ittiandro

Thanks

The LL seem to be ongoing I ordered mask liners from Amazon, hoping they will fix the problem. Last night’s report, too, shows them at 30% above the red mark, with only 0.67 AHI’s, but none in the LL area. I don’t know if they are hidden, which would make the report inaccurate.

The LL statistics are: Min. 0.00, Median 6.0, 95%= 38.4, Max 51.6

Flow limit : min 0.00, Med. 0.00, 95% 0.12, max 0.69

I increased the Ramp Start . Now on the machine display, the Start Pressure is 12 , with Ramp time =auto, but the Sleepy Head report shows Ramp Off.

I don’t know if you need the report for further comments. If you do, let me know. I don’t want to take up too much of your time.

Thanks

Ittiandro

I tried to remove the calendar again, but there are no more details than those already shown with the calendar on. I increased the Ramp start pressure to 12 as suggested, but I don’t quite understand because the pressure is already set at 12-16, so the machine should already work at 12. I enclose last night’s report. It shows quite a high % of LL, around 57%, the highest so far. On a closer look, I find a few oddities. The total sleep time is only about 4 hrs. In reality, it is longer than that, because I recall waking up with the mask still on at about 6 a.m. I then removed it and continued to sleep without it until around 9 a.m. The type of mask in the Resmed machine showed as pillows, instead as full face. I don’t know if this has any bearing, but I corrected it. The humidity level is set at 5, but last night I had an unusually dry mouth and this morning I found some water in the tank, which is usually empty. Thanks

Ittiandro

Thanks by clicking on that triangle to suppress the month's calendar, there are no more details than previously. The mask is an Air Fit F 20 L. I had it for about a year. I noticed that washing the silicone seal and my face every night improves the leaks, just as shaving. My beard is not very strong, but I found that even a short unshaven stub can let air through the seal. The velcro straps, especially the lower one, are probably a bit worn and they would come off easily. I didn't think it was time to replace the silicon seal and/or the straps, though. I fastened them with tape after setting them comfortably and now they stay on, even though there is some air still leaking when I move the face or the jaw.
Here are the Pressure and Mask pressure graphs. What is the difference, anyway?

Thanks

Ittiandro

Thanks Sierra

1. Yes, it may be because the machine was off while I went to the bathroom, but it shouldn't be for 30 min, unless I forgot to put the mask back on right away. I'll check and make sure.

2. I attach a graph from last night. It shows 2.07 AHI’s , well above my usual avg of about .50. 2.07 AHI's is still quite O,K., but the graph also shows LL for 26% of the total sleep time, i.e. into the red zone. It is not the first time. Usually, I wouldn’t worry if I feel well, but lately I’m tired at wake up. It could be that there are more than marginal AHI’s that the machine does not record because of the LL and this could affect my sleep.
   I’ll speak to my respirologist, if this persists. In the meantime, I’d appreciate if you can look at the graph, because I think I found some incongruities More importantly, looking at the Flow Rate graph, it is at 0( or almost) for approximately 4 minutes and the Flow Limit graph goes flat for longer than 4 minutes, i.e. for most of the time zone of the LL. Does this point to some kind of breathing irregularity, or outright interruption, if only intermittent? If so, I wonder why there are no recorded AHI’s for most of the LL time zone.

Thanks as usual

Ittiandro

I hope the Report shows.

Thanks

Ittiandro

Thanks Sierra

A. The whole point is to determine whether or not LL areas hide apneas. From my own records, some LL ( 20% of the total sleep time and above) do show apneas, some don’t, so we are back to square one: how can we know whether or not there are hidden apneas corresponding to the grayed out LL areas?

B. There are LL zones in the event flag graph which do not show apneas under them, yet the Flow Limit graph in Oscar ( I assume that it is the same as the Flow Rate in Sleepy Head) does show a flat bar at value 0 at the same time area of the LL. ( Are these flat bar segments, with 0 value, in the Flow Rate ( or Flow limit) breathing interruptions? If so, why then are they not recorded as apneas? May be because too short? Actually the Flow Limit graph shows a few such flat zones at 0 not matched by a corresponding LL and/or an apnea in the event flag graph. Can these be unrecorded apneas ? If you tell me how to attach the Oscar daily report for June 5, I’ll send it. You told me once, but I forgot.

C.Incidentally, what is the difference between the Pressure graph and the Mask pressure one?

Thanks

Ittiandro

I have been on CPAP for about a year and my AHI's are now down to about 0.50 or less, sometimes 0, mostly with 0 O.A's , only hypoapneas and sometimes unclassified apneas. Lately I feel tired at wake up, though. I notice frequent large leaks, often above 30, sometimes up to 50 or 60 l and I wonder if my fatigue is due to O.A.'s that the machine does not record because of the large leaks. This possibility has already been raised in this Forum as well as elsewhere. In fact, there is a post by Snuzy ( https://myapnea.org/forum/resmed-10/1#comment-18035 ) who did a search confirming that , according to him, ResMed AHI data get compromised when there are large leaks over 30% of the sleep time. I did check my large leaks pattern and I found it is often around 30% of my sleep time. I wonder if this explains my fatigue, even though this claim has been debated. I’d like to see clear on this issue, if possible. Are there any graphs in Oscar pointing to the possibility of hidden OA’s that are not recorded directly in the event flags graph because of the large leaks issue? Also, why doesn’t the machine display red face icons at wake up, when there have been large leaks during the night.? Perhaps it is time I replace the silicon seal on the mask My machine is a Resmed Air Sense 10 Autoset. I use Oscar. The OA's have all but disappeared after my doctor has adjusted the pressure range to 12-16, but can I still have unrecorded OA's because of the leaks?

Thanks

Ittiandro

I am considering to use an oximeter with my Resmed CPAP on Oscar. I know that Oscar has a tab for importing oximeter data, but I am not clear how and where to physically record the Oximeter data to import them into Oscar.

1. Is there a USB outlet and cable on the oximeters? On all the oximeters listed on Amazon I haven’t seen any USB outlet.
2. Where does the oximeter cable connect to?
3. Is there a separate SD card to record the oximeter data to?
4. How are these data transferred from the oximeter to the SD card? I suppose it is not the same SD card that is plugged in the Resmed machine for the nightly sleep data.
   
5. Is it necessary to transfer the oximeter readings to Oscar? Can’t I read them off directly from the oximeter ? Thanks

Ittiandro

Thank you all for your comments.I might consider to buy an Oximeter, but I don't know whether all the brands are compatible with Oscar or not . THanks

Ittiandro

I have been on CPAP treatment for Sleep Apnea for about one year and the results have been dramatic: the AHI's went down from about 40+ per hour to about 0.50 avg, with no OA’s, mostly brief hypopneas and occasional RERAS. The results have improved even more after my doctor has recently increased the mask pressure to 12-16 H2O, with an option to increase it to 14-16 if needed. I believe my sleep it is not yet optimal , though, as l still experience some sweating and back aches at wake up, albeit not regularly and i wonder if further increasing the mask pressure would help to further reduce hypopneas and RERAS and, generally, improve my sleep. In fact, contrary to what I expected given the severity of my disorder, I never felt subjectively any changes or improvement in my sleep quality after starting treatment, none of those …AHA ! feelings of relief many people report after their sleep dramatically improves by undergoing treatment. The only tangible difference is that I no longer need to wake up several times to relief the bladder. A big relief, but perhaps I still have some way to go, even though at 79 I cannot expect the same quality of sleep as when I was younger. I know that, in the end only a doctor can make recommendations on this, but I was wondering if there are people who have noticed reduced hypoapneas or RERAs after increasing the pressure.

Thanks

Ittiandro