CPAPtalk.com

roster wrote:Well now, it looks like jnk had a change of heart during the night and decided to edit out some of the stench he started this brouhaha with:

jnk wrote: Last edited by jnk on Sat Feb 26, 2011 10:23 pm, edited 1 time in total.

jnk wrote: Last edited by jnk on Sat Feb 26, 2011 2:14 pm, edited 1 time in total.

Very nice jnk. A noble move on your part.

Thanks, Rooster.

In the first "edit" you list above, I changed "pleny" to "plenty." That's an embarrassing misspell, even for me. No content change or wording change was made.

In the other one, I fixed wording a full 10 minutes after I posted it, as you can see from the post time and edit time. LinkC's post was made before I could fix the wording, thus the edit tag.

Enjoy your threads, Rooster. You have convinced me; I'm outie.

Good day, Sir.

jnk wrote: I'm outie.

TMI. I have no interest in your navel.

lucynethel1998 wrote:Last night my BEST night EVER! But still periodic breathing????

What you posted does not indicate that you have PB.

SleepingUgly wrote:

lucynethel1998 wrote:Last night my BEST night EVER! But still periodic breathing????

What you posted does not indicate that you have PB.

Then I am far more confused than ever. Why does the top line show periodic breathing then? AND state .5% time in periodic breathing? I am sorry to not understand, but I really do NOT. Why is it even shown & categorized if irrelevant?

lucynethel1998 wrote:Why does the top line show periodic breathing then? AND state .5% time in periodic breathing? I am sorry to not understand, but I really do NOT. Why is it even shown & categorized if irrelevant?

No one said it was irrelevant, yet. We're back to quibbling over what is significant, which is clearly very subjective. You spend 500+ minutes in sleep, it seems, and had PB for less than 3 minutes of that time. If you are setting zero time in PB as the goal, then you have some work to do. If, like some others here, you are just hoping for a night in which the PB is somewhere less than 30% of the night, then you're fine.

I forgot what the threshold for significant PB is, but at some points I had 3.5% or maybe even more of the night spent in PB, and the doctor wasn't the last bit worried. I'm confident that .5% of the night is insignificant, but if you're worried, you can ask your doctor about it.

lucynethel1998 wrote:Last night my BEST night EVER! But still periodic breathing????

SleepingUgly wrote:What you posted does not indicate that you have PB.

I think SU (SleepingUgly) is right. No more PB (periodic breathing) than that tiny little bit you had, Lucy, means next to nothing, imho.

lucynethel1998 wrote:Then I am far more confused than ever. Why does the top line show periodic breathing then? AND state .5% time in periodic breathing? I am sorry to not understand, but I really do NOT. Why is it even shown & categorized if irrelevant?

My thoughts (but I'm not a doctor) on why Philips Respironics included a category for PB data:
viewtopic.php?p=566612#p566612

I think the category is there in case a person's breathing shows up a LOT of PB -- a LOT more than the miniscule bit that appears in your data, Lucy.

SleepingUgly wrote:I forgot what the threshold for significant PB is, but at some points I had 3.5% or maybe even more of the night spent in PB, and the doctor wasn't the last bit worried. I'm confident that .5% of the night is insignificant, but if you're worried, you can ask your doctor about it.

Thank you so much for this info. My problem is I see all these numbers but can't find any info ANYWHERE on what "specific" number means "what". I love my software telling me WHAT is happening. Now what I would love is for it to tell me what is MEANS! picky, picky old me I know....

kteague wrote:I found even the dictionaries are ambiguous.

Quoting from fallible memory - Brook, flowing body of water, smaller than a stream. Stream, flowing body of water smaller than a river but larger than a brook. River, a flowing body of water, larger than a stream.

roster wrote:even a patient using the most competent sleep lab in the country and being attended by the most competent sleep tech in the country would do well to verify everything at home in his own bed with his own machine and software.

In the words of the great American conservative idol, "Trust, but verify!"

lucynethel1998 wrote: I also have to take Coumadin to thin my blood since some bad heart problems (prior strokes & heart attack etc) so that may also be helping cause the sinus bleeding?

Is your cardiologist aware of the this? I trust he is checking your Prothrombin time regularly, like once a month. My oldest brother died from a hemorrhagic stroke 1 1/2 yrs ago. A major cause was too-thin blood that was allowed to happen because he wasn't having his blood checked often enough. He was on Coumadin. Yes, your med very well may be contributing to, if not causing, your sinus bleeding.

idamtnboy wrote:

lucynethel1998 wrote: I also have to take Coumadin to thin my blood since some bad heart problems (prior strokes & heart attack etc) so that may also be helping cause the sinus bleeding?

Is your cardiologist aware of the this? I trust he is checking your Prothrombin time regularly, like once a month. My oldest brother died from a hemorrhagic stroke 1 1/2 yrs ago. A major cause was too-thin blood that was allowed to happen because he wasn't having his blood checked often enough. He was on Coumadin. Yes, your med very well may be contributing to, if not causing, your sinus bleeding.

I do check it often and just got set up to go back to checking it (my INR levels) 1 time (or more as I deem needed) MYSELF at home. I used a machine prior called INRatio2 that was 30PLUS percent OFF all the time. Nearly killed me a couple timed. This time using a brand of tester called Coagucheck. I really try to self manage and since I will be on this drug till I croak, want the control to check WEEKLY (if not more) as I have had close calls & internal bleeds when my level went HIGHER that 5.2 several times now. I am so sorry about your brother... I am now worried that I have had MAJOR headaches every single day since beginning apap. In my 62 years PRIOR? Maybe a dozen or so headaches in my entire life. THIS scares me most of all since I don't know what it means. Having sinus surgery a year ago is hopefully the cause and just sinus related. I will just do the best I can and try to be faithful to apap. And yes, hope to survive as well.

Okay, here are some before (May and June 2009) and after (last week) reports. If I had not had the software I wouldn't have known that my titrated pressure wasn't enough.

Brief history. Diagnosed with severe OSA with AHI 53 but the bulk of it was in REM sleep. In non Rem sleep I only averaged about 12 AHI. No split study first night because I had long REM latency (longer than normal time getting to REM) and had barely got there when study had to end. Not enough time to titrate.

Titration study was horrible. I barely got 150 minutes of sleep. Tech was a sadist and wanted me to use first a nasal mask which covered my nose and the pressure caused immediate nasal congestion.. So we had to stop and I ask for nasal pillow mask. He said those were hard to use and wanted me to use a full face mask which again put pressure across the bridge of my nose and again immediate nasal congestion. I refused to proceed with it and insisted on nasal pillow mask. Did fine. Finally could breathe and got small amount of sleep. Only had 20 minutes of REM sleep.

Came out of it with cpap pressure of 8 cm.
I already had my APAP. So I set it to minimum 8 cm and the first 2 images below are with that pressure with a narrow range and a large range.

See all the clusters? REM stage events. Felt like total crap even with a so so AHI.

Wasn't long after that that I increased my pressure to 9 and then to 10 to ward off the clusters. At 10 I had success.
Only rare events. So I have left it this way pretty much ever since except for bringing the max down but it never goes near it now. Follow up with sleep doctor's PA got her blessing and said considering the REM events, APAP with a minimum of 10 would be just what she would advise...

While the titration pressure at 8 cm is likely fine for my Non Rem events, I need just a bit more in REM. The events would just happen before the pressure could increase to clear them. If I had more REM sleep at the titration study maybe the tech would have been more spot on with the pressure.. Who knows?





Leak rate reported on the 2 old reports is Total Leak. Different Encore Pro versions.

Recent report from last week is below.
Encore Pro 2 default setting was for unintentional leak, hence the baseline at zero.
This is pretty much what I have had for months and months.
Despite these excellent reports I still struggled with frequent awakenings during the night and was still fatigued and still needed to nap often. I have a bad back. It was the pain that would wake me with tossing and turning. Got a new bed last Dec and finally the need for naps has ceased and my energy level is slowly creeping up. So I am proof that there are often other things that affect the restorative powers of sleep. While my back pain is not gone, it is reduced and I don't toss and turn so much and I rest "better".

Pugsy wrote:Okay, here are some before (May and June 2009) and after (last week) reports. If I had not had the software I wouldn't have known that my titrated pressure wasn't enough.

Brief history. Diagnosed with severe OSA with AHI 53 but the bulk of it was in REM sleep. In non Rem sleep I only averaged about 12 AHI. No split study first night because I had long REM latency (longer than normal time getting to REM) and had barely got there when study had to end. Not enough time to titrate.

Titration study was horrible. I barely got 150 minutes of sleep. Tech was a sadist and wanted me to use first a nasal mask which covered my nose and the pressure caused immediate nasal congestion.. So we had to stop and I ask for nasal pillow mask. He said those were hard to use and wanted me to use a full face mask which again put pressure across the bridge of my nose and again immediate nasal congestion. I refused to proceed with it and insisted on nasal pillow mask. Did fine. Finally could breathe and got small amount of sleep. Only had 20 minutes of REM sleep.

Came out of it with cpap pressure of 8 cm.
I already had my APAP. So I set it to minimum 8 cm and the first 2 images below are with that pressure with a narrow range and a large range.

See all the clusters? REM stage events. Felt like total crap even with a so so AHI.

Wasn't long after that that I increased my pressure to 9 and then to 10 to ward off the clusters. At 10 I had success.
Only rare events. So I have left it this way pretty much ever since except for bringing the max down but it never goes near it now. Follow up with sleep doctor's PA got her blessing and said considering the REM events, APAP with a minimum of 10 would be just what she would advise...

While the titration pressure at 8 cm is likely fine for my Non Rem events, I need just a bit more in REM. The events would just happen before the pressure could increase to clear them. If I had more REM sleep at the titration study maybe the tech would have been more spot on with the pressure.. Who knows?





Leak rate reported on the 2 old reports is Total Leak. Different Encore Pro versions.

Recent report from last week is below.
Encore Pro 2 default setting was for unintentional leak, hence the baseline at zero.
This is pretty much what I have had for months and months.
Despite these excellent reports I still struggled with frequent awakenings during the night and was still fatigued and still needed to nap often. I have a bad back. It was the pain that would wake me with tossing and turning. Got a new bed last Dec and finally the need for naps has ceased and my energy level is slowly creeping up. So I am proof that there are often other things that affect the restorative powers of sleep. While my back pain is not gone, it is reduced and I don't toss and turn so much and I rest "better".

Can you tell me where on the graph it shows REM sleep? I just have no clue I guess? I don't see anything in my software that explains where REM is shown? I just had an even better nigh last night! Best night of sleep maybe ever in my life actually, or at least FEEL that way. Would like to see why (or WHERE in my graphs) it is coming from!

You can't tell from software whether you're in REM or not. Someone who has REM-dependent OSA may guess that clusters of events are occurring in REM because that's when their events occurred on their sleep study, but there's no way to know definitively when you're in REM without an EEG.