Would like help using detailed data to confirm diagnosis

I self diagnosed because a was pretty damn sure I had sleep apnea. I've got some detailed data I would like to share because I think it confirms that I have sleep apnea. I had an AHI of 14.1 one night due to leaks and mouth breathing. An AHI of 14.1 would still be considered mild apnea even though I was receiving some treatment, right? My non responsive(central?) index was only .4, so my high AHI wasn't caused by centrals induced by high pressure. AHI's this high have happened to me in the past quite often, but I only recently got a card reader so I don't have the detailed data from previous high AHI's. When I am getting good therapy my AHI ranges from 1-6. Thanks! I'm really interested in what the wealth of knowledge within this forum has to say about this.

what's your machine set to?

I don't consider AHI=14 low, but AHI does not tell the whole story. If it were me, I would try to get the leaks <10. With leaks under better control, I would also probably try lowering the pressure range to 10-15, to see if that eliminated the centrals and worked as well for the OAs.

Machine is set at 13-20. My 90% pressure is usually around 14. When everything is working OK my machine never goes above pressure of 16.

I am not looking for any advice to lower my AHI in this thread. I know there are a lot of leaks, and I am working on that by reading this forum. This data is from one of my worst nights so it shouldn't be used as an indicator for how my therapy is going(its going pretty good). I posted this data because I want to see if it can be used as a likely indicator for diagnosing sleep apnea. My thinking is the AHI reading remains accurate besides the leaks. This is a fairly high AHI and would warrant a mild apnea rating from a sleep study, correct me if I'm wrong. Considering I was getting some CPAP therapy when this happened I think it's safe to assume my real AHI would be higher.

moresleep wrote:I don't consider AHI=14 low, but AHI does not tell the whole story. If it were me, I would try to get the leaks <10. With leaks under better control, I would also probably try lowering the pressure range to 10-15, to see if that eliminated the centrals and worked as well for the OAs.

The PR report that was included is showing total leak, not just the unintentional leak. Hence trying to get the total leak down to < 10 is unreasonable.

That said, there's plenty of room for improvement in that leak line. All the sharp spikes are indicating some kind of real leaking going on. A good leak line looks like the leak line for the first hour and a half of the shown data---flat or nearly flat.

To the OP: What caused the hour long gap in the data? And what was different after the machine was turned back on? Were you not actually asleep during that first hour and a half of data?

Also, to moresleep: The presented data a grand total of 3 CAs for the entire night with a CAI = 0.4. So CAs are NOT the issue here. The part of the data that is interesting---in the sense of indicating that therapy is both needed and was not effective on this night---is the number of OAs. The OAI = 11.9 and the machine was running a bit more than 8 hours for the night. That means the machine detected around 100 OAs for the night. (12*8 = 96).

It could be the min pressure is not set high enough and the machine is chasing the OA events---i.e. the pressure is being raised too slowly and too late to effectively treat the OSA on this particular night. But there are also a heck of a lot of events when the pressure is maxed out at 20 as well. So it could be that the OP actually needs more pressure than the standard max of 20cm.

To the OP: What's your long term 90% pressure level? It's 20cm on this night. If it's often that high and you often have nights as bad as this one, then my guess is that you may need a titration study done for a bi-level since BiPAPs and VPAPs have higher maximum pressure settings than the typical 20cm max for APAPs and CPAPs.

Yep. You are correct. You have sleep apnea.
It doesn't really matter if it is mild, moderate or severe unless it just matters to you. With this pressure range we have to assume some therapy (as you say). How much worse would it be at 4 cm minimum? We don't know. Treatment is the same regardless of level of severity.

Since you are only wanting confirmation as to the diagnosis..then I would completely trust the machine's data and if you were a family member of mine I would be comfortable telling you to use the machine every night.

Since you say this report is not typical and didn't really want it picked apart, I won't.

Technically these machines can't be used to diagnose OSA (although I'd put my money on you having it). What your AHI is ON pressure does not tell us anything about what your AHI is off the machine.

Pugsy wrote:Yep. You are correct. You have sleep apnea.
It doesn't really matter if it is mild, moderate or severe unless it just matters to you. With this pressure range we have to assume some therapy (as you say). How much worse would it be at 4 cm minimum? We don't know. Treatment is the same regardless of level of severity.

Since you are only wanting confirmation as to the diagnosis..then I would completely trust the machine's data and if you were a family member of mine I would be comfortable telling you to use the machine every night.

Since you say this report is not typical and didn't really want it picked apart, I won't.

Thanks for the answer Pugsy! I was almost certain I had it before I bought the machine. I've been suspicious of it for around 8 years, but never had the money to do anything about it. I'm 22 and I'm pretty sure I've had apnea since I was 5. My spine is messed up. It doesn't have any S-curve in it. This is what I assume causes my sleep apnea.

I finally bit the bullet after having a wasted summer. I found a way to skip all the prescription requirements and threw all my equipment on my credit card. This forum is great and I wouldn't have made it this far without it. I feel like I'm a different person now, and it's fucking fantastic! I still have some really bad days, even when I had a good night of sleep. I've been on the APAP for about 2 months so I'm still working everything out.

I'm going to go ahead and attach a detailed report of what my nights usually look like since that what everybody seems to want to talk about. I know leaks are still an issue for me. The night the data comes from I had on a homemade ace bandage chin strap and also had my mouth poly-gripped shut. Mouth breathing is a big issue for me, so I went ahead and bought the hybrid mask a couple days ago(can't wait till it gets here!). I went ahead and got the FFM because my sinuses are also horrible. I can't get them to clear since moving to a city with low humidity. I've tried allergy medication, nasal irrigation, and nasal sprays. I've been a mouth breather my entire life which I think stopped my nose from working. My airway closes before I fall asleep if I relax enough. Having my minimum pressure set to 13 was the lowest pressure setting to stop this. If there's something from the data that I've missed please let me know. I'm open to all suggestions!

Technically these machines can't be used to diagnose OSA (although I'd put my money on you having it). What your AHI is ON pressure does not tell us anything about what your AHI is off the machine.

Yea I know they can't technically diagnose it. I'm just interested in peoples' opinions on it.

robysue wrote:

moresleep wrote:I don't consider AHI=14 low, but AHI does not tell the whole story. If it were me, I would try to get the leaks <10. With leaks under better control, I would also probably try lowering the pressure range to 10-15, to see if that eliminated the centrals and worked as well for the OAs.

The PR report that was included is showing total leak, not just the unintentional leak. Hence trying to get the total leak down to < 10 is unreasonable.

...

Using Encore Pro, my average leak is generally around 6, which I consider reasonable. The leaks here may be bad enough to partially obscure what is going on. Except for the vent holes on the mask, leaks are the enemy...

moresleep wrote:

robysue wrote:

moresleep wrote:I don't consider AHI=14 low, but AHI does not tell the whole story. If it were me, I would try to get the leaks <10. With leaks under better control, I would also probably try lowering the pressure range to 10-15, to see if that eliminated the centrals and worked as well for the OAs.

The PR report that was included is showing total leak, not just the unintentional leak. Hence trying to get the total leak down to < 10 is unreasonable.

...

Using Encore Pro, my average leak is generally around 6, which I consider reasonable. The leaks here may be bad enough to partially obscure what is going on. Except for the vent holes on the mask, leaks are the enemy...

Yes, in Encore Pro, you can select to report only unintentional leaking. And 6 L/min is more than likely a decent unintentional leak rate as long as it's not bothering you.

But the OP is posting a report from Encore Pro that is clearly showing total leak. We agree the leak curve shows some real problems with leaking. But it is entirely unreasonable to expect to get the total leak down to <10 L/min. And while this version of Encore Pro might be new enough to have the option to switch between total leak and unintentional leak, the OP needs to know that his Encore Pro is currently set up to report total leak. And he needs to either learn to interpret total leak (which is not that hard) or learn how to change his preferences to report unintentional leak (which is also not that hard)

soul_power wrote:I'm going to go ahead and attach a detailed report of what my nights usually look like since that what everybody seems to want to talk about.

Can you post a screen shot with a view of the whole page? I had trouble like that once and to cure it I went into 'view' and chose 'full screen mode' and then took the screen shot. See if that works for you, that way everyone can see the entire night.

(Also can't see your avatar)

Your latest report is quite good. The leak isn't enough to worry about. This software is indeed reporting total leak as Robysue has said and can't be compared to Pro's unintentional leak report. 2 different entities. Confusing for some people. A bit of an elevated and prolonged spike later in the night (right before hour 6) but not grossly huge and within the machines ability to compensate.

I would say you have a good handle on things and I wouldn't suggest changing anything. Work on the leak as best you can but that is an ongoing chore for everyone and with time it will improve. It is far from horrible right now. If this were my report I would be patting myself on the back.

You are so lucky to find out now that you have this problem and have been able to isolate the problem and deal with it effectively. You have saved your body a lot of grief later on.

Welcome to the forum.

To AmeriKen... I can see the full report just fine. Perhaps a problem with your desktop resolution. I see it all, nothing is missing.

I'd still be concerned with the leak spikes... hopefully those will even out with a mask change... but who knows.

Pugsy wrote:.

To AmeriKen... I can see the full report just fine. Perhaps a problem with your desktop resolution. I see it all, nothing is missing.

Wow, I'll screw around with my res. Must be the sleep apnea.

I don't think you can make a blanket statement that NR=central. Or that OA=not central on an M series machine. That may be the most likely scenario, but I don't think the M series does any pressure pulses to verify open airway. Even with pressure pulses, you really can't rule out centrals without a chest belt.

A PRS1 Auto would probably give you better data.

Hitting a pressure of 20 worries me.