First Night's Data

[Melman]

I just started using SleepyHead last week and have 5 nights of data that, based on my limited experience, are so inconsistent it’s hard to believe they are from the same person. I made two changes in the course of these sessions. After the first I changed from a Quattro FX to an Amara View and on the third night I began trying to sleep on my side. The first two nights I started out on my back. I know I changed positions several times all 5 nights but believe I spent more time on my sides during the last three nights.
Now to the data:

Feb 7 Quatro FX, Back) Very good AHI (0.91) but significant number of flow limitations and RERAs.  

Feb. 9 Amara View, Back) Poor AHI (7.73), significantly more flow limitations and RERAs plus multiple OAs

Feb 10  Amara View, side) Good AHI (2.96), fewer significant flow limitations< RERAs, and OAs and all clustered in a 45 minute period. Data for the rest of the night looks very good. Leak rate as worse than I would like but cluster of events does no correlate with highest and lowest leak rate. My wife got up briefly just before the cluster of events. Perhaps that disturbed my sleep? Also, she noted I was on my back at that time.

Feb 11 Amara View, side) Excellent AHI (0) and no significant flow limitations. Leak rate as very high for 26% of the session but I don’t think that invalidates the data for the remainder.

Feb 12 Amara View, side) The ugly; AHI 15.3, significant flow limitations, lots of OAs, plus Cheyne Stokes breathing. But again, not distributed over the entire night but occurring in a n approximate two hour period out of Eight.

Is it unusual to see such an inconsistent pattern? It almost seems like I need a video and sound recording to see what’s going on.

I do intend try auto mode but does a constant pressure setting explain this data?

I hope this isn't a data overload but someone responding to an earlier post said there are data geeks here.
 



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[Sleeprider]

It does make it easier to see them all stacked up nice and neat here. I have been an avocate of you trying out the auto mode, and I think this explains why...you're inconsistent. Lots of us are. Maybe it's your sleep position, including chin tucking, could be sleep stage or something else. I do know your events are related to flow limitation, and it can result in obstructive apena or hypopnea. It's no mystery that sometimes 10 is fine, and other times it's not. Luck of the draw...my guess is your sleep lab got one of those periods where 10 worked pretty good.

What are your thoughts? To me this looks like your airway closes off from a chin tuck.

[Melman]

You could be right about the chin tuck. But how do I know if I'm asleep?   I just ordered a buckwheat pillow in hope of better stabilization of my head position.

A source of my frustration is that I spent most of my life troubleshooting technical problems, but under conditions in which the variables could be identified and controlled. That's clearly not the case here.

As for the sleep lab, it's not accredited and they have trouble with noise. I have suffered from insomnia most of my life and was probably awake more than asleep during the study. I have little confidence in their results. In fact I quit using my CPAP for several years. It was overnight home oximetry tests with and without CPAP ordered by my family practice DR. last year that convinced me I really needed it.

Another variable I haven't mentioned is that because of my chronic insomnia I can't sleep at all without medication. I've tried virtually every prescription and non-prescription remedy over many years and the only thing that gets me to sleep and keeps me asleep for more than a couple of hours is clonazepam. That's why I want to be careful with how I handle any pressure changes. I need the pulmonologuist for the clonazepam. Otherwise I would use my family practitioner for CPAP  prescriptions but she will not prescribe controlled substances for extended periods.

If it weren't for that concern I would have changed the settings already. I'm pretty sure I can convince him with the data. I've met with him every 6 months for about 10 years and suspect you know more about this than he does.

[Melman]

It does make it easier to see them all stacked up nice and neat here. 

I agree, the correlation between the flow limitations and events is very clear.

[Sleeprider]

If you feel you need permission, just let the doctor know you plan to try auto CPAP mode at 9-14 "to clear up the obstructive episodes that correlate with high flow limitations" You can just leave a message with his receptionist. If he has a problem, he will get back to you.

[Melman]

Thanks,

Did that today and am waiting to hear back.

[Beej]

Maybe read up on the sleep restriction technique for reducing insomnia. It is a type of cognitive behavioral therapy which has been helpful for many.

Just Goole sleep restriction therapy

[Melman]

I got a pleasant surprise. When I turned on my machine last night I saw that it had been reset to auto-mode with a minimum pressure of 8 and max of 14.   I assume that was the response from my Dr.'s office. It would have been nice if someone had told me but I probably won't complain .  I'm pleased with the data. OpalRose and Sleeprider, I was already convinced you were right about switching to auto and the data definitely supports that. It appears the machine proactively responded to flow limitations and prevented ant RERAs, OAs, etc. It also appears that the Amara View did not handle the pressure increase well. It's the most comfortable of many masks I have used but I need to readjust the headgear almost every night to pass the mask fit test.

I realize it's just data from one night but for now I'm pleased.   Thanks for your help and encouragement.

[OpalRose]

Well, that's  a big difference.  

One leak issue early morning, but pretty good all night.

Go with these settings for a few days and let us know how it goes.

BTW, do you feel like you slept any better?

[Sleeprider]

Be sure to pass the results along to your doctor. It's great to know he will work with you, and it looks like he ended up with the same conclusions as we did.