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Question about Bipap readings

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limecutter +0 points · 5 days ago Original Poster

Some days I will wake up earlier than usual and look at my machine for the readings of the day. It is generally below 5 events per hour. If it's too early to get up I will lay there and try unsuccessfully to go back to sleep. I'm positive I don't even doze most times. When I get up an hour or so later my readings are elevated sometimes over 10 events per hour. How can that be? I thought it might be the machine but it was under warranty and I swapped it out for another one.

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Sierra +0 points · 5 days ago Sleep Innovater

I see that fairly often with my ResMed A10 APAP. I don't think it is any fault of the machine. My view is that when we don't sleep soundly and keep waking up events which may or may not be real apnea events are recorded. Some call it "sleep wake junk". However, you have to look at the events in detail to decide if they are being falsely flagged or not. Even then it can be hard to tell.

OSCAR is a free opensource software application that uses a PC or Mac and a SD card reader to look at the detailed data on your SD card. It can be very helpful in understanding what is going on, and perhaps even more importantly whether or not there is room for improvement it the machine setup.

Here is an example of a night where I noticed the effect you are having, although perhaps not as extreme. First here is the total night which resulted in an AHI of 1.94 (about average for me). Of that 0.91 is Central apnea, which again for me is about normal.

Oscar (SleepyHead) lets you turn off individual sessions in the night. Since I got up for a bathroom break, this night was broken into two sessions. You just turn the sessions on and off with the red-green switch in the bottom left. Here is what the first half of the right looked like. AHI was .99 which is very good for me.

Now here is the last part of the night. AHI for this period is now 4.0, and CA events at 1.45. Have not looked in detail, but from the Minute Ventilation graph these appear to be real CA events.

So, it is kind of normal what you are seeing, but even your score of 5 for AHI while acceptable, it is on the high side. There may be opportunity for improvement. Kind of as a rule of thumb, more pressure reduces obstructive apnea, but can increase central apnea (CA) at the same time. So it can be a bit of a tradeoff. Ideally you want just enough pressure to control the OA while not increasing the CA. As a starting point I would suggest trying to determine your ratio of CA events to OA events. That can help focus where the problem may be. If you post a Daily Report from OSCAR I can comment on what I think is happening.

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limecutter +0 points · 5 days ago Original Poster

Thanks for the reply, yes I have both CA and OA. My doctor actually lowered the pressure because of the CA. It's now usually down in the 2 - 3 range but I have to be very precise in making sure my mask is on perfect, my mouth tape is on perfect, I have the gel mask sealant just so. If I screw up one thing in my ritual, everything goes out the window. I just found out about Oscar recently and I'm trying to get up to speed. Is there any online or otherwise instructions for reading these charts? I'll try to download my data later and post it. Thanks again!

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Sierra +0 points · 5 days ago Sleep Innovater

If you post your daily report here with a list of questions, I will be happy to try and answer them. One of the things you would want to look for are when the events occur, what type they are, and what the actual pressure was at the time they occurred. That can give you a good idea what the issue is. With a BiPAP the other thing to look at is the pressure support, and whether or not it is too much.

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limecutter +0 points · 2 days ago Original Poster

This first screen shot was from last night which is pretty typical most nights:

This second one was from a couple of nights ago when I happened to lay awake in bed for a while in the morning.

This next shot is from the same morning but I turned off my awake time. It's usually more pronounce than that but for some reason I can only go back so far to get my data.

Thanks for your help.

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