Sleep Study Results - Need Help!!

I'm doing much better after my most recent titration. My cognitive abilities are beginning to return (Uber Techno Skills ).

I was startled to realize that I had 22 events, starting at 10/6 setting the first hour or so. Feeling absolutely lousy, high EDS, motivated me to have the Sleep Study.

What puzzles me, my Encore Reports indicated AHI ranging from One to Two while set at 10/6 for less than a year. The Sleep Study catches far more events. Is there something wrong with my BiPap data gathering??

Since my new setting of 12/8, I'm feeling much better, EDS is better but not gone. But, can I rely on my Encore Reports?

I'm confused?? Any other input most welcome!!

SG

What puzzles me, my Encore Reports indicated AHI ranging from One to Two while set at 10/6 for less than a year. The Sleep Study catches far more events. Is there something wrong with my BiPap data gathering??

Since my new setting of 12/8, I'm feeling much better, EDS is better but not gone. But, can I rely on my Encore Reports?

All your Apneas and Hypopneas are with you sleeping in the Supine position. Do you sleep on your back in your bed at home? If you are a side sleeper at home, I won't look any further at your sleep data as back sleeping could explain the Big difference between home reporting and your sleep study results. If you sleep on your back at home, I'll look some more.

I just noticed that you slept about 1/2 the time on your side or prone in your sleep study and had 0 events. The other 1/2 of your sleep time was spent on your back and you had all the reported "bad" events (14 + 8 = 22). If you sleep on your side(s) or prone at home, I would expect that your home reporting #s are accurate.

When I fall asleep at home, I'm supine. When I wake up, I'm supine. The only time I intentionally sleep on my side is when I'm so sick I can't wear my mask.

I'm a little cynical towards my 'Brick'. It's just not unusual with computers to reinstall firmware and such over a period of time.
The data I read off of the 'Brick' is lower than my Encore Reports. For you folks out there on the fence about purchasing an Oximeter, this is a prime example of getting one.

You feel like crap, the Encore Reports, in the Doctor's eyes, are completely acceptable and compliant. Unfortunately, we moved and I didn't follow up with the Doctor, as he requested.

Thanks,

SG

When I fall asleep at home, I'm supine. When I wake up, I'm supine. The only time I intentionally sleep on my side is when I'm so sick I can't wear my mask.

With such a huge (negative) difference between side sleeping & prone sleeping (0 bad events during your sleep study) and all your bad events (22) while sleeping on your back, what are your reasons for sleeping on your back? In your study, you slept 1/2 and 1/2.

Re the EP numbers and the machine LCD #s: AHI (for the machine's Noon-to-Noon GMT/UTC day) is the same as what EP would report for that same defined 7-day or 30-day rolling average. Nightly reset AHI #s will also be the same. Avg System Leak in EP is a weighted average whereas the LCD System Leak is a simple average (can be very different #s). Therapy Usage hrs/night are accurate within reporting granularity (6 minutes).

cinco777 wrote:
With such a huge (negative) difference between side sleeping & prone sleeping (0 bad events during your sleep study) and all your bad events (22) while sleeping on your back, what are your reasons for sleeping on your back? In your study, you slept 1/2 and 1/2.

That's a great question about sleeping on my side. I was having trouble sleeping at the Sleep Center. Go figure! And, brings up the issue of Sleep Tech's requesting patients to sleep supine.

What throws up the red flag, of all the time using my BiPap, I've NEVER EVER had that many events in a single hour. NEVER!!

cinco777 wrote:
Re the EP numbers and the machine LCD #s: AHI (for the machine's Noon-to-Noon GMT/UTC day) is the same as what EP would report for that same defined 7-day or 30-day rolling average. Nightly reset AHI #s will also be the same. Avg System Leak in EP is a weighted average whereas the LCD System Leak is a simple average (can be very different #s). Therapy Usage hrs/night are accurate within reporting granularity (6 minutes).

Yep, you know your stuff!! Thank you!! I'll check my 'Brick' stats again. Always, AHI has reported less than Encore Reports. I'll look closer to confirm your right. Admittedly, I'm not the brightest bulb in the package right now.

Thanks,

SG

In case you missed it (it was awhile ago), here is a link to an analysis that I did on the accuracy of the Respironics LCD #s.

viewtopic.php?f=1&t=44484&p=397330#p397089

SuperGeeky wrote:What puzzles me, my Encore Reports indicated AHI ranging from One to Two while set at 10/6 for less than a year. The Sleep Study catches far more events. Is there something wrong with my BiPap data gathering??

A PSG sleep study and the machines we use don't use exactly the same definitions for events. Not surprising that the number of events noted by one vs the other don't "match."

Good point by cinco that the usual sleep positions at home vs in the sleep lab can affect the results.

Besides the body's sleep position, more subtle things like how your head is tilted on the head pillow at home vs the head pillow in the lab, firmness or softness of the pillow, how one mattress vs the other supports the body... any of those things could have at least some effect on how apt to collapse the airway is.

Even if you slept on your side in both locales (home and sleep lab) tilting the head down (chin toward chest) can close the airway more, I think. The head pillow could affect how you tilt your head when sleeping.

SuperGeeky wrote:And, brings up the issue of Sleep Tech's requesting patients to sleep supine.

There are two ways to look at that kind of request.

On the one hand, if sleeping on one's back is something that the person almost never does at home, it can be difficult to go to sleep and stay asleep. Sleeping on one's back can even cause back or hip pain for some people. (A pillow placed under bended knees could help lessen the chance of that.)

On the other hand, I think it's good to see worst case scenario -- sleeping supine (on one's back.) Good to know what pressure it takes to well and truly keep the airway open when a person is sleeping on his/her back. Because.... even if we "never" sleep on our backs at home, you never know if the day might come when you have no choice but to be stuck in a hospital on your back for days/weeks/months. Following a stroke, recovery from broken leg, God knows what. Perhaps unconscious after an accident. Best to at least know what pressure it takes for sleep-breathing in that position.

Cinco777, I just generated a seven day Encore Report and checked it against the 'Brick'. Encore Report is showing AHI of 1.2, Brick is showing AHI of .7.

I never thought twice about it....

Rested Gal, thank you!! I don't know what we would do without your postings. I traveled out of town for my Sleep Study, we moved, I forgot my trusted, oh so comfortable squishy pillow.

Regardless of all the parameters, I'm just not buying into 22 events. I don't know 'jack' about CENTRALS, but eight?? Really!! Where did those come from?? And, I didn't have this a year and a half ago, first Sleep Study with no CPAP. And, I lost 40 lbs since then...

Though, the new prescription has improved my therapy, I have more work to do. I know one thing, I'm sleeping on my side with an Oximeter tonight. Still trying to figure out how to match up events. Since it's not all that obvious, might be a good sign.

SG

Cinco777, I just generated a seven day Encore Report and checked it against the 'Brick'. Encore Report is showing AHI of 1.2, Brick is showing AHI of .7.

Your EP is reporting on a "local time" Noon-to-Noon day whereas your "brick" is reporting on a GMT/UTC Noon-to-Noon day. Plus the LCD #s for AHI are 7-day and 30-day averages. For the same day definition and for the same 7-days or 30-days making up the rolling average, the 7-day Avg and 30-day Avg AHI for both EP and the LCD are the same. I suspect that your comparison is not a valid comparison in that you are not comparing the same 7 days and the same time-period for each of the 7 days. If you don't get the same results in your comparison, include your comparions #s (I use a spreadsheet for comparisons that are complex) in your next posting. Thanks.

Which time zone are you located in? That is, what is your local time offset to GMT/UTC (London time)?

Cinco777, Eastern Standard Time. My AHI just doesn't vary enough, you know like some outlier skewing the results to justify that kind of a difference. Encore Report 1.2 versus .7 on the brick?? Not even close!!

However, if you can share your spreadsheet, or post it on photobucket, I would be interested on what your doing, sounds interesting...

Thanks,

SG

Here is my previous post (yesterday) that links to an earlier thread that I started. You will see my spreadsheet (I post my images to Photobucket) in the first post of this thread.

Re: Sleep Study Results - Need Help!!
by cinco777 on Wed Nov 18, 2009 6:36 pm

In case you missed it (it was awhile ago), here is a link to an analysis that I did on the accuracy of the Respironics LCD #s.

viewtopic.php?f=1&t=44484&p=397330#p397089