Screenshots to verify I am reading SleepyHead correctly?

[ShelaghDB]

I am now back to normal, or as close to it as normal, as i have gone back to the CPAP setting on my AutoSet. The settings are exactly as they set my "brick" up but we wanted to have me get back her and then start to work with my settings slowly.

I was going through the room with apneas a few days ago but it was to be expected as the settings I had guessed at were all wrong for me.

I "think" they are ok but i am admittedly, not sure IF i am reading these graphs etc properly.

Can someone plea verify for me what they are getting from what they see here and then I will know if I am right or not and maybe have a question or two....

I am very curious about the small window that shows my apnea event numbers. Whether this is good or bad
I see, what i think is, a window that says I have had 31 apneas.....but then in the smaller events window, I see what says 173 obstructive events so I am admittedly somewhat confused.....

I feel great if that helps? ;-)














T.I.A

[justMongo]

You slept about 6 hours and had an AHI (Apnea-Hypoapnea Index) of 30.17 per hour.
6 x 30.17 = about 181.

You are confusing apneas per hour with total apneas for the sleep period.

Is 30.17 AHI good -- not from what I've seen.
On this forum they speak of a goal of under 5 per hour.

[xxl]

30.17 is your average events per hour. Your 173 was your total for your session of 6.33 hours. From looking at your average for your last 7 days it has come down from about 46 events per hour to near 30. This is an improvement but far from where you should be. You should be trying to get your AHI number below 5. It also appears that the machine is ramping up to 10 in straight CPAP mode with relief pressure of 1. If it were me, I would be wanting to put the unit in AUTO mode and expand your min and max pressures. My min is set at 12 and my max at 16. Also I may set the EPR to 2. Yes this is my personal formula and may not work for you. You could try setting your min to 8 and max to 16? I know that some set the unit up for a 4 min and 20 max.

[zonk]

I,m not a doctor or been in a medical school or any high school for that matter but if were me,
I would set the machine on auto 10 - 20 and see what that brings. Maybe fine tune pressure range at some stage
Hopefully the machine treat the obstructive events and not causing any central events in the process but will cross the bridge when come to it

[becker44a]

. . .
I was going through the room with apneas a few days ago but it was to be expected as the settings I had guessed at were all wrong for me.

I "think" they are ok but i am admittedly, not sure IF i am reading these graphs etc properly.

Can someone plea verify for me what they are getting from what they see here and then I will know if I am right or not and maybe have a question or two....

I am very curious about the small window that shows my apnea event numbers. Whether this is good or bad
I see, what i think is, a window that says I have had 31 apneas.....but then in the smaller events window, I see what says 173 obstructive events so I am admittedly somewhat confused.....

Over the course of the night, SH is reporting the following:

Sleep time: 5 hrs 56 min (5.933 hrs)
Obstructive events = 173
Clear Airway events = 6
Total apneas = 179

We can then calculate as follows:
AHI = Total Apneas / Sleep time = 179 / 5.933 = 30.17

This agrees with the AHI reported by Sleepyhead. The average number of Apnea events was over 30. One way to look at this is: you averaged about one event every 2 minutes. Another is: if this was the result of a sleep study, you would be diagnosed with "Severe Sleep Apnea".

The AHI categories are:
0 - 5: Normal
5 - 15: Mild
15 - 30: Moderate
Above 30: Severe

The flow graph shows several significant clusters of events, and looks a lot like mine did before I started doing things to avoid sleeping on my back. I would suggest you try some of the techniques mentioned on this board, as they don't involve much expense, and might reveal something significant:
* Wedging firm pillows behind your back as you lie on your side.

* One or more tennis balls on the back of a tee shirt (duct tape can be used for a temporary test).

* Wearing a backpack or something like it, loaded with various lumpy or uncomfortable objects, like tennis ball cans, plastic dog toys.

* Etc.

Whether your apnea is positional or not, you need to work to find some means to achieve lower AHI numbers, as the accepted target of 5 is far below (one-sixth) your score for this night.

It is pretty clear that 10cm pressure isn't enough to prevent most of your obstructive events, but based on your earlier experiences with Auto mode, I would leave the machine's settings alone for now, and try these other experiments.

Hope this helps.
A.Becker

[robysue]

I,m not a doctor or been in a medical school or any high school for that matter but if were me,
I would set the machine on auto 10 - 20 and see what that brings. Maybe fine tune pressure range at some stage
Hopefully the machine treat the obstructive events and not causing any central events in the process but will cross the bridge when come to it

ShelaghDB has tried Auto mode and she found it "hellish" to try to sleep with. She is one of the group of patients who really does not do better in Auto mode.

She's had to work hard to figure out how to get back to where she was with the Escape: She can sleep with constant pressure, but the Escape was not set at her titrated pressure, it was set several cm below the titrated pressure.

[zonk]

I,m not a doctor or been in a medical school or any high school for that matter but if were me,
I would set the machine on auto 10 - 20 and see what that brings. Maybe fine tune pressure range at some stage
Hopefully the machine treat the obstructive events and not causing any central events in the process but will cross the bridge when come to it

ShelaghDB has tried Auto mode and she found it "hellish" to try to sleep with. She is one of the group of patients who really does not do better in Auto mode.

She's had to work hard to figure out how to get back to where she was with the Escape: She can sleep with constant pressure, but the Escape was not set at her titrated pressure, it was set several cm below the titrated pressure.

I,m aware of that, I was the one who suggested for her to try the same setting she had on the Escape as a starting point to gather some data. But now in light of the data that been presented which clearly shows to me the setting is far optimal so my suggestion of the AutoSet mode
But anyway, I have already stated that I,m no expert and always read the signature below the black line 'Take everything with a grain of salt and evaluate on your own'

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE EVEN WHEN COMING FROM A MEDICAL PROFESSIONAL. ALWAYS SEEK THE ADVICE OF YOUR OWN PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

[ShelaghDB]

Thanks, at least now i know for sure..........I thought my numbers had come down.......that what was confusing me...

When I look at the first photo, I see AHI 30.17 with Obstructive as 29.15, Clear Airway 1.01
Then I looked at events and saw 173 events.

My numbers were far worse a week ago.
These are better by comparison.
As for my numbers, one week ago I had much higher central apneas

Now I plan on trying to sleep on my side and do other tricks that have been mentioned here to me but i needed to get back to where I was most comfortable before i started or I would not have had any idea of where I stood.

But as i have been doing this, I haven't yet quite figured out how to read all these charts properly as you can now see, hence, my questions.

I appreciate the advice from many of you, s suggesting my setting my machine at the same levels you have but for now I want to be sleeping as comfortably as i can since the last week was not any fun and while i do this, before i make any changes, I want to make sure i fully know how to read the software and know what I am looking at.
Once I am fully comfortable on my own and don't need to start a thread for every move I make, I will personally, I believe take
robysues advice that was given a few days ago, about moving my machine up a notch here and t here and keep going until I am where I should be.

Unlike robysue, I am not yet convinced that i can't handle the AutoSet and must always stay at CPAP but at least i do know for sure, at the same time i had changed everything all at once. I am hoping that once i take the changes slowly, it will work better. Plus i will understand what I am doing.

I am also on temporary medication that can create central apneas so I also have to be aware of them spiking and am watching for that reason too.

In any event thanks for the comments. I should have explained a bit better first that they were better than what i had a week ago.
And yes, I understand 5 events is what people judge to be the best but after a few weeks on a machine Id be a bit foolish I believe to think I could have reach that spot so quickly.

Last but not least, in reference to the person that suggested that my numbers would bring upon a description of Severe Sleep Apnea during a sleep test, BINGO..........they did!

The doctor was also ware from my charts that I brought that the weight gain was quick sudden and temporary and in his opinion, my sleep apnea, albeit Severe, he believed will right itself completely with the lost weight.
The weight is already starting to drop off of me but it will take several months to do it properly so i am not in a big rush show 5 events a night.
But even on the sleep tests i slept on my back and they forgot to tell me to get onto my side.....I didnt know....

[robysue]

ShelaghDB,

As others have pointed out to you, the data indicates that you had 173 OAs during the entire night, and that it works out to an average of 31 apneas per hour.

On an diagnostic sleep study, an AHI greater than 30 lands you in the severe OSA category. So clearly your therapy is not yet optimal. Out of curiosity, what was your AHI on your diagnostic sleep test?

As I recall from another thread, your old Escape was set to 10 cm but your titrated pressure was actually 13. That goes a long way in explaining the bad data here.

Now for a "how to read my SH data" lesson. Let's look at this window you posted:

Do you see each of those light blue tick marks in the Events table and superimposed on the Flow Rate graph? Each tick mark indicates the exact time one of the 173 OAs happened. Some of the tick marks are thicker than others because the OAs were happening so close together that the individual tick marks run together.

The machine was turned on at 0:37. The first cluster of events starts less than 30 minutes after you go to bed. That's probably way too soon for the first REM cycle unless you have some kind of REM-related disorder as well as OSA, but you haven't said anything about that. So That's probably not what caused that cluster.

Were you still awake around 1:00? Had you just fallen asleep? And did you fall asleep on your back? Those are all relevant to figuring out why that cluster of events was recorded.

The second large cluster that starts at 2:30ish might be REM. But the cluster lasts longer than a typical early in the night REM cycle does. Again, the question becomes, were you on your back? Were you restless?

The very last cluster that starts around 5:30 might also be REM related. Or supine sleep related. Or restlessness.

But I think the most likely reason there are still so many OAs being scored is that your AutoSet is set to 10cm and your titrated pressure is 13cm.

In the long run you're likely going to need more pressure. Since Auto mode on the AutoSet really disturbed your sleep and you are feeling better now that you've switched back to CPAP mode because you are at least sleeping through the night now, it's reasonable to have a plan to slowly work on titrating the pressure up where it needs to be long term.

I would suggest that you consolidate the sleep right now: The dial winging in Auto mode caused some serious sleep problems as I recall. So you need to get at least 3-6 more days of sleep at the current pressure before you do anymore dial winging. You need to be extremely comfortable with sleeping with the PAP at 10cm before you increase the pressure up to 11cm. After you bump the pressure up to 11, if you have no trouble sleeping at 11cm, leave the machine set at 11cm for another 3-4 days and then bump the pressure up to 12cm. Again, if you continue to sleep ok with the machine set at 12cm for 3-4 nights, then bump the pressure up to 13cm.

If you have serious problems sleeping at a NEW pressure at any point in this process of slowly increasing your fixed CPAP, try lowering the pressure by only 0.5 cm instead of 1cm and see if that's enough to allow you to once more sleep comfortably with the machine.

The idea is to make slow changes to the PAP pressure so that you continue to feel like you are sleeping all night long. As you continue to sleep with the machine and slowly increase the pressure your AHI should start to come down. By the time you have been using 13cm for a week or two, your AHI should be down in the normal range (below 5.0).

Since Auto mode was hellish for you, it's important for you to keep your eye on the long term picture: If it takes you a few weeks to gently train yourself to sleep with the pressure you need, you'll be better off just doing that rather than trying to dial wing in Auto mode creating additional problems with your sleep and never getting to the point where you can comfortably sleep with the machine set to a pressure range that is therapeutic for you.

[zonk]

I am also on temporary medication that can create central apneas so I also have to be aware of them spiking and am watching for that reason too.

From: http://www.mayoclinic.org/diseases-condi...n-20030485

Drug-induced apnea. Taking certain medications such as opioids — including morphine sulfate (Ms Contin, Avinza, others), oxycodone (Oxycodone HCL, Oxycontin, others) or codeine sulfate — may cause your breathing to become irregular, to increase and decrease in a regular pattern, or to temporarily stop completely.