Please advise on Data from last night Sleep

This is the highest AHI ive had since i started CPAP. But probably the best nights sleep. Im concerned my average AHI has been 1.9. It seemed the leaks are down. Maybe there will just be nights like this im not sure. Please advise if you see anything i need to work on doing to lower AHI. I may have slept more on my back than normal i dont really know.

Also can someone help me in cropping the graph. I have tried everything i know and i cant get the entire pictire in the Snipit tool. I use the mouse to scroll down but it cuts off half of the snore data.

Thanks for all your help and advise.

If it were me; I'd raise the lower pressure to at least 8 for a few nights to see if it helps. I would then try changing to cpap mode at a pressure of 9 to see what it shows. You could even just narrow the range more by setting lower pressure to 8 and upper pressure to 9 or 10. Some of us just do better on one set pressure.
Although leaks look better, you want to try for as straight a leak line as possible. All those leak line ups and downs and pressure up and downs would ruin any sleep I was trying to get.

Brenda

My doctor has it set on Auto for now. He wants 6 weeks of data and then he said he'll set the ramp. I have asked and was told not to touch it. I'm doing everything i can think of. As i noted i seem to have slept very well. Feel very refreshed. Nose pillows didn't appear to be leaking. I did notice a time or 2 i would exhale a small amount from my mouth. I will use the chin strap tonight to tray and avoid air escaping my mouth. Thank you very much.

You will have nights where the AHI seems to be much higher with no apparent changes in anything.
I see it myself now. One night AHI 0.5 and next night 4.0. Try not to sweat it too much. I do understand you are still in sort of a trial phase with your doctors direct input and that is why I haven't suggested an increase in that minimum either. It might only be warranted if you happen to spend more time on your back anyway.

So while you are being good and following doctors orders, try not to be disheartened when you see a really good night one night and next night it seems not as good. This happens to all of us at time anyway.
One of the reasons we don't change the pressures based on one or two nights of data.
AHI of 4.7 if you are feeling fine, is still under 5 and while not as pretty as 1.7 it is still much improved over pre cpap and I wouldn't worry.

If you think supine sleeping is a factor then try to stay on your side if you can. While it is common to have more events or events that might need more pressure on your back...sometimes it isn't a huge difference. Give it time to settle in so you have lots of reports to see how the overall trend is going.
See if you have more nights like last night or see if it was a fluke and you have more nights with AHI less than 2. We can't expect perfection though we do seem to try for it.

Later after doctor has seen the data, he may adjust the lower pressure himself....which is what I would do if this were my report but only a tiny bit. You won't need much tweaking to get things dialed in.
For now, learn and make a mental note if you think supine sleeping is a factor.

Your report image is just fine...what do you wish to crop off of it? This one is perfect. I can see everything I need to see.

Thank you very much. Im learning. Have a blessed day!!

Agreeing with pugsy here on two things:

1) The graph shows up fine: Although with my standard choice of "magnification" for the browser, I do have to do a command-minus sign on my apple (control-minus sign on a PC) to shrink stuff down to see the whole thing. This is not a problem with the graph, it's my choice of how large I want the fonts in the browser window to be.

2) An isolated night or two of a higher than normal AHI when you actually feel fine is not something to over react to. And I say that as someone who in my newbie days did indeed want to panic every time I saw an AHI > 3.5. But back then I so seldom even felt "ok" let alone "fine" And I'll admit, it still bothers me when I see the AHI on those rare nights with an AHI >3.5. But I've learned to chill out and not worry unless there's clearly something else wrong. Now if I saw really inflated high AHI for most nights for a couple of week in a row AND was starting to not feel as good in the day, then I think I would start thinking about upping my min EPAP a bit or upping my max IPAP a bit depending on what kind of event was triggering the higher than normal AHI. But for a random night here and there? There's no reason to increase the pressure in my opinion.

Desktop resolution will make a difference on image viewing. Higher resolution will let it easily fit.
When I see the image I see it and have loads of room all the way around it. If I used lower resolution I might have to scroll or do like Robysue does. I tend to forget about other computer resolution.

The cropping is perfect. All data is easily seen. If image were smaller it would probably "fit" on screens with lower resolution but at the expense easily viewing the small AHI numbers. Images can be resized if need be though. I have never use Snip It if that is a program. I have used the Snipping Tool for so long I have forgotten other options but if you feel the need to resize the image I can help with doing that fairly easily and probably not lose a lot of small detail. So it may not be cropping that you need to do but instead re-sizing if the image is shown too large on your screen. Though for me, no problem at all with the size as it is. So much easier when I can see everything easily.

I know the OP is asking about having an AHI 4.3 for this particular night, but I do have a question about his "VS rate / Pressure" relationship.


1) wmcanally,
Do you see these pressure stair steps such as we see from 03:00 to 03:50 very often?


2) To anyone,
On wmcanally's chart from 03:00 to 03:50 there is a "pressure stair step" that seems to be associated with a series of VS events. Can't see the "Snore" graph very well, but I can see the VS pattern in the Event Flags section.

I frequently see this same apparent "VS to pressure stair step" relationship on my daily charts. For me, this "VS to pressure stair step" pattern seems to be what leads to my highest "pressure" peaks of the night.

Is this "VS rate to stair step Pressure" relationship pretty common?

wmcanally wrote:

PLease educate me on what 'VS" means.

Thank you

Java Time wrote:Is this "VS rate to stair step Pressure" relationship pretty common?

Yes, fairly common with Respironics APAPs. The machine will increase pressure in response to obstructive event precursors and flow limitations are a type of event precursors that the machine will sense. Since snores are often a symptom of small flow limitations that don't make criteria for full blown hyponea or apnea you will often see pressure increases when you see snores. One doesn't have to have a snore to have a flow limitation though.


To Wmcanally
VS... Vibratory snores

Ok thank you for the information

1) wmcanally,

It may also be informative to you to look at the association between the "VS" in the "Event Flags" and the "Snore" graph

Just curious, one new user to another. Do you see these pressure stair steps such as we see from 03:00 to 03:50 very often or are your pressure increases more frequently like what you had earlier in the night?

Also, if your sleep doc is like mine, he/she may increase your minimum when you go in for your 30 day checkup. If the doctor DOESN'T suggest that, you might want to ask them if you could try a higher minimum, like maybe 8cm for awhile. The reason I mention that is it seemed to wake me up when I had big swings in pressure like you are having. I've heard this from some other people as well. Anyway, something to at least ask your doctor about.


2)

Pugsy wrote:

Java Time wrote:Is this "VS rate to stair step Pressure" relationship pretty common?

Yes, fairly common with Respironics APAPs. The machine will increase pressure in response to obstructive event precursors and flow limitations are a type of event precursors that the machine will sense. Since snores are often a symptom of small flow limitations that don't make criteria for full blown hyponea or apnea you will often see pressure increases when you see snores. One doesn't have to have a snore to have a flow limitation though.

Thanks Pugsy,

These stair steps are present at most of my highest pressures, frequently going 2 or 3 cm of pressure higher than my "typical" high pressure.

They don't happen every night, but on a high pressure night (for me) there is usually VS activity that seems to be closely associated with the pressure increases. Frequently, I'll see a couple of single step increases, followed by several "double-step" increases. Very similar to what wmcanally is showing.

Mine aren't necessarily associated with a bunch of other events like wmcanally's, but from what you are saying it sounds like my PRS1 machine is trying to stop the events before they start.

Java Time wrote:Mine aren't necessarily associated with a bunch of other events like wmcanally's, but from what you are saying it sounds like my PRS1 machine is trying to stop the events before they start.

I used APAP for over 2 1/2 years. Sometimes I had some snores with increase pressures very obviously associated with the snores and sometimes not. Sometimes I had pressure increases and zero snores. Before I tweaked my minimum upwards just a bit I would have reports that looked a lot like this one above.
OP here is very new to therapy and things will settle down quite a bit over next 3 or 4 weeks and he will be able to have a better handle on what is "normal" for him. You will do the same for what is normal for you.

Some people will have a tendency to have more events when sleeping on their back and they may also have more tendency to have snores also. Snores don't have to be present though and if the minimum is raised as little as 0.5 cm those users that have a large number of snores can see a marked decrease. It is all highly variable between individuals.

If only looking at snores and nothing else, I don't get too excited about them unless there are a large number of them in large clusters occurring for the majority of the night and every night.