3 Sleepy Head graphs

[me50]

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can you tell what my minimum mask pressure was during this sleep period?

I noticed that my pressure jumped up to 19.7 during a leak, even though the leak was within the normal range. I pretty much disregard this pressure as it was not due to an actual event.

Also, I see a line going down in the mask pressure graph at 23:30 that goes down to the line that says 8 and again at around 4:30 AM and this line is a broken line. Anybody know what that means? I have seen this before (maybe not the broken line though) and it isn't when I turn the machine off and then start therapy again. Not worried about it but am curious what it means.

Another thing that I noticed is that my machine reported a central just before I woke up and for the first time that I have noticed, the pressure increased. Should I have it checked to see if the machine is behaving as it should?

Your thoughts are welcomed.

[robysue]

can you tell what my minimum mask pressure was during this sleep period?

The minimum mask pressure spikes look like artifacts. I'd just ignore them. Technically the minimum mask pressure should be equal to your minimum pressure setting minus your EPR setting. Out of curiosity: Did you change the EPR setting between the session(s) that run from the beginning of the night to about 2:00 and the last (two?) sessions that runs from about 4:15 to 5:30ish? The latter sessions look as though EPR was either turned off or set to 1. The earlier sessions clearly have EPR = 3.

I noticed that my pressure jumped up to 19.7 during a leak, even though the leak was within the normal range. I pretty much disregard this pressure as it was not due to an actual event.

Pressure can be increased (sometimes dramatically) due to snoring and flow limitations. Can we see the snoring graph, the flow limitation graph, the leak and the pressure graph all at the same time? It would also help to zoom in on the graphs right around the leak.

If I had to make a blind guess, I'd guess that there's some activity going on in the FL graph that's driving the pressure increase.

Also, I see a line going down in the mask pressure graph at 23:30 that goes down to the line that says 8 and again at around 4:30 AM and this line is a broken line. Anybody know what that means? I have seen this before (maybe not the broken line though) and it isn't when I turn the machine off and then start therapy again. Not worried about it but am curious what it means.

I suspect those are just graphing glitches or atifacts in the data. Anomalies do happen in the data.

Another thing that I noticed is that my machine reported a central just before I woke up and for the first time that I have noticed, the pressure increased. Should I have it checked to see if the machine is behaving as it should?

Again, we need to see the FL graph and the snoring graph. If there were FL or snoring going on around the time of the CA, then that's why the machine increased the pressure.

[me50]

the earlier sessions before about 4 AM were set at EPR 2 so yes, you are correct. Hope this is what you wanted me to do. I don't usually zoom in on the graphs

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[robysue]

me50,

Could you try to resize the SleepyHead graphs so they all appear togeher like this:

The graphs that would be most useful to include are the flow rate (wave flow), and the pressure, leak, and flow limitation graph. A ten minute window showing the pressure increase would be ideal.

Note that the pressure graph is a bit easier to work with than the "mask pressure" graph. The top curve in the pressure graph is the therapeutic setting, which is the pressure at the start of the inhalations. The bottom curve is the pressure on exhalation: On a Resmed S9, its value is the therapeutic setting minus the EPR setting. On a BiPAP, that top curve would be called the IPAP curve and the bottom one is the EPAP curve.

The mask pressure graph shows you the effect of EPR on each and every breath cycle. The value of the peaks in in the mask pressure curve equal the therapeutic setting. The value of the valleys equal the therapeutic setting minus the EPR setting.

So the top pressure graph gives the overall picture of what's happening with the therapeutic pressure setting----the value of the peaks in the mask pressure graph.

In my graph there is an offset between the mask pressure graph and the pressure graph. My data is very old, and at the time I was using an S9, there was a great deal of discussion on the forum sponsored by Vendor #1 about the fact that on S9s, the pressure graph and the leak graph would display obvious offsets relative to the wave flow graph. (The mask pressure graph does not show up in the default set of graphs in ResScan.)

[me50]

robysue I am not sure how to do that. I did think I gave you the 4 graphs you asked to see and thought I showed you the timeframe you asked for. Sorry.

[robysue]

robysue I am not sure how to do that. I did think I gave you the 4 graphs you asked to see and thought I showed you the timeframe you asked for. Sorry.

Here's a step by step set of instructions on how to turn the graphs that SleepyHead displays on and off.

Once you are into the daily data window, look for the menu in the lower left hand that I've circled in the figure below:


If you click the mouse once when it is hovering over this menu, you should get a full menu of all the available graphs for that day's data. the menu will look something like the one in the next image:

Note how some of the items on the menu have a bar that is half green and half black and others have a bar that is half red and half black. Any graph with a green bar will be displayed in the Sleepy Head window. Any graph with a red bar will NOT be displayed. To turn a graph off, move the mouse to the appropriate graph name and click the mouse once. The bar will turn red and the graph will go away.

The next image shows what happens when I select the AHI graph that had a green bar in the previous image and click the mouse. Note how the bar by AHI is now red and the AHI graph is no longer shown.


The graphs that I want to see are:

• the event table
  
• the flow rate (wave flow) graph
  
• the pressure graph
  
• the leak graph
  
• the flow limitation graph
  
• the snore graph

I'd also like to see about 10 minutes or so of data with the pressure increase sort of near the center of the 10 minute window. The graphs you posted earlier are zoomed in too close to really see what's going on.

Turn off all the the other graphs since they are not needed to figure out why your pressure level is increasing when there are no apneas or hypopneas being flagged in your data.

To see all five of the desired graphs, you will need to resize the vertical dimension of the graphs. To do this, you need to put the cursor on or near the bar that separates the graph you want to resize from the graph immediately below it. The location of the bar for resizing the Flow Rate graph is highlighted in the next image:

You will need to move the cursor around until it becomes cross shaped. Then click the mouse and drag the bar in the appropriate direction to make the graph smaller or larger in the vertical direction.

NOTE: If the cursor looks like a little fist, you'll be moving the graph up or down in the list of graphs rather than resizing it. It may take some patience to figure out exactly where to put the mouse for resizing the graph instead of moving graphs around. If you mess up, you can always hit the "Reset" button at the bottom of the Sleepy Head graphs towards the left side of the graphs:


Recall that I'd like to see the following graphs:

• the event table
  
• the flow rate (wave flow) graph
  
• the pressure graph
  
• the leak graph
  
• the flow limitation graph
  
• the snore graph

The vertical height of each of these graphs except for the Flow Rate does not need to be very large. So you can make room for all the graphs by reducing the vertical size of everything except the Flow Rate graph. Leave it at the default size so that the shape of the inhalations can be seen.

Hopefully this is enough information to help you make a plot that shows me the data that I want to see to answer your question.