Need help evaluating results

[MightGuy]

Thanks in advance for any input or feedback.

About 8 months ago I was diagnosed with moderate sleep apnea after taking an at-home sleep test which reported an AHI of 25. I initially sought treatment mainly due to complaints from my wife about loud snoring where she mentioned it sounded like I was choking. I've fought insomnia my whole life but wasn't necessarily feeling like my sleep was any worse than usual when I talked to the nurse practitioner who ordered the sleep test.

I was prescribed a DreamStation Auto CPAP and it was initially set up with a fixed pressure of 7. I started using the DreamMapper app and noticed that my AHI was typically between 7-12 each night after about 3 months of use. When I asked the prescribing NP about it, she referred me to a sleep specialist to handle it instead. I had one telemed appointment with them and the doctor asked me to send in the data from my machine. After evaluating it, they had me bring my machine in and they changed the settings to automatically adjust with a min of 4 and max of 20. It seemed to make the AHI go down but I don't feel any better. In fact, after starting to use the machine, I have felt less rested than I did before I was ever diagnosed. I've thought that I might still be trying to get used to sleeping with it on but it's been nearly 9 months and I feel like my sleep is just getting worse each week.

I've attached a screenshot for a recent night from the data from my machine. Most nights my AHI is ~5-10 which from my understanding means I'm still suffering from Apneas.
   

[staceyburke]

You will get some excellent advice here. The main thing I see is the low number is 4. It needs to be raised to 8 and may need to go higher depending on your graphs. 2nd is leaks some are quite high, you need to adjust the mask WHILE in the sleep position you will be in not while you sit on the bed.

The 4- 20 is considered “wide open” 4 is the lowest the machine and 20 is the highest. Doing this makes it impossible for the machine to change quick enough to get rid oh events. That is WHY you need to raise the bottom number. Post tomorrow and tell us how you are FEELING along with the OSCAR charts

[MightGuy]

You will get some excellent advice here. The main thing I see is the low number is 4. It needs to be raised to 8 and may need to go higher depending on your graphs. 2nd is leaks some are quite high, you need to adjust the mask WHILE in the sleep position you will be in not while you sit on the bed.  

The 4- 20 is considered “wide open” 4 is the lowest the machine and 20 is the highest. Doing this makes it impossible for the machine to change quick enough to get rid oh events. That is WHY you need to raise the bottom number. Post tomorrow and tell us how you are FEELING along with the OSCAR charts

I'll try that and post back tomorrow. Thanks for the input.

[MightGuy]

Okay, here is the screenshot from last night. The AHI is definitely improved and I did feel like I could breath better but the leaks appear to be about the same.

I tried adjusting the mask a bit tighter but it was pretty snug before last night and now it's getting fairly uncomfortable. I tend to roll from side to side when I sleep and it seems like this causes the mask to shift on my head/face, not a lot but enough that I'll notice it leaking if I'm awake. I'll see if I can adjust it anymore or maybe I need to start testing out different masks.

I felt a little better this morning getting out of bed but not much. I'm not feeling any more alert or rested today than I have in the past few months, but I suspect that it would take some pretty consistent nights of good sleep before I really felt better.

Thanks again for your feedback.

   

[staceyburke]

That is much better I would leave it for a couple of days and if things do get better we will move up a little more but I think you need to see how this works first. When you wake tomorrow take some notes about HOW you feel. We could do better but you are doing pretty good now let’s see if you begin to feel better. As har as the leaks - if you mask feels to tight it probably is. You want it just snug enough to stop leak but over tighten and it causes more leaks. At the bottom you can go to the mask primer.

[jaswilliams]

Your leaks look great there is no issues with your leaks, you see the second green line on the leak graph, it’s not until that second green line gets much higher you have to worry

[MightGuy]

Your leaks look great there is no issues with your leaks, you see the second green line on the leak graph, it’s not until that second green line gets much higher you have to worry

Are you referring to the bottom line? I'm actually trying to read up on the wiki about evaluating leaks right now.

[jaswilliams]

Yes the bottom line, on a Philips machine they report all leaks (the top green line) this includes intentional leaks ie the leak caused by the mask vent.

The bottom green line is a visualisation of the non intentional leaks. If the Philips machine has what it classifies as a large leak an event is recorded in the events line you have had none of those.


The only other time leaks would be an issue is if they wake you up in that case they would then need addressing

[MightGuy]

Okay, it seems that maybe things aren't much better yet. Here's the captures from the last 3 nights. Each morning I've felt like crap getting out of bed and was tired all day.

   
   
   

[Sleeprider]

You are one of the lucky souls with positional apnea. Actually, there are many like you on this forum, and there are a whole bunch that solve this problem with a soft cervical collar. Other than that, i'd go with a higher minimum pressure of 9.0. Please read:
Positional Apnea http://www.apneaboard.com/wiki/index.php...onal_Apnea
Soft Cervical collar http://www.apneaboard.com/wiki/index.php...cal_Collar