Hi from new member (tried taping my mask)

DreamStalker wrote: Ummm ... actually, that mask was suggested in jest ... but whatever works I guess.

I did... sort of... get that

As for sex toys, I've been quite satisfied with my machine's nightly blow jobs during the past decade.

That is a good one.

Ok - just completed a night with mask sealed up with Tegaderm. There's no way there were any leaks around mask edges as I applied the tape pretty liberally.

Definitely better sleep, as did not have to contend with the air whistling around the edges of the mask. Also presumably gives an idea of my 'real' AHI at a minimum pressure of 7.



Interesting that SleepyHead does indicated some leakage - the mask has some built-in venting, probably as a safety measure (and which I did not block) I assume that this is the source of the leakage shown.

I can't do this every night, but provides a useful reference.

leptic wrote:Interesting that SleepyHead does indicated some leakage -

Where? The leak graph itself? The 2 leak lines? That bottom leak line isn't spot on accurate so we take it with a grain of salt.
The top leak line is the total leak which includes the expected intentional leak/vent rate along with any excess leaks. It's going to vary as the pressure varies so it will never be totally flat when using auto mode even if there are 0 excess leaks.

If you want to see excess only leak graphs that are accurate you would need to use Encore Pro software as it has a setting that makes the correct adjustments and will show only the excess leaks.
Mark (who came up with SH) tried to duplicate it with that bottom leak line but he admitted he never could get the calculations totally correct because of the variability of the pressures in auto mode. It's close but not spot on accurate.

If it weren't for the 2 sort of ugly clusters last night your AHI would likely have been quite decent.
The first one when you first turned the machine on and it had a bunch of CAs and OAs together...the second one at around the 2:15 mark. I don't know what to make of the first ugly cluster with all the CAs. I know you say that you pretty much go right to sleep immediately with no awake/semi awake time but that close to a known awake time makes me wonder a little bit if those are real or not. The machine does want to respond but it does it after those events and while it can't go from 7 to 11 in the blink of an eye it doesn't take it 20 minutes to get there or it shouldn't anyway.

I wonder what those clusters would look like with a 7.5 or 8.0 minimum pressure with the leaks better managed and you sleeping more soundly....

To get your AHI without including that first ugly 20 minutes or so...use your mouse cursor to highlight just the time from the right side of the cluster to the end of the night and look on the line just above the flow rate graph for the AHI and watch it change to what it would be if that first 20 minutes was removed from the evaluation. I am wondering if there is a lot of semi awake breathing going on that first 20 minutes of the night causing those flags. This is where I really wish the machine could tell us for sure we were asleep or not.

Good job on the leak control experiment. The leaks don't have to be perfectly flat...they just have to be below large leak territory so that we can trust the numbers we see so that we know for sure what is going on.
And of course the leaks can't be waking us up even if they are small and well within acceptable limits...anything that wakes us up is unwanted.

Pugsy wrote:

leptic wrote:Interesting that SleepyHead does indicated some leakage -

Where? The leak graph itself? The 2 leak lines? That bottom leak line isn't spot on accurate so we take it with a grain of salt.
The top leak line is the total leak which includes the expected intentional leak/vent rate along with any excess leaks. It's going to vary as the pressure varies so it will never be totally flat when using auto mode even if there are 0 excess leaks.

Thanks - that's good to know.

If you want to see excess only leak graphs that are accurate you would need to use Encore Pro software as it has a setting that makes the correct adjustments and will show only the excess leaks.
Mark (who came up with SH) tried to duplicate it with that bottom leak line but he admitted he never could get the calculations totally correct because of the variability of the pressures in auto mode. It's close but not spot on accurate.

Ah - I'm not sure I need it, but how does one get Encore Pro? SleepyHead is great software and I certainly appreciate all the work that Mark has put into it.

If it weren't for the 2 sort of ugly clusters last night your AHI would likely have been quite decent.
The first one when you first turned the machine on and it had a bunch of CAs and OAs together...the second one at around the 2:15 mark. I don't know what to make of the first ugly cluster with all the CAs. I know you say that you pretty much go right to sleep immediately with no awake/semi awake time but that close to a known awake time makes me wonder a little bit if those are real or not. The machine does want to respond but it does it after those events and while it can't go from 7 to 11 in the blink of an eye it doesn't take it 20 minutes to get there or it shouldn't anyway.

It definitely felt like a better night of sleep. On occasion I am vaguely aware, during the early phase of my night, of waking up at the very end of what might have been a very, very long sigh. I suspect that what happens is I enter a very relaxed state, and the breathing morphs into a series of long sighs. Eventually these sighs (apneas) become sufficiently long that I have the CO2 buildup that leads to strong inspiratory urge and arousal. My earlier experiments with equipment borrowed from my university lab were suggestive of this - the diaphragm belt showed no signs of respiratory effort - just a long relaxation. The end-tidal traces also just indicated a very long exhalation trailing into an apnea.

I also experience some sleep paralysis and wakeful dreaming so perhaps these weird centrals are related to another sleep disorder (or my increasing hypochondria).

I wonder what those clusters would look like with a 7.5 or 8.0 minimum pressure with the leaks better managed and you sleeping more soundly....

Will definitely try - I think I can be more economical with the Tegaderm tonight and still get the same results.

To get your AHI without including that first ugly 20 minutes or so...use your mouse cursor to highlight just the time from the right side of the cluster to the end of the night and look on the line just above the flow rate graph for the AHI and watch it change to what it would be if that first 20 minutes was removed from the evaluation. I am wondering if there is a lot of semi awake breathing going on that first 20 minutes of the night causing those flags. This is where I really wish the machine could tell us for sure we were asleep or not.

Thanks for the tip! Excluding the initial cluster, my AHI went down to 4.14

I'm going to try and get some ambulatory EEG equipment from my department and will be interesting to see how this all links up. Also curious about the WATCH-PAT 200 someone referenced here - I contacted the company and may try to get one for evaluation. I agree that actually knowing what sleep stage you're in (if asleep) seems important.

Good job on the leak control experiment. The leaks don't have to be perfectly flat...they just have to be below large leak territory so that we can trust the numbers we see so that we know for sure what is going on.
And of course the leaks can't be waking us up even if they are small and well within acceptable limits...anything that wakes us up is unwanted.

Thanks - I see my sleep doc this morning at 11:15 EST. Will ask about all this stuff - I'm told by the tech that I might get "chewed out" for doing my own titration. I hope this does not impede the doc's ability to assess the response to therapy. I will be sure to blame it all on Pugsy (just kidding - what happens on this forum stays on this forum).

If you want to mess with Encore Pro just send me a private message and I will point you to it.
It's Windows only though so if you are using something other than Windows you will need to put Windows on it to use it.
To be honest I don't know if it's worth the hassle to just see the unintentional leak graph but it does offer wave form graphs that makes it easier to maybe spot SWJ. It can be a real PITA sometimes to get installed.
I used to have a link to a document that had examples and explanations for what was shown on the Encore reports but it appears that Respironics has moved that document so I can't point you to that. I may have it saved somewhere and if I find it I will point you to it.
Edit...I did find it but it has some ASV stuff in it that you will just need to skim over.
https://dl.dropboxusercontent.com/u/978 ... 0Guide.pdf

I just don't know about whatever is happening right at the beginning of the night meaning I don't know if
1...it is worth worrying about as in maybe it's just semi awake breathing irregularities fooling the machine
2...if we even can do anything about it even if it is worth worrying about because if those are real centrals we can't do anything about them with your machine.

Hopefully you will exit the doctor visit this morning with the bulk of your butt intact. If you get your butt chewed too much just tell the doctor that it's in your nature to screw with stuff just because it's your job.
The changes made were really very minor in the overall scheme of things. Anyone who gets their panties all in a wad over such minor changes needs to get a reality check and get over it. It's not like you went and did what I did...get a totally different machine from what you need and use settings totally different than what was originally prescribed.

Thanks Pugsy,

Just saw the doc - he was pretty laid back about it. I don't think he's going to have any problems with these kind of adjustments, especially given that I'm probably going to buy the machine today.

It's only the last few days, and thanks to you guys, that I have truly understood the importance of leak management. Just not having that mask fart into my ears all night resulted in a much better sleep.

The doc also pointed out that this is something I'm going to have to indicate on my driver's license... apparently if it's well managed shouldn't be an issue though. I was already careful about scheduling long-distance drives and making frequent snooze stops already. We have a big holiday road trip planned this August, which should be interesting.

The doc also pointed out that this is something I'm going to have to indicate on my driver's license... apparently if it's well managed shouldn't be an issue though.

But you won't have to specify your gender next year.....so it evens out?

BlackSpinner wrote:

The doc also pointed out that this is something I'm going to have to indicate on my driver's license... apparently if it's well managed shouldn't be an issue though.

But you won't have to specify your gender next year.....so it evens out?

So not having to admit that I'm a "male driver" will cancel out having sleep apnea?

Seriously, driving is one of the areas where I have noticed improvements since starting cpap. I had gradually adopted a very grandfatherly approach to driving, which was I think an adaptation to my horrible levels of alertness.

Last night had promised the kids I'd camp out with them in the back yard, as dress rehearsal for the camping trips I've promised to take them on this summer.

So did a night without cpap and, while the 'campout' was a lot of fun, the way I felt in the morning was a good reminder of how much this therapy is helping. Next time I'll rig up an extension cord (and prepare for ridicule), and start shopping for a battery. Fortunately we've resolved to forgo backpacking and stick with car camping for now...

This kind of thing drives home just how much more 'high maintenance' our lives have become - totally livable (and evidently better than living in chronic exhaustion).

PS Happy Canada Day to my fellow Canucks!

Search for Captain Loki's post on that. He has whole setups at various cost levels.

You may want to pick up a PR S1 second hand - it takes less power and If it ends up under water or smoked it won't matter as much.

BlackSpinner wrote:Search for Captain Loki's post on that. He has whole setups at various cost levels.

You may want to pick up a PR S1 second hand - it takes less power and If it ends up under water or smoked it won't matter as much.

Thanks for the tips! Rigged up with extension cord last night and was better. Did not wake up with that 'marinated in cortisol' feeling!



It also helped that I realized our 'self-inflating' sleeping mats worked a lot better with some additional inflation via lung-power...