Sleepyhead data - Help needed please

Machines today don't try to fix leaks with more pressure. A long time ago yes but not in several years.
Pressure increase come from some sort of apnea event or event warning sign.

Can you get a screen shot of the flow limitation graph from last night?
I suspect that your flow limitations are driving the pressure up.
Flow limitations are flow reductions that don't meet the criteria for a full blown apnea event of some sort. They may or may not be all that critical in terms of how you feel because sometimes nasal congestion can impact the flow limitations.

On your screen shot the machine settings aren't all that important but the AHI bar graphs that you have scrolled past are.
You can end that side of the statistics with the % of time over red line.

I hope you don't mind it in 'Drive' (I know Palerider hates it lol) ...finding Imgur a bit of a faf at the moment!

https://drive.google.com/open?id=0B-yNM ... kVtVnNKLWs

That last screenshot is for the 27th not the 28th like the previous.

OkyDoky wrote:That last screenshot is for the 27th not the 28th like the previous.

Sorry, clearly I'm not functioning properly today! Try this

https://drive.google.com/open?id=0B-yNM ... 2NQUVhjTEE

I am not crazy about any links...to google drive or imgur. I am lazy...I prefer the image in front of me embedded in the post.
My internet speeds are crazy slow sometimes and often I have trouble getting any image anywhere to load when I have to use a link.
At the moment I am okay with your links but eventually I was going to get you to try to learn to do the images so I didn't have to be so frustrated or work so hard.

Here's an image of a flow limitation graph where there are essentially no flow limitations.
I think you can spot the difference easily enough. Yours is going to be more active.... I can see it already with the 27th report.
Any way we can blame any of this on nasal congestion?
I am reasonably certain your flow limitations are driving the pressures. Now whether the FLs warrant such aggressiveness is the million dollar question.

The Flow limitations do appear to be quickly raising your pressure. Pugsy when you get a look at the shot, what do you think about trying the For Her Mode?

Compare your pressure line with the spikes in the FL graph...there's the reason for the pressure increases and I suspect that's why you are getting the leaks at the higher pressures.

Flow limitations are something the machine is designed to try to kill...with more pressure...more pressure makes the seal not work so great.

Flow limitations and snores are considered warning signs that the airway is trying to collapse. They aren't growing up to be full fledged apnea events (OAs/Hyponeas) because the pressure is doing its job. It's in the algorithm for the apap to do this.
It's not just OAs and hyponeas that cause the machine to change pressures...snores and/or flow limitations will do it also.

Funny you should say that, people sometimes ask if I have a cold, especially just recently. I guess I'm used to a little congestion and think of it as normal.

Good spot Pugsy, so what now?

OkyDoky wrote:what do you think about trying the For Her Mode?

He would be my first guinea pig. You know about as much about the for her algorithm as I do. ResMed made it clear as mud.
I have zero idea what to expect to see with the for her algorithm being used in this situation.

IF...big IF..this isn't nasal congestion Flow limitations we have to first decide if the FLs warrant even trying to do anything with.
At this point we don't know for sure that anything else needs to be done with these FLs. They aren't horribly horrible...I have certainly seen worse but of course doesn't look nearly as good as my boring FL graph.

If he is sleeping good, feeling good...I don't know that I would go out on that long skinny limb unless he just wants to be a guinea pig.

I am 99.9999% sure that it's the pressure that is the leak instigator though and while the leak line is a little bit ugly...again if he is sleeping good and feeling good I don't know that I would screw with things just to get a prettier leak line.

Hannibal 2 wrote:I guess I'm used to a little congestion and think of it as normal.

Good spot Pugsy, so what now?

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Has the congestion improved or worsened with the addition of a real working humidifier?

If you couldn't see these reports....how do you feel about how you are sleeping and how you feel in general?
Try not to let the reports cloud your response.

We need to figure out if we really need to do anything about the FLs.

I'm pretty sure I've spoken to my daughter on the phone on two occasions since I've had the new setup, and both times she asked "do you have a cold".

With the exception of today I have been sleeping well and feeling refreshed and alert. Today I feel very heady and a bit lethargic.

Edit: my partner has also commented about me having a cold

I was just thinking that the For Her mode increases at a slower rate and may help with the aerophagia and leaks but it also might allow more events and take a little more pressure. Something he might keep in mind if he wants to try. Never know how it would turn out till tried.
If it is nasal congestion try using nasal saline before bed and see if it helps. Some also do sinus washes but I have no experience there.
Like Pugsy said if sleep is good no need to change but if you want that option is there.

OkyDoky wrote:I was just thinking that the For Her mode increases at a slower rate and may help with the aerophagia and leaks but it also might allow more events and take a little more pressure. Something he might keep in mind if he wants to try. Never know how it would turn out till tried.
If it is nasal congestion try using nasal saline before bed and see if it helps. Some also do sinus washes but I have no experience there.
Like Pugsy said if sleep is good no need to change but if you want that option is there.

I don't fancy being a guinea pig right now lol, but I have some eucalyptus oil I can put on a cotton swab near the air intake, have done this before when I have a cold

Is the nasal congestion better/worse/the same as when you used the other machine with passover humidity?

The not feeling so good today....did you wake very many times last night compared to the other nights? We know you mentioned one wakening with known mouth breathing...any other awakenings?
Even if you don't remember waking up the leaks could be disturbing your sleep and you not realize it.
Plus it looks like only 6 1/2 hours of use last night...that's going to make it hard to feel decent even if things were perfect.

You are going to need to learn to be able to make subjective evaluations too. The numbers from the machine aren't the whole story.

Another thing...it's possible that the varying pressures could also be disturbing the sleep at some level.

There are a lot of possible things that could also be playing a factor in how you feel....getting a nice low AHI and decent leak is the easy part...now comes the hard work.
I've got some ideas that you might try but you need to be patient with the experiments and be able to evaluate the subjective feelings too and that part is difficult.
Your overall numbers are going to be acceptable/good....but they don't always tell the whole story.

I forget...do you take any medications?
Is 6 1/2 hours the best you can do? Why? or Why not?'
How many wake ups during the night that you think you may be experiencing?

There's no rush to be a guinea pig with the for her mode.

First thing is use the oil near the intake to see if it helps with the FLs...
Consider limiting the max severely to see if we can eliminate the leaks being a potential sleep disruptive factor and see just what happens if the machine can't go as high as it thinks it wants to.
Might also help with the bloating a bit.
I would try limiting the max to 10 and see what happens in terms of leaks...sleep quality and see if any OAs or hyponeas develop.