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Comparing Sleepyhead data with doctor anaylsis

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Comparing Sleepyhead data with doctor anaylsis

Postby Fredd » Thu Jun 07, 2012 10:57 am

I started using CPAP at the end of April. On May 15 my sleep doctor reviewed the transmitted data from my CPAP and told me that it appeared to be working correctly. Recently I started using Sleepyhead to review the data and I want to compare the doctor's analysis with the data. Mostly I'm curious about the leaks. Sleepyhead reports AHI at 1.91, RERA index at 2.14, average total leaks at around 25 and 95% total leaks at around 30. What does 95% total leaks mean?

Do those numbers indicate that the mask and CPAP are functioning properly?
1st sleep study:
AHI: 12.5
Spontaneous arousals: 131

2nd sleep study:
CPAP setting at 7 cm H2O
AHI: 0
Spontaneous arousals: 154

CPAP/SleepyHead Results:
Date 1st used CPAP: 4/23/12
AHI: 1.75
RERA Index: 2.15
Fredd
 
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Mask: ResMed Mirage FX Nasal Mask
Humidifier: Yes
Year Diagnosed: 2012

Re: Comparing Sleepyhead data with doctor anaylsis

Postby robysue » Fri Jun 08, 2012 1:57 pm

Fredd wrote:I started using CPAP at the end of April. On May 15 my sleep doctor reviewed the transmitted data from my CPAP and told me that it appeared to be working correctly. Recently I started using Sleepyhead to review the data and I want to compare the doctor's analysis with the data. Mostly I'm curious about the leaks. Sleepyhead reports AHI at 1.91, RERA index at 2.14,

The efficacy data is right on target as far as the doc is concerned. They want to see that AHI < 5.0. There's no official "cutoff" for the RERA number, but the fact that your AHI + RERA index < 5.0 means your treated RDI is less than 5.0. Many docs look at the RDI (respiratory distrubance index) instead of or in addition to the AHI. Ideally they'd like to see that RDI < 5.0. Note that RDI = AHI + RERA index

average total leaks at around 25 and 95% total leaks at around 30. What does 95% total leaks mean?
Since you are using a PR machine, the leak that is reported is total leak, which includes both the intentional leak rate for your mask at your pressure and the unintentional leak rate.

My guess is that these otal tleak rates are very, very good. If you tell me the mask you're using and the pressure you're using, I can evaluate them more carefully.

The 95% leak rate is a statistical 95 percentile. Saying that your 95% leak rate is 30 L/min means that for 95% of the night your total leak rate was AT or BELOW 30 L/min. And for 5% of the night your total leak rate was AT or ABOVE 30 L/min.

And how much is 5% of the night? 5% of one hour is three minutes. So if you used the machine for 8 hours, 5% of eight hours is a grand total of 24 minutes.

Do those numbers indicate that the mask and CPAP are functioning properly?
Yep. Those numbers indicate that your CPAP/mask combo is doing a very nice job at keeping your apnea under control.
current settings Min EPAP = 4, Max IPAP = 8 and Rise time = 3

8/1/2010 sleep study results:
AHI = 3.9 [AHI = (#OA +#CA + #H w/desat) per hour]
RDI = 23.4 [RDI = (#OA +CA + #H w/desat + #H w/arousal) per hour]
Dx: Moderate OSA
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Re: Comparing Sleepyhead data with doctor anaylsis

Postby trebons » Sat Jun 09, 2012 4:43 pm

Fredd wrote:Do those numbers indicate that the mask and CPAP are functioning properly?

CPAP doing what suppose to do and numbers can change from one night to the next but how do you feel is far more important
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Re: Comparing Sleepyhead data with doctor anaylsis

Postby Fredd » Mon Jun 11, 2012 9:11 am

Thank you very much for the responses.

The reason that I'm asking about how well my CPAP is working is because it's not effective in treating my problem. After what seems like a good night sleep with (or without) CPAP I still, often, but not always, get out of bed feeling like I have not completely awakened - brain fog. It has been suggested, by robysue and others (in other posts), that I increase the CPAP pressure because even though it is treating the apneas/hypopneas effectively it may not be enough pressure to reduce spontaneous arousals.
1st sleep study:
AHI: 12.5
Spontaneous arousals: 131

2nd sleep study:
CPAP setting at 7 cm H2O
AHI: 0
Spontaneous arousals: 154

CPAP/SleepyHead Results:
Date 1st used CPAP: 4/23/12
AHI: 1.75
RERA Index: 2.15
Fredd
 
Posts: 31
Joined: Mon May 21, 2012 3:32 pm
Machine: Philips Respironics Remstar Pro
Mask: ResMed Mirage FX Nasal Mask
Humidifier: Yes
Year Diagnosed: 2012

Re: Comparing Sleepyhead data with doctor anaylsis

Postby CrohnieToo » Mon Jun 11, 2012 1:54 pm

Have you considered other reasons for your continued "fog"?? Medications? Thyroid? B12 levels? etc., etc.?

Some may suggest that you are still paying off your "sleep debt" but I've never been one to buy too much into the "sleep debt" theory.
ResScan 3.10 - Resmed S8 ResLink & oximeter
ConTec CMS-50D+ oximeter - Philips EverFlo 5L Oxygen Concentrator
PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2.14.0
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Re: Comparing Sleepyhead data with doctor anaylsis

Postby greatunclebill » Mon Jun 11, 2012 1:57 pm

Fredd wrote: The reason that I'm asking about how well my CPAP is working is because it's not effective in treating my problem.


you can't ass-u-me that because you have symptoms that the cpap is not effective. some people feel better instantly while some people don't feel better for months or years. the fact that their symptoms don't go away for months does not mean that their treatment is not effective. it is just taking longer to work.

there also could be other medical problems not yet diagnosed that could be contributing to or causing your symptoms. the best thing you could do is talk to your primary physician and explain things to him. ask if there is anything else that could also cause these symptoms. you could have other things going on, maybe in the neurology world, that simple routine blood tests would never identify. never say never.

(was typing while chronie too was posting. LOL.... slow typer)
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Re: Comparing Sleepyhead data with doctor anaylsis

Postby Fredd » Tue Jun 12, 2012 8:18 am

Thank you for the responses.

Although I have no doubt that I have mild sleep apnea as detected in two different sleep studies and I have no doubt that the CPAP is reducing the apneas and hypopneas to a low frequency (AHI < 2) based on the results of my second sleep study and my ongoing review of the data (using Sleepyhead software), I have quite a lot of doubt that sleep apnea is directly causing my brain fog and quite a lot of doubt that the CPAP (at the current setting of 7 cm) will correct my primary problem of brain fog.

My brain fog (inability to focus and concentrate) is described as a feeling like not fully awakening from sleep. In fact, I do not even know if I'm going to have a bad day until about an hour after I have gotten out of bed in the morning. Sometimes I fully awaken and have a very good day and sometimes I go through the whole day feeling like I'm still trying to wake up.

Of note, the brain fog is not always accompanied by fatigue and also the symptoms are very intermittent. So, on some days I have brain fog and I am tired; on some days I have brain fog and I am not tired; on some days I feel great and I feel neither tired nor brain fog and on some days I have good focus and concentration, but I am tired.

There are times when I sleep well (or so it seems) and then I have brain fog the whole day and then there are times when I go to bed late and I am only in bed for 5 or 6 hours, but throughout the day I feel good.

These symptoms occur with our without CPAP.

I have considered so many other possibilities beside sleep apnea as the cause (hypoglycemia, anemia, allergies, hypoxia, hypoxemia, seasonal affective disorder (SAD), adrenal fatigue, neurasthenia, hypoadrenia, depression, candidiasis, hypoglycemia, neuroglycopenia, inner ear problem, slow heart rate, low body temperature, thyroid related problems, multiple chemical sensitivies (MCS), histadelia, histapenia, celiac disease, hyperammonemia, hypoxia, b-12 deficiency), but blood tests, allergy tests and physician diagnoses seem to rule many of them out and some don't correlate with the symptoms.

The only definite information that I have is:
1. I have mild sleep apnea
2. I have many non-respiratory-related spontaneous arousals during sleep (more than 140 during the second sleep study even while using the CPAP)
1st sleep study:
AHI: 12.5
Spontaneous arousals: 131

2nd sleep study:
CPAP setting at 7 cm H2O
AHI: 0
Spontaneous arousals: 154

CPAP/SleepyHead Results:
Date 1st used CPAP: 4/23/12
AHI: 1.75
RERA Index: 2.15
Fredd
 
Posts: 31
Joined: Mon May 21, 2012 3:32 pm
Machine: Philips Respironics Remstar Pro
Mask: ResMed Mirage FX Nasal Mask
Humidifier: Yes
Year Diagnosed: 2012

Re: Comparing Sleepyhead data with doctor anaylsis

Postby CrohnieToo » Thu Jun 21, 2012 5:15 pm

I don't know if UARS would be pertinent here but there are some 80+ sleep disorders in addition to OSA and some sleep labs aren't any too sharp at recognizing anything other than sleep disordered breathing.
ResScan 3.10 - Resmed S8 ResLink & oximeter
ConTec CMS-50D+ oximeter - Philips EverFlo 5L Oxygen Concentrator
PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2.14.0
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Year Diagnosed: 2006



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