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APAP Discussion
#1
(12-07-2013, 03:50 AM)welshmike Wrote: However, because I had the best night's sleep over Thursday night while forcing myself to sleep on my left side by wearing a towel stuffed backpack I will, subject to what I will read on the UK forum, repeat that exercise.

That's a good remedy for now.

It's hard to say how the S9 responds to the breathing patterns it detects. It has two sensors, pressure and flow rate. When you sleep on your back it's likely that your airway is more collapsed, causing the pressure to rise. You could combat this by lowering the upper end of your pressure range, but I wouldn't do that until taking a closer look at the data.

When these pressure boosts wake you up, do you find yourself lying on your back?
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#2
(12-07-2013, 09:36 PM)Sleepster Wrote: That's a good remedy for now.
It's hard to say how the S9 responds to the breathing patterns it detects. It has two sensors, pressure and flow rate. When you sleep on your back it's likely that your airway is more collapsed, causing the pressure to rise. You could combat this by lowering the upper end of your pressure range, but I wouldn't do that until taking a closer look at the data.
When these pressure boosts wake you up, do you find yourself lying on your back?
Sleepster,
As someone more experienced with discussing such matters... let me ask a follow up Q to your point highlighted above - Do you suppose companies like ResMed [ & Phillips/Respironics]... do you suppose they have produced educational materials to at least explain to our HealthCare "professionals" just how these "Auto" machines respond to what I must assume are our "bodies" many different symptoms !??
Regards,
Sam Ross
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#3
Yes. Those materials are promotional. It's all about marketing.

The actual algorithm used is a closely-guarded secret. I suppose the secret could be uncovered, but it would be hard to do and if anyone has done it they've kept it to themselves.

The problem is that the machine can get "carried away", raising the pressure so high it causes the patient to awaken. That's why the pressure range can be adjusted to something more narrow than the wide-open 4 cm to 20 cm.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
(12-08-2013, 02:32 PM)Sleepster Wrote: Yes. Those materials are promotional. It's all about marketing.
The actual algorithm used is a closely-guarded secret. I suppose the secret could be uncovered, but it would be hard to do and if anyone has done it they've kept it to themselves.
The problem is that the machine can get "carried away", raising the pressure so high it causes the patient to awaken. That's why the pressure range can be adjusted to something more narrow than the wide-open 4 cm to 20 cm.
Sleepster - I suspect you and I share many of the same beliefs as to how much "marketing" drives the lack of "forthright" information (to us patients) coming from the manufacturers.
Further, I believe they are also "skimpy" in the amount of "forthright" information given to the MD(s) and Tech(s) trying to treat us.
Add to this what I suspect are very rigid & often "nonsensical" Medicare & other insurance billing restrictions... well you surely can see by now my level of scepticism !

Q - Should such "frank" discussions be split away from thid general "intro" THREAD at some point?
New Subject
I'm also trying to get a handle on the certifications for MD(s) in the U.S. and the "subspecialty" certifications for "Sleep Medicine"... and found it ONLY SLOWLY improving. I find the most trustworthy information can be found at Wikipedia... where they show that only the Primary Care, Neurologists, & Psychiatrists can be certified for a "Sleep Medicine" "SUBspecialty"! My primary care MD has made the comment that "...that area is quite profitable..."!!
Regards,
Sam Ross
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#5
Kelsey-Seybold is a major player here, and their pulmonologists treat SDB. I've never used them. My ENT prescribed the CPAP, but he's not much help. My PCP physician at least tries to help. The sleep lab and the DME were both disappointing. I'm still getting my supplies from that same DME. Very limited mask choices. So far I've been underwhelmed with the level of treatment I've received for my SDB.

Fortunately, CPAP therapy seems to be working for me.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#6
quote='Tez62' pid='51587' dateline='1386363545']
Side sleeping will not stop apnea's, nothing will, they maybe reduced a little but once your CPAP detects an apnea, your pressure will increase opening your airway allowing you to breathe again.
[/quote]

From my recent experience I disagree.

I tried sleeping on my back with the hose coming over my head and had several obstructive apneas. Last night and the night before I started sleeping on my left side with the hose coming in from the side of my bed (of course) and am kept on that side most of the night by wearing my towel stuffed backpack.

However when I have been woken up just once or twice, possibly by the APAP increasing its air pressure, I find that I am nearly on my back.

The chart from the SD card shows an obstructive event. The leads me believe that my soft palate had closed my airway.

So for me it is sleep on my left side, mask coming over the bedside, wear backpack.
Death is not the greatest loss in life. The greatest loss is what dies inside us while we live.
http://en.wikipedia.org/wiki/Norman_Cousins
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#7
APAP's don't increase the pressure during an event. It's only after the event that the pressure is raised.

Sleeping on my side allows me to set my machine at a lower pressure because it prevents many apneas and hypopneas from occurring.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
(12-11-2013, 03:37 PM)Sleepster Wrote: APAP's don't increase the pressure during an event. It's only after the event that the pressure is raised.

Sleeping on my side allows me to set my machine at a lower pressure because it prevents many apneas and hypopneas from occurring.
I understand that the APAP is increasing the pressure to force air past my closed soft palate so that air movement into an out of my lungs is resumed.
That increased pressure wakes me up.
My APAP's pressure range has been set by the respiratory clinical nurse specialist and I understand that I must not change it. She will if appropriate after she has seen the data from on my SD card.
I am forcing myself to sleep on my side to reduce the potential for OSAs happening.

Death is not the greatest loss in life. The greatest loss is what dies inside us while we live.
http://en.wikipedia.org/wiki/Norman_Cousins
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#9
(12-11-2013, 03:37 PM)Sleepster Wrote: APAP's don't increase the pressure during an event. It's only after the event that the pressure is raised.

That's what my sleep doctor said and that's the reason he doesn't like auto machines. You have to have an event for the pressure to adjust instead of using a set pressure and not having any events.

He gave me an auto machine because I insisted but he kept the range narrow and based on my stats he may be correct.
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#10
I've split this thread from the Success Story thread because it has, mostly because of me, diverged into a discussion of APAP algorithms, etc.

APAP's will indeed wait until you've had an event before raising the pressure in response to them. This is a fact that the manufacturers don't advertise. Nevertheless, they still offer benefits to many patients. Folks who require high pressures like them because they allow them to spend more time at lower pressures. They can also be used to titrate a patient when the results from a proper sleep study are not definitive. If you're a geek like me, and you're lucky enough to not need an uncomfortably high pressure, you can do all the adjusting with a good CPAP machine, the right software, and a lot of patience.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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