Sleepyhead data - Help needed please

OkyDoky wrote:Your leaks do look better. You only had that one large leak at the end of the night when your pressure increased. Looking forward to see what the minimum pressure increase looks like and hope with the leaks controlled and the pressure increased smoothed out a little you get better sleep.

Thanks for taking a look, I'll do a few days now on the higher minimum and see if it makes a difference. Hopefully Imgur will be working next time, not having much joy with software at the moment.

Leaks much improved last night and again they only happened when the pressure got up there.
So improved that if I saw that tiny amount of large leak (and I slept through it) I wouldn't give it more than a second glance.
It may very well be that those other large leaks were mask movement and not mouth breathing which is nice to know if a person doesn't have using a full face mask high on their list of things they want to do in life.

Let's see what tonight brings with the new mask fitting adjustments and tightening the pressure range with more minimum.

Pugsy wrote:Leaks much improved last night and again they only happened when the pressure got up there.
So improved that if I saw that tiny amount of large leak (and I slept through it) I wouldn't give it more than a second glance.
It may very well be that those other large leaks were mask movement and not mouth breathing which is nice to know if a person doesn't have using a full face mask high on their list of things they want to do in life.

Let's see what tonight brings with the new mask fitting adjustments and tightening the pressure range with more minimum.

Very pleased with that, as I said before I have been feeling a lot more consistently refreshed and alert since changing to the new machine, hopefully a little fine tuning is all that was required, we'll see.

If I don't have any issues tonight then perhaps I should do 3 or 4 nights before asking your opinion again on my data. I don't want to take up too much of anyone's time but really do appreciate the guidance while I learn to interpret the data for myself.

Let's see what tonight shows and if it looks good we can leave it at that for a few nights and then see if it stays consistent.

I don't mind daily "work". For me it's easier than trying to look back over 7 different nights.
Plus I think it's a little easier for people to follow.
Once we get "close" and a good result then we can say get more nights at these settings and see if the pattern holds.

Thank you for that.

I was awoken last night by a mouth leak so I'm hoping that was a one off, will look at the data when I get home and post it here later.

Only other observations, very slightly bloated from the higher pressure first thing, but tolerable and nowhere near as bad as when I was on fixed CPAP pressure of 12.

Also, not feeling quite as alert today as I have been, but maybe all of the above could be transitional in getting used to the new settings?

If the bloating persists we can reduce the minimum a little or maybe add a bit of EPR if you have some available and probably not cause a huge problem and just let the pressure roam a bit more unless the roaming causes a problem. No sense in making you uncomfortable.

About the mouth breathing...if it's rare and short lived then it probably isn't the end of the world.
I know I probably do a little bit every now and then but there comes a time when we sometimes have to make some compromises. I learned a long time ago that trying to do the stuff to fix/stop all mouth breathing ended up causing more problems than the 10 minutes of mouth breathing might have caused. I also don't get all in a panic over one "bad" night of anything and go start changing a bunch of stuff based off one night's worth of bad stuff.
We all can have "off" nights for some reason and as long as we don't make a habit of them it's not the end of the world.

Number one primary goal...get the best sleep we can. Not get that 0.0 AHI and not 0.0 leak line all the way across.
The best numbers in the world don't mean much if our sleep is crap. You gotta have good sleep to have any chance of feeling the good numbers.

The bloating was noticeable but really minimal and dispersed by the time I leave for work so I'm not too concerned about it.

I was going to ask about EPR, mine was set to 3 by the ResMed tech but I have no idea where it should sit realistically for me.

Yes, I'm not going to chase numbers every night, I am getting a good night's sleep and generally feeling refreshed and alert, just fine tuning really and trying to educate myself a little.

EPR at 3 is the most you can get. So we can't get you any more to help with the bloating. Exhale relief is usually the first thing we look at when someone is having bloating/aerophagia issues but since you are already maxed out in that area we next look at reducing the overall pressure a bit and start with the minimum and in severe cases we might even limit the max.

Should the bloating get worse or get more annoying you could probably have some room to reduce that minimum pressure a bit which would probably help. I was suggesting what I said because you seemed to be up there anyway but there is no urgent need to use the higher minimum all night.
It's not like your therapy was suffering and it was allowing a truckload of apnea events to happen when it was lower.
You made a fairly good size jump in the minimum....you probably could split the difference and do just as well.

As to what exhale relief setting is "best".
There's not one. I just tell people to use whatever feels best to them whether it is 1, 2 or 3 or even off.
It's a comfort setting and I personally feel comfort is very important because if I am not comfortable then I don't sleep so great and like I said above....sleep is my number one goal and whatever it takes to get good sleep is fair game and just fine in my book.

Did I read somewhere that the EPR setting has a correlation with the pressure settings, i.e. a high EPR compromises the set minimum pressure?

Higher EPR COULD compromise a lower setting but it doesn't always mean that it does compromise anything.
EPR causes a drop during exhale and if the pressure is already barely holding the airway open as it is then any drop could allow some apnea events to happen. Now if the minimum pressure was already doing a really good job then the drop during exhale might not allow anything to collapse in the airway.

So it really all depends on how good of a job that minimum pressure is doing in the first place as to whether any drop during exhale is maybe going to compromise the therapy. And remember...it's a relative quick drop anyway.

It's an easy fix in most cases if someone found that using EPR allowed a few apneas to sneak past the defenses...either reduce EPR or increase the minimum pressure to off set the drop.

Using EPR doesn't always allow/cause a substantial increase in the AHI...it all depends on if someone is using a minimum pressure just barely getting the job done or if they are using a pressure with some room to drop without allowing the airway to collapse.

Got it, great explanation, thank you!
I'll be back soon with last night's data

Hannibal 2 wrote:Did I read somewhere that the EPR setting has a correlation with the pressure settings, i.e. a high EPR compromises the set minimum pressure?

yes, EPR lowers your non-inhalation pressure by however many points you've set it to... here's how it works:

palerider wrote:

Hannibal 2 wrote:Did I read somewhere that the EPR setting has a correlation with the pressure settings, i.e. a high EPR compromises the set minimum pressure?

yes, EPR lowers your non-inhalation pressure by however many points you've set it to... here's how it works:

Thanks for clarifying

Just looked at my data for last night, I had increased the minimum pressure to 7.4.

To me it looks worse than the previous night where all I had done was tighten my mask slightly and routed my hose over the headboard, for 'time over leak redline' it was my best result so far, and 'total time in apnoea' 2nd best so far.

My untrained eye can't tell if the leak rates are pushing the pressure up, or the pressure up is causing the leaks.

http://i.imgur.com/aIZNoRh.png