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Pugsy, did you notice on the 9/28 report his pressure was changed to Cpap=20cms and his AHI=6.30? What do you make of that?

DoriC wrote:Pugsy, did you notice on the 9/28 report his pressure was changed to Cpap=20cms and his AHI=6.30? What do you make of that?

Yes, I noticed it but to be honest I didn't see enough reports showing the basics to form much of a conclusion. There were snippets of stuff and often the AHI graph pushed the pressure graph and I couldn't see it. I just went back and looked at the images to see if I missed anything. Basics meaning the AHI bar graph on the left..the events graph on the top right..flow rate, pressure graph and leak graph. The AHI graph is redundant and useless in this (and most) situations. That's why I don't bother turning it on.
Looks like he didn't have any centrals with that AHI of 6.30. I don't know why and haven't seen enough of the progression of pressures used to form any idea (and might not be able to anyway). I don't know even if I had more than snippets I could formulate an opinion. His reports are way crazy and with the history of head injury...it really is something beyond my comfort levels for speculation.
For me though....I would put that night in the "fluke, alien event" category and not attach much importance to it. Sort of like with Johnthomasmacdonald's reports. He would have some really nice normal reports and then some really nasty reports and I never could come up with anything that remotely explained it....other than aliens. My logical mind tells me that there was some reason as with hueyville here...something changed but I have no idea what and I don't know of any way to find out.

So something changed with hueyville's sleep that night to give him the rare decent enough report but I have no idea what and the reason I haven't offered much is because he is already working with a doctor who is seeing the full reports and not the snippets that I have seen and it isn't my place to muddy the waters and I don't really have anything to offer anyway.

He needs an ASV machine..plain and simple and the doctor is working towards that end. And from the sounds of recent events...finally put it on the fast track where it should be. I think I do understand the doctor's caution though...he didn't want to jump the gun and wanted to try the "easy" stuff first just in case the big guns weren't needed. Plus he has all the reports to review and we only have a few to think about. I am sure there was a method behind his "madness" for what he has chosen to do every step of the way.

Now if the good nights were the norm and not the rare unexplained decent night...I just imagine that the doctor would have maybe tried to figure out what changed...but they aren't. Probably 98% of the nights are horribly ugly and I see no reason to try to figure out what changed on those rare decent nights. Gotta treat the majority of stuff and the majority is horribly ugly.

So in other words...hueyville's issues are beyond my comfort level for forming much of an opinion about anything given his history and what is shown on the bulk of the reports.
I don't know that having more complete reports to review would help me come up with any ideas...I doubt it and that's why I didn't ask for them.
He's under the care of a doctor who truly cares and is working hard to help...that's what I would have suggested anyway.
He definitely needs its and I am happy he is getting it.

I have followed everyone of hueyville's posts because his problems are unique and pretty substantial. I haven't commented much because I really didn't have anything constructive to say that is needed or hasn't been said by someone else. I did and do read them so that maybe I glean a bit of information that is new to me that might be useful later. I always like to learn new stuff.

That's why you're so trusted, because you never give more advice than you're comfortable with. This is definitely such a case but I couldn't help wondering if just a pressure change had somehow been overlooked by the Drs. Wishful thinking on my part, I guess.

Huey, wishing you the best and hopefully when you get the ASV machine you'll be getting the therapy you need. Sounds like you've got a good medical team following you. Keep us posted.

I am working on more screen captures. Average week is 2 to 3 nights where i have AHI in the 50 fo130 range, 2 to 3 in the 15 to 50 range and then 2 to 3 in the 3 to 15 range. My numbers bounce around like a tennis ball dropped from outer space. What info do you want to see? I will try to post up what you need if you want to give me a list.

If you want to put up some reports for us to mull over..this is what I like to see below..just involves one screen image.
You can turn off the AHI graph (Preferences/Graphs..remove the check mark) and you can resize the existing graphs by dragging the bottom line of the graph up (hover mouse over the bottom line till you see a little short double line..then click and drag) a bit to make the graphs just a little smaller so that they all fit on one screen image.
With your machine the only graphs that I really care to see are the Events graph on the top right...the flow rate graph...the pressure graph and the leak graph...and leak graph really isn't needed if the leak line is stable and well under large leak territory (around 90 L/min on your machine..might be a tad higher because of your higher pressures).

So that one detailed report looks like this one of mine. This one has a bit of a leak..I was experimenting using the Nano cushion and the Bella Loops and didn't quite have the tension just right. Still below large leak territory though..and I slept well so I don't really care but I did do another night with the loops a tad tighter and the leak line was a little prettier..I just didn't bother to upload it to photobucket.

Between work, taking wife to doctor and myself to docs have some time issues. I will format some screen captures as requested. Doc said last week study with backup dafe waz an AHI of 6.xx. He says if we can get me consistently in thr 6 to 15 range he would not be displeased. Funny thing is they emailed my last 2 months data to Respironics. Said they were very intedesfed in my numbeds. I am going to use mask every night from here on out for wifes sake. Now we go to bed together and wake in same bed twice a week. We are seeing some improvement.

Between work, taking wife to doctor and myself to docs have some time issues. I will format some screen captures as requested. Doc said last week study with backup dafe waz an AHI of 6.xx. He says if we can get me consistently in thr 6 to 15 range he would not be displeased. Funny thing is they emailed my last 2 months data to Respironics. Said they were very intedesfed in my numbeds. I am going to use mask every night from here on out for wifes sake. Now we go to bed together and wake in same bed twice a week. We are seeing some improvement.

Hey...there is no urgent need for those reports. We are curious but other than "what if" there's not a lot we could do anyway.
If you don't have time...no big deal. When you get your ASV machine...now those are the reports that are important.

If you end up with a PR S1 ASV...get with me about it especially if you end up with the 960. I can get you fixed up with the software you will need for the 960. SleepyHead's compatibility time frame is unknown and there are some features on the Encore reports that are useful. Right now Encore Pro 2.12 is the only software that will work with the 960..it's a bit of a PITA but if I can manage it..most anyone else can. I know some hints to make using it less of a headache.

If you end up with the S9 Adapt ASV...I can help you with ResScan too should you need it.

I will most likely end up with a Respironics machine. Due to the puzzling nature of my particular case my doctor had his lead technician who he assigned my case call Respironics to discuss machine options. Apparently Respironics is not only being helpful but inquisitive. I give my doc a weekly pdf version of my Respironics EncoreViewer v2.1 report. My 1st appointment witb him I brought the partial study results from the 2 docs that kicked me to the curb. I gave him a 2 week EncoreViewer report of using their numbers and how bad they were. I also gave him a 2 week report of the best setting I found in 2 years of dial winging and two 1 week reports of the best week on cpap, cpap w cflex, bipap and bipap w biflex. Just to confound him even more brought a 1 week report of the worst setting I had found in each of the 4 main modes.

After introductions I handed the 1.5" thick stack of reports to him. He spent at least 45 minutes reading through the highlights and asking questions. When I realized he was actually interested, reading, asking questions instead of rolling the entire mess into the trash can and asking me to leave I felt for the 1st time I was talking to a doctor with compassion. When he said he had no clue as to what was wrong with me I knew I had found the 1st honest sleep doctor of my ordeal. I stressed that due to having finally meeting my out of pocket for the year his answer was we better get to work.

He said lets start over from scratch. He had me in the lab 2 days later for a cpap study. We spent 4 weeks playing with cpap changing pressures once a week. Then went back to lab for bipap study and spent a month changing pressures based on that study. Then back in the lab for a bipap study with a backup rate. He only played with that for 2 weeks and now I go back to lab Sunday night for ASV study.

In talking to Respironics the docs tech called and asked if I woulx send them all the reports I had given the doc in electronic format. I sent all the reports including several out of sleepyhead. 2 days later I got a personal call from Respironics asking questions and for me to send more reports. They implied that they may have a machine that is not on the retail market that might be my best choice. Only problem is insurance is not going to buy a machine that is not a retail item. The way my symptoms keep cbanging my tech and doc think I need one of the machines they use in the sleep lab so that no matter how my needs change I will have a machine that can keep up. But while that may be best, the real world and insurance will most likely have me in the Respironics ASV machine. I am stunned to see how much effort the new doc is putting into me. Sunday will be lab visit 4 in 3 months and seems certain we will go back in again before year end.

One thing that can cause wild swings is that the AHI counter is getting confused by too many events. AHI only makes sense for numbers below some value which. If you breath fast at 20 times a minute, there are 1200 breaths per hour and if one in ten were counted as an event, that would be an AHI of 120. Some systems claim to only report an event once per 30 second which should cap out the AHI at 120.

There are also cases where an increasing AHI is an improvement (this doesn't apply to the data above). If your typical event is say 90 seconds long but under treatment that event becomes two 30 second events with a break in between, your AHI will double but you spend less time not breathing and your oxygen levels will not drop nearly as far.

A few doctors will do a CO2 test as well so you might find out if that is an option on your next sleep study. Our sense to breath is when carbon dioxide levels get high, not when we are low on oxygen and more places are starting to add that to their sleep data.

I think you should look at an SpO2 recorder to see how your oxygen levels are doing.