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GaryG wrote:reread Pugsy's comments and actually with my less than 3 months experience, I kinda disagreed with Pugsy. Now I have no scientific evidence but I don't necessarily agree the directly correlating sleep study numbers with CPAP machine numbers, but otherwise she has good points and is usually very knowledgeable. I hope she doesn't get mad at me.

Ahh Gary, I guess you are too new to know about my voodoo doll.. Just ask Drubin007 I don't get mad.

My thoughts are simply my thoughts based on privately picking the brains of several experienced members here, my own medical background and conveying my thoughts to my sleep doctor (who agreed with me). If anyone wants to glean a few pieces of my thoughts and think that they might make some sense to them, then wonderful. If someone thinks I am all wet, then so be it. There is a good chance I might be but my thinking helps me come to grips with what I see and what I feel. It wouldn't be the first time I have had some "rogue" ideas.

Last time I looked I hadn't been put on the gospel maker list and I am certainly not offended if someone doesn't agree with me. I certainly don't agree with everything that everyone says here. I doubt anyone expects a person to. Unless someone is giving harmful erroneous information I won't even bother to say anything. The human body is a miracle of diversities. We cannot all expect to fall in the same little mold. Different strokes for different folks. I just don't think that there is a one size fits all answer to this cpap thing and people want one. They want a quick simple line in the sand. I can see why doctors tell patients to not obsess over the numbers themselves.

So disagree with me all you want. Just remember I have that little voodoo doll handy.
Just kidding, while I do have one, I only use it for good.
I hope you find the validation that you are searching for that makes this whole cpap annoyance worthwhile for you.

GaryG wrote

I kinda disagreed with Pugsy. Now I have no scientific evidence but I don't necessarily agree the directly correlating sleep study numbers with CPAP machine numbers

Since starting Sleep Apnea therapy in March '09, I have seen numerous similarities between the PSG results from my two sleep studies and the number and distribution of sleep events (NRAH, OA, H, and FL) reported by my Respironics APAP machine and graphically displayed by EncorePro and my own user-written Excel Charting Program. Like Pugsy, my recognizing, analyzing, and learning from these similarities has provided me with additional information, clues, and ideas for improving my sleep therapy. In six months, I progressed from a weekly average AHI of over 8 (that left me feeling like a Zombie) to a weekly average of 0.4 (for the last 3 months) that leaves me feeling rested and energetic. The AHI for my CPAP sleep study was 2.7 (I didn't feel rested afterwards) and now averages 0.2 (weekly avg) when I sleep on my left side every night. This is a significant improvement vs my CPAP sleep study.

Similarities that I have noted (YMMV) between my PSG results and my APAP usage include:
1) Large number of sleep events when I sleep on my back. I trained myself not to sleep on my back over the course of one month.
2) Lowest number of events when I sleep on my left side (I did not sleep on my right side during either of my studies). I investigated sleeping on my right and left side and determined that left side sleeping leads to a more restful sleep and fewer OA and H events. However, which side I sleep on doesn't affect the number of Flow Limitation events.
3) No centrals during sleep study and no NRAH events with APAP.
4) No Stage 4 sleep (0%) and minimal REM sleep and no remembered dreaming in my No CPAP study, and 16% Stage 4 and 18% REM and remembered dreaming during my CPAP study. With APAP, I remember dreaming, usually multiple dreams, most mornings when I awake.
5) My two studies showed many arousals attributed to periodic leg movement (15+/hour). APAP doesn't report this. However, training myself to sleep on my sides (mostly left side) and taking 2 -3 Tylenol/night for minor pain (mostly sore neck) has reduced my "tossing and turning" all night to zero (per my wife, I stay in the same sleeping position and don't kick for an entire sleep session).

cinco777 wrote:Since starting Sleep Apnea therapy in March '09, I have seen numerous similarities between the PSG results from my two sleep studies and the number and distribution of sleep events (NRAH, OA, H, and FL) reported by my Respironics APAP machine and graphically displayed by EncorePro and my own user-written Excel Charting Program. Like Pugsy, my recognizing, analyzing, and learning from these similarities has provided me with additional information, clues, and ideas for improving my sleep therapy

Same here but I haven't had to inclination to do spreadsheets. Too lazy. My sleep study was really not all that exciting in the regular stages of sleep. Very mild number of events, I think they said 11 per hour though some were 40 second in length. It seems to take me a little longer than normal to get to REM staged sleep but when I finally do I start through events all over the place with 53 per hour. It was fairly easily spotted on the graphs. Couple of hours with not much going on and 45 minutes of all hell breaking loose. With this cycle repeating 3 to 4 times a night depending on number of hours slept. The non rem staged events are very easily dealt with and rarely pop up.
The ReM events sometimes are stubborn and sometimes easily dealt with but I almost always see pattern of the groups or clusters that seem to occur very close together given the number of green bars on the report and the depth of the color. I accept it as what I have to deal with. Position doesn't seem to make any huge difference in my case. Since we don't want to prevent REM we simply want to decrease those stubborn events that occur in REM. Sometimes I had success and sometimes I didn't. Over the past 4 weeks since I got the new AFlex auto I seem to be noticing less groupings and less needs for higher pressure to address those clusters. It is very gradual and I can't put my finger on it but I am seeing less dark green bar clusters and the pressures haven't been rising so high so often. I haven't done anything really different except change machines. Settings are pretty much the same except I added AFlex. Masks are fine. Leaks are not perfect all the time but they are within acceptable limits.

I still feel the best with AHI less than 2, and I still have more nights with the 3-4 range but I am getting a few less than 2 AHI. Not as many as I would like but I just don't see what else I can change. If I never got them then, yeah, do something but once or twice a week I get less than 2. So for right now I am just watching the trend to see where it leads me.

For me there was a direct correlation with the timing and number of events that I had during the sleep study and what I experience nightly now. I have 5 months worth of graphs that show it pretty well. Satisfies me anyway.

i hope i didn't de-rail lou's thread by introducing comments from another, if so then i apologize.

the point in pugsy's comment that i thought was relevant and would help lou understand his morning numbers was the part about using the software to analyze the night's data to get a clearer picture of what happened over night.

thanks for all the useful comments and best wishes to everyone in their xpap therapy!

Pugsy wrote

It seems to take me a little longer than normal to get to REM staged sleep but when I finally do I start through events all over the place with 53 per hour.

My story is different. My titration PSG (2nd study with CPAP) showed a REM AHI, 4.3, only marginally higher than my non-REM AHI of 2.5. Both my studies, with and without CPAP, exhibited a random distribution of Apneas - there was no clustering. Another similarity between my 2nd study and my current APAP usage is that the vast majority of my sleep events are Apneas not Hypopneas. I had 0 Hypopneas in my second study (all events were Apneas), and have 75% fewer Hypopneas than Apneas using my APAP.

When I started this journey and after educating myself from reading this forum, I thought that, when viewing my sleep reports, I would see an Apnea usually preceded by Hypopnea(s), a Hypopnea usually preceded by Flow Limitation(s), and a Flow Limitation usually preceded by a snore as each sleep event designated a further closing of the airway. Didn't happen, at least for me. My Apneas appear all by themselves. The same with my Hypopneas when they occur. Likewise for my Flow Limitations and my Snores (very rare and almost all from the hose rubbing against something or from my coughing with my mask on). In six+ months of analyzing my sleep results, I have not seen any time-related correlation between my sleep events (OA, H, FL , and VS). However, I do have a high Flow Limitation index (4X higher than my AHI) and would like to reduce it but nothing that I have tried so far has worked.

I am currently pursuing a theory that most of my Apneas and Hypopneas, as detected by my Respironics APAP, are taking place when I awaken briefly during the night as I am a shallow breather when sleeping and my breathing rate is on the low side (less than 8/minute). I believe that my low breathing rate sometimes leads my APAP to think that I have stopped breathing and it records an Apnea for me.

Pugsy wrote:

GaryG wrote:reread Pugsy's comments and actually with my less than 3 months experience, I kinda disagreed with Pugsy. Now I have no scientific evidence but I don't necessarily agree the directly correlating sleep study numbers with CPAP machine numbers, but otherwise she has good points and is usually very knowledgeable. I hope she doesn't get mad at me.

Unless someone is giving harmful erroneous information I won't even bother to say anything. .

Pugsy, Ditto, this is a point well made.