app1nag - Therapy Assistance Thread

[justMongo]

I'm /guessing/ that the top line is flow and the bottom one pressure. Both flat lines last for 8 seconds or less, too short to score as either obstructive or central apnea. The little bumps in pressure are probably Resmed's attempt to differentiate between OA and CA; the tiny bumps in flow might indicate an incipient CA - which you aborted by starting to breathe. If that's all you found, no problem. If there are lots of those, then probably toning down the drink should take care of it. One night is not the rest of your life.

I hope others more experienced will comment as well.

Yes, less than 10 seconds is not scored; and the FOT wave starts at 4 seconds. The flat-topping on the inhalation waveform suggests an obstructive event.

[Sleeprider]

doesn't a flat line like these indicate an issue?

Too short for a CA with Resmed. I'm pretty sure Respironics would have scored at least a hypopnea. The surrounding breathing pattern looks like a period of arousal rather than deep sleep.

On your flow rate graph, right click in the left margin near the label and select the Dotted Lines option, then check Zero. This will add a dotted line at the zero flow which is where no inhale or exhale is occurring. Everything above the line is inhale and everything below is exhale. It really helps me to interpret the graph, and it might be useful to you. Notice how that pause in breathing occurs at the end of an inhale rather than exhale? I think you'll find most OA events occur at the end of exhale.

[app1nag]

thanks very much for all this information !

[app1nag]

Is there any correlation between large leaks and low AHI numbers? I've been using a WISP mask and the leak #s while not high enough to give me a sad face on my Airsense, are still higher than I think they should be. However, my AHI has been less than 1 for many weeks. Last night I tried nasal pillows and my leaks were very low, but my AHI was 1.47, which is still a good # compared to 20 without therapy. I'm wondering now if the AHI #s that I've been seeing with the WISP are not accurate because of leakage.

Thanks !

[Sleeprider]

The machine relies on its pressure sensor to detect respiration (inhale/exhale), the tidal volume and minute vent, and the presence of an open or closed airway. As leakage rises above the expected intentional mask vent-rate, the feedback becomes more ambiguous, resulting in undefined events and likely missed hypopneas. At very large leak rates the machine does not detect any events. So the answer to your question is that the detection of events is less reliable at higher leak rates, and likely biased to a lower number of detected events.

If you're happy with nasal therapy, have you tried nasal pillows? Leaks tend to be much easier to control.

[app1nag]

yes. In my post I stated that I tried pillows last night and got higher AHI...thanks for the feedback.

[Doc J]

I would trust the results with low leakage, 1.47 is a good start. I'm a big pillow fan for a lot of reasons, low leaks and comfortable. I've been away so forgive me if you have already talked about your pressure range. Do you need that big of range? I'm a fan of 4-5 range. Anything too low causes events too high will cause leaks? I was prescribed pressure of 17 and watching noticed my machine was running 11 to 12 with great results so I slowly backed off to 10-15 range with super low AHI.

Good work on paying attention to data and trying new things never hurt anyone.

[app1nag]

[attachment=2015]my Autosense has gone close to 20 on occasion so I think my higher setting is ok...

[Canuck 2]

Is there any correlation between large leaks and low AHI numbers? I've been using a WISP mask and the leak #s while not high enough to give me a sad face on my Airsense, are still higher than I think they should be. However, my AHI has been less than 1 for many weeks. Last night I tried nasal pillows and my leaks were very low, but my AHI was 1.47, which is still a good # compared to 20 without therapy. I'm wondering now if the AHI #s that I've been seeing with the WISP are not accurate because of leakage.

Thanks !

Another check for you would be to see if the machine is set for pillow mask instead of nasal mask.

[Sleepster]

Is there any correlation between large leaks and low AHI numbers? I've been using a WISP mask and the leak #s while not high enough to give me a sad face on my Airsense, are still higher than I think they should be. However, my AHI has been less than 1 for many weeks. Last night I tried nasal pillows and my leaks were very low, but my AHI was 1.47, which is still a good # compared to 20 without therapy. I'm wondering now if the AHI #s that I've been seeing with the WISP are not accurate because of leakage.

There's no clinically significant difference in those values of the AHI. It's very important to keep your leaks under control, much more important than that small difference in AHI.

You are correct in your observation about the smiley face. You need to look at the leak graph and make sure you're not experiencing significant periods of high leak. They will ruin your sleep quality.