Efficacy data on S8 machines

Dumb question but I have to ask ... are the pressure values nightly averages or maximums? I'm guessing average for the night.

Obviously by definition the AHI, AI, and HI values are in units of events per hour and leak rate is in units of liters per minute.

Also, if the APAP is set to a min of 8 cm and max of 12 cm pressure, is it possible to have a reading greater than the max 12 cm?

Thanks,

- roberto

The S8 reports "95% pressure" which is the pressure that the blower operated AT OR BELOW for 95% of the sleep session.

If your S8 Vantage is set to 8-12cmh2o, you SHOULD NOT be getting a 95% pressure value GREATER than 12.0 cmh2o, except perhaps incrementally (12.2, 12.4).

Hope this helps!

Chuck

leak is measured as L/s liters per second on Resmed machines, to get per minute you will need to mulitiply by 60.

SmartData is avg per session, then per week, per month etc.

Thanks guys.

I double checked the setting the "ceritified clinician" set for the APAP and the max is actually set to 13 cm ... my boob

With only 4 days of APAP data I seem to be peggnig the max pressure:

Use/Pressure/Leak/AHI/AI/HI
7.0/12.20/0.16/3.90/0.10/3.80
7.0/13.20/0.12/3.30/0.00/3.30
6.0/12.20/0.48/4.20/0.00/4.20
7.0/13.20/0.18/2.80/0.00/2.80

If the pressure readings off the efficacy menu are 95 percentiles, the machine must be working near max setting for most of night. Also noticed that I'm ready to get up after 6 or 7 hours of sleep and can't seem to get any more even though I have scheduled myself 8 hours of time ... feel fine though.

Based on treatment part of sleep study report, I was titrated to an average of 10 cm for CPAP based on 5 hours data:

Pressure/Cent/Obst/Mixed/Hypop
10.0/1.2/0.6/0.0/4.0

After careful examination and interpretation of the study plot, it looks like they were bumping the pressure up and down between 9 cm and 14 cm. Noticed that my O2 was a little bit higher with higher pressures too and also had more stage 3 sleep with higher pressure during the titration ... not sure if they are actually correlated.

They didn't monitor or at least have any data on the report for leaks ... I guess they already new what to expect with the Swift?

Nevertheless, I'm basically already doing better on APAP than I did for the treatment portion of the study on CPAP with respect to AI.

Anyway, I have the card reader and AutoScan on order from cpap dot com and expect it early next week. Maybe I can get more detailed nightly info on what is going on.

Wondering if I should go ahead and bump my min and max by 1 cm or wait another week for more data.

Also just wanted to say again ... many thanks as you guys have pointed me in the right direction for taking complete control of my treatment.

- roberto

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

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CPAPopedia Keywords Contained In This Post (Click For Definition): swift, Titration, CPAP, APAP

Roberto-

Your numbers look fine, but here's the ONLY important part: How do you feel?? You say that you feel fine, and for that CONGRATS!!!!!

Certainly,there is nothing in your numbers that would arouse concern. Even your hypops are low (based on scoring by a ResMed machine). I wouldn't even worry about giving it more headroom since your numbers are so good. (BTW, the 95% presssure isn't a 95th percentile pressure. Its not blowing away at 95% of 13 cmh2o all night long. Its blowing away at whatever pressure is indicated OR LESS for 95% of the night,. It may be blowing most of the night at 9.0.

The only complaint that I heard is that you're awakening after 6-7 hours when you'd like to get 8. This could be this cortical arousal I mentioned in my comparison post, due to the sharp attack of the S8, especially during REM sleep which happens mostly in the early morning/end of the night. Dunno, Just a thought.

But if you're feeling fine bro, NO WORRIES!

CONGRATS!

Chuck

I'd say your results are very good. You only have 1 session out of 4 where AI is above zero, then it is only .10 and/or very low that could be only 1 o 2 events for the whole session. HI remains under <5 so I would change nothing.

Pressure/Cent/Obst/Mixed/Hypop
10.0/1.2/0.6/0.0/4.0

You indicate above that CA's and MA's where seen in one result?
How are you getting/measuring that result?

If that is the case, I would keep the Max. pressure set where it currently is. You would only want to raise the Max. pressure IF AI numbers increased on a regular basis. I don't see that in your data. You only had 1 session out of 4 where some AI's were seen, not warranting an increase in my opinion. Nothing wrong with having 1, 2 or 4 AI's per night, in fact any count under <5 is okay.

However, when ever you see CA's or MA's on your PSG report you should be mindful of their presence and use caution when setting any Max. pressure with an autopap as that can make it worse.

Thanks guys for the advice ... again. I will leave things as they are and continue with the development of a reference baseline using the Swift mask.

Snoredog wrote:

Pressure/Cent/Obst/Mixed/Hypop
10.0/1.2/0.6/0.0/4.0

You indicate above that CA's and MA's where seen in one result?
How are you getting/measuring that result?

Snoredog -
The CAs and MAs quoted came from my initial sleep lab study report. As I may have mentioned before, the sleep doc told me that the CAs were likely a response to the newly found bounty of air getting to my lungs and said that the CAs would gradually disappear as my brain adjusts to the continued treatment ... basically, nothing for me to worry about.

I was just a bit concerned over the hypops but I guess the HI values between 3 and 4 are acceptable and there is no need for additional tweaking.

You guys are the best ... thanks and take care ...

- roberto

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

chuck and snoredog:

so you don't need to bump your pressure if your ahi's continue to be under 5, even if you're hitting the top of your ceiling regularly? my sleep doc prescribed 6-10, but i've been bumping pressure 1 cm every coupla nites. now i'm at 13, and this a.m. i told myself to stop. truth is, the ahi's are pretty much the same (low), whether i'm at 10 or 13. so maybe go back to 10? (i realize there is the danger of csa's with high pressure.)

if i could get my sleep doc on the phone, i would ask, but repeated requests for a return phone call has produced no result. i have a serious, non-apnea related matter to ask about, so i will persevere.

until then, you guys are what i have.

caroline

Unless you are able to look at your nightly data, I don't think you can tell if you are hitting the top of your ceiling "regularly". As Chuck said, the number off of the efficacy menu means that 95% of the time your pressure is at or below that top ceiling value. It could be you only had one event for which it raised the pressure that high and yet remained near the bottom for most of the night.

I think higher pressures also increase the number of arousals which degrade your sleep time.

As Chuck and a few others have stated, the best way to figure out what is happening and determine your sweet spot is to integrate oximeter oximeter data into your analysis.

Anyone seen this? ...

http://www.turnermedical.com/SPO_PulseO ... UAodP25pLw

Maybe we could check into the group price and see about getting ourselves better monitored.

Hope you get in touch with your doc Caroline.

- roberto

[quote="chdurie2"]chuck and snoredog:

so you don't need to bump your pressure if your ahi's continue to be under 5, even if you're hitting the top of your ceiling regularly? my sleep doc prescribed 6-10, but i've been bumping pressure 1 cm every coupla nites. now i'm at 13, and this a.m. i told myself to stop. truth is, the ahi's are pretty much the same (low), whether i'm at 10 or 13. so maybe go back to 10? (i realize there is the danger of csa's with high pressure.)

if i could get my sleep doc on the phone, i would ask, but repeated requests for a return phone call has produced no result. i have a serious, non-apnea related matter to ask about, so i will persevere.

until then, you guys are what i have.

caroline

Snoredog wrote:I totally disagree with the doctor that says they are from introduction of cpap pressure and that they will go away. Fact is they don't go away, I've had several PSG's and they have been present on all 3 even with cpap.

So are you saying that I may have had CAs during my diagnostic portion of the sleep study? Because in my report, there were no CAs or MAs detected during the diagnstic part ... only towards the end of my titration portion.

I then asked the doc about the CAs near the end of my study period and that is when he told me why they appeared and that they would go away.

- roberto

snoredog:

My AI's with the Resmed, whether the pressure is 10 or 13, are all under .4 (yes, less than half of 1). I have hypos that run from a low of 1.9 to a high of 2.8. That is consistent with my last cpap titration, which was done two months ago, which reported no apneas and 3 hypos at pressures of 7& 8, and the sleep lab did not test higher (which disappointed me, because my complaint was insufficient pressure at 8.)At 6, there were 21 hypos and no apneas. There were no CSAs at any pressure. A diagnostic was not done with the titration because the diagnostic was done five years ago.

I do not remember exactly the data from five years ago, and I seem to have temporarily misplaced it. But as I recall, there were no apenas, some hypos and some csa's. Although I didn't have the big apnea numbers that a lot of people here do, I had severe daytime sleepiness. On my diagnostic, I slept for 11 hours and then flunked the MSLT the next day.I vaguely remember an AHI of 11, but I could be making that up.

I've been bumping it up every couple of nights, as I've had the apap slightly more than a week, as I hit the ceiling pressure for two nights, as folks here have suggested.

So what should I be doing?

Thanks.

Caroline

DreamStalker wrote:So are you saying that I may have had CAs during my diagnostic portion of the sleep study?

If you had had Central Apneas during the diagnostic portion of a full PSG sleep study, they would have shown up. That's what the belts they put around the chest and abdomen during a full PSG study are for...to sense the physical effort we use when breathing in and out. No airflow + no physical effort = central apnea; as opposed to an obstructive apnea where a person's chest and abdomen are heaving in an effort to breathe but cannot get air through the closed airway.

There's always the chance the belts could slip or loosen during the PSG and "centrals" be noted that weren't really there. But I'd guess the absence of centrals being noted in a sleep study would be correct.

DreamStalker wrote:Because in my report, there were no CAs or MAs detected during the diagnstic part ... only towards the end of my titration portion.

I then asked the doc about the CAs near the end of my study period and that is when he told me why they appeared and that they would go away.

- roberto

I'm no doctor but I think your doctor is absolutely correct. From what I've read by sleep techs who do titrations night after night after night, it's not at all uncommon for the pressure changes going up (not necessarily the particular pressure itself) to cause temporary centrals. Wait it out and they often disappear as the body adjusts to the change.

If someone, like Snoredog, does have a lot of central apneas along with obstructive apneas all the time, that's a different matter. But for most people, I really think that the fear of high pressure causing centrals is not something to worry about. Having the software to monitor one's treatment is good. It's a useful barometer even if every detail isn't 100% "right" all the time.