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Long time cpap'r with new machine - confused. - Printable Version

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Long time cpap'r with new machine - confused. - aucivil - 03-05-2017

My history:  Diagnosed via sleep study in 2003.  Had a 90.  Been using a ResMed S7 cpap ever since.  Did mess with the setting and increase the flow a few years back.  Believe the original was set a 11 and I blindly bumped it up to, I think, 16 maybe 17.  

My original cpap started failing so I contacted the prescribing physician to see about getting a new machine.  It had been so long, I was no longer in their system.  They would not write a prescription without me coming back in (understandable).  Appointments were about two months out.  Would probably have to go through another sleep study.  Probably the best way to proceed but I didn't want to go through the aggravation, time and process to get a machine.   

Looked around and boy the machines have changed.  I opted to acquire a Resmed Airsense 10 Autoset on my own and downloaded Sleepyhead software.  I've had it for two nights with the following setup:

Machine Settings
Mode APAP
Minimum Therapy Pressure 7.00 cmH2O
Maximum Therapy Pressure 20.00 cmH2O
Antibacterial Filter No
Climate Control Manual
Exhale Pressure Relief Off
Humidifier Enabled Status On
Humidity Level 2
Mask Setting Nasal
Patient Access Yes
Ramp Enable Off
Machine auto starts by breathing Off
ClimateLine Temperature 27 ºC
ClimateLine Temperature Enable 2

Downloaded My first two nights of data (below) and have no idea what I'm looking at but they don't look too good based on the Hypopnea reading dominating the pie chart (whatever that means).

AHI - 1.65
Large Leak 0.81%
Clear Airway 0.22
Obstructive 0.11
Unclassified Apnea 0.11
Hypopnea 1.21
RERA 0.11


AHI - 1.79
Large Leak 0.60%
Clear Airway 0.00
Obstructive 0.22
Unclassified Apnea 0.00
Hypopnea 1.57
RERA 0.22

Need to be educated because as I prefer to get this set up on my own.  Is there a good document to help interpret Sleepyhead data, to read up on what all this means and what I need to adjust?  Or maybe point me in the right direction.   Dont-know
 
Thanks for any info.

RE: Long time cpap'r with new machine - confused. - OpalRose - 03-05-2017

Actually, your numbers are pretty decent.  A slight pressure increase would take care of the hypopneas.  You can raise it to 7.5 and see if that makes a difference.

What is the 90% pressure reading on #SleepyHead?
Try to set your pressure range to 2cm below and 2cm above that number.

Here is a link to help with SleepyHead.
http://www.apneaboard.com/wiki/index.php?title=Beginner%27s_Guide_to_SleepyHead

Also notice you have large leaks. This could be from your mask or mouth breathing.

Once you get a couple more posts (you need 4), follow the tutorials in my signature line to post a screenshot here.

RE: Long time cpap'r with new machine - confused. - Sleeprider - 03-05-2017

aucivil, once you have 4 posts you will be able to post screenshots of your therapy data. The links in my signature below this post describe how to organize charts and post the data. As Rose said, an AHI less than 2 with predominately hypopnea is very good, and can probably be fully resolved with a bump in minimum pressure. We often recommend within 2 cm of the 90% pressure, but setting it equal to your median or average after a few nights should work fine for the Autoset.

Good luck.

RE: Long time cpap'r with new machine - confused. - aucivil - 03-05-2017

(03-05-2017, 08:47 AM)OpalRose Wrote: What is the 90% pressure reading on sleepyhead
Try to set your pressure range to 2cm below and 2cm above that number.

Is this what you are talking about?

From statistics box

Pressure   Min     Med     95%     Max
Day 1       6.00    11.88   17.88    19.66
Day 2       6.00    11.48   16.64    18.56

RE: Long time cpap'r with new machine - confused. - OpalRose - 03-05-2017

(03-05-2017, 09:04 AM)aucivil Wrote:
(03-05-2017, 08:47 AM)OpalRose Wrote: What is the 90% pressure reading on sleepyhead
Try to set your pressure range to 2cm below and 2cm above that number.

Is this what you are talking about?

From statistics box

Pressure   Min     Med     95%     Max
Day 1       6.00    11.88   17.88    19.66
Day 2       6.00    11.48   16.64    18.56


Yes, that's what I was talking about.  Wow, I'm surprised that you have such good results with such a wide pressure range.  

Definitely need to adjust the minimum pressure.  Being that your 95% reading is higher than I thought it would be, I would go with SleepRiders advice and set closer to Median pressure.  Try a range of minimum 11 or 12 and max setting left at 20.

It will be interesting to see your graphs when you are able to post.  I'd hate to see your max pressure bumping up close to 20 for any length of time.  Sometime when folk have to use higher pressures, it may be a good idea to talk to your doctor about a bipap machine so that you are more comfortable.

RE: Long time cpap'r with new machine - confused. - aucivil - 03-05-2017

(03-05-2017, 09:14 AM)OpalRose Wrote: Sometime when folk have to use higher pressures, it may be a good idea to talk to your doctor about a bipap machine so that you are more comfortable.

That'd be some bad luck.  I just bought this machine - would hate to have to buy another so soon.
(03-05-2017, 09:00 AM)Sleeprider Wrote: aucivil, once you have 4 posts you will be able to post screenshots of your therapy data.  The links in my signature below this post describe how to organize charts and post the data.   As Rose said, an AHI less than 2 with predominately hypopnea is very good, and can probably be fully resolved with a bump in minimum pressure.  We often recommend within 2 cm of the 90% pressure, but setting it equal to your median or average after a few nights should work fine for the Autoset.  

Good luck.

Thanks

RE: Long time cpap'r with new machine - confused. - aucivil - 03-05-2017

I will post the screenshots asap

RE: Long time cpap'r with new machine - confused. - aucivil - 03-05-2017

(03-05-2017, 08:47 AM)OpalRose Wrote: Once you get a couple more posts (you need 4), follow the tutorials in my signature line to post a screenshot here.

It list me as having 4 post but when I try to post the screenshots it says I need 4 post before I can post images.  I'll try after this post.

RE: Long time cpap'r with new machine - confused. - aucivil - 03-05-2017

[Image: screenshot-20170305-084848-XL.png]

[Image: screenshot-20170305-083555-XL.png]

RE: Long time cpap'r with new machine - confused. - Sleeprider - 03-05-2017

Looks great so far, and I'll stick with my recommendation for a minimum pressure at 11.0. You are not using EPR, and I think it's best to stick to one change at a time. So after getting established at the higher minimum pressure, you might want to try EPR (exhale pressure relief). I think it makes CPAP treatment much more comfortable as it gives 1-3 cm pressure relief during exhale, and makes your machine a bilevel limited to 3 cm pressure support. FWIW, I usually have AHI less than 1, but have had a number of 1.4-1.8 this week. Point being, you're doing fine.

On the charts, you're nearly perfect, but trade the mask pressure for flow limitation.