Apnea events defined

[BreatheRight]

First of all, I'm going to figure out how to download the OSCAR so I can ask for more help.

(2) my events per hour have definitely decreased since on the ResMed (APAP, I guess it's called) -- (from 25 down to 2.5 to maybe 5 per hour) -- yea
*** I really don't know what or how an event is defined -- I've tried finding information online (guess I'm not looking in the right place)

(3) I wake up during the night --- 
*** several times as well as not able to return to sleep for a long period of time (sometimes over an hour and not just once but 2-3 times nightly); 
*** being awake does NOT count as an event, correct?  And if that's true, the 'events' I'm seeing daily aren't really telling the full picture; 
*** so, my total hours from my report show I've been in bed 8-9-10 hours per night --- doesn't mean I've slept that many hours!

(4) My clinician made all the settings for me and had to change them a couple of times (ResMed AirSense 10) --- but I still awaken throughout the night with a VERY dry mouth.  
*** should he change my settings or should/could I?  (He can change my settings from his office to the unit in my home --- no privacy there -- just kidding!)

(5) Have to add one disappointing feature --- 
*** I have the F20 mask WITH foam --- love it --- but I cannot put it in my SoClean.  Using unscented baby wipes but wasn't told I couldn't add it to the sterilizer; I read about it.  
It's okay, I guess but oils and creams plus saliva --- I feel it's not all that clean.  

*** If I change to the F20 mask with silicone (NO foam) -- I am assuming it can be put into the SoClean unit (another expense and unsure if I will like that mask as much as the one with foam).  

*** Just asking for opinions on this!


Love checking on this board daily --- have found great tips and information.  Thank YOU for providing this.

[Bugbitten]

Nice questions!

New user here too. Looking forward to responses.

[dickydutch]

Not sure if you're aware, but the F20 with foam (Also called AirTouch F20) and F20 with silicone (AirFit F20) are both the same mask frame, so you only need to purchase the insert rather than the whole headgear to try out the silicone one.

[BreatheRight]

Yes --- I'm aware of the silicone vs the foam --- same mask frame.  To purchase the foam part -- found online for $23.00

My question was if I could put the silicone into the SoClean as I'm not supposed to put the foam into the unit.  I guess it decreases the life of the foam or will ruin it. 

[Gideon]

1. OSCAR the download lin is in the Black Banner on top of this page or click on the link at the start of this sentence.  

2. Events.  OSCAR reports events, it doesn't define them.  the events reported by CPAP machine are considered medically acceptable even though  breathing effort and state of awakeness cannot be determined.  This is Sleep Apnea, so events that occur while sleeping are what counts, others can be discounted
Event Definition Apnea, Hypopnea, Flow Limitation

• Apnea: 80% to 100% reduction in airflow for >= 10 seconds
  
• Hypopnea: 50% to 80% reduction in airflow for >= 10 seconds
  
• Flow Limitation: <50% reduction in airflow for >= 10 seconds
  

These events may be either Obstructive or Central in nature They represent different degrees of similar events. All of these may be disruptive. While Central Hypopneas are important in diagnosing Central.Mixed.Complex apnea they are not monitored in most Sleep Studies.

• RERA - RERAs are a series of flow limitations ending in arousal.
  

Hypopneas can be further broken down by Central or obstructive hypopneas.

Hypopneas - Obstructive and Central
To determine the statistics for Central apneas and Central hypopneas >50% of total AHI above we need to determine which hypopneas are central in nature. The description below defines the difference between obstructive and central hypopneas.
An obstructive hypopnea contains one or more of the following:

1. An increase in PAP flow signal
   
   
2. Snoring during the event
   
   
3. Paradoxical breathing
   

A central hypopnea will have none of the above.
Central Hypopnea. Central hypopneas are associated with reductions of purely in-phase thoracic and abdominal effort or movement signals, followed by an increase in chest and belly movements at the end. There is no evidence of phase shifting or paradoxical breathing, no airflow flattening, and no snoring throughout the entire central hypopnea.
A Central AHI is composed of Central Apnea and Central Hypopnea. The Central Apnea numbers are easily extracted from modern PAP machines which report detailed efficacy data. We need to concentrate on Central Hypopnea numbers to demonstrate a Central AHI >5 and that Central apneas and Central hypopneas >50% of total AHI

Central Hypopnea. Central hypopneas are associated with reductions of purely in-phase thoracic and abdominal effort or movement signals, followed by an increase in chest and belly movements at the end. There is no evidence of phase shifting or paradoxical breathing, no airflow flattening, and no snoring throughout the entire central hypopnea.
Paradoxical Breathing explanation: The chest and abdomen should expand when they inhale and contract when they exhale. If the chest and abdomen contract while inhaling and expand while breathing out, a person may have paradoxical breathing.


3. Waking up: A dry mouth is usually indicative of mouth breathing.  Being awakened is an event, you should have one, or a reason such as a bathroom break for each awakening.
There is not enough info to determine why you are having an issue not falling asleep.  That is something that we may not find a reason for, but we can look.

4. Request the clinician manual via the CPAP Setup manual link in the Black banner above. It is a manual process and requires an email and may take a bit of time.  Whether you change them or have your clinician do so is your choice.  Legally he cannot change anything other than comfort settings without a prescription from your doctor, however, you can change anything you wish.

5. You will be fine if you follow SoCleans instructions up to the point of actually using the SoClean, which is to follow the Manufactures's instructions for cleaning.
NoteAll ResMed machines warranties of newly delivered machines will be voided if ozone cleaners are used. In other words, ResMed believes that ozone cleaners will damage their product.  Your choice.  The consensus here is that SoClean is very good at cleaning your wallet of cash, and not much else.  Again, your choice.

[BreatheRight]

I couldn't find where to make a NEW thread so I'm adding to a past one I posted!  HELP OR ADVICE NEEDED!!

I changed masks and it has made a great difference -- NO cheek marks and the headgear isn't making my cheek bones sore.  The Vitera goes up between my eyes and the headgear is around my forehead.  Great change.  There are air holes and at first made me too aware of the air flow but it's just part of the headgear, for some reason!!!

I've been on CPAP for about 13 months and issues I continue having are:
1) water chamber is totally dry every morning (I have tried to change the humidity level -- guess I haven't accomplished that yet)

2) RED nose -- over the bridge of my nose -- both masks I've used and I've tried a couple of gel pads over my nose, which move around -- every morning my nose (or bridge) is so red -- at least I'm female and can use extra concealer.  Does anyone else have this issue?  (I can't loosen the headgear to prevent this or there's leaks around the mask.)

3) I have an app on my iphone to detect snoring ..... the report was a lot worse before I started using the ResMed CPAP but I have since used this app and I still snore -- especially during the middle hours of my sleep.  I thought using the CPAP cut down or cut out snoring?  Any suggestions or is this a forever thing?  It's embarrassing to be with family and/or friends and here I am snoring and keeping others awake.  So not a pretty sound!!!

I will continue using the CPAP because I think it's a more relaxing sleep -- maybe because I get the extra humidity; it's calming!
Not crazy about chasing the hose around all night because I'm a restless sleeper and it just seems to be wrapped around my neck, which causes me to wake up and 'uncoil'!!!
I check my daily MyAir report and my numbers are good; events are low, mask isn't removed many times nightly -- overall, I'm benefitting from this but the issues are still there.  I've asked the local place where I've bought my supplies and equipment with really no solution -- it's a 'trial' thing -- well, it's been a trial alright!

ONE MORE QUESTION:
Has anyone purchased the 'travel' CPAP?  Is it worth the money?  There is one that's by battery (so you aren't searching for an outlet if you are away from home); the unit is smaller but for the most part, you couldn't add the water chamber.  JUST any suggestions?  (Don't know if the extra cost is worth it or if traveling, just not use a CPAP at all -- using one hasn't eliminated the snoring anyway.)

Sorry to be so lengthy -- just submitting my pros and cons after a year with this equipment.  
THANK YOU for any advice!!  Love this forum site!! 

[staceyburke]

There are several different masks that the hose is attached on top of your head and the hose is on a swivel. Such as ResMed P30i or F30i.

[SarcasticDave94]

My newest and best mask is the Vitera and it doesn't leave marks as it's best adjusted loosely. It's almost guaranteed to leak if it's tight. The marks may be a too tight mask adjustment.

Adjust it this way:

1. Lie back on the bed with mask over face but no straps
   
2. Holding mask in place turn on PAP therapy
   
3. Add light finger tension to minimize leaks and remember how it feels with mask sitting there
   
4. Now add very loose straps
   
5. Adjust lower set first to mimic finger tension from earlier
   
6. Ditto top strap set
   
7. Now the top of head height adjust-loosen top of head strap and pull mask straight off face with other straps in place and reset it further down your face just before bottom edges would lose the seal, re-settle and set the top of head strap
   If you don't settle mask lower it'll leak at nasal bridge
   

Note if mask leaks at nasal bridge, adjust lower set out/looser just a small bit first before considering tightening top set. Loosening the bottom set actually should add tension to nasal bridge area.

The Vitera air holes are to allow you to exhale without rebreathing CO2. Air should not be escaping anywhere other than that front vent grid.

I'd lower humidifier number by 1 and see if that gets water to last all night.

Travel CPAP is hit or miss on delivery as effective therapy. I've noted that you don't see much benefit to PAP therapy, so this means very likely your pressures aren't optimized. Have you used OSCAR to view your data? My guess is therapy isn't doing as well as it could. Get OSCAR and show us.