Help making sense of the data

Hi All

New here, hoping you fine people can help me understand the data more.

I have been using my CPAP since the start of January. My results from the sleep test pre-CPAP gave an average AHI of 66 events per hour, this has now reduced to an average of around five or less. However i have good days and bad days and i cannot work out why i am waking up between 1-4 times per night still. I originally was given a Resmed P10 Nasal Pillow mask, however i found that i would open my mouth causing leaks every night. I switched to a Resmed F10 full face mask which has been much improved in terms of reducing leaks ( you can see from the overview below when i switched). I have played around with the pressure setting (was set at 12 by the doctor originally) to see if there would be any change but i believe this is having little or no impact.

Overview showing everything:


Data from last night (you can see the gaps where i am waking up and removing the mask, this is on the worst case scenario compared to other previous nights):



Thanks to anyone that views this, any questions i will be happy to answer!
Dan

https://imgur.com/a/2TYewe5

https://imgur.com/a/SPCOeZu

Links to images just in case you all only see the word "image" and can't get to the image.

Pugsy wrote: ↑

Wed Apr 19, 2023 9:06 am

https://imgur.com/a/2TYewe5

https://imgur.com/a/SPCOeZu

Links to images just in case you all only see the word "image" and can't get to the image.

Thanks Pugsy, i saw that and was trying to fix

Do you happen to know why you've been provided with a fixed-pressure machine? And what is happening during the breaks? Do you go back to sleep with your mask off, or ...?

Your machine has the capacity to provide EPR (expiratory pressure relief). You have fairly heavy flow limitations, and they may be related to your hypopneas. It is possible that some EPR would help with both.

EPR will drop you pressure by 1, 2, or 3 when you exhale. By the same token, it will increase your pressure when you inhale. That little pressure boost may be helpful in overcoming FLs (if they originate in your pharynx) and hypopneas. Or not. But experimenting with EPR seems like a good idea.

Try starting with 1 to see how you like it. Normally, the companion recommendation would be to increase your pressure by 1 to compensate. This would help you avoid an increase in OAs. But you have relatively few OAs, so that may not be critical. So I think my suggestion would be to make no other changes at this time.

Miss Emerita wrote: ↑

Wed Apr 19, 2023 11:49 am

Do you happen to know why you've been provided with a fixed-pressure machine? And what is happening during the breaks? Do you go back to sleep with your mask off, or ...?

Your machine has the capacity to provide EPR (expiratory pressure relief). You have fairly heavy flow limitations, and they may be related to your hypopneas. It is possible that some EPR would help with both.

EPR will drop you pressure by 1, 2, or 3 when you exhale. By the same token, it will increase your pressure when you inhale. That little pressure boost may be helpful in overcoming FLs (if they originate in your pharynx) and hypopneas. Or not. But experimenting with EPR seems like a good idea.

Try starting with 1 to see how you like it. Normally, the companion recommendation would be to increase your pressure by 1 to compensate. This would help you avoid an increase in OAs. But you have relatively few OAs, so that may not be critical. So I think my suggestion would be to make no other changes at this time.

Hi Miss Emerita

I do not know why I have a fixed pressure machine, i did ask when I first received it and i was told that they prefer to start the trial with CPAP rather than APAP. I am awaiting a telephone appointment to review the data again so I will ask this question again for a more detailed response.

During the breaks I'm not sure why I wake up, normally I will need to go to the toilet once during the night at most. However to answer your question, the majority of the time I will remove the mask (while awake and conscious), then when ready put it back on and go back to sleep within 10-15 min. I have even recorded video of myself throughout the night and I can't see anything other than just waking up. Perhaps due to still having episodes? Unsure but another question inwill raise with the specialist when they call.

As for the EPR, I will set this back to 3 as it originally was and experiment, again in have been adjusting to see if I would benefit without it. Trial and error I guess!

Appreciate the response and insight, a final question on the CPAP/APAP, is there any reason as to why i should have an APAP or was the question based around why the sleep specialist reccoemnded it?

Kind Regards

For many people, an APAP machine means they can spend a fair amount of the night at lower, more comfortable pressures, while getting the benefits of higher pressures when their airways become unstable and start shutting off. You are already at 15, and if you did need a higher pressure to overcome hypopneas and obstructive apneas, you'd be at a pretty high pressure the whole night long.

It's normal to wake up several times during the night. Some people (including me) will wake up after every REM cycle. (The timing of your first two wake-ups in the chart you posted made me wonder if that was the story for them.) From what I can see on your chart, your wake-ups weren't associated with respiration-related events. But if you want to, you can zoom in on the minutes before your wake-ups to see whether you spot anything odd going on.

The trick with wake-ups is to roll over and go back to sleep without long periods of being awake. A lot of time elapsed between your bedtime and the time you got up, yet you managed just 6.5 hours with the machine. Your actually sleep time was probably no more than 6 hours. For many people, that's just not enough for a rested day the next day.