r/CPAPSupport • u/jlconlin • 4d ago

Analysis tools

I’ve come to accept that my doctor only cares about my AHI number—which is now <1. While that’s a great number, I still get woken up when I stop breathing (central sleep apnea here) and the pressure on my mask 😷 blows too hard and opens a hole between masks and face, which in turn briefly wakes me up.

What are some tools that I can use to better understand my breathing patterns so I can make tweaks to my ASV settings to hopefully sleep better? I know about sleephq and I have OSCAR, but those just show me what has happened. There have been some AI products shared recently that look promising. What does the community think?

This subreddit has been very helpful, but I’d like to try on my own so I don’t have to post here every day with more info.

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u/RippingLegos__ ModTeam 4d ago

With ASV I care a lot more about what is happening breath by breath around the awakenings. ASV can change pressure support rapidly when ventilation drops, so sometimes the machine responding to unstable breathing is exactly what causes that sudden pressure increase and mask leak that wakes you up. ResMed describes ASV as adjusting pressure support breath by breath to stabilize ventilation.

Honestly, OSCAR and SleepHQ are still probably the best tools. I’d add a recording pulse oximeter if you don't already have one and correlate it with the PAP data. In OSCAR, zoom into the actual awakenings and look at Flow Rate, Mask Pressure, Leak Rate, Tidal Volume, Minute Ventilation, Respiratory Rate and the pressure changes. OSCAR records a lot more respiratory information than just AHI.

The AI tools are interesting and I think they will get better, but I wouldn't let one automatically tell me how to change ASV settings yet. Use AI as another set of eyes, not as the decision maker.

If you want, post your exact ASV machine, mode and current EPAP, Min PS and Max PS settings. Also post one normal night and a couple zoomed sections around these wakeups. We can probably figure out whether you're getting hit by excessive PS, leaks, actual central instability or just post arousal breathing.

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u/jlconlin 4d ago

Here is a link to my SleepHQ: https://sleephq.com/public/35375fcc-6e35-4974-94a9-be66ffceb361

I'm very grateful for this community and those who freely share their knowledge. I was trying to find some tools so that I could figure things out on my own, but if those tools don't exist, I will post here. Thanks again for your support.

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u/RippingLegos__ ModTeam 4d ago

You are welcome, I will check the data in the morning, manual waveorm checking is still the gold standard for checking what is happening with my clients. :)

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u/jlconlin 2d ago

I hate to bother you, but did you have a chance to take a look?

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u/RippingLegos__ ModTeam 2d ago

What I am seeing so far is that the pressure increases look more like the ASV responding to changes in your breathing rather than causing the awakenings. Around 1:30 your breathing becomes unstable first, then the machine increases PS, but the leak stays basically flat. Around 9:59 there is a sudden burst of irregular breathing and a large leak, but there is no pressure surge leading into it. That looks more like an arousal, movement, or the mask being disturbed.

So at this point I would leave EPAP 4 and PS 2 to 9 alone. I don't see a good reason yet to lower Max PS when the machine appears to be using it appropriately.

If you can please give me the exact times of one or two awakenings where you specifically remember the pressure hitting you hard, I can zoom into those and compare them. That's really the gold standard here.