples of what you will see. For a different machine than yours but the basics are the same.
http://www.healthcare.philips.com/pwc_h ... _Guide.pdf

Since you are using Encore Viewer the above may help you understand what you are seeing. Some of the data that they show your machine doesn't report so just ignore that part.

If you want to post an image of one of those nightly detailed reports and don't know how...we talk about it here
viewtopic.php?f=1&t=81072&p=737779#p737779
The trend and summary are pretty much useless...the nightly detailed report with the graphs are the most informative.

[Pugsy]

You actually didn't lose much data by not having the SD card in the machine. The machine will store everything except flow rate or wave form graphs for almost a month.
The machine put the missing data on the SD card when you put it back in the machine. Using Viewer wave form graphs are all you will miss.

[amybeth]

Thanks Pugsy! I see lots of VS and OA/H clusters. would my pulling my SD card back out now that I stuck it back in and showing you my last couple night's graphs be of any benefit? I sure will if you think so! I am learning a lot here this morning. Thank you!!

[Pugsy]

Yes, it would help to see the report with the clusters to get an idea what might be going on

From the sound of it your minimum pressure may not be quite optimal if you are consistently seeing clusters of OAs and snores.
Usually those are related to maybe sleeping position (on your back) or maybe REM stage sleep.
Just need a little bit more pressure to start with to better prevent those clusters.
Also, often when the minimum pressure is more optimal the pressure line stabilizes and the machine doesn't go to the higher pressures as often.

See this thread..it shows a prime example.
viewtopic.php?f=1&t=39869&st=0&sk=t&sd=a

[amybeth]

[Pugsy]

Hard to see any pattern in all that activity.

Did you have a formal titration study in a lab to get a pressure or are they using the APAP to find you a suitable pressure?

Your minimum is too low and the machine simply can't respond quickly enough to keep the airway from collapsing either partially or fully.

I would suspect that 7 to 8 cm minimum would do a much better job of keeping the airway open in first place and thus lessen the machine from having to going as high and increasing as often. In other words with the minimum pressure optimize I suspect that the overall pressure line would stabilize quite a bit. Prevent the collapse in the first place instead of trying to fix it after the fact.

Your leak line isn't as "leaky" as you might first think when looking at it. Remember your machine reports total leak which includes the mask's vent rate and the vent rate increases with pressure increases..so a good portion of that higher leak graph line is related to pressure increases and not necessarily mask unwanted leak.

Are you scheduled for follow up anytime soon?

If they are using the APAP to find you a suitable pressure then most likely they wouldn't get all upset about your increasing the minimum yourself....if you are comfortable doing it.
I would suggest that if you decide to increase the minimum that you do so in small steps...it will be easier adjustment for you and might get lucky and not need as much as we originally might think.
So no more than a 1.0 increase at a time and watch the reports...3 or 4 days..then maybe another 1.0 and watch the reports for another 3 or 4 days.
Big changes are a harder adjustment for some people and can make sleep quality go down the tubes.
So small changes is normally more comfortable way to get to a higher pressure.

[amybeth]

Thank you so much! I am totally comfortable changing my min pressure! I'm pretty much on my own with this therapy thing since I refused it get my machine from a DME and got it online instead, my insurance totally sucks (thanks Obama) I got it online because it was $1000 cheaper, but I had to sacrifice getting help from the DME. So, this is why I'm here. And this is why I am sooooo grateful for all of your help! I will up my min pressure by 1.0 and be back in a few days for more advice.

[amybeth]

Forgot to add... The result of my titration (where I'm not sure I even slept!) came back with a recommended starting at 8.0. When I was deciding whether to buy from the DME or not, she said if I went on my own I should get an auto since they wouldn't be able to help me.

[Pugsy]

Your report looks a lot like my very first reports back when I started cpap therapy and was using the APAP with 8 cm minimum.
It took a 10 cm minimum to get the clusters broken up. I never worried about random single alone events.
Don't know how much more you are going to need but it won't be a huge amount.

Once I saw the clusters break up...that's when I saw my first signs that cpap was working...no more morning killer headaches and no more getting up to pee 4 or 5 times in 6 hours.
The other stuff like energy and hours of sleep and daytime sleepiness was a lot longer to see marked improvement in.

Titration recommended 8.0 but if you didn't sleep well and didn't get much REM sleep then maybe not an optimal titration study. That happened to me. Didn't get but maybe 10 minutes of REM sleep and that's where my sleep apnea is so much worse. So not surprised that they didn't quite get it right.