Newbie.. sleepstudy completed and need help with Resmed Airsense inital setup

[SABETTERSLEEP]

Dear Experts,

Do you have any suggestions on settings for improvement..
Appreciate your advice and help..

[Gideon]

At this point I wouldn't make changes unless your symptoms indicated doing so. You reported no symptoms at these settings. How do you feel?

[mesenteria]

You had unacceptable leakage in your last chart.  The machine is designed to overcome a modicum of leakage, which all of us have for brief periods most nights.  Large leaks, as a category, are too much for the blower to overcome.  These must be strictly minimized to every extent imaginable, even to the extent of trialing other sleeping arrangements and masks.

Secondly, if you hover your cursor over your live, on-screen, charts, in the upper table where the coloured vertical lines indicate events in the timeline, you'll see a balloon open with text indicating the type of event AND ITS DURATION. I like to know how long events last.  For me, and this is only for me, I ignore events lasting less than about 14 seconds.  They are innocuous at that length, although I also only have two or three during the entire night.  A run of many of them clustered together is not going to be good for you because they'll lead to prolonged desats of O2.

[sheepless]

"I ignore events lasting less than about 14 seconds. They are innocuous at that length..."

where does this come from? can you cite an authoritative source that says these are innocuous? it's a given that longer is worse but why are apnea defined at minimum of 10 seconds instead of 14 if this is true?

we know that hypopnea and flow limitations are harmful. I suspect even pauses less than 10 seconds are cumulatively undesirable as well, at least insofar as they disrupt sleep. I would not discount any flagged sleeping apnea events, particularly over 4.9 ahi.

[mesenteria]

Sheepless, I do not know why 10 seconds is the demarcation point any more than 4.9 AHI is deemed to be sufficient for treatment purposes.  It could be that ten seconds is the point at which a normally perfused person crosses the 90% threshold...on average. 


As I took pains to point out, I use 14 seconds as my own limit because I have a few CA's most nights that never exceed 14 seconds.  This is only four seconds more than the supposed cut-off for RESMED's reports.  I also stated that isolated events are generally not problematic until they begin to cluster, even if of short duration.  

My intent for the post was to get the OP aware that there is more to the report than just the mere frequency, or grouping, of events.  Their duration is also noteworthy.  A single obstruction or central that is 42 seconds long is not going to do a person with apnea, who wishes to have improved sleep and to feel rested the next day, much good.  At the very least it will cause an arousal which, if it were just prior to REM, has just robbed the person of that stage of sleep.  Again, not at all good.

[sheepless]

mesenteria, I understand most of what and why you said what you said. I just think it's easily misunderstood and potentially misleading, especially to neophytes who aren't likely to understand the nuances, to say 10 to 14 second events are innocuous. I saw that you took pains to say for you only but the reason you gave was because they are innocuous which is too easy to generalize and take out of context. otoh, good point about longer being worse. I read your posts with interest.

apologies to the op for the diversion.

[Gideon]

I'll point out that event duration shorter than 10 seconds may be significant. What if you had a lot of 8-second events, would that be significant? Not disagreeing with the 14-second event, just showing the other side of the story.

[mesenteria]

That could have been made clearer in my original comment, I suppose.  If a person has thirty 8-second events, and they don't show up on the AHI count next morning, who is to say, except the person reporting not feeling rested, that they are problematic or innocuous?  They don't seem to have a deleterious effect on me, and I routinely get two or three each night, but less than 14 seconds each.  If they clustered and five or six 10-second CA's came inside of, say, two minutes (and this happened several times each typical night), or ran in higher numbers, or exceeded (my OWN personal limit) of 14 seconds, I would look to them being related to my well-being or the success of my treatment, or how rested and invigorated I feel next morning. 


They might show up on the RERAs.  This is what I meant about looking into the reports more comprehensively.  Duration is important, but only if, apparently they exceed 10 seconds.  For someone with hypopneas, RERAs, the odd obstructive, and several strung CA's, maybe even 10 seconds is too much, and certainly 14 and on upward.  But, with an AHI as low as the OP's I'd say 10-14 seconds, as few and as far-between as they are, are going to be of no great significance.