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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 14, 2018 5:44 pm

Joined: Sat Jun 02, 2018 11:41 am
Posts: 42
PAP Mask: Dreamwear nasal, FFM
PAP Machine: Phillips Respronics
Pressure Setting: 4-20

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Thanks, I would love to hear about his experience with the level two home study.

I will continue to keep you updated.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Fri Jun 15, 2018 6:32 am

Joined: Sat Jun 02, 2018 11:41 am
Posts: 42
PAP Mask: Dreamwear nasal, FFM
PAP Machine: Phillips Respronics
Pressure Setting: 4-20

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Terrible night of sleep last night. FFM was comfortable but I don't think I slept more than an hour and a half straight then took off the mask and tried again later. I see lots of Hypopneas which I don't normally see.

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Pugsy
Unread post  Post subject: Re: Questions  |  Posted: Fri Jun 15, 2018 11:19 am
User avatar

Joined: Wed Aug 02, 2017 8:01 pm
Posts: 756
PAP Mask: ResMed AirFit P10 or DreamWear Gel nasal pillows
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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If you didn't sleep well and had a lot of time awake with mask and machine on and tossing and turning...I don't know that I would even trust that AHI.
It might contain a lot of sleep/wake/junk false positive flags.

Often my "worse" nights in terms of AHI results are when I have a lot of awakenings and tossing and turning from my back pain. I know that the bulk of the "events" aren't real as I was awake or half awake and they don't matter or count unless we are really asleep.

Remember the machine only measures air flow and it can't tell if you are asleep or not.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Fri Jun 15, 2018 11:46 am

Joined: Sat Jun 02, 2018 11:41 am
Posts: 42
PAP Mask: Dreamwear nasal, FFM
PAP Machine: Phillips Respronics
Pressure Setting: 4-20

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That makes sense, I have seen some of Jason’s videos going through the data and explaining away the false readings of the machines. I am really not worried about the events so much as the terrible sleep I got. Hopefully a quick nap today and better sleep tonight will get better data. I go in for my follow up on Tuesday so I will see what the doc says about options.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Sat Jun 16, 2018 7:10 am

Joined: Sat Jun 02, 2018 11:41 am
Posts: 42
PAP Mask: Dreamwear nasal, FFM
PAP Machine: Phillips Respronics
Pressure Setting: 4-20

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Last night I tried the FFM and changed the pressure from 4-20 to 5.5-20, here are the results. It takes some getting used to initially with the extra pressure and my AHI went up

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Pugsy
Unread post  Post subject: Re: Questions  |  Posted: Sat Jun 16, 2018 10:38 am
User avatar

Joined: Wed Aug 02, 2017 8:01 pm
Posts: 756
PAP Mask: ResMed AirFit P10 or DreamWear Gel nasal pillows
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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Full face mask users will often need a little more minimum pressure than they maybe needed when using a nasal mask.
I think it might have something to do with how the lower straps of most full face masks tend to pull that lower jaw back just every so slightly and maybe alter the airway a bit thus causing maybe a little more pressure to be needed.

That cluster...you needed more pressure than you had at the time to prevent it. Maybe you were on your back or maybe it was REM...but that's why you see the cluster.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Sat Jun 16, 2018 11:43 am

Joined: Sat Jun 02, 2018 11:41 am
Posts: 42
PAP Mask: Dreamwear nasal, FFM
PAP Machine: Phillips Respronics
Pressure Setting: 4-20

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Yeah I was wondering about that cluster. Maybe I moved around a bit, I tend to do that in my sleep. I don’t remember waking up then but I know I did a few times.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Mon Jun 18, 2018 10:00 am

Joined: Sat Jun 02, 2018 11:41 am
Posts: 42
PAP Mask: Dreamwear nasal, FFM
PAP Machine: Phillips Respronics
Pressure Setting: 4-20

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After hardly any sleep the night before last night I feel I got really good sleep! More than 5 1/2 hours on my CPAP straight which is a record for me in my first month. Looking at my data it seems like I slept well and I actually woke up around 2 am feeling pretty good. I don't know why I woke up since my alarm was set for 4 am but feeling good is feeling good.
I see some CAs which I had none of in my sleep studies. I also see some hypopneas which don't really look like anything to me but I am not a sleep tech. I hope I don't need to be that tired to do this well going forward with CPAP, the night before had nothing to do with CPAP as I didn't even use my machine, just rude people in a hotel making waaaay too much noise all night long.

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Pugsy
Unread post  Post subject: Re: Questions  |  Posted: Mon Jun 18, 2018 4:10 pm
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Joined: Wed Aug 02, 2017 8:01 pm
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PAP Mask: ResMed AirFit P10 or DreamWear Gel nasal pillows
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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Nice report and even better you feel the good looking report.

If you are worrying about the few centrals you have flagged...quit it.
They may or may not even be real and even if every single one of them was the real deal there's not nearly enough of them to give cause for worry.

Remember...it's normal to have a few centrals here and there that are real. It's normal to have what is called a sleep onset central or sleep stage transition central.
It's normal to wake after a REM stage sleep cycle and you may or may not remember it but as you go back to sleep there's a good chance for a sleep onset central to happen. We don't always have them but when we do it's not a big deal.

Centrals are only a problem if they are causing a problem and it takes a whole bunch of them to cause a problem. Doctors won't even bat an eye until a person starts seeing an average of 4 or 5 per hour....every hour...all night and every night.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Mon Jun 18, 2018 4:31 pm

Joined: Sat Jun 02, 2018 11:41 am
Posts: 42
PAP Mask: Dreamwear nasal, FFM
PAP Machine: Phillips Respronics
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I am hoping this becomes more of the norm and I can get into the groove of falling asleep better and staying asleep. I’m not concerned about the cas now.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Tue Jun 19, 2018 12:03 pm

Joined: Sat Jun 02, 2018 11:41 am
Posts: 42
PAP Mask: Dreamwear nasal, FFM
PAP Machine: Phillips Respronics
Pressure Setting: 4-20

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I saw my doc today. She went over my numbers but it is nothing more than sleepyhead showed me. At the very mention of anything than CPAP she almost visibly cringed. It has seemed that this industry is 100% keyed into CPAP and no other treatment. I know it is effective for some and too invasive for others and I have been working hard to get myself tolerant and I haven’t been on it long enough but it really put me off this doctor. Even when she weighed me and I have lost ten pounds she still didn’t really see that as a good sign. She said it may help but seemed to only be thinking of CPAP as a course of action. I will continue it but also be looking for another doctor. If my job didn’t depend on it I would just trash the machine but I guess I am stuck with this for now.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Fri Jun 22, 2018 5:38 am

Joined: Sat Jun 02, 2018 11:41 am
Posts: 42
PAP Mask: Dreamwear nasal, FFM
PAP Machine: Phillips Respronics
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I got a few new items in the mail yesterday and decided to check them out.

Mask Bright cleaner--tried it and really liked it so I will be using that from now on, thanks Jason.

Dreamwear full face mask--I tried it last night for awhile. It seemed pretty comfortable but for some reason I couldn't fall asleep well with it. Maybe it was too hot and muggy last night and I didn't turn on the A/C so i will try again tonight with better conditions. I switched back to my Airfit F10 and slept but looking at my sleephead this morning it doesn't look like I slept all that well. I haven't had an AHI that high yet (over 6 with the F10!).

Do people vary their pressures for different masks?

I have included snapshots of the Dreamwear, shorter duration with lower AHI and the F10 with longer wear but more AHI.

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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Mon Jun 25, 2018 4:21 am

Joined: Sat Jun 02, 2018 11:41 am
Posts: 42
PAP Mask: Dreamwear nasal, FFM
PAP Machine: Phillips Respronics
Pressure Setting: 4-20

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Here is a screenshot of a little timeframe from the other night. I see a lot of events but AHI for that period was under 5. Can anyone tell if those are real Hypopneas and how does a CPAP machine tell an O2 desaturation or what does it use to define a hypopnea?

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Pugsy
Unread post  Post subject: Re: Questions  |  Posted: Mon Jun 25, 2018 6:27 am
User avatar

Joined: Wed Aug 02, 2017 8:01 pm
Posts: 756
PAP Mask: ResMed AirFit P10 or DreamWear Gel nasal pillows
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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The machine has zero way to know oxygen levels going on during the night unless you have an integrated pulse oximeter which is VERY expensive.

It defines hyponea by the amount of air flow reduction during breathing and it needs to last at least 10 seconds to earn a flag.

It needs to be at least a 40 or 50 percent reduction in air flow up to 80 %
(I forget which brand uses 40 and which brand uses 50 as the minimum criteria ResMed uses one and Respironics uses the other) that lasts at least 10 seconds.
Over 80% and it earns the OA flag.

So a breathing air flow reduction of 70 % that only lasts 9 seconds...no flag. Or even a 95% reduction that lasts 9 seconds...no flag.

Also...so a flow reduction of 35% that last 30 seconds...no flag.

Real or not...means awake or asleep. You need to be asleep for it to be "real". The machine doesn't know if you are awake or asleep. It has no way to measure sleep vs awake status. It only measures air flow or breathing. To learn how to figure out awake breathing vs asleep breathing means you have to zoom way in on the flow rate graph to look at each breath to maybe get an idea if you were asleep or not.

If you want to learn about asleep flags vs awake flags..go here and watch all the videos.
http://freecpapadvice.com/sleepyhead-free-software
Impossible to do at the scale of the above image.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Mon Jun 25, 2018 9:57 am

Joined: Sat Jun 02, 2018 11:41 am
Posts: 42
PAP Mask: Dreamwear nasal, FFM
PAP Machine: Phillips Respronics
Pressure Setting: 4-20

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Thanks Pugsy! I did zoom way in and some of them are pretty flat for awhile but no big breaths before or after—maybe more of a ca?
I bought a pulse odometer online but it hasn’t arrived yet but most of them are when I am asleep.
The journey of education continues!


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Wed Jun 27, 2018 6:44 am

Joined: Sat Jun 02, 2018 11:41 am
Posts: 42
PAP Mask: Dreamwear nasal, FFM
PAP Machine: Phillips Respronics
Pressure Setting: 4-20

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Here are a few shots from last night zoomed in. Should I worry about FLs at all? I have decreased my pressure down to 4-5.5 and last night was pretty good sleep even after drinking a few beers. 3.5 hours then 2 after a bathroom break and I feel pretty good today. I am still learning to interpret the Hypopneas and I don't know what to think about the RERAs since it doesn't look like much and how does the machine know that I woke up?

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Pugsy
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 28, 2018 7:15 am
User avatar

Joined: Wed Aug 02, 2017 8:01 pm
Posts: 756
PAP Mask: ResMed AirFit P10 or DreamWear Gel nasal pillows
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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It doesn't know for sure if you woke up or not when you see a RERA flag.
What it does is say that your breathing looks like breathing that happens when people have an arousal related to some sort of respiratory related event.

In other words it's making an educated guess. It can't measure sleep status. All it can measure is the air flow pattern.

If your report was my report and I was sleeping decently and feeling decent then I wouldn't worry about it and I would keep on doing whatever I was doing.

Random occasional FLs or RERAs probably don't mean much as long as someone is sleeping decently and feeling decently. Dense clusters of either within a very short time frame could potentially disrupt sleep quality by causing arousals.


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Thu Jun 28, 2018 8:48 am

Joined: Sat Jun 02, 2018 11:41 am
Posts: 42
PAP Mask: Dreamwear nasal, FFM
PAP Machine: Phillips Respronics
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Not too worried, I am hoping to get off the machine though so trying to do everything I can to make that happen. I am already down about 12 pounds and hopefully more by the end of summer. It does make sense that the machine would try to interpret events and mark them but even to my untrained eye there are many events I see which don’t look like anything. As long as I stay down in the lower numbers though things are good. I am still fighting to get good sleep, sometimes it happens but more often than not it isn’t great. I haven’t slept through the night since going on CPAP, the longest is about 5 hours and most of the time it is about 3 but then I go back to sleep so I am getting enough rest and don’t really feel all that tired throughout the day. Last night I slept with a pulse odometer on and in looking at the data this morning I was between 99 and 95% all night.
I am still holding out hope that something else like an oral device or positional sleeping, even the MAD surgery can help (no way I will even consider the UPPP from all that I have read).


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MNsleeper
Unread post  Post subject: Re: Questions  |  Posted: Mon Jul 23, 2018 5:22 am

Joined: Sat Jun 02, 2018 11:41 am
Posts: 42
PAP Mask: Dreamwear nasal, FFM
PAP Machine: Phillips Respronics
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Last night my AHI went up over 6 for the first time. I only slept 6 hours but feel ok. I looked at my data this morning and I had 24 Hypopneas but looking at it closely they don't seem like much. I wasn't wearing my pulse oximeter so don't know my O2 sats but here is an example of what I am talking about.
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