You asked about the Snore Data and Flow Limitations:
tazmania wrote:I was doing a little research on Sleepyhead and saw this:
IMPORTANT NOTES about Philips Respironics System One machines:
1) The Philips Respironics System One machines record two kinds of Snore Data. In SleepyHead they are referred to as VS1 and VS2 data.
In SleepyHead 0.9.6, The Vibratory Snore index shown in the Left Sidebar data is the average number of VS2 per hour. In other words:
Vibratory Snore (index) = (number of VS2 scored)/(run time) In SleepyHead 0.9.3, The Vibratory Snore index shown in the Left Sidebar data is the average number of VS1 per hour. In other words:
Vibratory Snore (index) = (number of VS1 scored)/(run time) The thing is: VS1 snores are scored on a Philips Respironics machine only if the machine is running in Auto mode. If you are using a Philips Respironics machine in fixed pressure mode, the SleepyHead 0.9.3 Vibratory Snore index will always be 0.0; but that does NOT imply that you are not snoring.
2) The Flow Limitation data is recorded on a Philips Respironics machine only if the machine is running in Auto mode. If you are using a Philips Respironics machine in fixed pressure mode, the Flow Limitation index will be 0.0; but you can't assume that means you are not having any flow limitations.
If you want to see the VS snores and FLs but still want to have a fixed pressure setting, then what you need to do is simple:
Set the machine in APAP mode and set both the min Pressure and max Pressure to your current pressure setting of 11cm. When min Pressure = max Pressure, the machine can't change the pressure, but at the same time it records the VS and FL data so you get a fuller picture of what's going on each night.
My current steps are to ensure I'm not introducing too many new aspects to my sleep habits. As such I am using the new CPAP in continuous pressure mode with the same C-flex setting of 3. Looking at my daily detailed stats I noticed a lot of zeros thinking the machine was working really well for me. But after reading this I realize I don't have data and was misunderstanding some of the stats. I've shared my Sunday night daily stats in a post above.
All the stats except for FL and VS are correct. And while there is some extensive leaking going on most of the night, the leaks are not large enough to be flagged as Official Large Leaks most of the time, and that means the efficacy data recorded is accurate enough to be trusted. So in terms of therapy, it looks like your machine is doing an excellent job of managing your OSA. Also your machine does record VS2 data, and if you were doing a lot of snoring, it would show up in the VS2 data: In other words, if snoring were a problem, the VS2 Index would not be 0.0, even though the VSI = 0.0.
As for flow limitations: They may or may not be an issue. Switching to APAP with min Pressure = max Pressure = 11cm will allow you to continue sleeping with a fixed pressure setting, but will also allow you to record the FL data. My guess is that there won't be a whole lot of issues with FL in your data, however.
What is interesting in this data is the overall variability that's evident in the flow rate graph at three distinct periods of time:
- first between 23:30 and 0:30 (when the leaks are at their worst)
- second between 1:30 and 2:10 (leaks are higher than they should be)
- third between 3:20 and 3:45, when you turned the machine off and gave up for the night after what appears to be waking up because of large leaks
Any ideas on what might be going on during those time frames?
Were you very restless, tossing and turning in bed trying to get comfortable and back to sleep after waking up and having trouble getting back to sleep? If so, what do you think woke you up? The leaks? The collar? Something else? In this case, there's some evidence that you really need to work on the leaks even though they're usually not flagged as Official Large Leaks. And there's evidence that the collar might not be working as intended. (Or it could be you just need to give the collar more time.)
Or were you sound asleep and dead to the world? In this case, it could be that the irregular breathing might be an indication of REM sleep. And that in REM your mouth opens and your tongue drops off the roof of the mouth and air goes in through your nose and out through the open mouth. And the collar didn't prevent this from happening.
Last night I incorporated the cervical collar to no great effect. How long before I should start to use the machine in Auto mode?
It depends on what problem you are trying to
solve by switching to Auto.
Switching to full Auto mode (where min Pressure is not equal to max Pressure) is not likely to reduce the number of events since they're already so close to 0.0. It's not likely to do a better job in preventing snoring since the VS2 I = 0.0 (i.e. you're not snoring enough to matter.)
If the goal is to try to fix the leaks, switching to APAP is not likely to do that. Moreover, if you wind up having some significant pressure swings in Auto mode, that could aggravate the leaks. And because switching to Auto might aggravate the leaks, you may find yourself waking up even more frequently to deal with leaks than you are now.