Introducing Me!

[Pugsy]

Normally we do an old fashioned screen shot of the image of the detailed report.
Upload it to some place like Photobucket and put the IMG code address in the body of a post her or private message.
You see the code first...use the preview button to see if the image shows up..then submit.

We talk about it here and there are some examples you can see.
viewtopic.php?f=1&t=81072&p=737779#p737779

[UKTony]

Thanks for the mask tip... I'll take a look at that once I figure out if I'm leaking?!

As for making heads or tails of the data, I have the following AHI data:

Code: Select all

10th - AHI 14.55 / H 8.16 / OA 5.92 / RERA 0.64 / PBCSR 1.07% / Clear Airway 0.48
11th - AHI 15.66 / H 6.00 / OA 9.00 / RERA 4.96 / PBCSR 2.29% / Clear Airway 0.65
12th - AHI  9.13 / H 4.64 / OA 4.35 / RERA 3.33 / PBCSR 1.57% / Clear Airway 0.14
13th - AHI  7.35 / H 4.61 / OA 1.15 / RERA 1.44 / PBCSR 0.66% / Clear Airway 1.58

Now bear in mind I have no idea what all of this means, in clinical terms... but it looks like it's getting better as I become more comfortable with the Darth Vader setup.

Cheers

Tony.

[UKTony]

Thanks Pugsy... which graphs should I post, which are most useful to me and others?

Tony

[Pugsy]

I like the detailed graphs..like this one.
First go to Preferences (upper left under File) and then graphs tab. Remove the check mark for the AHI graph. It's redundant information and moves the Leak below the viewing area.
Main important graphs...the left side with the AHI break down and on the right side these graphs.
Events
Flow Rate
Pressure only if you are using auto adjusting pressures
Leak
All those other graphs below leak...don't really matter at this point. Later as you learn more you can tackle those...the norms are widely variable and not really needed to evaluate basic therapy right now.
So it looks like this. You won't have dual pressure lines...I have a bilevel machine...you don't.

[UKTony]

OK... let's see if this works.....

[Pugsy]

That works.

Do you know if your OSA happens to be worse when on your back or during REM?
Wait..you said REM was never achieved...

Okay, any many in the reports (if you have seen them if you had a lot more OSA events when sleeping on your back?

By the way..both are common.
Supine sleeping and REM sleep can often cause more apnea events and sometimes the need for more pressure.

I happen to be much worse in REM...supine sleeping doesn't matter.

This report isn't horrible... you have some clustering of events going on at various times in the night. I suspect either supine sleeping or REM stage sleep.

That first cluster of CAs at the beginning of the night. There's a good chance that you were still awake or maybe just falling asleep and it's normal to see some centrals at sleep onset and especially when we are awake. The machine doesn't know if you are asleep or not and sometimes it flags awake breathing irregularities as some sort of apnea event by mistake.

Is this the best report? Have more like this or is this the only really half way decent report and all the other a big mess?

If it weren't for the clusters of stuff mainly between 4 and 5 AM and again at around 6 AM your report would have been better looking. Incidentally that is also the time frame where we are likely to have more REM sleep.

I think that your pressure is not quite optimal for those periods of time that you the clutter and clustering.
A little more pressure and I suspect the snores will reduce and the number of OAs and Hyponeas will reduce.

Your leak line is fine. Large leak territory is somewhere between 80 and 90 L/min...you never were very close to it.
Leaks aren't a factor unless they are waking you up. Leaks don't have to be large to wake a person up and anything that wakes us up is unwanted.

So the first thing I would address to hopefully make you feel better would be the pressure. Talk to your doctor about a slight increase...I think 1 cm would probably do it unless this report is a fluke.
Or if you and/or your doctor is comfortable with you making the change...then do it. I think you will see a substantial improvement during those wee hours of the morning.

Once you get your therapy optimal...then we talk about other things that can make us feel crappy if you are still feeling crappy.
Fragmented sleep is a major factor...and usually the first thing we look at and then go from there.

[UKTony]

There's definitely a pattern, my wife tells me that between 04:00 and 05:30 almost every night I go through the same thing....before the machine my wife called it the jackhammer meets rooting piggy phase. I guess this could be REM... I have no way of knowing, I only entered REM briefly during the sleep study while hooked up to the machine. I can't remember the last time I woke and remembered a dream, it was certainly more than 20 years ago. Sometimes I remember dreaming but never anything more than that I did.

There are more graphs that didn't get copied, not sure if seeing those would help. I will include the previous nights same data below so you can see that... the 2 night's previous, as you can see from my earlier post were all over the place because there was an alien strapped to my face!

[UKTony]

Do I need to worry about Tidal Volume?

[Pugsy]

Do I need to worry about Tidal Volume?

No. Not now and not with using this particular machine. It's a data point that is more useful for the people who need the ASV types of machines. If you were using EncoreBasic software...it wouldn't even show you tidal volume because it doesn't really matter much with a regular cpap machine.

Tidal volume.
http://en.wikipedia.org/wiki/Tidal_volume
Mainly useful now if you had some sort of lung condition..and if you did I bet you would already know about it.
Norms vary a lot...it's normal to see what appears to be wild fluctuations when presented compressed in this scale.
To try to analyze tidal volume patterns...that's going to take a whole lot more education and practice.
And I am not the one to try to educate anyone on it because I haven't even tried to learn about it because for most people what we see are normal variations anyway.

This last report...you can still see the clustering pattern....I bet it's either REM sleep..supine sleeping or maybe both.
Check out this link and look on the right side under Physiology section. There's a hypnogram of normal sleep architecture.
Notice the REM pattern..normally first one starts about 90 minutes after sleep onsetl...then the number of cycles increase as well as the duration of the REM cycle.
http://en.wikipedia.org/wiki/Sleep

When we wake up during the night for any reason...it upsets the cycles of sleep...have to start over in light sleep again...don't get the REM sleep or the deep sleep that we need for the restorative powers of sleep to work their magic.
Even arousals where we don't remember waking up. Still have to restart the cycle progression somewhat.

[Pugsy]

I forgot....there's a Glossary for SH link in my signature line.
Pretty much all the nomenclature you see on the reports we have some basic explanations for.

[Sheriff Buford]

my wife called it the jackhammer meets rooting piggy phase.

Welcome Tony!! I like the term... made me have a great laugh for the day . Our spouses go thru a lot.

You'll know when you hit REM because of the dreams. You may not remember the dream specifics.... but you'll remember that you did dream.

Your leak rates are high... you will have to tackle them and try and get them down.

Be sure to work all your issues here...

Sheriff

[imfletch]

Welcome Tony,
Everyone else has already beaten me to the point: a dry mouth is a sure indicator that you're sleeping with your mouth open. I originally started with the Mirage Quatro full face mask, but it created a sore on the bridge of my nose and I moved on to a total face mask. Lately, as I've learned to keep my mouth shut, I've had good success with a Swift FX Nasal Pillow mask. That one is next to nothing on your face so it is easy to use.
The people here are awesome and will lead you through the process and answer every little question you have.
Pugsy is often a walking encyclopedia (just dated myself, I should have said Wiki) of apnea-related information.
Proudly proclaim your new "hose head" status!

[UKTony]

Thanks for all the welcomes guys!!...

I'm glad that everyone here is so happy to share.... glad to say that I'll not be suffering any of the negative emotions that are commonly mentioned here with regards to discomfort or stigma. Quite the opposite, I started my adult life with an above average IQ and very creative and sharp brain. Over the last two decades, I've found it increasingly difficult to think, let alone think creatively, I've been walking around in a constant haze, fuelled by espresso. Not only that that, but I've gone from being a clown to being an impatient, intolerant, grumpy old man. From reading all the data on the site I can expect some of these things to change, and to be honest, I've noticed a huge change in my appetite after only a few days on the hose, so I'm extremely positive (almost as excited as when I gave up smoking 20 years ago), at the changes I might witness in the coming months.

Thanks once again for the warm welcomes!!

Tony.