Made it though my first week - Wish for a Results FAQ

I made it though my first week on my APAP Most damage is my permanently bent mustache hairs from the mask.

I have been having trouble finding FAQs on what a proper interpretation of my results on the machine mean.

I understand what the Acronyms mean, I just don't know what is good, o.k., or needs Improvement

For the WEEK:

AHI: 11.7
AI: 2.9
HI: 8.9
Leak: 0.26L/s
Pressure: 11.8

Obviously much better from my PRE Therapy results! (From my sleep study...)
RDI: 76/hr
Sp02: 58%
REM Sleep: 10.6%

If one of the pros could fill me in, as I don't see my doctor for a few months.

Congratulations on getting past your first week. It takes time and a bit of changing settings to improve your results. However, your numbers are a bit high so you need to keep working at lowering them. However, you AI is good, your leak rate is good (you want it under 0.4 L/s) and your 95% PRESSURE seems common. However, was there a type on your test "Sp02: 58%" - I thought if your SpO2 was less than 62%, you were dead. How many hours are you using the machine each evening?

Since your ResMed machine already subtracts for intentional mask vent, what you see showing as leak is excess leak. You probably want to get the leak rate to be less than 0.10 L/sec. As close to 0.00 as possible. I believe that ResMed says that above 0.20 L/sec and it can maybe impact data and therapy, above 0.40 and all bets are off.

Your AI is good. Your HI is probably okay, especially since this is your first week. Overall AHI is maybe a bit high because of the hypopneas and that seems to be common with ResMed machines.

The less than 5 AHI is a common milestone that many strive for.

More importantly, how are you feeling? For just a week into things, not bad at all. Room for some improvement but not huge things to worry about just yet. Do you use EPR?

KengEsq wrote: However, was there a typo on your test "Sp02: 58%" - I thought if your SpO2 was less than 62%, you were dead. How many hours are you using the machine each evening?

I am far from dead at this point....even if the powers that be have been working on me! (Cancer, Kidney Transplant, -- now Apnea!) No, it really was, at the lowest point, 58% Sa02! probably when I was sleeping on my back (which I rarely do). I am on the APAP 6 to 9 hours a night) Oh, and I'm 48, 5'9" and 195lbs. with a 17" neck

I probably can't do much about my leak...my facial fur is not going to be removed for the sake of my mask. It was enough to have to shorten my mustache as it was.

As far as how I feel: Much more awake now, and it is great only having to pee once or twice a night rather than 4 or 5 times. And waking up after a few hours in the same position is odd. In the daytime, there has been some oddness. My jaw has changed alignment a bit...takes a few hours to get back to normal. And, at times, I feel a bit 'winded', like I'm hollow when I breathe. I suspect my blood pressure (which is drug controlled) is lowering due to my better sleep, and I'm feeling it in the daytime. Just have not been home when I feel funny to take my BP.

It is nice, however, to be able to read in the daytime without falling asleep, or needing a nap and feeling worse when I would wake up. That, and no more snoring, so the DH doesn't have to sleep in the guest room after an hour!

Oops, yes, I have my EPR set to 3. And, one other thing, only wake up once a night in a slight-panic feeling, as if I'm suffocating. I take off the mask, pee, put it back on and go back to sleep. Not a big deal.

RedBackFur wrote:Oops, yes, I have my EPR set to 3. And, one other thing, only wake up once a night in a slight-panic feeling, as if I'm suffocating. I take off the mask, pee, put it back on and go back to sleep. Not a big deal.

I bet there is a mistake on that Sp02 reading - at 58% you would be dead for certain - at 88% you would be in trouble since below 88% the pressure of the oxygen is not sufficient to pass into your red blood cells and you will suffer serious damage to your brain and the rest of your body.

You may want to try the EPR on off. Are you using the machine in APAP mode - if so what are your current minimum and maximum settings?

Keep faithful in your therapy and life will continue to improve. I see you already have noticed changes for the better.

On a ResMed, your goals are to get leak down close to 0.0 and to get AI consistently below one.

Along with KenEsq's questions, I would ask: Was your diagnosis stricly OSA? And what was your prescribed pressure based on titration, if you had a titration study? Is this the machine you are going to keep, or are they having you use it temporarily in an attempt to find the right pressure(s)?

@ Ken, that number may represent the lowest dip in saO2, not an average or a sustained saO2. (In my diagnostic sleep study, for example, my lowest saO2 was reported to be 71%, and I was below 85% for 39 minutes.) However, I agree that 58% could be because of movement artifact of some kind, or something.

KengEsq wrote:

RedBackFur wrote: You may want to try the EPR on off. Are you using the machine in APAP mode - if so what are your current minimum and maximum settings?

I am in APAP mode, and my RX is set for minimum 8, Maximum 14.

If you want more Specifics:

Sa02 Intervals/Percent Sleep Time from Study:

>89% 3.2
80-89% 56.6
70-79% 36
60-69% 4.1
50-59% .2

Do you know what your titrated pressure was during your sleep study? If your auto is set at minimum of 8cms and your average pressure is almost 12cms, you may need to raise the minimum a bit to prevent some of the events. I'm not an expert here but I'm sure one of them will clarify that for you.

KengEsq wrote:I bet there is a mistake on that Sp02 reading - at 58% you would be dead for certain - at 88% you would be in trouble since below 88% the pressure of the oxygen is not sufficient to pass into your red blood cells and you will suffer serious damage to your brain and the rest of your body

i don't know about that. during my sleep study my lowest reading was 66% and I'm still here. AHI was 105 during that part of the test. I'm fairly certain I didn't die. AND if what you say is the case about 88%, then don't you think the techs would have stopped the study as soon as it dropped below 88%? That's a huge liability for them if what you're saying is true.

jnk wrote:On a ResMed, your goals are to get leak down close to 0.0 and to get AI consistently below one.

Are you saying that ResMeds tend to under-report events?

brain_cloud wrote:

jnk wrote:On a ResMed, your goals are to get leak down close to 0.0 and to get AI consistently below one.

Are you saying that ResMeds tend to under-report events?

Every brand of machine uses a different definition of hypopnea, so there is no real under-reporting or over-reporting. Every brand of machine gives an estimate that is meant to be used for trending purposes. Because of the way ResMeds sense, define, and report events, the most significant number, especially at first, is the AI, and getting it consistently below one is the goal if at all possible.

ResMeds tend to report certain changes in breathing as hypopnea that other machines do not. It is neither right nor wrong--just different. So the hypopneas can be ignored at first.

ResMeds subtract the expected vent rate from what it reports to you as mask leak, so the idea with a ResMed is to let the machine know what mask you are using (if it is a ResMed mask) so it can do that. Zero leak is the goal.

Some accuse ResMed of OVER-reporting, since people who use multiple brands of machines get higher estimated AHI when using a ResMed machine at the same straight pressure they use with other machines. For example, one highly-respected member of the forum has found that cutting the estimated HI reported by a ResMed in half puts you in the ball-park of what your estimated HI would likely be on a Respironics machine. That is not because one is more accurate than another or better than another. One just estimates differently from the other.

All that is part of why on a Respironics machine the total AHI is the most important number to watch whereas on a ResMed the AI is the most important number, according to what I've read posted by more experienced members.

jeff

Great explanation, Jeff. It took me a lot of reading here to finally understand that "different" does not mean "better or worse". Your post just reinforces that.