Interpreting The Numbers

I feel like the dog that finally caught the pickup truck he’d been chasing. Now that I’ve got it, what do I do with it?

I’ve been on treatment since Dec 18. I think it’s going well, mainly thanks to this group. I slowly built up to wearing the mask all night, and I’ve passed nine hours a few times. I rarely take the mask off anymore before the alarm goes off.

Since I get zero feedback from the VA, I decided to buy the software. Besides, I really like toys and gadgets! I bought Encore Pro from cpap.com, and the reader from 4factors. Again, this group saved me some money. I didn’t figure out that the reader was going to come from Hong Kong, and it was a frustrating two weeks after the software arrived. I got it all installed, thanks to the excellent instructions provided by Sleepy-in-AL. Thank you for taking the time for writing this up! I did have a little difficulty getting the card reader to work, because the instructions didn’t address the one from 4factors. I finally found a post that said that the correct driver was on the Encore Pro CD, and it worked fine after I installed this driver.

So, now I have downloaded the data, and created reports. What’s next? Here are my numbers from last night (From MyEncore):

Treatment mode: CPAP with C-Flex at 7.0 cm. H2O
Apnea/Hypopnea Index (AHI): 9.7 events/hr.
Total Obstructive Apneas: 31
Total Hypopneas: 59
Total NR Apneas: 0
Total Snores: 892 (Where does THIS come from?)
Total Flow Limitations: NA
Total Time in Apnea: 378 sec.
Fraction of Night in Variable Breathing: 25.4%
Obstructive Apnea Index (OAI): 3.35
Hypopnea Index (HI): 6.38
NR Apnea Index (NRAI): 0.00
Snore Index (SI): 96.4
Flow Limitation Index (FLI): NA
Average Apnea Duration: 12.2 sec.



It is all pretty, but I haven’t found much information that tells me what I’m looking for. So, how do I look? Is the AHI high? If any of the numbers are not what is desired, what do I change to correct them? I do have the setup instructions for the CPAP, so I am able to make any changes I want.

I want to say again how much I appreciate the positive support and excellent advice so freely offered here!

Sam

RAINSUX wrote:I feel like the dog that finally caught the pickup truck he’d been chasing. Now that I’ve got it, what do I do with it?

I’ve been on treatment since Dec 18. I think it’s going well, mainly thanks to this group. I slowly built up to wearing the mask all night, and I’ve passed nine hours a few times. I rarely take the mask off anymore before the alarm goes off.

Since I get zero feedback from the VA, I decided to buy the software. Besides, I really like toys and gadgets! I bought Encore Pro from cpap.com, and the reader from 4factors. Again, this group saved me some money. I didn’t figure out that the reader was going to come from Hong Kong, and it was a frustrating two weeks after the software arrived. I got it all installed, thanks to the excellent instructions provided by Sleepy-in-AL. Thank you for taking the time for writing this up! I did have a little difficulty getting the card reader to work, because the instructions didn’t address the one from 4factors. I finally found a post that said that the correct driver was on the Encore Pro CD, and it worked fine after I installed this driver.

So, now I have downloaded the data, and created reports. What’s next? Here are my numbers from last night (From MyEncore):

Treatment mode: CPAP with C-Flex at 7.0 cm. H2O
Apnea/Hypopnea Index (AHI): 9.7 events/hr.
Total Obstructive Apneas: 31
Total Hypopneas: 59
Total NR Apneas: 0
Total Snores: 892 (Where does THIS come from?)
Total Flow Limitations: NA
Total Time in Apnea: 378 sec.
Fraction of Night in Variable Breathing: 25.4%
Obstructive Apnea Index (OAI): 3.35
Hypopnea Index (HI): 6.38
NR Apnea Index (NRAI): 0.00
Snore Index (SI): 96.4
Flow Limitation Index (FLI): NA
Average Apnea Duration: 12.2 sec.



It is all pretty, but I haven’t found much information that tells me what I’m looking for. So, how do I look? Is the AHI high? If any of the numbers are not what is desired, what do I change to correct them? I do have the setup instructions for the CPAP, so I am able to make any changes I want.

I want to say again how much I appreciate the positive support and excellent advice so freely offered here!

Sam

Your AHI is a bit high for my liking, I'd increase pressure by 1cm and get it down below 5 (AHI=<5).

Your current AHI=9.7, that is the SUM of both Apnea + Hypopnea. If you add up your individual AI and HI scores they should equal the AHI=9.7

Your OA (obstructive apneas) =3.35 per hour, and your HI (hypopnea) is 6.38 also a bit high, you can get those lower.

I would suggest increasing pressure from 7.0cm to 8.0cm and seeing what that AHI does. It should eliminate those 3.35 per hour apnea.

If that 7cm was given by a PSG, it should have been the pressure that handled your worst-case SDB, it is clearly not. You are pretty safe increasing to 8.0 even if you are at risk of CA/MA events.

You probably won't notice the difference by increasing it.

Thanks, Snoredog. I'll turn it up tonight. Should I expect immediate results, or will it take a few days?

Sam,

What was your titrated pressure?

From the data you posted, I suspect you need higher pressure.

The one number that jumps out at me is that at 7 cm you have a snore index of 96.4. Yikes! That is high! Ordinarily, the CPAP should largely eliminate snoring before it effectively controls apneas and hypopneas. This suggests to me that you may need a pressure several notches higher than 7.

Wayne

RAINSUX wrote:Thanks, Snoredog. I'll turn it up tonight. Should I expect immediate results, or will it take a few days?

I would think you should feel better, your residual AHI remains pretty high, by lowering it you spend less time not breathing for better quality of sleep.

You have to remember when they found that 7cm pressure, that was for only 1 night. We can have good and bad nights so needing a higher pressure doesn't mean your disorder has gotten worse.

[quote="WNJ"]Sam,

What was your titrated pressure?

From the data you posted, I suspect you need higher pressure.

The one number that jumps out at me is that at 7 cm you have a snore index of 96.4. Yikes! That is high! Ordinarily, the CPAP should largely eliminate snoring before it effectively controls apneas and hypopneas. This suggests to me that you may need a pressure several notches higher than 7.

Wayne

I hate to admit that I'm not sure what Titrated Pressure means. I just know that the sleep doctor recommended the setting of 7.

Where does the machine get the Snore Index? It doesn't have a microphone, does it? My wife says she doesn't hear me snoring anymore. But I hear HER! If it uses a microphone it is probably hearing her.

I'm going to set it to 8 tonight, and I'll watch the Snore as well as the AHI.

Thanks! I'll get the hang of this before long.

Sam

Sam,

“Titrated pressure” is the pressure that was determined to be best for you during the sleep study. Apparently it was 7 cm.

But, the titrated pressure was determined from one night’s sleep, and you may not have had a “typical” night of sleep in a strange bed with all the wires attached etc.

The way titration typically works, I think, is they start at 4 cm and increase the pressure gradually until they get the decrease in apneas, etc., that they’re looking for. Relatively speaking, you get a short time at each pressure.

While this normally works out okay, it is possible that they got a bad result.

If bumping up the pressure a bit (maybe as high as 10 or 11, one step at a time, two or three nights at each pressure) doesn’t give you much improved results, you should speak to your doctor about the problem.

I think the machine detects snoring by the vibration of the air column it is feeding you under pressure. I’m sure it would not detect your wife’s snoring.

Wayne

Sam-
what was your leak rate? You high AHI might be due to mouth leaks.
You might need to get your leak rate under control.


Maryb

WNJ, you're right. That was not a very good night. I had problems with the mask leaking, and it rained out at least once. I like the idea of slowly increasing the pressure.

Maryb, my leak rate is 21. I'm pretty sure that I keep my mouth closed all night, but when I roll over I sometimes have to readjust the nasal pillows. 21 looks fairly low on the scale.

Sam

21 is a very good leak rate.

My UMFF "leaks" in the high 40's when it's well sealed.

The air coming out the exhaust is included in the leak rate, so you don't want a zero rate. That would mean you were getting no air.

Wayne

The first night increasing pressure from 7 to 8, my snores went way down, the lowest it's ever been, my HI went up, around the middle of my range, and my OAI went down some, but still on the high side of my range. I'm going to leave the settings alone for a couple of nights and see what happens.

I think I was having to work a little harder to exhale. If this continues I will raise the CFlex a notch.

Sam

Hiya,

I was just wondering how the machine measures snore rate is it sound or vibrations? Also the Snore Index is this just an arbitary scale?

Thanks

I'm pretty sure it's vibrations. If it had a microphone it would be hearing my wife and my readings would be very high! My SI has been much lower for the last two nights, around 10. I think I have been "snorting" to clear my sinuses, creating an air column vibration, and I've tried very hard not to do this. It seems to be working! The apnea scores were better last night, too, and I didn't experience the exhale problem. We're going on a trip this weekend, so I'll probably leave the settings alone until we gat back.

Sam