Someone please help this Newbie!

I have a sneaky suspicion that when Alex gets to the right level to control the apneas, he's going to sleep for 3 hours and then wake up so refreshed that he's not going to know what to do with himself!

DreamOn wrote:I'd like to throw this out there for feedback from everyone....

I just took another look at the chart that Alex just posted, with the events spread out over a one-hour period. It could be that my own sleep-deprived brain isn't comprehending correctly, but is it even possible to have that many apneas in a one-hour period? Seriously, look at the event durations!

Could this be a problem with the machine? It's extremely odd to me that Alex would have such a high AHI during therapy at home, yet he had only 3 apneas and 25 hypopneas during titration. Very strange.

Perhaps Alex is one of those people that close off on the exhale. If they didn't use exhale relief or bi level on the titration then that wouldn't show. The proof will be when the pressure - EPR = his titrated level.

Wow, AJimen05... Good you posted your data and received all that great help. Did your sleep study note anything about apnea severity relative to sleeping position? Some people have much worse apneas while sleeping on their back.

DreamOn wrote:I'd like to throw this out there for feedback from everyone....

I just took another look at the chart that Alex just posted, with the events spread out over a one-hour period. It could be that my own sleep-deprived brain isn't comprehending correctly, but is it even possible to have that many apneas in a one-hour period? Seriously, look at the event durations!

Good point. I expanded and tallied the 23:10 to 23:20 period since that segment was as dense as any. Right around 405 of 600 seconds were machine-scored in apnea. Although that's possible, it sure does seem improbable. And it stretches the credibility of apnea scoring on a home-machine that relies on a single pneumotach flow-data channel IMHO.

Bear in mind that most of AJimen05's apnea events probably did not entail a complete lack of flow from beginning to end. I doubt his machine is "broken" per say. But I don't think these machines score apnea length or count as accurately as a PSG would---where a thermistor is used to score apneas to prevent pneumotach-based apnea over-scoring. This machine has a highly sensitive pneumotach but not the thermistor, EEG channels, effort belts, etc.

Unless you posted a one-hour period that was worse than much of the night, how is it that your AHI was 20 when there are more than 20 events in the segment you posted? Again, an AHI is an average over the time you wore it, so if you posted a non-representative sample of your events, that might explain it.

I would push for the APAP.

ozij wrote: ........ Which is why the following advice is irresponsible.

Lizistired wrote:You could uncheck the AHI and Pressure in both windows since they don't tell you anything you don't already know.

Excuse me?! Irresponsible?! To tell him how to hide excess graphs from the ResScan screen so he has room for the graphs he needs to see? He knows what his pressure is set at and the AHI is obviously high by looking at the events graph.
Maybe you should read more carefully.

Well done Alex,
I sure thought I had missed the central thing but I did remember your reporting 0 centrals from the machine and I thought OMG he maybe gave me a typo, so I went back and looked and it was 0 CA and 74 AI.

Anyway, so glad to see some improvement on the report and also in how your night went.
Rested Gal (another person I listen when she talks) made some suggestions that would be along the lines of what I would do if this were my report.

The EPR may have been the key.

SleepingUgly wrote:Unless you posted a one-hour period that was worse than much of the night, how is it that your AHI was 20 when there are more than 20 events in the segment you posted? Again, an AHI is an average over the time you wore it, so if you posted a non-representative sample of your events, that might explain it.

I would push for the APAP.

Good morning SU!

The screenshots were from the 23rd which someone wanted to see. They weren't from last night...I didn't have time to post last nights activity I just saw the summary from the sleep quality screen on the machine.

-SWS wrote:Wow, AJimen05... Good you posted your data and received all that great help. Did your sleep study note anything about apnea severity relative to sleeping position? Some people have much worse apneas while sleeping on their back.

DreamOn wrote:I'd like to throw this out there for feedback from everyone....

I just took another look at the chart that Alex just posted, with the events spread out over a one-hour period. It could be that my own sleep-deprived brain isn't comprehending correctly, but is it even possible to have that many apneas in a one-hour period? Seriously, look at the event durations!

Good point. I expanded and tallied the 23:10 to 23:20 period since that segment was as dense as any. Right around 405 of 600 seconds were machine-scored in apnea. Although that's possible, it sure does seem improbable. And it stretches the credibility of apnea scoring on a home-machine that relies on a single pneumotach flow-data channel IMHO.

Bear in mind that most of AJimen05's apnea events probably did not entail a complete lack of flow from beginning to end. I doubt his machine is "broken" per say. But I don't think these machines score apnea length or count as accurately as a PSG would---where a thermistor is used to score apneas to prevent pneumotach-based apnea over-scoring. This machine has a highly sensitive pneumotach but not the thermistor, EEG channels, effort belts, etc.

Hey SWS, my sleep study summary does not note anything about sleeping position...except for a section in the bottom that noted my 'supine' position througout the night under 11 cm/h20...go figure...

AJimen05 wrote: Hey SWS, my sleep study summary does not note anything about sleeping position...except for a section in the bottom that noted my 'supine' position througout the night under 11 cm/h20...go figure...

I'll continue reading along, AJimen05. I must say I think you're getting some EXCELLENT think-tank advice.

BTW, welcome aboard!

Good Morning, glad you had a better night.
If you get the "full scored data summary report with condensed graphs" from your sleep center, you will be able to see the whole study. Your DME has them too. They get sent with your prescription.
Did you have 2 studies, or did they slap a mask on you the first night because you weren't breathing?
You should still send these images to your doc and DME and try to get an auto.

If you have periods of dense events, and then periods of no/low events, I would wonder about positional apnea or REM-dependent OSA. But we can't tell that yet. Either one would be well served by APAP. There are NO drawbacks with an APAP machine because you can always run it in CPAP mode. If you lose weight, gain weight, or age (you aren't planning to age, are you?!) you can periodically tweak your settings more easily than you can with straight CPAP. So press the doctor while things are still bad!

Lizistired wrote:Good Morning, glad you had a better night.
If you get the "full scored data summary report with condensed graphs" from your sleep center, you will be able to see the whole study. Your DME has them too. They get sent with your prescription.
Did you have 2 studies, or did they slap a mask on you the first night because you weren't breathing?
You should still send these images to your doc and DME and try to get an auto.

Hey Lizzie,

I had 2 studies done...one PSG just to see how bad then the CPAP study with a machine and nasal mask. They went over these images during my last appt with them on monday. All they recommended to me was to change my mask since I was experiencing leaks...ridiculous.

SleepingUgly wrote:If you have periods of dense events, and then periods of no/low events, I would wonder about positional apnea or REM-dependent OSA. But we can't tell that yet. Either one would be well served by APAP. There are NO drawbacks with an APAP machine because you can always run it in CPAP mode. If you lose weight, gain weight, or age (you aren't planning to age, are you?!) you can periodically tweak your settings more easily than you can with straight CPAP. So press the doctor while things are still bad!

I'll continue to press for the APAP to make my life easier. lol...muah! Age? Heck no, I plan to stay 34 for a while.

Lizistired wrote:

ozij wrote: ........ Which is why the following advice is irresponsible.

Lizistired wrote:You could uncheck the AHI and Pressure in both windows since they don't tell you anything you don't already know.

Excuse me?! Irresponsible?! To tell him how to hide excess graphs from the ResScan screen so he has room for the graphs he needs to see? He knows what his pressure is set at and the AHI is obviously high by looking at the events graph.
Maybe you should read more carefully.

Pugsy wrote:Well done Alex,
I sure thought I had missed the central thing but I did remember your reporting 0 centrals from the machine and I thought OMG he maybe gave me a typo, so I went back and looked and it was 0 CA and 74 AI.

The EPR may have been the key.

I missed the part where Central Apneas were reported as 0. My bad.

AJimen05 wrote:DreamOn, here is the statistics page for the same day...showing no Central: (BTW, I have a comparison study and it shows both nights...The PSG night and the CPAP night. There is nothing here that talks about centrals. On my report it shows 691 apneas and 40 Hypoapneas before treatment and 3 apneas and 25 hypoapneas after treatment at 11cm/H20.

It looks like you didn't have large leaks worth mentioning for that night either. (Shown in the red circle.) That's excellent for that night. Congratulations!
However, previous nights in your first summary image show considerable large leaks. You can look at a summary of statistics for a specified of days determined by the date picker circled in green, or you could look through detailed graphs as I suggested earlier. It's great that you're getting results by changing your pressure, but I am a firm believer that addressing large leaks is a very important part of making sure therapy is working properly. Could we please see some leak line detailed graphs for the entire duration of the last three nights? It might prove useful...

AJimen05 wrote:They went over these images during my last appt with them on monday. All they recommended to me was to change my mask since I was experiencing leaks...ridiculous.

For that to be all they recommended after seeing therapy data like yours ... far worse than ridiculous.