Newbie here - Could you help me interpret data please?

Hi everyone,

I've been trialing a ResMed AirSense 10 Auto-set for the last 3 months almost unsupervised (long story short, the Clinic I did the sleep study with were extremely slow so I decided to hire a machine from another company). I cannot say I've noticed much of an improvement so far unfortunately.

As you can tell, I progressively increased the minimum pressure until I set it 10 cmH2O on 18/09/2023. I've also been using EPR at 3 cmH2O most of the time (someone on another post suggested this could be the reason behind so many CA events so I disabled it).

Last Monday, I went to see one of the specialists from the company providing the machine, who said the minimum pressure was too high for someone like me, so he set it down to MIN 5 - MAX 10 (I then changed it to 7-12 as I was feeling like crap with those settings). For reference, I'm 1,70 meters tall and weigh 75 kg. Neck circumference is 38 cm.

I've noticed a few things: the vast majority of events are CA, followed by Hypopnea. Barely any OA at all. Also, Hypopneas were below 1 while the pressure was set to 10 Min - 18.6 Max (EPR 3). However, they have tripled since reducing pressure and EPR. CAs have slightly increased.

When analyzing CA, the same patterns seems to repeat: flow rate becomes erratic then flattens, leaking stops, tidal volume rises and drops sharply (see graphs below)

Could you help me make sense of the data I've collected so far please? Do you notice anything worth mentioning?

SUMMARY



CA 1



CA 2:



HYPOPNEA 1:



HYPOPNEA 2:



ALL NIGHT 1:



ALL NIGHT 2:

The CA you highlighted looks like you were probably awake when it happened. The only thing I would recommend is to raise your minimum pressure to 8 or 9, preferably 9. If you think that 9 is too much of a change, go to8 for a couple nights, then try 9. That will help with the hypopneas.

You've been changing setting on a nightly basis - which is not a good idea.
You brain and body have to get used to sleeping with CPAP, and nightly changes don't let them do that. Stick to a single setting for a week.

More that anything, your "all night images" show you're stopping your therapy far too many time a night.
What is causing you to stop so many times?

Okie bipap wrote: ↑

Sat Dec 02, 2023 9:29 pm

The CA you highlighted looks like you were probably awake when it happened. The only thing I would recommend is to raise your minimum pressure to 8 or 9, preferably 9. If you think that 9 is too much of a change, go to8 for a couple nights, then try 9. That will help with the hypopneas.

Well, most CAs follow the same pattern. I could share screenshots of another event from a different night if that helps.

Regarding raising the pressure, it might be worth mentioning that my mouth sometimes drops open. I got a chin strap but do you think I should get a full face mask instead?

ozij wrote: ↑

Sat Dec 02, 2023 10:22 pm

You've been changing setting on a nightly basis - which is not a good idea.
You brain and body have to get used to sleeping with CPAP, and nightly changes don't let them do that. Stick to a single setting for a week.

You mean this last week? Well, it's because I've been feeling terrible since the "specialist" lowered the pressure to 5 MIN - 10 MAX.

ozij wrote: ↑

Sat Dec 02, 2023 10:22 pm

More that anything, your "all night images" show you're stopping your therapy far too many time a night.
What is causing you to stop so many times?

It took me 4 hours to fall asleep last night, so during the first 7 sessions I was awake the whole time. This is not normal though. I normally fall asleep without much trouble. The challenge tends to be to remain asleep since I tend to wake up after 2, 3 or 4 hours and sometimes have trouble falling back asleep right away. I suspect the apneas and low oxygen levels might have something to do with this? Would you prefer me to share the graphs from a longer night instead?

Unkikonki wrote: ↑

Sat Dec 02, 2023 11:24 pm

ozij wrote: ↑

Sat Dec 02, 2023 10:22 pm

You've been changing setting on a nightly basis - which is not a good idea.
You brain and body have to get used to sleeping with CPAP, and nightly changes don't let them do that. Stick to a single setting for a week.

You mean this last week? Well, it's because I've been feeling terrible since the "specialist" lowered the pressure to 5 MIN - 10 MAX.

I mean since 6 Sept. Including making changes after nights when you didn't even use the CPAP [/qu

Unkikonki wrote: ↑

Sat Dec 02, 2023 11:24 pm

ozij wrote: ↑

Sat Dec 02, 2023 10:22 pm

More that anything, your "all night images" show you're stopping your therapy far too many time a night.
What is causing you to stop so many times?

It took me 4 hours to fall asleep last night, so during the first 7 sessions I was awake the whole time. This is not normal though. I normally fall asleep without much trouble.

Do you mean "not normal" compared to nights without CPAP?
Of do you mean you showed chart of an atypical night?
I asked what made you stop the CPAP - you didn't reply. Of course you were awake, but what sensations or thought processes made you turn the machine off? What were you hoping to achieve by doing that?

The way to handle inability to fall asleep it to get out of be and to something relaxing until you feel ready to fall asleep, then get back to bed and try to sleepl . Do not stay in bed tossing and turning and fuming at your inability to sleep. And if you can't fall asleep within 10 or 20 minutes, get up again and repeat the process. Only return to bed when you feel sleepy.

ozij wrote: ↑

Sun Dec 03, 2023 9:46 pm

I mean since 6 Sept. Including making changes after nights when you didn't even use the CPAP

Sorry, just saw your reply.

Yes, changing settings so regularly was a mistake, a consequence of doing things unsupervised. However, "specialist" don't seem to know much better either. Two so-called specialists recommended to lower the minimum pressure to 5/6 based on best AHI reading, which was from a night I barely used CPAP. They don't even bother to check the data properly. I slept terrible under those settings and my AHI was visibly higher.

For now, I set the CPAP to 9-13, EPR off. After cleaning up and analyzing the data collected so far, it seems a minimum pressure of 10 gives the best results in terms of AHI, compliance and subjective feeling.

ozij wrote: ↑

Sun Dec 03, 2023 9:46 pm

Do you mean "not normal" compared to nights without CPAP?
Of do you mean you showed chart of an atypical night?
I asked what made you stop the CPAP - you didn't reply. Of course you were awake, but what sensations or thought processes made you turn the machine off? What were you hoping to achieve by doing that?

It was atypical in the sense that falling asleep is not normally a problem (that night it was). Rather, my main issue seems to be remaining asleep. It is common for me to wake up after 2 or 3 hours and find it hard to fall back asleep.

Anyway, I've decided to do a new sleep study since the one I did in March was prior to septoplasty+turbinoplasty which I'm sure has had an impact on SA; this time it'll be a L1 in-lab split study.