Hi, introduction and my experiences [Recommendation on settings?]

[robysue]

Does [my data] look typical for what you have seen with your or other sleep data?

The overall data based on the events table and the left side bar data indicate that on paper your therapy is going exceptionally well. Many people do not see AHI's this low *ever*. Your 95% Leak Rates on both nights are excellent---the 95% Leak Rate is 0.0 L/min on both nights, which indicates that the machine is detecting no excess leaking for at least 95% of the night. Lots of people don't see leak numbers that well even after becoming experienced PAPers.

The snippets of zoomed in data that you post mostly show stable, regular sleep breathing with a few isolated apneas on 3/28 and one isolated apnea on 3/29. On both nights you can see the ASV algorithm kicking in during the apneas and on 3/28 there's also some evidence of the ASV algorithm kicking in around 5:19-5:20 where the breathing is ragged, but no apneas are actually scored. (That by the way is right around the time you report the mild seizure.) On both nights, there's also evidence of the Auto EPAP algorithm kicking in and deciding to increase the EPAP by 1cm (at a time). Most likely those increases in EPAP are caused by snoring or flow limitations that are not shown in the data you posted.

And it appears that you're getting plenty of sleep with the machine: Your usage both nights is over 9 hours.

In other words, if you were a newbie with no issues other than run of the mill OSA, complex sleep apnea, or even idiopathic central sleep apnea, the data you've posted would be considered excellent. And people would say that your therapy is highly effective, at least on paper---as in your settings look just about perfect based on the data. Certainly my nightly data is no where near this good on a regular basis.


You specifically ask:

On Monday, around 5:20am (I didn't exactly note the time, which would have been greatly helpful), there was a very mild siezure, more like an aura, which is just a sense that one is approaching.
...
I'm wondering if you see anything interesting in this data.

There is something interesting in your data for 3/28 (Monday night) that starts around 5:19. I've boxed that in on the marked up copy of your data below:



Notice how the breathing is very ragged in the red box when compared to the normal, very regular sleep breathing that precedes this time frame. When the breathing becomes this irregular, the machine starts to react by increasing the IPAP, but not the EPAP. You can see this in both the Pressure Graph (which shows your IPAP pressure smoothed out over several breaths) and the Mask Pressure Graph (which shows the actual pressure in your mask at each instant.) That's the ASV algorithm kicking in: It's working hard on preventing a potential CO2 overshoot/undershoot cycle from starting and it's working hard to try to stabilize your breathing. Right after the end of red box your breathing stabilizes (quite quickly) and machine drops the IPAP pressure back down to a more normal non-ASV IPAP pressure for your settings.

It is quite possible that the breathing anomaly in the red box is related to your mild seizure in some way. Whether the seizure caused the funky breathing or the funky breathing caused the seizure is way above my pay scale---I'm just your run of the mill math professor at a pretty ordinary state comprehensive university. But it's just possible that the ASV algorithm is doing what your doc wants it to do here: Perhaps the reason the seizure was just a mild one is the ASV: Maybe the ASV stepping in and helping to stabilize your breathing is at least partially responsible for keeping the seizure mild. In other words, it's possible that the seizure may have been much worse if the ASV had not stabilized your breathing as quickly as it did.

[sam496]

-I'm just your run of the mill math professor at a pretty ordinary state comprehensive university.

Please don't underestimate your self ! I read the whole thing (not that I completely understood it) and not only did you take the trouble to review the concerns in detail and did a very good job in looking at the data and zooming in on event and giving very plausible reasons for it but also I think actually helped to placate the concerns of the OP. you also quite rightly IMO stressed that the OP should consult with her Doctors.

an interesting post Thanks