Help interpreting 1st numbers

Wouldn't it be cool to start one of those work from home job opportunities.

Hey Avi....I'm practically neighbors with them then. We were just outside of the path. I must say with the recent wrath of tornadoes hitting metro areas I no longer disregard the warning sirens.

DoriC, I'm glad you've enjoyed the posts. This whole process has been a real eye opener. I tend to get a little ramped up about things I find important almost to the point of being obsessive but on this one I think it's warranted as we're talking about life and death issues many times. Without a data capable machine I would NEVER be able to monitor and tweak my treatment.

For example, take a look what a difference one little number can make. I raised my lower pressure setting from 5 to 6 and get a load of this report. I also did not feel rested and kept going back to sleep on and off in starting at around 6am. When I did finally get out of bed almost 10 hours later I felt like I use too...walking around in a fog for a half hour or so. All of this from one change. Maybe I'm overstating this but how in the world can someone be titrated from one night in sleep study, be put on one number and expect optimum therapy when I have changed one low pressure setting from 5 to 6 on an APAP and totally changed how I feel. When you look at the charts I now have tons of events occurring at the higher end of my pressure setting vs. previously they were happening at the lower end of the spectrum.

Anxious to see what you think of this report Pugsy!




How do I make those images larger?

360 wrote:Anxious to see what you think of this report Pugsy!

Almost couldn't see the reports. Remember my dog from Hell ate my fancy prescription glasses.

Just goes to show a person that sometimes less is more.. and yes a very small change can make a huge impact in how we feel.
Why did you have more events last night? We can't really tell, sometimes they just happen for reasons outside of OSA. The most import thing is how you feel and yes, having an increase in events for any reason will make us feel crappy.

Sometimes in our desire to "improve the numbers" we lose sight of the whole picture. Now you know that you feel better and have better results at a minimum of 5. That is where I would leave it for a while and see if it is consistently better for you. Yes, sometimes the titration study is not optimal for any number of reasons. Sometimes they nail it with prescribed RX. Sometimes some of us just simply do better at APAP because we do have worse nights than others for whatever reason. Some people do better with narrow range, some with larger range. Some people do better on straight cpap. One size fits all doesn't apply with OSA or cpap or really much of anything in life. We have to find what fits US the best.

How to make the images larger? I don't know what you are doing to start with but when I do mine I have the report open to 100% size then I take a screen shot and save that image as a jpeg file, then I upload that file to my photo hosting site. Somewhere in the steps you do the image becomes smaller. Not sure what you are doing... Is the file format jpeg? Do you see it larger at your hosting site?

Pugsy wrote: Almost couldn't see the reports. Remember my dog from Hell ate my fancy prescription glasses.

There we go...not perfect but better. I'm a little stumped. I'm going to drop it back to 5 tonight and see what happens.

Better.. I can't see the color well though. Are a couple of those events centrals? They look sort of black to me. What was the breakdown on last night's AHI?

For some reason the pressure did respond to some triggers (whatever they were) as I see it climb... Puzzling. I would put it back to 5 minimum since you report feeling so much better and give it a few nights. Last night could have just been a quirk but I would hate to ask you to experiment and do something that might make you feel worse.....like see if tonight it would happen again.. I am not a mad scientist

Use what seems to give you the best day in regards to how you feel.. if it is 5, then use it. Give it some time and see if things develop into a trend that you can see and relate to how you feel. Like I am pretty consistent with data unless I go to bed way later than usual and for some reason, I have more events then. I don't drink so can't blame it on alcohol. Don't eat late because of heartburn. I don't know why a big difference but I have seen it more than once and I didn't change anything other than the time I went to bed. Again, sometimes the least little thing can make a difference.

When you line up the pressure graph with the events, you'll notice that pressure changes in response to obstructive apneas but not centrals or hypopneas. In the edited depiction below, I've lined up events with pressure and flow limitations. The red lines are obstructives. The green lines are centrals. The blue lines are likely from flow limitations or something else. The ones with the question mark I could not determine, but for the most part when you line up the events and flow limitations, all your pressure changes should be accounted for. The green arrows show no spike in pressure during centrals. The red arrows show areas where pressure is not reducing in a graceful hypotenuse manner because there is a little bit of flow limitation during those times.

If I understand: your AHI is lower when your min pressure setting is at 5.0, correct?
From the statistics pane, what are your AHI and median, 95th percentile and max pressure for the week before you started your pressure changes?

DreamDiver wrote: If I understand: your AHI is lower when your min pressure setting is at 5.0, correct?

WOW...thanks for putting that together. Is this the data you're looking for?

One of my days was messed up because I started using a new SD card...old one was bad.

Nicely done DreamDiver. I have no idea how you did that but nicely done.

360 wrote:

DreamDiver wrote: If I understand: your AHI is lower when your min pressure setting is at 5.0, correct?

WOW...thanks for putting that together. Is this the data you're looking for?
[image]
One of my days was messed up because I started using a new SD card...old one was bad.

If my median pressure in the statistics for the last week were 6.6, and my minimum pressure setting for the S9 were 4.0, I would up my minimum pressure to 6.6. Why? Because a good deal of your night is spent at around that pressure. However, you said this week that you had a significantly higher AHI and that you felt worse when you raised it to 6.0. How much is "significantly higher" with regards to AHI? From the graphs you shared earlier, it looks like it's around AHI of 2.0 That may not be significantly higher considering that your AHI might change by that much from night to night anyway. For myself, I've found that I cannot determine how I feel purely by AHI, just as you have realized. I think about how I feel before I look at the numbers. If it were me, I'd stick it out a couple more nights unless I felt seriously crummy in the morning. It might be the body's way of figuring out the new min pressure. However, you have to do what's right for you.

Pugsy wrote:Nicely done DreamDiver. I have no idea how you did that but nicely done.

In my opinion the numbers look very good. I would leave the setting as is and return to review them after a month.

I had another breakthrough over the last couple of nights. I was struggling to get a good night sleep for several nights and could not figure out for the life of me what went wrong as my settings were the same, etc. Then I remembered that we had bought a couple of new pillows and I went from using two pillows to one pillow that was pretty flat after using it a few days (never buy cheap pillows). So I changed back to my previous setup and here is what last night looked like. I'm waking up again raring to go in the morning and I'm looking forward to what I'll feel like in the morning since for me I definitely feel a cumulative affect when I get several good nights in a row. I just wanted everyone to know that at least for me something as simple as the height of my pillows has an extreme affect on my therapy even with an auto machine. No my numbers were not bad the other way but there is a big difference in a night like this.

I'd also like to give a thumbs up to the PapCap as you'll notice my leak numbers are a lot better. I still get a little leak every now and then but it's night and day from before. I do think they could make some improvements still as my large cap is too deep and would be more effective if it were a little more shallow. It does the trick though and at least for now I can keep the facial hair since I won't need to tape.

Thanks to some technical help from Pugsy I now get to post a decent sized chart...is she awesome or what!

Well last nights report is just plain old down right boring. This is the time when boring and uneventful are the best news ever. Good job. And yes, sometimes it can be the least little thing that can make a huge difference in how we feel. We can have the best "numbers" in the world but if something else if messing with the restorative quality of sleep we simply don't feel the good numbers. Always something......

BTW, your leak is certainly extremely acceptable. We don't expect perfection and it will almost always vary a bit.

Pugsy wrote:Well last nights report is just plain old down right boring. ...

Boring is good! 360, it looks like you're getting there. It's amazing how a small thing like head elevation can change your sleep patterns.

Yes...you would think that having your head lay more flat would make for a better airway but for me it's the exact opposite. One of the pillows is like a brick so my head is definitely elevated. We'll see how I feel in the morning. It's funny, I can't wait to go to sleep, not because I'm dead tired but because I'm curious how I'm going to sleep.

What was odd about last nights chart is how the pressure really flattened out, normally it's more like a roller coaster.

360 wrote:What was odd about last nights chart is how the pressure really flattened out, normally it's more like a roller coaster.

The machine didn't sense much that warranted a pressure increase for whatever reason. Sleep varies and different conditions will arise and sometimes you may see the roller coaster and sometimes not. You removed one potential cause of events and thus potential pressure increases.
I used to get the roller coaster (sometimes big roller coaster) but now for the most part those are rare and I see pretty much nice even pressure line.