Newbie Looking for Sleepyhead Feedback

I am a new CPAP user new to this forum and have found the information here very useful. I'm using a Dreamstation APAP with a Dreamwear mask. I purchased this outright because my deductible is high and it made no sense to go the DME rental route. Overall I'm very happy with the device and my ability to tolerate the mask. I tried CPAP several years ago and couldn't stand the mask. I decided to go into several years of denial/hibernation. I don't remember what my numbers were from my sleep study but it was mild. Seems like AHI around 10.

My pressure settings on the Dreamstation are currently 9 minimum 14 maximum. I'm only about a week in so I don't have a ton of data to analyze on Sleepyhead. But I eat this kind of information up and find the data very interesting. I don't see my sleep doc until early January and am interested to make as much sense of this now as I can.

I'm seeing some improvement which I expect I should be happy seeing after a little over one week; I know some people see results almost immediately. First night for me was 13 (though that was probably an anomaly as I was getting used to it) and last night was 3.59. Hoping to see these numbers push down further. Here is last night:



And here is a week ago:



The general trend so far looks good:



I am concerned seeing the frequency of central apneas. I seem to get about 1/3 of my nightly centrals in clusters in the first 10 minutes of sleep. And I wonder if those central (clear airway) apneas are here to stay. Or should I expect that those will change as I get used to the CPAP? One of my nights had an 0.71 central index which is encouraging.

Any thoughts on this data from all you Sleepyhead experts? Any feedback or input would be greatly appreciated.

Welcome to the forum.
Establishing an appropriate lower limit is very important as you are realizing. Your charts do not include pressure which is important to see. Look at the links below as to how best to display your data.

Ditch the calendar to allow for more results underneath it.

Oops...yeah hadn't realized I accidentally dropped my pressure graph before the screen cap. I just updated the screen caps in my original post.

The graphs we like to see on the right are
Events
Flow rate
Pressure
Leak

Flow limitation graph often spoken about only pertains to ResMed machines. Your Respironics machine doesn't do a flow limitation graph but instead has any Flow Limitations shown as flags when using auto adjusting (apap) mode on your machine.
FL flagging is disabled when using fixed cpap mode.

On the left side you can hide the calendar and turn off the pie chart (Preferences/Appearance tab and remove the check mark for show pie chart).
This allows the more useful statistics to come into view and you can easily get all the needed information in easy to review image.
See here for examples
viewtopic/t103468/Need-help-with-screen-shots.html

I wouldn't worry so much about the centrals right now especially when the bulk of them are real close to known awake times or when you first fall asleep.
Some centrals are normal...like sleep onset or sleep stage transition centrals and they aren't a problem unless present in large numbers or if they keep a person from proceeding deeper into the sleep stages.
Some of what you are seeing very well could be what we call SWJ (Sleep/Wake/Junk) flagging of irregular awake breathing as some sort of apnea flag. These machines can't tell if we are asleep or not. They only measure air flow or breathing and our awake/semi awake breathing is very irregular and can sometimes cause the machine to generate some sort of apnea flag. If we aren't asleep it isn't a real event and they only count when we are asleep. Awake flagged events have to be mentally removed from the evaluation process.

When people are new to cpap therapy they will often have periods of time while awake tossing and turning and breathing weird or a lot of sighing and this can cause SWJ event flagging. With time and experience these will often reduce as we go to sleep easier and faster and not so much awake/semi awake time is spent with mask and machine being on.

Yours are already reducing from when you started therapy and I expect that they will continue to reduce a bit...especially those little clusters that you see right at the beginning of the night or the end of the night when there's a good chance you were awake or semi awake.

The time over red line % statistic you see under the pie chart may not be totally accurate because the SleepyHead defaults are set up for ResMed red line numbers and Respironics red line numbers aren't the same as ResMed.
Preferences/CPAP tab...on the right you will see 24 L/min as the red line threshold...that's a bit low for Respironics.
Unfortunately Respironics never gives us a set number as the red line threshold because the threshold varies with pressure and mask used.
You can either turn that statistic off...ignore it or change the threshold to something more close to where Respironics red lines are...and with your pressures...probably 50 or 60 L/min would be a nice conservative number.
This statistic isn't that critical...the machine will flag large leaks over in the Events graph and it has the final say...if you don't see any LL flags on the Events graph then it doesn't really matter what the statistics says because you didn't have any large leaks.

So how is the sleep quality now? Spending much time awake with mask and machine on? How long to fall asleep?

Your report actually looks quite decent for 1 week of use. Looks pretty typical for someone adjusting to therapy but still having some awake time getting flagged a bit.
That first cluster of centrals at around midnight last night....is it possible you were awake at midnight?

Your CAs are insignificant. They occurred during the first 20 minutes and are most likely from restlessness while you were trying to get to sleep. They are called sleep/awake junk.

I noticed small clusters of central early in the night. These could very well be sleep/wake junk (SWJ) that gets flagged when your breathing is not regular and the machine starts reporting your irregular breathing as central. This is fairly common. I see it quite often in my wife's data on the nights she has trouble sleeping.

Pugsy wrote:The graphs we like to see on the right are
Events
Flow rate
Pressure
Leak

...

I wouldn't worry so much about the centrals right now especially when the bulk of them are real close to known awake times or when you first fall asleep.
Some centrals are normal...like sleep onset or sleep stage transition centrals and they aren't a problem unless present in large numbers or if they keep a person from proceeding deeper into the sleep stages.
Some of what you are seeing very well could be what we call SWJ (Sleep/Wake/Junk) flagging of irregular awake breathing as some sort of apnea flag. These machines can't tell if we are asleep or not. They only measure air flow or breathing and our awake/semi awake breathing is very irregular and can sometimes cause the machine to generate some sort of apnea flag. If we aren't asleep it isn't a real event and they only count when we are asleep. Awake flagged events have to be mentally removed from the evaluation process.

When people are new to cpap therapy they will often have periods of time while awake tossing and turning and breathing weird or a lot of sighing and this can cause SWJ event flagging. With time and experience these will often reduce as we go to sleep easier and faster and not so much awake/semi awake time is spent with mask and machine being on.

Yours are already reducing from when you started therapy and I expect that they will continue to reduce a bit...especially those little clusters that you see right at the beginning of the night or the end of the night when there's a good chance you were awake or semi awake.

...

So how is the sleep quality now? Spending much time awake with mask and machine on? How long to fall asleep?

Your report actually looks quite decent for 1 week of use. Looks pretty typical for someone adjusting to therapy but still having some awake time getting flagged a bit.
That first cluster of centrals at around midnight last night....is it possible you were awake at midnight?

Thank you so much for your detailed response. You apparently started responding after I updated those screen caps. I ordered things as you suggested and removed the calendar. I appreciate that feedback.

Great feedback on the CA's. That's very reassuring and I'll keep the SWJ in mind.

I think the sleep quality is actually getting better for sure. I don't necessarily feel better yet but this has been neglected for years and I'm realistic enough not to expect any overnight miracles and will remain patient. I'm not really spending much time awake with mask and machine on at all. Last night I feel asieep almost immediately; I've generally been falling asleep very quickly, like <10 minutes. I don't think I was truly awake at midnight last night, no. However, the night before I experienced the same cluster of CA's and I would describe myself as 50% awake at the time. I definitely cognitively noticed these happening. I remember thinking "that's odd...like I forgot to breathe." Interesting that the event period then closes out with an OA.

There are some people (relatively small %) who start cpap and have centrals pop up simply as a result of the cpap pressures.
As long as they aren't present in extremely large numbers most docs will take a wait and see approach because there's a good chance that they will reduce as the body gets more used to cpap pressure therapy.

The zoomed in CAs you show...they look real to me...don't look much like SWJ.
But while the cluster is a bit ugly you aren't having them clustering like that all night long and the numbers are already reducing from what you had the first few nights when you started therapy.

You aren't having huge numbers and they do seem to reducing in numbers and most docs will give them time anyway.
So I wouldn't worry about them for the time being but just keep a watchful eye out for them.
We all can have a few centrals..even the real deal centrals...and it not necessarily mean anything bad is going on.

I have seen people have a large number of real centrals...like 10 per hour every hour all night long and every night...have them pretty much fade away as their body gets used to cpap therapy. So sometimes time will fix it....and if it doesn't there are other options but doctors will most likely give the easy cheap option the first try...time. Because often it will be sufficient and no further treatment is needed.
For those that time doesn't resolve the issue there are other options...like bilevel or special machine that will breathe for you but you are no where near needing to go down that road at this time.