New user, many questions :)

Pugsy wrote:

ArmandXP wrote:I wonder if they will check to see if I change any of the settings (I turned on the EPR, because it wasn't set up), or if I adjust my pressure.

Your insurance won't care about anything other than hours of use. They won't be looking at anything other than compliance hours of use. They don't do any evaluation of the other data that is collected.
Unless your DME looks real closely at the summary data he collects with the modem...I doubt he will even notice.
EPR is a comfort feature anyway and it is considered to be something that a patient should have access to.
Changing pressure they might get upset about if they notice it but it would be more because you knew how to do it than the fact that you did it.

Thanks for the info. My DME doesn't really care about the settings from what I can tell. He was going to let me tell him over the phone what my compliance screen said. He was pretty cool about everything we talked about. So, I feel at ease now. I really like using the machine on the auto setting, than the straight CPAP setting. I'll let everyone know what happens, if anything does. But, I tell you, they'll have to pry this machine out of my cold, dead hands!!!!!

Still hoping my AHI gets better. The best I've gotten so far is around a 7. Don't know if that's a problem or not, but I want better results.

ArmandXP wrote:Still hoping my AHI gets better. The best I've gotten so far is around a 7. Don't know if that's a problem or not, but I want better results.

When you get a chance can you post an image of that AHI of 7 detailed report?
Is it still mainly Clear Airways?
How's the overall sleep? Still fragmented or getting better? Clusters of events around awake times?

Pugsy wrote:

ArmandXP wrote:Still hoping my AHI gets better. The best I've gotten so far is around a 7. Don't know if that's a problem or not, but I want better results.

When you get a chance can you post an image of that AHI of 7 detailed report?
Is it still mainly Clear Airways?
How's the overall sleep? Still fragmented or getting better? Clusters of events around awake times?

I'm still very new at this, but I've been sleeping pretty good. I wake up once in the night, and around one hour before my alarm goes off I wake up again. This morning I felt a little smothered, but went back to sleep. I'm not great at reading the graphs yet, but this night is much better than my previous few. I feel pretty good in the morning, better than I've felt over the last few months. Just want to get better results and not sure how to. Thanks again!!!


I wish there were a simpler way to upload photos on here. I'm using photo bucket....... I think the leaks are much better on this graph. Just not sure what I can do to improve things...

Seems like there's a lot of action going on when I wake up around 3am and go back to sleep till my alarm goes off.....Not sure what to do about that.....

Nothing you can do about that action going on at 3 AM in terms of what the numbers are going to show.
You already know you were awake during that time. You have to mentally toss those numbers out the window.
The machine is very likely flagged awake breathing irregularities as some sort of apnea event. Remember it doesn't know if you are awake or asleep.

With time and experience those "awake times and awake events" will decrease and you will then have a nice low AHI.
You already do with this night if you just remove the 3 AM clutter.

I can eyeball it and tell roughly about 20 events during the rest of the night. It's hard to know for sure exactly how many by looking at this image.
Remove the roughly 30 minutes of that sleep time where you were awake...let's make it 7 1/2 hours for ease in doing math instead of 8:10 hours of sleep.
So roughly....AHI 2.7....that looks a lot better doesn't it? 20 events over 7 1/2 hours...

You can get a more exact AHI by doing the math and looking at the Events tab.
Click on the events tab..click on each category of event and you will see each event numbered and time they happened.
Manually count each event that was flagged outside the 3 AM clutter time...total them up...divide the total by hours of sleep.

Your leak line...looks like only a couple of brief spikes above 20 L/min...so below 24 L/min for the vast majority of the night.
The pattern of the leak with the sort of plateaus...looks like mouth breathing/leaking to me.
If you are sleeping through it...don't worry about it. It's not large enough to seriously impact therapy pressure.
The machine can do a decent job of compensate for small leaks...no matter what the cause.

Give yourself some time...I think some mouth breathing for a lot of us is more from habit (gasping for air with the untreated apneas) than a real physical need to mouth breath. When I first started therapy I had a lot of mouth breathing habit and it was pretty big sometimes. I did elect to tape my mouth for a couple of months (my leaks were a LOT larger than yours here) and eventually quit taping because it was just annoying to do each night and the really massive mouth breathing leaks didn't return. I seem to have broke the habit.
I suspect with time and experience your mouth may learn to stay shut a little better...probably won't ever be totally perfect but unless it disturbs your sleep I wouldn't do anything about it.

So..the short version....this report is a huge improvement over the others....your AHI is fine if we omit the awake events which don't really matter because you were awake anyway.
Your leaks...not horrible..not real pretty but not horrible and if not disturbing your sleep...not bad enough to impact therapy itself all that much because the time spent above 24 L/min was really very minimal. It's not like you spent 2 hours in large leak territory.

Pugsy wrote:Nothing you can do about that action going on at 3 AM in terms of what the numbers are going to show.
So..the short version....this report is a huge improvement over the others....your AHI is fine if we omit the awake events which don't really matter because you were awake anyway.
Your leaks...not horrible..not real pretty but not horrible and if not disturbing your sleep...not bad enough to impact therapy itself all that much because the time spent above 24 L/min was really very minimal. It's not like you spent 2 hours in large leak territory.

Thanks a lot. Makes me feel a lot better, and it all makes sense, what've you've explained. I'm going to start manually calculating things and cut out the little bad times and see how much better it gets. Thanks again

DME just left my house after installing a cellular uplink. Yay! Nothing better than big brother watchin' ya! I had him bring a couple more masks for me to try, also. Going to try a gel mask from Respironics and see if that helps any with the mask leaks. Still have my old one, if this one is worse. Really want to get the best fit for me, but hate to keep asking for different ones. Very happy, though!

Terry, buddy,
I have switched masks five times and don't feel guilty at all. This is like picking a mate...gonna spend a LOT of time with the choice...so choose wisely and correctly.

imfletch wrote:Terry, buddy,
I have switched masks five times and don't feel guilty at all. This is like picking a mate...gonna spend a LOT of time with the choice...so choose wisely and correctly.

Ha! Very well put. I know what you mean.

Terry: I had three masks the first three weeks of CPAP. The first one drove my wife nuttier than I do with the fart-like noises created when I made the slightest adjustments. The second was flat-out wrong for my kind of sleeping behaviors. Finally, on the third try I got a F-F Quattro FX and have been super-satisfied with it since the first full night I used it which was on March 3.

Funny thing about remembering that date. I was a history teacher for four decades and, of course, was paid to remember/teach years, dates, months, etc., many of which didn't make a jacksh*t's worth of difference in anything. You better believe, though, that I'll remember that March 3 was one of the best night's sleeps I had in years and years.

Be patient as there will be some so-so nights along with the great ones. Sounds as if you're way ahead of the game at this point but your brain is going to have to learn new things such as NOT signaling you to wake up, maintaining best-sleep temperatures, and adapting to all the oxygenated blood that's enriching your system.

Two things I'll remember is how my chest muscles ached after the first few all-night slumbers. If I hadn't known better I'd have thought I'd been lifting weights the day before. Nope, it was all those contractions/expansions that had not gone on for any prolonged periods though most of my life.

Second, I really used to enjoy taking a 20-30 minute nap around supper time to recoup what had been lost to apnea in the night. Now, I can't do it! I'm simply not drained enough to nod off. Do I miss those naps? Yes, but the reward of CPAP outdoes all those little snoozes.

Again, great work so far and be patient. God bless.

Hi-- Your posts sound very similar to mine. I am getting a new cpap (for the first time), and would have just taken what they were going to send me, but have recently gone through the cpap thing with a family member, so I felt like I knew a little more about it. After researching online ('best cpap machines", etc) and reading this forum, I had written down as top choices the Resmed s8 Autoset II, the Resmed s9 elite, or the respironics M series Auto Cpap with W-flex. So I called the DME, and asked them which one my doctor had ordered (he had ordered the respironics remstar pro--which the DME told me was a "popular one, but on the older side"). She actually suggested I ask for the Resmed s9 Elite, and said "if I had to have a cpap machine, this is the machine I would want". So awesome to have a good experience as well with the DME. So this all happened today for me--I still haven't received my machine (and the DME is awaiting the doctor to update my order). But I was wondering how your first week has gone with the Resmed s9--are you happy with it? Is it comfortable? Easy to get used to? I'd love any feedback you have.
Thanks!

oops--I jsut realized you have a lot more posts--I thought I was at the most current, but I was reading one from 4/5/13. I'll go read on...I'm curious to hear how your experience has been.

Awesome to read all the updates. Very enlightening. I wrote in a previous "guest" entry (haven't made an account yet..but I will!) that I just had my first sleep study and am awaiting the same machine to come. What I found very helpful was the info about your AHI spiking to 120 your last hour of sleep, and someone commenting that you were probably restless and it was inaccurate. So, at my sleep study, I laid in bed with just monitoring on, no cpap, and after 50 minutes, the tech came in and put me on the machine. Then 5 hours later, woke me up and sent me on my way. So for that first 50 minutes, I never felt like I was asleep--I remember the blinking red light on the vcr bothering me the WHOLE 50 minutes. So I got my report in the mail, and guess what? For those lame 50 minutes of the study (without cpap), my AHI was 121. It has put everyone in a panic about my "severe sleep apnea" and that I need a machine "right away" (with a lot of urgency in their voices). So now I'm really questioning the validity of the whole sleep study. I will admit I've snored my whole life, and have been told I breath hold. So I'm definitely not disputing that I have sleep apnea, I just doubt my true AHI is really 121. Can you really get an accurate AHI with a 50 minute study? They titrated the cpap over the next few hours, and set me up with 10cm of pressure (but even that, I think the mask was leaking a bit). Anyhways, any thoughts from all you reading these posts?

Guest wrote: So now I'm really questioning the validity of the whole sleep study. I will admit I've snored my whole life, and have been told I breath hold. So I'm definitely not disputing that I have sleep apnea, I just doubt my true AHI is really 121. Can you really get an accurate AHI with a 50 minute study?

Yeah if things are bad enough you can see the bad with even less time.
They can tell if you are asleep or not so if you had something wild going on while awake they would count it.
With the machines we have the machines can't tell if we are awake or asleep ...it just flags everything and we have to figure out what to remove to get a true account of what happened.
In the sleep lab they have the EEG leads and know exactly when you were asleep and in what stage of sleep.
If they counted them...they were real.
If the events weren't real they simply couldn't have been factored in to the AHI.