1 week stats = anxiety help please

hello,
after being titrated to 9 pressure during sleep lab test i spent almost 4 months on the resmed elite set at 9, with little sleep maybe 3 or 4 hours per nite. i got switched to resmed vantage auto and had to ask for that, it was given to me without any settings...so i used it for one nite and got a pressure of 12. with the help of all you great people on the forum.. i was able to set the vantage at a 7 - 13 pressure. i was feeling o.k. till last nite when my pressure rose. i am posting my stats for the past six days and was hoping to get some feeback as my anxiety level is radidly rising. it seem to me that the pressure is far from the sleep lab study.

first morning: pressure: 12.4
leak: 0.14
ahi: 6.5
ai; .6
HF; 5.9

second morning: pressure: 12
leak: .8
ahi: 1.1
hf: 5.4

third morning: pressure 12.4
leak: 0.00
ahi: 5.3
ai 0.6
hf: 4.7

fourth morning: Pressure: 12.8
leak: .02
ahi: 5.
ai .06
hi: 4.4

fifth morning: pressure; 12
leak: 0.00
ahi 3.5
ai 0.2
hf: 3.3

sixth morning: pressure: 13
leak: 0.00
ahi: 4.7
ai: .6
hf: 4.1

also i am not sure why the read out for the last stat each nite is hf sometimes and hi other nights. i don't know if the read out is wrong or what each one means......i would appreciate any help the forum can give me...........do i need to up the max pressure past 13? this seems like an awful lot past the 9 i was titrated at, and 9 pressure was all the info, i could get from the dr. and the dme.........you guys and gals are the best, ellen

First of all Ellen, your numbers reflect a GOOD treatment response. Anything <5.0 is considered to be NORMAL, and many of yours are.

Second, most of your AHI is comprised of hypops, not apneas, and ResMeds are notorious for aggressively scoring hypopneas. So, take the hypop component with a grain of salt.

Do you have "Settling" enabled on your S8 Vantage? It would be good to do so, since "Settling" disables the scoring algorithm while you are settling in to sleep, but still awake, and prevents the S8 from artifactually scoring hypops while you're awake, and in wakeful, non-autonomic (automatic) breathing. You might find that your numbers go way down when you enable "Settling", if you haven't done so already. It should be set for the time it normally takes you to fall asleep, AND NO LONGER, since the machine won't begin treating you by adjusting pressure during that time as wel. It'll just chug along at minimum until the settling period passes.

Third, your 95% pressure numbers are pretty consistent. That's the pressure that your S8 is running at OR LESS for 95% of the night. Your S8 could be running at 9 most of the night, but making it up to 12.6 or so at times, and for 95% of the night, it isn't going above 12.6 or so. However, even so, that's quite a bit greater than your titrated pressure. However, there have been studies that demonstrate that auto-titrating machines such as yours are at least as accurate as an attended sleep study in establishing titration. So, it actually looks to me like you might have been mistitrated during your sleep study. But that's just my guess. Ideally, you'd like your 95% pressure to be consistent (yours is) except with changes like drinking, or weight changes over time, and to pretty well match your titrated pressure from a sleep study. Mine did with my S8 Vantage. The fact that your 95% pressure is running 33% higher than your titrated pressure makes me wonder whether they blew it during your sleep study titration. Been known to happen in the past.

Hope this helps!

Chuck

thanks so much chuck, you seem to always be their when i need you, my machine is set to setteling for 10 minutes which is about the time it takes me to fall asleep, sometimes maybe a little longer..thanks, ellen

BTW, I would consider increasing your max. pressure to give you some headroom, since your 95% pressure is pretty close to your max. But, I would discuss thus with your sleep doc first, since increasing your max. does come with the risk of precipitating/aggravating central apneas, and so ought to be done with caution.

Cheers!!!

Ellen:

No need to be anxious! You said you are feeling OK, after reseting your machine. Are you still feeling ok,including last nite? It seems you are more anxious now due to not knowing what the stats are saying-Is that it? Well maybe some info I can give will help you to stop worrying so much! First of all know that the HIGHEST reading your machine is giving you is the HIGHEST pressure reached during 95% of the nite! So you may have spent most of the nite at your titrated pressure of 9 or anyhwere from 7 to your top recorded pressure for the nite(IE: 12.4, 13 12.6 ETC) Your machine being set from 7 to 13! Your leak rates look pretty good to me except for the one nite (.80)! The AHI index is your AI + HI stats = AHI index! We strive for a AHI reading of 5.0 or lower and the lower toward zero the better. The AI stats are the most critical to be treated IMO and yours are VERY GOOD! The HI's are also very good as is your AHI"s all these nites. It seems to me you are being treated VERY WELL by the therapy being given by this machine. Keep reading all the posts by everyone here and use the search feature and you will understand all the lingo!

Hope this helps YOU and please ask any other questions you may have with cpap treatment etc. and someone here will get the answers to you!

All the best,

Steve,
ufo13

Steve-

YOU'RE THE BEST!!!!!!!

(BTW, your Swift velco tip has been WONDERFUL!!!. Right after I tried it, my large leaks went to 0, and my average leak is around 27L/min. Thanks!!!!)

Sorry for the brief hijack Ellen!!

Chuck

ellen:

mine does the same thing. it seems that there is no end to the "up" end of the range. i stopped at 13, only on principle, with a titrated pressure of 8. i cut it back to 12, since i was getting .6AI on 13, whereas I had been getting 0 or .1 AI's with 12 or less. my overall AHI's are lower than yours, but i thought my .6 AI might be an emerging central. I had no centrals or even apneas on my titration study.

since your AHI's are over 5, albeit not much, why don't you try cutting it back to 11 just as an experiment to see if it takes your overall AHI's down?

ultimately the "feel" test is reliable--as in how do you feel in the morning at various settings? numbers don't mean anything if you feel crummy. and if you feel great, it's unlikely that your numbers are bad.

caroline

Chuck:

Thanks for the kind words. Glad the fix helped! Also great the hear from you and enjoy reading all your posts!

Steve,
ufo13

OOPS! I MADE A MISTAKE ON THE SECOND MORNING STATS, THEY SHOULD HAVE READ PRESSURE: 12
LEAK: .8
AHI: 6.8
AI: 1.1
HF: 5.7
THANKS TO ALL WHO LEFT THEIR VALUABLE KNOWLEDGE, ELLEN:roll:

whatrdreamsmadeof wrote:OOPS! I MADE A MISTAKE ON THE SECOND MORNING STATS, THEY SHOULD HAVE READ PRESSURE: 12
LEAK: .8
AHI: 6.8
AI: 1.1
HF: 5.7
THANKS TO ALL WHO LEFT THEIR VALUABLE KNOWLEDGE, ELLEN

ellen -

6.8 makes no difference really ... you are doing well with your treatment as everyone else has stated above. Some nights will always be better than others. I think your pressure settings are just fine for now. So ... congratulate yourself for taking control of your treatment.

The only way you will be able to see just how close you are to your titrated or Rx pressure is to get the Autoscan software and the card reader (and ResMed card too if you don't have one). It will provide you with a MEDIAN pressure which is the number you are looking to match to your Rx pressure of 9. The software and card reader is not cheap though at around $225 for the setup.

Main question to ask yourself is if, overall ... are you feeling better than before going on xPAP? ... take care.

- roberto

what is Steve's "velcro fix"?

BTW, I AM concerned that your display alternates between HF and HI for the hypopnea index. If you're SURE that you're NOT misreading it, then I'd worry about a badly burned EEPROM and demand a replacement. If you're getting this kind of glitch, I wouldn't rest assured that there isn't some other glitch that could more consequentially affect the operation of the algorithm and the auto-titration that you're getting. I've NEVER had that, or any other anomaly on the display of my S8 Vantage.

Just a thought.

Chuck

hey chuck you know i double checked and i wasn't reading it wrong. sometimes it says hf and other times hi,,,,,,,,,,i hope i don't have to fight with the dme again......it seems never ending.....but i will try for a new machine. ugh!

Briefly, put on the Swift on and adjust it to fit. Then remove it.

Attach lengths of self-adhesive Velcro (hook side)cut to size, to the INSIDE on the bottom (back) straps of the Swift headgear on either side of the teal buckle, using the adhesive AND a staple or two (stapled from the inside-out).

The extra grip afforded by the Velcro hook-side strips will work wonders to prevent the back strap from riding up during the night and thereby, breaking the seal of the pillows. And, its not uncomfortable or even noticeable at all!

WORKS LIKE A CHARM!!! One of the TRULY GREAT lab-ratting breakthroughs discovered and shared here by one of CPAPtalk.com's GREATS!!!

Hope this helps!

Chuck

Ellen-

They won't hesitate for a second to replace your machine. They won't risk the liability of exposing themselves to a malpractice action if you inform them that there's an anomaly on the display, and they DON'T replace it. G-d forbid something happened to you, after you informed them of this, and they'd refused to replace it. Now, they might give you a loaner, and send yours back to ResMed for repair. But I'd bet dollars to donuts that they'll simply replace yours, and then send it to ResMed for a replacement of their stock. But don't worry. they won't take the chance with you.

BTW, I can't recall anyone else ever reporting that here.

Hope this helps!

_________________

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