ResScan - New to this (any concerns?)

Newbie here and starting to learn what to do and how to use the ResScan software... Here is a screen shot of my summary data... leaks look high, which I had suspected... any thoughts?

BTW: I'm using a Nasal Mask and have tried a full face once... it blew mycheeks open like a chipmunk and was not able to sleep with it. I also get pretty bad Aerophagia.

Thanks in advance!

Except the leaks your results look OK to me. Do you have a Resmed machine, if yes, you could use the ResScan to show more graphs. See the link in my signature line to download a ResScan software.

As to the leaks my guess is that you don't use a chinstrap like I do.

If you register you can then display your equipment.

Hertzgog, I switched from a full face mask to a nasal mask plus a chinstrap and I am getting unbeleivable good results on me S9 Autoset in an APAP mode.

Thanks for the advice!

I do have a chin strap... recently discontinued due to increasing aerophagia and lowering the pressure. I will wear it tonight to see if the leaks improve.

I've used my CPAP for about a year now, and everything was going great until the last several months... go figure?

Do many out there use Ambien as a sleep aid? I have since starting, and now need it... wish I knew then what I know now.

I just registered and will complete my profile very soon.

Thanks again!

See here about Ambien:

viewtopic/t28525/viewtopic.php?f=1&t=63 ... og#p593574

Sleep without Ambien!!

viewtopic.php?f=1&t=60835&p=570869

Since Apr 24th things changed.. was that the new mask?

In CPAP mode the pressure should remain the same but its not.

Your leaks seem to be following a trend of getting worse and then better but I think that is typical as you get used to sleeping with a different mask.

Your AHI is low so thats good. Your using it many hours a night which is good.

Give it some time and you won't want to sleep without it.

There is a link to a video tutorial on ResScan in my signature below, in case you have not seen it.

Thanks guys!

What changed on the 25th was starting a new medication which has sedative effects... I had problems waking up after two hours sleep and not going back to sleep. Have not changed masks since I've been on the one I'm using.

The changing pressures is self adjustment related.

I used the chinstrap last night and my Leak was @ 8.4! Yipee!! I had not been using it due to recommendation that could be playing a part in the "blowing up".

My concern now is the number of Central Apneas... could this be brought on by the CPAP itself? How can I lower that number?

I will be checking out the video after the kids are put to bed.

...glad I found this forum!

Thanks again!!!

Hertzgog wrote: My concern now is the number of Central Apneas... could this be brought on by the CPAP itself? How can I lower that number?

While centrals can be brought on by the cpap itself even if this were the case your central index is not even close to being alarming. I don't know that you can do anything about the centrals. We all can have them at various times in the night and they are entirely normal. I have composed an explanation about "centrals" or clear airway events that may help explain things and save my fingers from typing again. Probably goes into more detail than you want but will offer it anyway.
If your central index is pretty much like this report then you have nothing to worry about. In theory if brought on by cpap itself than a reduction in pressure might reduce them but I don't see the need in this case. Though your obstructive component of your AHI seems to be well controlled....up to you if you want to discuss this with your doctor. I doubt it would change the centrals significantly but you do appear to have some wiggle room with your pressure needs because the obstructive hourly index is quite low.

A quick word about "centrals" or "clear airway" events...these are cessation of breathing while the airway is open as flagged by the machine. They may or may not be "true" centrals that warrants concern if we saw a lot of them (and it takes more than a central index of 2.0 to cause concern). Centrals are common at sleep onset and sometimes we even hold our breath (that is open airway cessation of breathing) when turning over in bed and don't know it. The machine only has one dimension to work with when sensing and recording open airway cessation of breathing and that is air flow only. In a sleep lab setting the tech has EEG leads to determine sleep stage and thoracic belts to measure thoracic effort. Some of what our machines report would likely be tossed out the window in a sleep lab setting.
People seem to panic when they see "central" apneas but unless there are a large number of them and presenting with associated desats and can't be blamed on sleep onset or whatever...we have to sort of put them aside and try not to worry about them.

We don't treat centrals with an increase in cpap pressure except in those high level machines that are working sort of like ventilators (another story I won't go into now since it is not needed).
So when evaluating your AHI....and how well things are responding to pressure you need to remove any central index from the equation because we don't try to fix them with cpap machines with an increase in pressure anyway.

The AHI has 3 components..
Central index which is NOT an obstructive component because there is no collapse of the airway to cause an obstruction.
Obstructive Apnea Index...this is an obstructive component because there is either a full or partial collapse of the airway causing the measured reduction in air flow to meet the obstructive apnea definition.
Hyponea Index...these is an obstructive component because there is likely a partial collapse of the airway resulting in the measured reduction in flow to meet hyponea definition.

So when evaluating your night by looking at the AHI....mentally remove the central index from the total and evaluate only the obstructive component index. In your case removing the central index significantly lowers the AHI to obstructive components only and well withing acceptable limits and thus no need for any changes to be made (like a pressure change).

What would we do if the central index was higher than we want? We would first look at the actual reports and the event graphs to see when the centrals were being flagged. If in a cluster at sleep onset..do nothing. If in clusters associated with awakenings..do nothing. I once saw a report where the guy had a central index of 10.0...one might think holy crap...he has central sleep apnea or complex sleep apnea (mix of obstructive and central) but when looking at his reports in detail the centrals were all in huge clusters at sleep onset or in the middle of the night when he was waking up and tossing and turning for an hour or more trying to go back to sleep.
All he did was stop the laying in bed tossing and turning for a few nights and the central index plummeted to less than 1. Once we realized that these "centrals" were awake centrals or semi awake sleep onset centrals that were no cause for alarm he could go back to his normal routine of tossing and turning if he wished because we knew that was the cause of the large number of centrals and not some scary diagnosis.

What do we do if we can't explain away large numbers of centrals? That is a question for another time but we look at a lot of things including history and we suggest that their doctor be alerted for sure.

Hertzgog, you need to register your harware, so that I know what you have, before I could answer your question.

Info added...

Thanks for all the info! Makes me feel a lot better about the Centrals...

I do not have the Climate Control enabled... is this recommended, and what is it?

I've got my humidifier set to 4.5 currently...

Was also wondering if most people use Flonase or similar daily? It seems the docs are fast to write a Rx for everything these days, and not sure that I need it (after spring, that is). I know my Dad (also on CPAP) uses that and an antihistamine nightly...

Hertzgog (is it not Hertzog?), I started with S9 Elite that I got from my DME via Medicare 18 months ago, but after a month I paid $850 from my pockets for a new S9 Autoset (the flow generator only). This move helped me a lot b/c I used the APAP to self titrate myself and found that my optimal pressure was not 6 to 7 cm (on CPAP) as those screwy technologists found during my sleep test, but it was 13 cm (on CPAP). So I set my APAP accordingly and together with my nasal mask and chinstrap I get tremendous results. But, I can't get rid of my RES (Residual Excessive Sleepiness) after breakfast till noon. Can you help?

See my last night results:



p.s. I also don't use the climate hose. I set my room temp at 75 F, and my humidifier at 5.5. In the morning more than half the tank is still full of distilled water which I just fill up. On my "maustage" area above the upper lip I spread heavy layer of ChapStick b/c of the nasal mask.

I use FLonase pretty much every day for probably well over 2 years now. Most of the time just a squirt before bedtime just in case...

ClimateLine hose is the heated hose. It is an option and normally supplied with the machine.

Thanks for the replies guys!

...as for the RES, wish I could help!

I've been studying some more recent data and am concerned with what appears to be shallow breathing below. I've seen a lot of pretty, symmetrical graphs around here and mine seem to be all over the place?

The shallow breathing could be from the sleep stage that you were in. As to events, you got about a total of 12 centrals during the more than 8 hours that you slept. Pretty good.

Can't you get larger and clearer graphs, something like this:

http://www.flickr.com/photos/gsfc/6760135001/