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geforce1gb
Unread post  Post subject: Need help - analysing sleepyhead data  |  Posted: Sat Mar 16, 2019 9:01 pm

Joined: Wed Dec 19, 2018 4:45 am
Posts: 12

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Can someone please help me as to why my AHI is still high?

Appreciate your advice

Pressure 8-20
AFLEX - 3


Image

Pressuer 8-10
AFLEX - 2


Image


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diamaunt
Unread post  Post subject: Re: Need help - analysing sleepyhead data  |  Posted: Sat Mar 16, 2019 9:57 pm
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Joined: Wed Mar 02, 2016 2:26 am
Posts: 2415
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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Please reformat your charts so the useless AHI chart is hidden (and the snore chart too, just make the others bigger) and please don't use imgbb to host the pics, they're shrunk and fuzzy and I can't read anything when I blow them up. (don't shrink the pics).

Just upload them to the forum here, with the 'attachments' button.

We'll do our best to help you, but we have to be able to read the charts.

Instructions in my sig.

_________________
Sleepyhead Info
How to format your charts


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geforce1gb
Unread post  Post subject: Re: Need help - analysing sleepyhead data  |  Posted: Sun Mar 17, 2019 12:08 am

Joined: Wed Dec 19, 2018 4:45 am
Posts: 12

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apologies for that.

i have reformatted the graphs and reattached them.

thanks once again.


Attachments:
screenshot-20190317-173419.png
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Pugsy
Unread post  Post subject: Re: Need help - analysing sleepyhead data  |  Posted: Sun Mar 17, 2019 4:35 am
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1248
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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How is your sleep quality? How long does it take you to fall asleep?
Do you wake up during the night and have trouble going back to sleep?

You have some clustering at the beginning of the night where we assume you were still awake. Any chance you were awake during some of the other clusters during the night?

I am thinking some of your higher numbers reflect awake breathing irregularities flagged by the machine as some sort of apnea event but they aren't real if you aren't asleep. The machine doens't have any way to measure if you are asleep or not. It measures air flow/breathing only and awake/semi awake breathing can often cause false positive event flagging.

So the flagged events are related more to awake breathing or poor sleep than it is the airway closing off.

You might want to watch all the videos here and learn how to figure out if the flagged event was real (as in you were really asleep) or if it was related to awake/semi awake/arousal breathing instead which we often call SWJ or sleep/wake/junk.
http://freecpapadvice.com/sleepyhead-free-software

So...how's your sleep quality? Spend much time awake with mask and machine on?
Do you take any medications? If so, what?


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geforce1gb
Unread post  Post subject: Re: Need help - analysing sleepyhead data  |  Posted: Thu Mar 21, 2019 1:18 am

Joined: Wed Dec 19, 2018 4:45 am
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Pugsy wrote:
How is your sleep quality? How long does it take you to fall asleep?
Do you wake up during the night and have trouble going back to sleep?


No I dont wake up during the middle of the night. I normally start off ramp at 7.5 for 45 mins. The only time where I would wake up in the middle of the night is when I increase my max pressure to 20cm or min pressure above 9.

Pugsy wrote:
So...how's your sleep quality? Spend much time awake with mask and machine on?
Do you take any medications? If so, what?


I don't take any medication. Sleep quality is generally ok, it's better than not using the machine at all. When I am awake, I would take the mask off straight away.

I have been trying to get my AHI down as it's hovering between 4 and 6. Everytime I increase the max or min pressure, I would wake up with a very bloated stomach, even with a AFLEX setting of 2. Im currently using the dreamwear full face mask.

With the second image attached, I woke up at 5am with a very bloated stomach. My setting was 9.5 to 11.5, but changed the min to 7 when I woke up.

My current optimal setting is 8 to 10 with AFLEX of 2. Maybe I should stop focusing on trying to get my AHI number down and stick with that.


Attachments:
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diamaunt
Unread post  Post subject: Re: Need help - analysing sleepyhead data  |  Posted: Thu Mar 21, 2019 3:31 am
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Joined: Wed Mar 02, 2016 2:26 am
Posts: 2415
Location: Dallas(ish)
PAP Mask: Resmed P10
PAP Machine: Resmed S9 vpap auto
Pressure Setting: 18/13-25/19

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Try setting your pressure min 10, max 20, it's too low as it is.

_________________
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How to format your charts


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geforce1gb
Unread post  Post subject: Re: Need help - analysing sleepyhead data  |  Posted: Thu Mar 21, 2019 3:37 am

Joined: Wed Dec 19, 2018 4:45 am
Posts: 12

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I tried setting it from 8 to 20, and yeah i had a terrible night and woke up with a really bloated stomach :(


Attachments:
screenshot-20190317-173419.png
screenshot-20190317-173419.png [ 142.98 KiB | Viewed 1088 times ]
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Pugsy
Unread post  Post subject: Re: Need help - analysing sleepyhead data  |  Posted: Thu Mar 21, 2019 6:23 am
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1248
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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You are in a bad situation...you need more pressure to deal with the obstructive apnea events (those OAs and hyponeas) but more pressure causes you more problems from the aerophagia issues.

You need more exhale relief to maybe (stress maybe) enable you to use the more pressure and not have the aerophagia monster come calling.
The main problem with the Respironics apap machine is it can't give you all that much exhale relief or drop during exhale to let you maybe keep the aerophagia monster at bay.
The most drop you can ever get even at a setting of 3 is a 2 cm drop and that's only with a very forceful breath. Respironics exhale relief if flow based meaning how much of a drop you actually get is based mainly on the forcefulness of your own breathing.

I wish you had at least the ResMed AirSense 10 AutoSet apap machine...it has a different auto adjusting algorithm for responding to airway collapses and it has a real 3 cm drop during exhale that might let you use the pressures you need without causing aerophagia.

What you need is a bilevel machine....to have a chance of getting lower AHI numbers and not having the aerophagia monster show up.
The ResMed AutoSet with exhale relief (EPR) set to 3 essentially works like a bilevel machine but one with limited exhale drop.
A real bilevel machine will allow a person to have a bigger than 3 cm drop during exhale and that bigger drop will often offer enough relief from the constant pressure on the LES (lower esophageal sphincter) to help reduce air sneaking into the stomach.

Would changing to a bilevel machine guarantee success...it's a maybe but the strongest maybe available.

I would be having a chat with my doctor.
In the meantime...you have to be able to sleep decently and not be ill the next day from all the aerophagia issues...so I would accept a little higher AHI for now if using the lower pressures at least lets you sleep decently and feel decently the next day.

Sometimes aerophagia issues fade with time...sometimes they don't.
Me...I would be at least asking my machine supplier to at least try the ResMed AutoSet to see if 3 cm EPR would help or not...that's at the minimum...ideally getting a real bilevel machine would be my first choice.


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geforce1gb
Unread post  Post subject: Re: Need help - analysing sleepyhead data  |  Posted: Fri Mar 22, 2019 12:45 am

Joined: Wed Dec 19, 2018 4:45 am
Posts: 12

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Thanks for your reply. Wished I had bought a BIPAP machine to start off with.

I tried adjusting the pressure to from 8 to 15 last night with AFLEX of 3. Didn't experience any bloating but woke up at 6am for some reason and felt pretty tired throughout the day.

Not really sure what to make of it as...


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Pugsy
Unread post  Post subject: Re: Need help - analysing sleepyhead data  |  Posted: Fri Mar 22, 2019 7:27 am
User avatar

Joined: Wed Aug 02, 2017 8:01 pm
Posts: 1248
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirSense 10 AutoSet for Her
Humidifier: ResMed AirSense 10
Pressure Setting: Depends on the machine as I actually have more than one

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You are going to need more minimum to get that AHI down...
My suggestion for now...inch up slowly with the minimum and hope you can fool the LES so it stays closed well enough to hold off on the aerophagia issues.


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geforce1gb
Unread post  Post subject: Re: Need help - analysing sleepyhead data  |  Posted: Mon Mar 25, 2019 1:39 am

Joined: Wed Dec 19, 2018 4:45 am
Posts: 12

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Just thought I'll post an update. I changed my settings from 7 to 8.5 with AFLEX of 1. I feel much more rested today in comparison to all the other combination of settings I have used (attached in previous posts).


Attachments:
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