New User - Hello - Some Questions

[Lucidwan]

Hello everyone.

I'm new to this OSA thing, and everything that comes with it.

I had a test about 12 years ago, I was young and busy. I was asked to come back for a second test and never followed through.
Fast forward to today. As I explained in my first post (a reply to Thread-Giving-up-after-6-long-weeks ) I've had sleep issues for quite some time. In the last few years, I've really started having bad sleep problems, and health problems (not sure which is causing which.)

So several mos ago, I, after much nagging from my wife , finally went to the doctor which I'd been putting of and putting off for years now.
I'm working on a lot of issues, this one on the advice of my Doc, and other docs, has moved to the top of the list.

Here's some of my info if anyone is interested.

I'm 40, a bit overweight but not much maybe 20lbs.

My sleep study info was this:
I had a rough night to say the least, but manage to sleep some
in that environment strangely enough.
443 mins in bed with total sleep time of 286.5 mins for sleep efficiency of 64.8%. Sleep latency normal at 15.7 mins.
Rem latency prolonged at 206 mins
Stage 1 @ 8.6%, Stage 2 @ 45%, Stage SWS at 28.6%, Stage REM at 17%
Loud Snoring throughout study.
AHI Severely elevated at 47.5% - 89 Hypopneas, 138 OSAs no central or mixed.
Apnea index 28.9/hr, Hypopnea index 18.6/hr. AHI lateral pos was 15.3/hr, Supine 88.5. NREM AHI 43.1/hr, REM AHI 68.5/hr.
Lowest desaturation 86%
Spontaneous Arousal Index 12.5.

Summary was as follows - Loud snoring with decreased sleep effciency of 64.8%, severely elevated overall AHI of 47.5hr that increased in REM to 68.5hr with lowest oxy desat at 86%. Sleep latency was normal at 15 mins and REM latency prolonged at 205.5 mins. No significant restless leg movements, periodic limb movements or cardiac dysrythmia noted.

I've briefly looked at definitions of this stuff, it was enough that my Doctor was really concerned and pretty much told me I was going to die in my sleep if I don't get some type of treatment. He called the sleep clinic in the exam room lol and pretty much demanded they get me in that night. They squeezed me in about 3 days later.

I got my machine about 5 wks ago.
Fisher & Paykel Icon Auto + set at 11 (I've enabled APAP & Senseawake 8.5 - 12.5 atm - I was waking constantly with panic, wanting to pull it off. That's getting better but I turned these on to see if it'd help with it - 2 days and I think it may be helping..we'll see).
Heated Hose & Humidifier at 30.
I'm now using a Resmed Quattro FX after a couple of nasal pillows and masks. I seem to be able to keep this one on. I was pulling the nasal's off as well as the chin strap.

So I managed to obtain the data reading software for my machine. I'm hoping maybe someone can explain some of these things:

What is Flow Limitation? It varies from 0 to 4 or 5, with sometimes 20 up to 39. Is this the hose getting kinked or something?

What is System Leak?
Median 39-40
90% Percentile 30-40%
typical for both...some times as high as 80 or 100. Is this from the mask leaking? Is it leaking at all times? Is the vent on the mask part of this?

Sorry to be so long winded.

Thank you for having this site. The information and support is a great thing for newbies.

[Sleepster]

The mask does have some intentional leak, probably about 30 L/min, but it depends on the mask and pressure. Over and above that you have the unitentional leak from where the mask meets the face. You want to keep this below about 30 L/min also. So your total leak shouldn't go much above 60 L/min.

I can't tell from your data report how aften you're doing this as I'm not familiar with the way your machine reports leaks. Maybe someone else here can help you with that.

Flow Limitation - Partial closure of the upper airway, which impedes the flow of air into the lungs.

I also can't tell what your AHI is from your data report. You want to try to get that below 5. That is, 5 events per hour. Each event is either a hypopnea (partial closure of your airway) or an apnea (when you stop breathing due usually to a total closure of the airway).

At this point you want to concentrate on wearing your mask whenever you're asleep. You want to get your brain acclimated to sleeping while you're wearing the mask. Hopefully after a couple of weeks or so you'll start to notice a difference in the way you feel. Meanwhile maybe someone else here can help you figure out what your data report means.

[trish6hundred]

Hi Lucidwan, First of all, WELCOME! to the forum.! I don't know the answers to your questions but I will say, just keep trying and don't give up on CPAP therapy,in spite of the fact that it gets discouraging and frustrating but just keep trying to work with it. Hang tight and someone will be along with more suggestions to help you.

[zonk]

Check the manual for answers to your questions. You can request the manual via Email (section three, other manuals)
http://www.apneaboard.com/adjust-cpap-pr...tup-manual

Have you seen the Icon video
http://vimeo.com/20560260

I suggest make an appointment with your sleep doctor for a followup
Flow limitation is more like mini-apnea
S9 AutoSet adjust pressure in response to snoring and flow limitation which can precede an apnea

F&P web site is useless. Unlike ResMed they don,t provide enough information about their machines so I don,t recommend the Icon

[Lucidwan]

Thanks Sleepster, that makes much more sense. So I'm having some airway closings. I think the leakage is probably a bit high.

thanks for the info Zonk, I actually have seen the videos. They're great and all, but of course, F&P won't let you adjust anything or view it with software. I fixed that issue thanks to info on this site, and I've asked for a copy of that manual.
I do have a copy of their software. I can't find a copy of the music software - smartstick studio however.
I'm not totally sure I have a choice of machine based on how my insurance works. They're renting the machine for some set time, at which it's mine if I'm still using it. I had NO input, other than 30 days to figure out which mask works for me.
I can't complain because I paid 70 bucks for it. Every 3 mos they send me new mask, tube and consumables for $20.

I've uploaded a report I generated if anyone is interested - (I can't post links yet, so remove the space after https)

https ://docs.google.com/open?id=0B-LzhTmHIK2ZZ2VXLTN1WldueWs

[zonk]

Thanks for posting the report. I have not seen Icon report before

https://docs.google.com/open?id=0B-LzhTm...TN1WldueWs

[zonk]

Glossary (last page of the report)

[Lucidwan]

Yeah I saw the glossary and it's good info.
It doesn't really explain exactly what flow restriction is, or if leakage includes the vented air. (And based on how they don't give out software for thier equipment, I understand why).

Sleepster explained it for me.

I actually used the machine for 6.5 hrs last night That's a first.
I attribute it to turning on APAP and Senseawake - fully.

Thanks again for the help. I see NO reason why the patient isn't allowed a few cm of adjustment by default, or even allowed to turn things like Senseawake on (on the ICON specifically). With the information I gained from this site, I was able to help myself & not involve the others, who, for the most part, take your cash, give you a complicated piece of medical equipment & send you on your way.

[Sleepster]

I'm not totally sure I have a choice of machine based on how my insurance works. They're renting the machine for some set time, at which it's mine if I'm still using it. I had NO input, other than 30 days to figure out which mask works for me.
I can't complain because I paid 70 bucks for it. Every 3 mos they send me new mask, tube and consumables for $20.

But you are paying your insurance premiums and so is your employer in exchange for the work you do as an employee. You deserve to get what you're paying for. Call your insurance company and ask them if you can get a machine you'll be happy with.

I've uploaded a report I generated if anyone is interested

Every day it looks like the percent time in excessive leak is 0% so that's good. Also, your AHI is averaging below 5 so that's good, too. This indicates to me that your therapy is working.

You should discuss any concerns you have with your doctor and your equipment provider.

[Suzanne]

Thanks Sleepster, that makes much more sense. So I'm having some airway closings. I think the leakage is probably a bit high.

thanks for the info Zonk, I actually have seen the videos. They're great and all, but of course, F&P won't let you adjust anything or view it with software. I fixed that issue thanks to info on this site, and I've asked for a copy of that manual.
I do have a copy of their software. I can't find a copy of the music software - smartstick studio however.
I'm not totally sure I have a choice of machine based on how my insurance works. They're renting the machine for some set time, at which it's mine if I'm still using it. I had NO input, other than 30 days to figure out which mask works for me.
I can't complain because I paid 70 bucks for it. Every 3 mos they send me new mask, tube and consumables for $20.



I've uploaded a report I generated if anyone is interested - (I can't post links yet, so remove the space after https)

https ://docs.google.com/open?id=0B-LzhTmHIK2ZZ2VXLTN1WldueWs

Hi Lucidwan,

I have a Fisher & Paykel ICON Premo and would like to know how to get downloads myself. I did not get any software when I bought the machine, just the USB stick. The downloads that you posted look just like the ones you posted. My supplier prints them from the computer at their office and I take them to the sleep doctor when I go, but I would like to be able to get them myself.
How did you get the software?
Thanks,