Should I get a titration study done? (ASV)

Bwexler wrote: I question the model of machine in use if Sleepyhead is actually giving valid results.

I've been wondering that also. His sleep study data show short clusters of centrals with NO significant desats. AND the study recommends a CPAP or auto CPAP. If he is using an ASV, he probably shouldn't be...without setting it on CPAP mode.
J

bwexler wrote:First I would like to know what version of Sleepyhead is being used.
I just got a new PRS1Series 60 Bipap Auto SV and SH 0.9.3 does not provide accurate results (AHI 28,000+).
Jedi Mark is working on a new version that will work with the ASV machines.

I question the model of machine in use if Sleepyhead is actually giving valid results.

So if an ASV is being used a titration study may be helpful because SH data is questionable at this time.

His model machine does work well with SleepyHead..so I don't doubt the results. His machine is a 950 not the 960 and it works well..plus I think I also gave him Encore software to compare.
The 950 model...some worked with SH and some didn't but the ones that didn't ...it was very obvious.

Back to the original question...I didn't vote. I can't decide.
OP is wanting to know why the wake ups...assuming that they might be related to the machine or therapy or sleep apnea but a sleep study can't always tell us WHY we wake up. It just confirms that we do wake up. Now there might be something show up during a sleep study right before a wake up that might point to the cause but there is no guarantee that the cause of the wake up will be easily seen.
Sleep studies don't always point to WHY we wake up....it's not as easy as one might think. Sure there's a change in the EEG pattern during the sleep stages but WHY the changes occur is not always so easily seen on that EEG.
Now a sleep study might show that the sleep stages aren't optimal and maybe someone spends more time in light sleep or something along those lines but I just don't know if a sleep study would be the end all answer to what the OP is looking for here.
If insurance will pay for it..deductibles already being met and all that...it's obviously a rock to be turned over just in case there might be something there that is easily seen and remedied but there is no guarantee that the cause of the wake up will even be seen...as much as we like to assume that the machine and proper settings and optimal treatment should fix all our sleep issues...it simply can't fix everything.

zoocrewphoto wrote:

sleepinow wrote:

zoocrewphoto wrote:

sleepinow wrote:I do have leaks at some nights but others I do not. Based on the images above, my AHI is very good, yet I wake up every night 5 or more times and SleepyHead does not pick them up which is WHERE I am so confused. The confusion being, what the hell am I waking up from. I am thinking proper titration would get rid of this issue

I am confused here. What are you hoping to see in sleepyhead? An event at each time you woke up? Something different at each time you woke up? Do you know what times you actually woke up? Your machine has no idea when you are awake or asleep, so it can't tell you when you woke up. The only way to know, other than remembering the time, is to turn your machine on and off again so that those time markers are included in the data.

I was hoping to see if anything from the results in sleepyhead can be shown as a possible indication as to why I wake up. I might try turning machine on and off but then it will be just harder to go back to sleep. Someone told me to post data and that is what I did lol

I see your sleep study info. Have you posted one of the nights where you woke up a lot? It needs to show your pressure, events, and leak.

You are hoping that your sleepyhead data will give you some information, but you haven't shown us any of your sleepyhead data. And honestly, we don't even know what settings you are using.

Yes I have posted it before my sleep study page. My settings are 5.5 EPAP PSmin 0 PS Max 15 BMP Auto

Scroll up ahead and you will see it. That .10 AHI indicates that I should have slept well. But the truth is, I keep waking up for no reason. Not one I can understand at this point. It feels like I wake up inbetween dreams but that might be wrong

bwexler wrote:First I would like to know what version of Sleepyhead is being used.
I just got a new PRS1Series 60 Bipap Auto SV and SH 0.9.3 does not provide accurate results (AHI 28,000+).
Jedi Mark is working on a new version that will work with the ASV machines.

I question the model of machine in use if Sleepyhead is actually giving valid results.

So if an ASV is being used a titration study may be helpful because SH data is questionable at this time.

The results (at least the AHI) are similar when used with EncoreBasic. I do have issues with SleepyHead at times but it has similar results to EncoreBasics. The worst I have had was not enough data was shown on SleepyHead, which happened a few if not many times. I use the PRS1 950 Series Bipap Auto SV. Similar to yours but without the heated hose option

Pugsy wrote:

bwexler wrote:First I would like to know what version of Sleepyhead is being used.
I just got a new PRS1Series 60 Bipap Auto SV and SH 0.9.3 does not provide accurate results (AHI 28,000+).
Jedi Mark is working on a new version that will work with the ASV machines.

I question the model of machine in use if Sleepyhead is actually giving valid results.

So if an ASV is being used a titration study may be helpful because SH data is questionable at this time.

His model machine does work well with SleepyHead..so I don't doubt the results. His machine is a 950 not the 960 and it works well..plus I think I also gave him Encore software to compare.
The 950 model...some worked with SH and some didn't but the ones that didn't ...it was very obvious.

Back to the original question...I didn't vote. I can't decide.
OP is wanting to know why the wake ups...assuming that they might be related to the machine or therapy or sleep apnea but a sleep study can't always tell us WHY we wake up. It just confirms that we do wake up. Now there might be something show up during a sleep study right before a wake up that might point to the cause but there is no guarantee that the cause of the wake up will be easily seen.
Sleep studies don't always point to WHY we wake up....it's not as easy as one might think. Sure there's a change in the EEG pattern during the sleep stages but WHY the changes occur is not always so easily seen on that EEG.
Now a sleep study might show that the sleep stages aren't optimal and maybe someone spends more time in light sleep or something along those lines but I just don't know if a sleep study would be the end all answer to what the OP is looking for here.
If insurance will pay for it..deductibles already being met and all that...it's obviously a rock to be turned over just in case there might be something there that is easily seen and remedied but there is no guarantee that the cause of the wake up will even be seen...as much as we like to assume that the machine and proper settings and optimal treatment should fix all our sleep issues...it simply can't fix everything.

You did give me the Encore so thanks alot because it showed me why Sleepyhead was not showing results


I see what you mean there, but I am absolutely very healthy. I want to do anything to get rid of waking up every single night multiple times. I even take two 3mg melatonin pills to try to keep myself from waking up. My room is very dark too so I do not know what to do.

I do understand sleep studies may not point out why I might wake up but is it not worth taking the chance? Wouldn't it be better if I found WHY I can not sleep rather than just leaving it as it is. If someone showed me a better option like a brain mri or something I would follow. I just want to be healthy and take care of my body.

Oh and I do not get sayings. I am REAL bad at them, I give people blank stares when they tell me things like that. So "rock to be turned over" does not register in my head to mean anything that makes sense.

Would a titration study at least help? A 10-25% improvement is significant to me. And if Sleep Study show exactly when I wake up during which stage of sleep, wouldn't that bring me to a closer solution?

sleepinow wrote:Oh and I do not get sayings. I am REAL bad at them, I give people blank stares when they tell me things like that. So "rock to be turned over" does not register in my head to mean anything that makes sense.

Sorry, I forget everyone didn't grow up talking like I do.
Turning over rocks...looking for answers anywhere and everywhere.

sleepinow wrote:Would a titration study at least help? A 10-25% improvement is significant to me. And if Sleep Study show exactly when I wake up during which stage of sleep, wouldn't that bring me to a closer solution?

I can't answer the question. I am sorry. I don't know if the sleep study is going to give you the answers you want and need.
I know that people sometimes expect answers when there are no answers available. Medical science isn't that good yet.

I don't know how much knowing when you wake up (whatever sleep stage you might be in) is going to maybe help you know WHY you woke up. Of course it would be better to know why so you can fix it (hopefully or at least come to grips with it) but I don't know if a sleep study will tell you "why". Is it worth a try?..Since it is so important to you.....sure it is and that's why I said what I said about turning over rocks...I would look anywhere and everywhere I possibly could look and a sleep study is somewhere to look.
I just have to temper what I say with "it may or may not tell you WHY".
Have you talked with your doctor about exactly what can be determined in the sleep studies? What do they look for that might answer your questions? I would think he/she would be the best person to help you decide just how much help a sleep study might be in answering your questions.

BTW just how many awakenings and for how long are we talking about here?

My doctor is a pulmonoligist but he treats many apnea patients. He introduced me to how a machine works and functions in his office. He shows me the machine and such.

The awakenings have been happening for a really long time probably 2-3 years+ or maybe 10 years+. I do not remember . I remember having sleeping issues being younger but I think the waking up issue is pretty old. I wake up every night probably 4 - 7 times. That would be an average, sometimes it is worse to the point of me not being able to fall back asleep.

I do remember one time when I believe I slept a full deep sleep, but that was when I ran like six miles. I can not exercise now because of my left leg (I think I torn my tendon, I am getting an mri hopefully soon). Usually when I run long and hard the number of times that I wake up during the night is less.

sleepinow,
The point Pugsy makes...that your awakenings may not be OSA related and therefore a titration study may not help. I'm starting to lean that way too.

One thing that can happen with ASV machines is that the pulses the machine uses to stimulate breathing during central apneas...can actually awaken you, Do you notice when you awaken that the machine seems to be blowing harder then normal?

With an epap of 5.5 and max ps of 15cm...that means during a machine triggered breath, you would get a blast of 20.5cm H2O. That could cause awakening or leaks that cause awakenings.

From your sleep study data, your centrals don't cause a desaturation so they are not very long...but in cluster. Essentially insignificant. Most people have some...usually during sleep transition periods.

Could it be that before treatment, your awakenings were caused by your OSA...but now are caused by your machine?

To test that, you could "dumb down" your machine to function as a bipap with timed breaths OFF.

That's my best theory at this point.
Jamis

PS Pugsy is from Missouri...them hillbilly's they talk funny!

I see, well does anyone have any suggestions as to what I should try to do?