Newbie Sleepyhead report feedback please!

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
billy1
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Newbie Sleepyhead report feedback please!

Post by billy1 » Mon Apr 23, 2018 4:26 pm

Hello all
I've been on CPAP for almost two years but only discovered the forum and sleepyhead a couple months ago. I have had pretty good results in terms of what I feel, but would love to get some general feedback from the community on what my data shows and would like to know what I can improve to get my AHI down. On here it seems like a "good" outcome is between 0 to 1. I'm usually sub 3 at best. Also, I use fixed pressure. When I started reading the forum I tried APAP but my AHI jumped up to the neighborhood of 5. I'm including an APAP and fixed rate report.

I also think my leak rate is high from what I've seen written about others' reports. I usually wake up with the mask on my face. I guess this means I'm breathing out of my mouth and should try a chinstrap or taped mouth.

Can you all confirm the above and let me know if there's anything else I should do to improve things?
Thanks!
Billy
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Pugsy
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Re: Newbie Sleepyhead report feedback please!

Post by Pugsy » Mon Apr 23, 2018 4:41 pm

Welcome to the forum.

First of all your leak rate is just fine for your machine, your mask and your pressure. It's well within the machine's ability to compensate. You have to understand how your machine reports leaks and the Respironics machines report total leak which is the mask's expected vent/intentional leak plus any excess leak. That top leak line.
Don't try to compare your leak numbers to a ResMed leak report because ResMed machines report only excess leak numbers.

As long as you aren't seeing a bunch of prolonged LL flags in the Events graph....LL is large leak...or the leaks aren't waking you up...don't worry about them.

Mentally remove the Clear Airway Index (Centrals) from your AHI evaluation...you can't fix them with your machine even if they are real and probably some aren't real but even if they were all real you aren't having enough of them to do anything about them.

Try 0.5 to 1.0 cm more fixed pressure and see if the hyponeas and the RERAs reduce. Use fixed mode since you like it best.
Evaluate your therapy not only by the "numbers" but by how you are sleeping and feeling during the day.
Your report isn't horrible and once the CAs are removed...even less ugly but the RERAs and the hyponeas seem to point to maybe slightly less than optimal therapy. I would try to clean them up if it were me...and just a little more pressure will probably do the trick.

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palerider
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Re: Newbie Sleepyhead report feedback please!

Post by palerider » Mon Apr 23, 2018 8:13 pm

Turning your flex setting down may help with both the centrals and the hypopneas.

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TedVPAP
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Re: Newbie Sleepyhead report feedback please!

Post by TedVPAP » Mon Apr 23, 2018 8:37 pm

If it were me, I would work to get my AHI lower and then you can decide if the lower AHI correlates with feeling better.

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billy1
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Re: Newbie Sleepyhead report feedback please!

Post by billy1 » Mon Apr 30, 2018 5:49 pm

Thanks all.

TedVPAP
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Re: Newbie Sleepyhead report feedback please!

Post by TedVPAP » Mon Apr 30, 2018 9:06 pm

billy1 wrote:
Mon Apr 30, 2018 5:49 pm
Thanks all.
That is a lame update :) . Come on man, tell us how you are doing.

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Last edited by TedVPAP on Mon Apr 30, 2018 9:35 pm, edited 1 time in total.
Use data to optimize your xPAP treatment:
how to see your data https://sleep.tnet.com/resources/sleepyhead
how to present your data https://sleep.tnet.com/resources/sleepyhead/shorganize
how to post your data https://sleep.tnet.com/reference/tips/imgur

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palerider
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Re: Newbie Sleepyhead report feedback please!

Post by palerider » Mon Apr 30, 2018 9:27 pm

TedVPAP wrote:
Mon Apr 30, 2018 9:06 pm
billy1 wrote:
Mon Apr 30, 2018 5:49 pm
Thanks all.
That is a lame update :) . Common man, tell us how you are doing.
Aren't you supportive...

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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

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Bill44133
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Re: Newbie Sleepyhead report feedback please!

Post by Bill44133 » Mon Apr 30, 2018 10:44 pm

Your reports looks sloppy.. I am thinking if take your 13 fixed pressure to 14 it should clean it up. I always say if you are going through the trouble of sleeping with the mask and machine you want your therapy to be the best it can be.

i wish you well.. :)

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billy1
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Re: Newbie Sleepyhead report feedback please!

Post by billy1 » Mon Jun 18, 2018 7:00 pm

Sorry for the delay and lack of an update. I have somewhat of an excuse which is I had surgery to fix my deviated septum. So it's taken a while to recover and to be able to implement the suggestions, which I appreciated. I've also had time to read the basics and I'm finding those useful as well, so thank you Pugsy and everyone else for taking the time to write all this stuff down. I was also worried about mouth breathing, so tried tape and a chin strap, but I'm going to go with the general approach of not worrying about it.

So, the update. After the surgery I stuck with fixed pressure and tried to see if I needed less to get the same results, which was my hope since my nasal passages were pretty narrow. That hasn't yet been the case. Even at my previous fixed level, 13, my AHI was still above 3 and sometimes well above. I had a handful of bad nights of sleep. After a couple of weeks I switched to APAP since that seems like the norm on this board, and I thought I'd let the machine try to figure out what pressure I should be at. It was also suggested in the comments that I try a little more pressure to try to reduce the hypopneas and RERA's (which was helpful to know what to look for). I moved up to 14-18cm, and the machine hovers around the low end through the night, and spikes to 15/16 at a few points during sleep. Unfortunately, I haven't seen any improvement. In fact my numbers got a little worse. My obstructive and hypopnea numbers total around 4, and I'll get an occasional RERA of between 0.0-0.5. And I feel less well-rested. Before, with AHI's from 2.0-4.0, I was feeling pretty good. So I still need to try to figure out what is going on.

I haven't adjusted the flex setting and am going to try that starting tonight. I might also go back to fixed pressure but get a few more nights sleep at each setting before changing anything. I'm basically starting over to try to find the right pressure and settings.

If anyone has any thoughts on this I would certainly appreciate it. And I'll write back quickly this time!
Thanks again for the earlier feedback.

billy1
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Re: Newbie Sleepyhead report feedback please!

Post by billy1 » Mon Jun 18, 2018 7:02 pm

I should add, I definitely feel like I'm getting more air through my nose after the surgery. So it should take less pressure, unless it's really the throat that needs to be maintained open. But maybe the increased airflow is messing with me. Not sure if that makes sense, but trying to intuit what is happening post surgery.

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Pugsy
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Re: Newbie Sleepyhead report feedback please!

Post by Pugsy » Mon Jun 18, 2018 7:06 pm

It really is the throat area. You didn't have surgery on the throat area of the airway to fix floppy tissues. That area behind the tongue and down below the tongue a bit. That areas wasn't changed. Yeah, it's getting more air now but the tissues are just as floppy and saggy as they ever were.

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Jas_williams
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Re: Newbie Sleepyhead report feedback please!

Post by Jas_williams » Mon Jun 18, 2018 11:47 pm

billy1 wrote:
Mon Jun 18, 2018 7:00 pm


If anyone has any thoughts on this I would certainly appreciate it. And I'll write back quickly this time!
Thanks again for the earlier feedback.
Pop up a new daily graph for us to review and we will see if anything stands out

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billy1
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Re: Newbie Sleepyhead report feedback please!

Post by billy1 » Thu Jun 28, 2018 2:16 pm

Hello all. Posting some notes here and an updated chart. First, yes, I know I know the surgery doesn't solve the main problem in the back of the throat. But my rationale was that if I improved the nasal airflow for the cpap then I would need less pressure. Maybe not. Still, it has improved my daytime breathing. I lowered the flex setting to 1 and continued with fixed pressure of 13.0. The weeks following the cpap flex change have felt much better. AHI's have been between 2.0 and 3.0 in the last week. I've attached the two most recent reports. Sleepyhead said I had too much leakage. I use a nasal mask, the dreamwear. Any thoughts are welcome. I can still try increasing the pressure as suggested before to see if that helps. I really appreciate the feedback and any suggestions for what I can do to improve the outcome. Thanks again everyone.
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Pugsy
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Re: Newbie Sleepyhead report feedback please!

Post by Pugsy » Thu Jun 28, 2018 4:24 pm

I don't see a big problem with leaks. Your machine isn't flagging any Large Leaks either. See the LL on the Events graph? That's large leaks per your machine. If it doesn't flag it...it didn't happen despite the SH statistic saying to the contrary.

Did you ever change SleepyHead's default red line from the ResMed 24 L/min to something more appropriate for your Respironics machine?
It's not the same as the ResMed 24 L/min that SleepyHead defaults to.

Respironics never gives us an exact red line number like ResMed does. That's because the large leak boundary line varies with mask and pressure used. My past experience with Respironics machines has indicated to me that large leak territory boundary line is probably at least twice the 24 L/min of ResMed and maybe even more.

Either turn off the statistic or alter the red line number to something more closely in tune with a Respironics machine at your pressures and 70 L/min probably would be a good conservative estimate. When I was using the Respironics machines I never say a large leak until I hit 90 L/min total leak (top leak line in SH).

To change it....Preferences/CPAP tab and either turn that feature off and just rely on the Events graph flagging so change the 24 to something around 70 L/min. It's for sure higher than 65 because you are hitting 62 total leak and not getting a LL flag.

Now if those leaks are disturbing your sleep then that's another thing but in terms of being qualified for large leak...not happening on these 2 reports anyway.

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Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

billy1
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Location: USA

Re: Newbie Sleepyhead report feedback please!

Post by billy1 » Thu Jun 28, 2018 7:21 pm

Thanks Pugsy. Other than the leaks, or lack of a leak problem, does the rest look ok? Would you recommend increasing the pressure to bring down the hypopneas? These are good scores for me in my two year history of using the machine so I feel pretty good about it. And I know you all believe scores aren't everything. Thanks again.