Need help understanding my Nov. 23 charts, pls.

[kingskid]

Here is a sample Nov 12 night:
http://imgur.com/a/G0jay

Here is a sample Nov 23 night:
http://imgur.com/a/TcgND

I sleep well, but started CPAP because my breathing would sometimes stop at night. I've included my sleep test results of a year ago. I am a shallow breather and am almost always congested on one side of my nose or the other. I really like my AirSense 10 for Her and the P10 pillows. When I look at the charts, even after a year on CPAP, my AHI is good, but I don't know what the individual charts are telling me. So frustrating to be so dense! Have been wondering if I need to set a EPR? I started out with straight CPAP at 7, which is where my titration was set. Then I decided that since I had an APAP to let the machine figure out what I needed and set some low and high settings (forget what they were). However, maybe my settings were off, but it's like I fought with the machine all night, so went back to straight 7. Now I'm at 7 - 9.6 and even 7-9 worked okay. Anyway thanks for any help in trying to understand my individual charts!

Sleep Summary (Entire Night)

Total Time in Bed (Minutes) 427.7
Total Wake Time “ 66.0
Wake after Sleep Onset “ 36.0
Sleep Onset Latency “ 30.0
REM Onset Latency “ 70.5
Total Sleep Time “ 361.7
Sleep Efficiency 84.6%
Number of Awakenings 8

Sleep Stage Summary Normal%

Stage 1: Latency (min.) = 0.0; Time (min.) = 11.0; %TST= 3.0 7 ± 5%
Stage 2: “ “ = 3.0; “ = 70.5; “ 19.5 45 ± 5%
Stage 3: “ = 15.0 “ = 185.2 “ 51.2 20 ± 15%
Stage 4 “ = 0.0 “ 0.0
REM “ = 70.5 “ = 95.0 “ 26.3 20 ± 5%

Respiratory Disturbances
Mean
# Index Saturation Longest Time (min.)
OA 6 1.0 10.0 10.0 1.0
MA 0 0 0 0 0
CA 9 1.5 10.0 10.0 1.5
APNEA# 15 AI: 2.5
HYP 122 20.2 10.0 10.0 20.3
A+H# 137 AHI: 22.7
RERA 0 0 0 0 0
A+H+R# 137 RDI: 22.7

Oxygen Saturation Summary

Avg. SaO2 Total 90%
Avg. SaO2 REM 89%
Avg. SaO2 NREM 90%
Lowest SaO2 70%
SaO2 < 89% 83.7
%TIB SaO2 < 89% 19.6

Cardiac Summary

Mean NREM Hr: 77.9
Mean REM Hr: 78.2

[Sleeprider]

Kingskid, use the links in my signature to help you organize your Sleepyhead charts in a useful way. It appears you have mostly CA events, but the charts you posted lack the information needed to really be able to help you much.

Your sleep study shows you had both obstructive and central sleep apena events, with considerable hypopnea. That you are achieving less than 2 AHI with treatment is very encouraging. The third link in my signature is an article that discusses how to interpret the Sleepyhead data. Feel free to read thorough that. We really need to see different charts with Events, Flow, Pressure, Snores and Flow Limitation. The left side summary (Use F8) also has important information.

[DariaVader]

the congestion is showing up on the charts as flow restrictions, is my guess. What have you done to try to alleviate the congestion? I use xlear nasal spray every night, half hr before bed so nose is dry - that helps me a lot

What is left after treatment is centrals, but there aren't enough of them to need treatment - seems like the low pressures are right for you.

[robysue]

Here is a sample Nov 12 night:
http://imgur.com/a/G0jay

Here is a sample Nov 23 night:
http://imgur.com/a/TcgND

I sleep well, but started CPAP because my breathing would sometimes stop at night. I've included my sleep test results of a year ago. I am a shallow breather and am almost always congested on one side of my nose or the other. I really like my AirSense 10 for Her and the P10 pillows. When I look at the charts, even after a year on CPAP, my AHI is good, but I don't know what the individual charts are telling me. So frustrating to be so dense!

What are you wanting know about the charts? Except for the flow limitation graph, the ones you posted are not really critical to determining if your therapy is going well or not. Indeed the Respiratory Rate, Tidal Volume, and Expiratory Time are really only of interest if you have some kind of a known medical problem (other than OSA) that affects your breathing.

Have been wondering if I need to set a EPR? I started out with straight CPAP at 7, which is where my titration was set. Then I decided that since I had an APAP to let the machine figure out what I needed and set some low and high settings (forget what they were). However, maybe my settings were off, but it's like I fought with the machine all night, so went back to straight 7. Now I'm at 7 - 9.6 and even 7-9 worked okay.

Not everybody is more comfortable with variable pressure. If you are more comfortable sleeping with fixe pressure and a fixed pressure of 7cm controls your apnea, it's fine, even preferable, to use fixed pressure mode on your machine.

As for EPR: If you feel as though you have trouble exhaling against the pressure, sure, turn EPR on and see if it's more comfortable for you. But if you're comfortable with your machine's current settings, there's no special reason to turn EPR on.

Bottom line is How are you feeling? And that's the one thing you didn't tell us. Are you still having problems getting to sleep or staying asleep? Are you still waking up not feeling particularly rested? Are you still dealing with a lot of daytime fatigue?

[kingskid]

Thanks, will keep trying.

[kingskid]

Kingskid, use the links in my signature to help you organize your Sleepyhead charts in a useful way. It appears you have mostly CA events, but the charts you posted lack the information needed to really be able to help you much.

Your sleep study shows you had both obstructive and central sleep apena events, with considerable hypopnea. That you are achieving less than 2 AHI with treatment is very encouraging. The third link in my signature is an article that discusses how to interpret the Sleepyhead data. Feel free to read thorough that. We really need to see different charts with Events, Flow, Pressure, Snores and Flow Limitation. The left side summary (Use F8) also has important information.

----------------------
Ok, will re-read that info. Thanks.

[kingskid]

the congestion is showing up on the charts as flow restrictions, is my guess. What have you done to try to alleviate the congestion? I use xlear nasal spray every night, half hr before bed so nose is dry - that helps me a lot

What is left after treatment is centrals, but there aren't enough of them to need treatment - seems like the low pressures are right for you.

-------
Thanks Daria. I've tried Xlear several times, but haven't noticed anything different. Yes, I think the low pressures work really well. My AHI is always under 2, mostly under 1. My main concern is if I am breathing deep enough while asleep. My O2 saturation during my sleep test got pretty low. I can't tell from the charts. May need to get an oximeter?

[kingskid]

Here is a sample Nov 12 night:
http://imgur.com/a/G0jay

Here is a sample Nov 23 night:
http://imgur.com/a/TcgND

I sleep well, but started CPAP because my breathing would sometimes stop at night. I've included my sleep test results of a year ago. I am a shallow breather and am almost always congested on one side of my nose or the other. I really like my AirSense 10 for Her and the P10 pillows. When I look at the charts, even after a year on CPAP, my AHI is good, but I don't know what the individual charts are telling me. So frustrating to be so dense!

What are you wanting know about the charts? Except for the flow limitation graph, the ones you posted are not really critical to determining if your therapy is going well or not. Indeed the Respiratory Rate, Tidal Volume, and Expiratory Time are really only of interest if you have some kind of a known medical problem (other than OSA) that affects your breathing.

Have been wondering if I need to set a EPR? I started out with straight CPAP at 7, which is where my titration was set. Then I decided that since I had an APAP to let the machine figure out what I needed and set some low and high settings (forget what they were). However, maybe my settings were off, but it's like I fought with the machine all night, so went back to straight 7. Now I'm at 7 - 9.6 and even 7-9 worked okay.

Not everybody is more comfortable with variable pressure. If you are more comfortable sleeping with fixe pressure and a fixed pressure of 7cm controls your apnea, it's fine, even preferable, to use fixed pressure mode on your machine.

As for EPR: If you feel as though you have trouble exhaling against the pressure, sure, turn EPR on and see if it's more comfortable for you. But if you're comfortable with your machine's current settings, there's no special reason to turn EPR on.

Bottom line is How are you feeling? And that's the one thing you didn't tell us. Are you still having problems getting to sleep or staying asleep? Are you still waking up not feeling particularly rested? Are you still dealing with a lot of daytime fatigue?

Thanks Robysue. I feel more confident about having a good pressure range after the comments here. My main concern is the SAO2 of 70 that I got during my sleep test. I don't think that was an anomaly since I have awakened fighting to breathe more than once prior to CPAP therapy. I try to do diaphragm breathing exercises before drifting off to sleep, but once I'm asleep, it's probably back to normal breathing. Guess I don't need an EPR of more than 1 (default setting?), and always have plenty of energy and feel just fine. Only concern is if my brain and heart are getting enough O2 while I'm sleeping, and if not, what to do about it....

[Crimson Nape]

kingskid,
You might try playing with the EPR to reduce the Flow Limits. My Flow Limits resembled yours, if not worse, until I tried using the EPR feature. Now my Flow Limit graph looks like peach fuzz on a bad day and blank on a good one. The worst thing that can happen is it doesn't work for you. I use to operate under the assumption that the EPR was for comfort only and didn't serve a purpose until you got into the Bilevel models with higher pressures. . . Boy, Did I destroy my belief in that! . . .I guess next I'll find that there's no Easter bunny too.

[robysue]

kingskid,

If you are worried about the O2 levels while using CPAP, you could invest in a recording oxymeter that is compatible with Sleepy Head. They're not that expense.