AI & HAI clusters w/o mask leaks?

Hope that this is answerable as it has so far eluded my own analysis.

I have the ResScan software (reciently purhased) and I review it each morning. Often there are clusters of AI & HAI (10 to 30+events) during the first hour and last hour of sleep. Mask leaks are recorded at zero during these periods. Perhaps there is no relationship between mask leaks and AHI events; however I thought that the most efficient treatment (reducing the number of events) occures when leaks were eliminated--this is my expectation. Since this seems not to be actually occuring, therefore I am asking for help interputing this paradox.

Isn't it nice to have the software to actually see what's happening?

Without seeing the reports, it's hard to pinpoint "why".
I also see you're using an Auto......we don't know what your pressure range is or at what pressure these events are occurring. It could be that it's bumping against the 10 cm. limitation at those times and the algorithm isn't allowing it to go higher to address those events.

What position do you sleep in? (could you be on your back at those times?)


Den

It could also be your sleep cycle. The circadian rhythms of each individual's sleep cycle differ slightly. DO you have a copy of your sleep study, so as to look at the architecture of your sleep. A lot of folks have more events in REM sleep, and that could be what is happening. It would be hard to say without a detailed look at your particular pattern, and when events are occurring for what reason (as was said before, back sleeping has a major impact on SOME folks).

I'm dealing with the same, exact issue. I spent some time with my DME folks yesterday, and about all I got was a good head scratch and a full face mask (uncomfortable). They also suggested reducing my pressure from 6cm to 4cm, as it appears that my AI and HI are higher when my leak rate is lower. I passed on that on, as I'm already feeling a bit O2 starved at 6cm.

Thanks for posting! I'll be interested in your progress.

Brian

For me, it was the ramp/settling time. I noticed that my machine would record clusters of probable false events before I had even fallen asleep, perhaps while I was shifting around and regulating my breathing. If you are on Auto, you should be able to adjust the settling time. I highly recommend setting it to the amount of time you think it will take you to fall asleep. As for the events near the end of your sleep, that could be REM when most events occur and your minimum pressure may not be enough to catch those.

I have considered that these events could be false recording as they seem to ocurre close to falling asleep. Some of the early AM events are preceeded by awakening--not all. This is why I am puzzeled. Most nights I sleep throughout the entire night. The worst cluster had two 60+ apneas recorded.

I use both CPAP and APAP with settings from 13 to 16.4--and I don't use ramp or settling features.

I do not remember dreams and therefore think that I do not awaken close to a REM cycle--this could be wrong.

I question if my machine needs to be returned to ResMed for tech eval or prehaps I am having pressure induced apneas as I transition into sleep?

Thanks to all---and here is where I am at as of this post.

Last nights data appears to confirm my posted hypothesis (maybe?). Lowered pressure setting to min 13, max 17 and ERP 2. Slept 7+ hours.

Had difficulty falling asleep and during that hour the Autoset II in APAP recorded 5 apneas (small cluster) turned the APAP off and watched TMC (old Bogat movie). No AM clusters this morning.

Mask leaks were low and smart data rated leak rate at excellent. Using ResMed nasal mirage ultra II standard. Lowest leaks but not as comfortable as the activa.

Conclusion---false apneas recorded before falling asleep (may occur PM or AM), possible pressure induced issues to be explored or that my rate of breathing is irregular and appears as apneas to the Autoset computer.

Question: should I use settling and set it for 30 to 45. Would the AutoSet II computer ignore irregular breathing during settling or ramp?

I have a recording oximeter (CMS60D) used second time last night. Taped the finger probe onto finger and forearm.

Lots of chop most likely movement induced artifacts--no sustained readings below 90%---just brief dips lasting one or two seconds.

One of the best features of this forum is that by thinking/writing about the problems---the problems become clearer and sometimes so does the solutions.
I had written I don't use the ramp or settling feature, but in being asked this question I again looked into these features. Thought that I was looking at false AI readings. Using the settling feature in the autoset II todays data does not have those mysterious AI clusters. I have the impression that using the SETTLING feature (gives me time to fall asleep before data collection begins) is what I needed to know. All looks good.

Congrat! I'll give that a shot as well tonight.

Thanks for sharing.

rbtgjns wrote:One of the best features of this forum is that by thinking/writing about the problems---the problems become clearer and sometimes so does the solutions.
I had written I don't use the ramp or settling feature, but in being asked this question I again looked into these features. Thought that I was looking at false AI readings. Using the settling feature in the autoset II todays data does not have those mysterious AI clusters. I have the impression that using the SETTLING feature (gives me time to fall asleep before data collection begins) is what I needed to know. All looks good.

You are correct. Data collection begins AFTER ramp/settling ends.