(07-03-2017, 05:22 PM)robysue Wrote: June 25 data (http://imgur.com/a/ZbgkV)

My first guess is that you never really got to sleep during that third session (the one from 23:50 to 0:55).  And that you finally gave up, threw the mask off, and went to sleep without it.  If that's the case, then all those events scored during that session probably are not real, and there's no need to jump immediately to the You Need More Pressure bandwagon.

The flow rate on the first session has rather large spikes and it would not surprise me if you were awake fighting for sleep during this entire 30 minute session.

So that's my first question: How much of the first and third sessions represent "I was awake, but fighting to get to sleep" breathing?

The second session is the interesting one: It looks to me like your breathing might be settling down into sleep breathing around 22:50 and I think there probably is some real sleep breathing 22:30 and 23:30.  The reason I think that is that there is a whole lot less "spiky-ness" to the graph in that period.  The flow rate in high quality sleep breathing has very few spikes in it and the numbers for the peak inhalations and exhalations are not as large as those of wake breathing.

The leaks during this second session are good, but not great.  And I mean "good enough to not worry about" if that's what most of your leaks look like.

But something went badly wrong after you put the mask back on at a bit before 23:50.  My guess is that you just could not get back to sleep, possibly because of a leak that you just could not seem to fix.  And in all that tossing and turning, you were partially holding your breath or simply doing a lot of wake breathing that got mis-scored as Hs. Which increased the pressure, which in turn increased your discomfort and also made the leak get worse. All of which made it even more difficult to get back to sleep.

Now there's also just a chance that cluster of CAs right at 0:00 are an indication that you finally fell asleep HARD. And then started having a ton of obstructive events as well as either mouth breathing or a mask leak caused by a combination of facial relaxation and increased pressure.  In that case, your min pressure may be too low.

This day's data leads to these questions:

1) What was your diagnostic AHI? And how many of the events were listed as Central or Mixed Apneas instead of obstructive apneas?

2) Did you have a formal titration study? If so, what pressure setting was recommended after the study?

3) How uncomfortable are you when you are first trying to get to sleep with the mask on? What makes you uncomfortable? Be as specific as possible.

(07-03-2017, 05:06 PM)robysue Wrote: First comment: Why no daily data from June 29 and June 30?

Now for the stuff you're really wanting:

Overall comments
1) The overall AHIs are too high, but you knew this already.  

2) There are a bunch of things that stand out, and not in a good way, in your data.  Lots of CAs on some nights. Lots of OAs or Hs on other nights.  What was your original diagnosis? Simple OSA? Or did you have clinically significant numbers of CAs on your diagnostic and/or titration studies? It makes a big difference in trying to evaluate your daily data.

3) Leaks appear to be a real problem on some nights.  Leaks need to be investigated. What mask are you using? And do you think you mouth breath at night?

4) Usage is appears to be a huge issue. Best night has just over 7 hours of mask time, but there is a 50 minute gap in the middle of the night on that night.  So you're obviously NOT sleeping much with the mask. So that begs the question: How much sleep are you getting without the mask each night?  

5) Bedtimes are drifting. You started out with three nights where you went to bed between 9pm and 10pm. The other three nights show bedtimes of 11pm, 1am, and 11:30.  

6) Mask off times are very erratic: It seems like you are taking the mask off and presumably returning to sleep without it on many of these nights.

So you're not off to a great start.  Lots of folks have rough starts, and we can help you sort it all out.

I will post more impressions on each night's data separately.