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Almost a month so far...
#1
Now that I've been using my machine for almost a month, I thought it might be time to post some screen shots of Sleepyhead to see if anyone has any suggestions on how I could do better...

I tried to follow the directions on arranging Sleepyhead... Hopefully I did it right... Got horrible sleep last night... Figure that's the time to do it.. Ugh.

Thanks!


   

   

   

   
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#2
Results look excellent. At 5-15 pressure EPR 3 you have near-zero obstructive events and a very low level of CA. The lack of pattern in the CA suggests this is probably sleep transition or movement. You could probably narrow your range to 7-11 based on the pressure statistics and have no real impact on therapy, and it might actually stabilize pressure lower. The minimum pressure of 7.0 works with your current EPR to provide an EPAP of 4, and the machine will be more responsive if you make that change. You have had good results at 5 to 15 pressure and only tried one night at EPR 2 where AHI went higher, but we don't know what type of events increased.
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#3
Yeah, seems to be working well so far... As you can see, I was lowering the EPR, but after a night decided to put it back where it was since things seemed to be working ok...

I was wondering about raising the pressure to 7, but didn't know if I should do that until the machine is officially mine... The DME I got it from said something about it being a rental for 10 months (paid for by insurance) until I get 70% compliance for 30 days.... (I'm at day 26 of 100% compliance so far.) They've been such a pain to deal with that I don't want to give them any excuse to postpone the machine being paid for by my insurance.

Once it's mine, I'll most likely try a minimum pressure of 7.

Thanks for the advice!
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#4
You numbers look great, No real suggestions

You may find the number of CA's drop if you reduce the EPR from 3 to 2

Also you may be more comfortable if you raise the minimum pressure from 5 to 7 so there are not so many pressure swings... These suggestions are for comfort only as your normal AHI is under two which is good.
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#5
Every DME is different it seems in regard to how difficult or easy they are to work with. In my experience dealing with 2 DMEs, they really haven't scrutinized the settings. All of the changes I've made were within the parameters of my prescription (APAP 7-20) and have never had poor numbers. Recently I've changed therapy modes altogether and made some significant changes to settings and I haven't gotten any flak from them. I believe that so long as numbers and usage look good they likely won't give you a hard time, but when you get the ego driven RT frustrated, who knows.
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#6
I decided to up my lower setting to 7, turn off ramp, and left the EPR at 3...  I'll play with that after I see how the increased pressure does...

So far so good... I figure I can feign ignorance if the DME complains... What?  7?  How did that happen?

Really, they can't complain much... I've been 100% compliant since I started...   Smile
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#7
(06-01-2018, 08:05 PM)SoCalCpapGuy Wrote:
I decided to up my lower setting to 7, turn off ramp, and left the EPR at 3...  I'll play with that after I see how the increased pressure does...

So far so good... I figure I can feign ignorance if the DME complains... What?  7?  How did that happen?

Really, they can't complain much... I've been 100% compliant since I started...   Smile

I got in trouble for compliance once. I was using different machines and the DME couldn't or wouldn't piece all of the machine data together to sum the time for compliance. They told me to "quit playing" and "be a good boy". Had to give a solid 30 days on 1 machine to get back in good graces to receive supplies. It was worth it.
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#8
(06-01-2018, 08:16 PM)JesseLee Wrote:
(06-01-2018, 08:05 PM)SoCalCpapGuy Wrote:
I decided to up my lower setting to 7, turn off ramp, and left the EPR at 3...  I'll play with that after I see how the increased pressure does...

So far so good... I figure I can feign ignorance if the DME complains... What?  7?  How did that happen?

Really, they can't complain much... I've been 100% compliant since I started...   Smile

I got in trouble for compliance once. I was using different machines and the DME couldn't or wouldn't piece all of the machine data together to sum the time for compliance. They told me to "quit playing" and "be a good boy". Had to give a solid 30 days on 1 machine to get back in good graces to receive supplies. It was worth it.

I've only got one machine, so they'll at least see that I've used it every night... By the time I see my doc, I'll have used it close to 3 months with 100% Compliance...  Hopefully the DME will be happy...
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#9
(06-01-2018, 08:05 PM)SoCalCpapGuy Wrote:
I decided to up my lower setting to 7, turn off ramp, and left the EPR at 3...  I'll play with that after I see how the increased pressure does...

So far so good... I figure I can feign ignorance if the DME complains... What?  7?  How did that happen?

Really, they can't complain much... I've been 100% compliant since I started...   Smile

They are almost universally concerned only with compliance (4+ hours/day; 70% days/month).  They definitely don't care if you turn off Ramp, and even the most controlling probably wouldn't notice the EPR.  They just don't want you to violate Medicare/Medicaid rules.
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#10
(06-01-2018, 09:32 PM)OShaunBlake Wrote:
(06-01-2018, 08:05 PM)SoCalCpapGuy Wrote:
I decided to up my lower setting to 7, turn off ramp, and left the EPR at 3...  I'll play with that after I see how the increased pressure does...

So far so good... I figure I can feign ignorance if the DME complains... What?  7?  How did that happen?

Really, they can't complain much... I've been 100% compliant since I started...   Smile

They are almost universally concerned only with compliance (4+ hours/day; 70% days/month).  They definitely don't care if you turn off Ramp, and even the most controlling probably wouldn't notice the EPR.  They just don't want you to violate Medicare/Medicaid rules.

I think you said it well Shaun. If the DME were out to violate people on noncompliance, it would in essence be like shooting themselves in the foot.
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