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USAMarkD70
  Unread post  Post subject: Newb Here - Help Interpreting SH Data Please  |  Posted: Fri Sep 04, 2020 9:58 pm

Joined: Wed Sep 02, 2020 9:17 pm
Posts: 19
Location: Florida
PAP Mask: Dreamwear
PAP Machine: ResMed AirSense10 AutoSet...for now
Pressure Setting: Auto 14 - 20cmH2O...for now....

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Been reading and learning a lot this past week. Not gonna lie...a little bit much to take in. Looking at the SH data...I seem to have a lot going on here. Is anyone able to take a peek at this and let me know how much trouble I'm in? My Dr. prescribed APAP from 5 to 15cmH2O. It looks like I'm maxing out at 15. I'm wondering if I should switch to CPAP and bump the pressure a little and see how I get on with it? Still getting used to the mask. Does one EVER get used to it? I have only used it for three nights so far. I've not had a good night's sleep in years it feels like. Hoping someone can help. Next Dr appointment isn't until mid-October.

Happy to post more data if needed. Wanted to try and keep it simple.

Attachment:
Screen Shot 2020-09-05 at 12.54.12 AM.png
Screen Shot 2020-09-05 at 12.54.12 AM.png [ 290.82 KiB | Viewed 4995 times ]

Attachment:
Screen Shot 2020-09-05 at 12.55.47 AM.png
Screen Shot 2020-09-05 at 12.55.47 AM.png [ 280.86 KiB | Viewed 4995 times ]


Thank you so much in advance,

SleepyInFlorida


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Pugsy
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Fri Sep 04, 2020 11:31 pm
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 2461
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirCurve 10 VAuto

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Set your minimum to 10 and your maximum to 20.
Use available exhale relief (called Flex with your machine) and even the ramp feature.
Yes, we do get used to this stuff but it does take time.
Make use of the ramp feature. It will start out low and work up and hopefully you will be asleep by the time the machine hits the new minimum.

Next time you post an image for review. Don't zoom in on anything unless someone asks you to. Just take a screen shot of the detailed data page without any zooming in.

If you don't know how to change the settings...
go here and request the clinical/provider manual for your machine via email. It explains the secret button pushing that you need to do to get to the clinical setup menu area where you can change the pressure.
And where the button is to push to start ramp.

https://www.apneaboard.com/adjust-cpap- ... tup-manual

_________________
I may have to rise but I refuse to shine.


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Respirator99
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Sat Sep 05, 2020 2:42 am
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Joined: Mon Apr 27, 2020 1:06 am
Posts: 339
Location: Australia
PAP Mask: Resmed Airtouch F20
PAP Machine: Resmed AirCurve 10 CS Pacewave ASV
Pressure Setting: Min EPAP: 8.0 Max EPAP: 11.0 PS Min: 3.0 PS Max: 8.0

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G'day SleepyInFlorida. Welcome to the forum.

Just expanding on what Pugsy said, see the links in my signature for instructions on how to organise your charts. It's more-or-less as you have it, but turn off the calendar and pie chart - that will make other data visible. You could also turn off the afternoon nap session (use the yellow bar at the extreme bottom left) and allow your night session to fill the page. And finally, turn off the VS2, which doesn't really help us but clutters up the chart.

This whole apnea / CPAP business can be quite daunting, especially as most of us were sleep deprived and foggy when we started out. But stay with it - it really does get better. Probably the hardest part is getting a mask which fits properly, is comfortable and doesn't leak. There's an excellent discussion on masks here: http://www.apneaboard.com/wiki/index.php/Mask_Primer

Good luck!

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USAMarkD70
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Sat Sep 05, 2020 7:33 am

Joined: Wed Sep 02, 2020 9:17 pm
Posts: 19
Location: Florida
PAP Mask: Dreamwear
PAP Machine: ResMed AirSense10 AutoSet...for now
Pressure Setting: Auto 14 - 20cmH2O...for now....

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Thank you, both Pugsy and Respirator99! I really appreciate you sharing your knowledge and experience. I appreciate the support and encouragement as well. I will try as you both suggested and spend more time reading today. I'll know how to post properly next time as well. ;)

I did see a video of where Jason showed how to enter the Therapy settings on the Dreamstation and I've tried it. Seems to get me in there just fine.

I'll post again if I come up against something.

Thank you again!


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DeltaBravo3.8
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Sat Sep 05, 2020 2:15 pm
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 595
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: Required to start over on ResMed AirSense 10 AutoSet.
Humidifier: HumidAir and Heated hose
Pressure Setting: Auto PAP 7-14, EPR full time 3

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I'm on a phone so I can't see details like on a PC. You may want to consider upgrading SleepyHead to OSCAR. They're similar but OSCAR is newer and supported, SleepyHead is not.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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USAMarkD70
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Sat Sep 05, 2020 3:41 pm

Joined: Wed Sep 02, 2020 9:17 pm
Posts: 19
Location: Florida
PAP Mask: Dreamwear
PAP Machine: ResMed AirSense10 AutoSet...for now
Pressure Setting: Auto 14 - 20cmH2O...for now....

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Thank you, Dave! I did upgrade today. Glad to see it's being actively developed and supported. Thanks again.


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DeltaBravo3.8
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Sat Sep 05, 2020 8:45 pm
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Joined: Sat Jul 04, 2020 8:38 am
Posts: 595
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: Required to start over on ResMed AirSense 10 AutoSet.
Humidifier: HumidAir and Heated hose
Pressure Setting: Auto PAP 7-14, EPR full time 3

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Quite welcome.

My connection may be remote, but advisement by us forum members will be anything but remotely accurate. Dare I put forth some docs could learn a few apnea tips by seeing the great things done here. Best wishes for success ASAP.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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USAMarkD70
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Sun Sep 06, 2020 6:28 am

Joined: Wed Sep 02, 2020 9:17 pm
Posts: 19
Location: Florida
PAP Mask: Dreamwear
PAP Machine: ResMed AirSense10 AutoSet...for now
Pressure Setting: Auto 14 - 20cmH2O...for now....

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Hi Folks! I have an updated screenshot with suggested changes. Should I start a new post?

The tips provided above definitely seemed to have helped. I seemed to have peaked at max pressure of 17cmH2O. But still quite a few events.

Thank you again for all the advice!


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Pugsy
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Sun Sep 06, 2020 6:48 am
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 2461
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirCurve 10 VAuto

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It's best to stick with just one thread.
That way people can follow the progress and what was done or said easier.

_________________
I may have to rise but I refuse to shine.


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USAMarkD70
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Sun Sep 06, 2020 6:55 am

Joined: Wed Sep 02, 2020 9:17 pm
Posts: 19
Location: Florida
PAP Mask: Dreamwear
PAP Machine: ResMed AirSense10 AutoSet...for now
Pressure Setting: Auto 14 - 20cmH2O...for now....

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Thank you, Pugsy! Here's a screenshot from last night.

You're right definitely good to read other posts and see the progress. They are encouraging and one can see the great recommendations and the positive results they lead to.

Thank you again!


Attachments:
Oscar-screenshot-20200906-092738.png
Oscar-screenshot-20200906-092738.png [ 238.93 KiB | Viewed 4912 times ]
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Pugsy
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Sun Sep 06, 2020 10:57 am
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 2461
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirCurve 10 VAuto

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You are probably going to need more minimum as well.
Once the machine goes up it pretty much stays up.
I suspect up around 14 cm minimum but you might go up slowly in small increments to make the adjustment process a bit easier.

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I may have to rise but I refuse to shine.


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USAMarkD70
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Sun Sep 06, 2020 4:13 pm

Joined: Wed Sep 02, 2020 9:17 pm
Posts: 19
Location: Florida
PAP Mask: Dreamwear
PAP Machine: ResMed AirSense10 AutoSet...for now
Pressure Setting: Auto 14 - 20cmH2O...for now....

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Ok. I have it set at 10 now so I'll bump it up to 12cm for a couple of nights. Thank you as always, Pugsy!


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USAMarkD70
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Wed Sep 09, 2020 3:04 pm

Joined: Wed Sep 02, 2020 9:17 pm
Posts: 19
Location: Florida
PAP Mask: Dreamwear
PAP Machine: ResMed AirSense10 AutoSet...for now
Pressure Setting: Auto 14 - 20cmH2O...for now....

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Here are some screenshots from the past couple of nights. I asked my DME contact if they could exchange my Dreamstation for a Resmed AirSense10 Auto. She said not normally but they would allow me to do this as a one time exception. :) I think this sounds like it might be a better fit for my needs.


Attachments:
Oscar-screenshot-20200909-180025.png
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Oscar-screenshot-20200909-180059.png
Oscar-screenshot-20200909-180059.png [ 238.23 KiB | Viewed 4810 times ]
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USAMarkD70
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Wed Sep 09, 2020 4:09 pm

Joined: Wed Sep 02, 2020 9:17 pm
Posts: 19
Location: Florida
PAP Mask: Dreamwear
PAP Machine: ResMed AirSense10 AutoSet...for now
Pressure Setting: Auto 14 - 20cmH2O...for now....

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I hit the Submit button a little too soon and haven't found a way to edit my post.

Is it worth exchanging the Dreamstation AutoCPAP 500X110 for the Resmed AirSense 10 Autoset? From what I've read and reviewed online, the Resmed Airsense seems to have a better algorithm and should reduce the needed pressure a little bit. It seems like I'm needing a lot of pressure to help which I don't really like. I continue to wake up several times a night. Still tired during the day, needing a nap in the afternoon. Trying to stay positive about this! I appreciate all the help and recommendations! I know I'll get great night's sleep soon!


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DeltaBravo3.8
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Wed Sep 09, 2020 11:10 pm
User avatar

Joined: Sat Jul 04, 2020 8:38 am
Posts: 595
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: Required to start over on ResMed AirSense 10 AutoSet.
Humidifier: HumidAir and Heated hose
Pressure Setting: Auto PAP 7-14, EPR full time 3

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If you've got the opportunity to swap, yes go for it. The ResMed has EPR which is Pressure Support but in reverse. EPR is exhale pressure relief. It is a Comfort setting, but if used as we'll no doubt advise, it's also got some therapy merit. And I think the ResMed will consistently be a better performer for therapy.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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Pugsy
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Thu Sep 10, 2020 6:34 am
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 2461
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirCurve 10 VAuto

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Ditto...get the swap done if you can.
The more responsive algorithm and the more/better exhale relief will probably be not only better for you but more comfortable.
Even if we max your Flex relief on the DreamStation the most you can get for exhale relief is 2 cm drop during exhale. With the AutoSet it's 3 cm and that slight difference could potentially be a critical help with the pressures it looks like you are going to need.

If you can't get it done today though...change your Flex relief to AFlex instead of the CFlex and set it to 2 or 3 (whichever is more comfortable) and try that. I have used both CFlex and AFlex. I liked AFlex better myself. I couldn't tell that CFlex did squat. Maybe it will be the same for you.

_________________
I may have to rise but I refuse to shine.


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USAMarkD70
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Thu Sep 10, 2020 11:36 am

Joined: Wed Sep 02, 2020 9:17 pm
Posts: 19
Location: Florida
PAP Mask: Dreamwear
PAP Machine: ResMed AirSense10 AutoSet...for now
Pressure Setting: Auto 14 - 20cmH2O...for now....

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Thank you both! Much appreciated! Will call my DME today re: the swap. Sounds like the ResMed AirSense10 AutoSet is the way to go.

I may try those settings tonight if I can't get the new unit today.

Thank you again! :)


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USAMarkD70
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Sat Sep 12, 2020 8:24 am

Joined: Wed Sep 02, 2020 9:17 pm
Posts: 19
Location: Florida
PAP Mask: Dreamwear
PAP Machine: ResMed AirSense10 AutoSet...for now
Pressure Setting: Auto 14 - 20cmH2O...for now....

Offline
Well, I did get the machine two days ago. It did NOT come with an SD card. I had a generic one so I tested it with a "quick" 40 minute nap. It recorded the data fine. I then put the card in for the first night's use. It did NOT record anything. The machine showed data but it would never write anything to the card. I formatted the card on my computer and then put it in the machine. That seemed to work fine. So I got data from last night.

I'm attaching a screen shot. AHI seems decent but I have several CAs, RERAs and HAs. I'm considering just leaving things as they are for a while to see if I adjust to the settings but certainly welcome any advice/suggestions anyone might have for this.

Thank you so much as always! Hope everyone has a safe and fun day!


Attachments:
Oscar-screenshot-20200912-111423.png
Oscar-screenshot-20200912-111423.png [ 242.83 KiB | Viewed 4642 times ]
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DeltaBravo3.8
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Sat Sep 12, 2020 1:45 pm
User avatar

Joined: Sat Jul 04, 2020 8:38 am
Posts: 595
Location: Waynesboro, Pennsylvania, USA
PAP Mask: F&P Vitera & Simplus, ResMed F20 N/P30i & old Amara View
PAP Machine: Required to start over on ResMed AirSense 10 AutoSet.
Humidifier: HumidAir and Heated hose
Pressure Setting: Auto PAP 7-14, EPR full time 3

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It may appear we have conflicting situations here. CA events are about half your events. We probably need to review your sleep study data to learn how CA were there to determine if these are treatment emergent or pre-existing. I'm just thinking with info we already have this is treatment emergent but let's be sure and refer to the study info.

The conflict is your CA need you to go one direction that is lower pressure swings and your Flow Limit chart says pressure needs to go up with more relief than your AutoSet EPR can provide. You may wish to enquire with Doc how much more pressure you need to go before he/she pulls the trigger on scripting a BPAP/Bi-level. You're at 14 now on pressure, and this is more or less when BPAP is demanded.

You might turn pressure up more, but I think as is it is going to negatively impact comfort. Unless you get posts from Respirator99 or Pugsy about settings changes, do no edits and try again one more night.

Like I said, you're in a tough situation. I think addressing CA hinders FL and other event treatment. And addressing FL and the other hinders comfort. I do think one action is to pass the word to Doc that you'd like to consider medical necessity for Bi-level due to high therapy pressures potentially hindering comfort.

_________________
Duct tape carrying K9; the tape helps quiet stupid.
Dave K9DWB 73s


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php/OSCAR_Help
http://www.apneaboard.com/wiki/index.php/OSCAR_Chart_Organization


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Pugsy
Unread post  Post subject: Re: Newb Here - Help Interpreting SH Data Please  |  Posted: Sat Sep 12, 2020 4:53 pm
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Joined: Wed Aug 02, 2017 8:01 pm
Posts: 2461
PAP Mask: Bleep/DreamPort nasal mask
PAP Machine: ResMed AirCurve 10 VAuto

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First of all...how was the overall sleep quality? I see fragmented sleep where the machine was turned off and on a few times...were there more awake times with mask on but you didn't turn the machine off? Specifically interested in the times of the centrals/CAs.

Now there were some parts where there were some OAs and Centrals flagged in the same neighborhood so it wouldn't be impossible for the OA to cause an arousal and then the central is a post arousal central and not a real central.
Go here and watch the videos and learn to distinguish awake breathing flow rate from asleep breathing flow rate.
http://freecpapadvice.com/sleepyhead-free-software

So the first thing we need to figure out if the flagged events are real asleep events or false positives. And we can have false positive OAs and hyponeas....I see them all the time when I know I was awake. It's not limited to just centrals/CAs.
Unless we are asleep....they don't count.

Your flow limitation graph is ugly and likely the most likely culprit for driving the pressure mostly.

Are you experiencing any nasal congestion? Sometimes nasal congestion shows up as increased activity on a FL graph. Only problem...more pressure doesn't fix nasal congestion flow limitations.

If you know you didn't sleep solidly and soundly and you had a lot of wake ups during the night....don't go changing anything at this point. Lets instead work on better sleep quality so we don't have awake flagged positive events muddying up the evaluation process. I know some are because I see some events flagged either right before or right after a break in the therapy.

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