Is this possible?

Karen, I am no expert. Just learning myself and most of what I have learned came from here but I have been able to connect what I learned about the numbers to what I feel.

AHI or Apnea/Hypopnea Index is the gold standard to measure your sleep quality relative to OSA. This could also be referred to as Sleep Disturbances. The number represents the number of sleep disturbances (Hypopneas and Apneas) per hour. An AHI of 5 or lower is supposed to be good. I feel like crap at 5, at least at this point in my therapy and taking into account some other health issues.

The numbers commonly referred to with regards to Respironic's Encore Pro are Leaks, Snores, Flow Limitations, Hypopneas and Apneas. The one I just figured out is the 90% number. This is the pressure, on an APAP, where 90% of your sleep disturbances are cleared - do not happen anymore. This should more or less correlate to your sleep study titration.

Leaks you know are a problem. The number reported is leaks and large leaks. The exhaust on your interface constitutes a leak and the leak rate at a given pressure is reported for each mask. Anything above that number represents a real leak in your system - mask/interface connections, mask/interface on your face, hose connections and connections to the humidifier. The machine can compensate for small leaks. What's a small leak you say? I don't know, someone else may pipe up. A large leak is either mouth breathing or an extended disconnect in machine/hose/interface chain.

There are folks who can describe the next set much more precisely and scientifically than me but I'll take a stab.

Snores, Flow Limitations and Hyponeas are all considered precursors to an apnea event. I don't know how snores are detected and reported (acoustically or flow variatons?) but Respironics seems to be very sensitive to them and use them to up pressure. They do not contribute to the AHI number.

Flow limitations are a reduction in air flow, indicating a partial blockage, somewhat less than a hypopnea or apnea. They do not contribute to the AHI number.

Hypopneas are a reduction in air flow indicating a partial blockage such that, in a sophisticated guesstimation, your oxygen saturation would go down significantly. A reported hypopnea does contribute to the AHI number.

Apneas are a cessation of flow indicating a cessation of breathing for 10 seconds or more and they do contribute to the AHI number.

Encore Pro reports other statistics like ticking when snores, flow limitations, hypopneas and apneas occurred, how long was spent at each pressure, what the AHI was at that pressure, how much time was spent in Apnea etc.

Learning how to interpret that and decide what is, or isn't good means looking at it over time and correlating it to your own sense of well being. How well have you slept? How energetic do you feel? How many times did you get up in the night? Any headaches? Sluggishness, etc. There are other variables as well, like other health or emotional factors, so it ends up being a very subjective thing but I think all folks would agree - a low AHI is good and, in general, the lower the better. Everything else sort of tells you why the AHI is high or what events are leading up to problems so no set of numbers is absolutely "right". Changes in somewhat consistent numbers can make more sense when tied to things like congestion, Acid Reflux, drinking alcohol.

Derek's software "My Encore" summarizes and charts Encore Pro data in a variety of ways. I haven't used it enough yet to tell you more about that. Others can.

Hope this helped?

David

Kathleen-

Here's the quick and dirty:

Ideally, you want an AHI (Apnea-Hypopnea Index) < 5.0. You want an AI=0 (Apnea Index) or close, and you want an HI (Hypopnea Index) and SI (vibratory snore index) as low as you can get. But mostly you want an AHI less than five, which is considered to be normal. (BTW, that means that on average, you will be having less than five events per hour).

Now, in terms of pressure, the ideal pressure is whatever pressure works for you to achieve an AHI of 5 or less. Your Remstar Auto will take care of that for you, after it gets to know you.

Hope this helps!!!

Chuck

THANK YOU THANK YOU

Wow! Thanks, all of you for all of the good info!
I need to 1) keep a 'sleep diary' 2) study my reports daily, against the info you've provided,
...and THEN I'll be more familiar with what's going on...
...and THEN I'll probably be asking more questions

So....when are 'they' going to come out with a cpap model that 'speaks to us in the morning' and lets us know how the night went, and what to do about it????????? OH NO! I didn't mean that! There's already enough PEOPLE telling us what to do (DME/NP/docs etc.). I rely more on what I learn here because it is from many EXPERIENCED people.

Thanks for taking the time to help out!
Kathleen

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CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP

Offerocker wrote:I need to 1) keep a 'sleep diary' 2) study my reports daily, against the info you've provided

Kathleen, Don't be a slave to your reports, and don't let the reports tell you how you feel.

Download your data every 5 days or so.

When you've been feeling really good, print out your report. And keep a hardcopy handy.

Then when you feel bad, print out another report to compare to your "good" report. That comparison should show you why you are feeling badly.

At least that's pretty much how I do it.

Thanks Sleepy for the thread tip. Unfortunately, my problem is a virus erased my Windows XP ID number so I can't add MS patches, etc. A bunch of other stuff went haywire at the same time. I had to have the computer go back in time to a more healthy enviroment and had to strip and reload some newer programs to get back to a running condition (after a major virus hunt and destroy mission with two different tools). I can run Encore now but I can't add Derick's My Encore until I add a language tool from MS and I need that ID number to use the MS website,(it thinks I have a pirated edition of XP)... a work in progress.

Chris

I'm just curious how my original topic got off topic by everyone. I really would like everyone's honest opinions/experiences on what my question was. I'm new at this just like alot of other people are, and am depending on the folks in this forum for reliable information. With the risk of sounding rude, which by no means am I trying to be, but please if you have other things to discuss that aren't related to the original topic, please post a new topic for discussion. To reiterate my question, what's people's thoughts/ experiences on when I increase my pressure per my Dr.'s instructions, is it possible that I become more tired? The only thing that I can come with is maybe it's because I am sleeping better at 10cm, and my body wants more of that good sleep. Almost as if I'm starting CPAP therapy all over again. I say that because when I first started, I was more tired during the days for the first week or so until my body adjusted to getting better sleep.

cpapjack wrote: I'm just curious how my original topic got off topic by everyone. I really would like everyone's honest opinions/experiences on what my question was. I'm new at this just like alot of other people are, and am depending on the folks in this forum for reliable information. With the risk of sounding rude, which by no means am I trying to be, but please if you have other things to discuss that aren't related to the original topic, please post a new topic for discussion.

This happens all the time, quite innocently and quite naturally. That is the nature of a message board. Don't fight it. Get used to it.

cpapjack wrote:To reiterate my question, what's people's thoughts/ experiences on when I increase my pressure per my Dr.'s instructions, is it possible that I become more tired?

One possibility: maybe your pressure is too high now. Maybe with the increased pressure your AHI is going up instead of down. Maybe your doctor was wrong.

Thanks for your reply Guest. I figured that much about that kind of stuff happening all of the time. It just seems like it's been happening way more than usual. Anywho.

I was thinking that to about the pressure thing. But during my sleep study, I seemed to do the best between a pressure of 8-12. I started at 8 when I first started cpap'ing so I think that's why the Dr. decided to up it.

Guest,

How do you make the box that say's cpapjack wrote: ?

cpapjack wrote:Guest,

How do you make the box that say's cpapjack wrote: ?

In the upper right corner of the post your want to quote is a button that says Quote. Click on that. If you prefer you can also cut an paste something from a post, highlight it and press the quote button at the top of your reply window.

Darth Vader Look wrote:

cpapjack wrote:Guest,

How do you make the box that say's cpapjack wrote: ?

In the upper right corner of the post your want to quote is a button that says Quote. Click on that. If you prefer you can also cut an paste something from a post, highlight it and press the quote button at the top of your reply window.

Thanks for the tip DVL.

cpapjack wrote:...but please if you have other things to discuss that aren't related to the original topic, please post a new topic for discussion.

I agree with your sentiment but I would not get my hopes up too much. I have seen topics fly off on rather dramatic tangents in the 6 months I have been participating on the forum (as a lurker, guest and two usernames). At first I resented it as well but actually they generally end being fun and surprisingly informative so I have learned to accept, tolerate and been guilty of initiating or perpetuating the events.

In answer to your question - I don't know. I know I had sleep debt. I know that I have had ups and downs in the 6 months I've been a hosehead. I know that those ups and downs are connected to a variety of events both therapy and non-therapy related. I have had confirmation, via Encore Pro, that my prescribed pressure was too low by 1-2cm and I am reasonably confident that I am fairly sensitive to reasonably small changes in pressure. Without data you can only go by how you feel. If it is just tired and low energy then perhaps you are paying back sleep debt. If you get dry mouth, headaches and chronic fatigue then you may need to investigate further.

David

Well said, David!

Snoozin' Bluezzz wrote: Without data you can only go by how you feel. If it is just tired and low energy then perhaps you are paying back sleep debt. If you get dry mouth, headaches and chronic fatigue then you may need to investigate further.

I know and you know what, that really sucks. I remember when I started reading this forum, I was hearing about the evil DME stories. I was ignorant to the thought of me becoming a victim of one of those evil DME's since my insurance covers me a 100%, but you know what, I have and I've about had enough with them already. I'm trying to play the game with them that they like to play with us, but it's too early to tell who's gonna win yet because I just started.

See this post to see what it is I'm referring to. viewtopic.php?t=10209
I really believe if I had an APAP machine, I'd be able to get the results I'm looking for alot sooner.