(01-17-2015, 06:21 PM)quiescence at last Wrote: I resemble that remark. So it is probably time to interject a question - in the interest of more tinkering, is anyone thinking they will invest in EmotivTM Insight coming out this spring? I am seriously considering it. I think I can scrape enough together soz I don't have to justify it (as a medical device) with Mrs. QAL. It sure would be fun to do some backyard [back bedroom] research with EEG to correlate with all the wonderful data grabbed and displayed by the sleepyhead.
OK, well now you're really
Looks like some The Matrix
Be sure to post here about it.
(01-17-2015, 02:50 PM)vsheline Wrote:
(01-17-2015, 12:02 PM)TyroneShoes Wrote: it makes me wonder; what would "partially arouse" someone from sleep other than a OA, CA, or H ... that could be a medically-significant sleep disturbance?
Flow Limitation caused by partial obstruction of the airway.
Although RERA events might not create significant O2 desaturations or might not reduce the Tidal Volume by at least 50% (and therefore not meet the definition of an hypopnea), the arousals will fragment sleep and can lead to fatigue and excessive daytime sleepiness.
It seems odd that something could be significant enough to partially-rouse you or invoke a response, that would not be also responded to by the xPAP, or at least flagged.
The Autoset does two things I am a little fuzzy on; it responds by raising pressure to events that it does not flag, probably related to flow limitation, and it flags events reported in SH that are "experimental", from SH's point of view, yet does not appear to respond to them.
It seems that the "experimental" events are similar to other events, but they may not reach the level of change or time limit that determines what AHI events are predicted on.
Dont feel bad for tinkering. Have myself and the wife down to less than 1 AHI 99 percent of the time. Now Im chasing down RERAs and Flow limitations and kicking SH over from AHI to RDI. Our machines flag both and by inching up the min pressure a bit at a time have about wiped out most of em. Doubt Ill ever get rid of all of em but the lower I get them the better the wife and I feel.
01-17-2015, 10:05 PM
(This post was last modified: 01-17-2015, 10:09 PM by Sleeprider.)
[quote='TyroneShoes' pid='97371' dateline='1421537833']
@ Sleeprider, your advice is great, and I am taking it under advisement. I do not expect to just brush off my hands and claim "well, that's over". I'll be checking daily looking for chinks in the armor. My thought there is that things change, and I do not trust 2014-vintage APAP technology to be smart enough to always catch everything and adjust; the ability to change parameters is there for a reason; by design.
But I am at a point where watchful waiting is the order of the day, and tinkering is on hiatus unless something pops up.
Your story piques my curiosity, tho. Should I assume that the algorithm in your older xPAP did not have the sophistication to catch certain events?
In August of 2019, assuming things don't change a lot between now and then, the 5-year (insurance) clock will have run out on my Autoset, and I expect whatever they have by then to be an improvement.
Thanks for the feedback. FWIW my sleep last night sucked for restfulness, but did drive down AHI, particularly CA. I'll try again with some "tinkering".
My older APAP was fully data capable and I used Respironics Encore Pro software to fine-tune the settings. The data was written to a Smartcard and requires a special reader to get from the machine to the computer. It was not compatible with Sleepyhead. So I was missing detailed wave form examination, and the device did not record RERA, Pressure Pulses or periodic breathing and did not identify CA events.
Fast-forward to when I started with the 60 series and Sleepyhead in mid-December this year. I have access to all those details, and it's much easier to download. This started a whole new tweaking cycle after 7 years of what I thought was as good as it gets. My experimentation with BiPAP is coming from the presence of a stubborn AHI that includes Cheyne Stokes Respiration, OA and RERA that I was totally unaware of.
I wonder what the next 5-10 years will bring. In fact, very few of us are able to see the RERA events, and many users are still be given a brick. IMO the whole sleep disturbance industry is based on trial and error, with a bunch of professionals trying their best to limit access to information and data that will let "patients" help themselves. That's been the story since I started and it's gotta change.
Yep I dont think they even try to eliminate FLs or RERAs in a sleep titration though they can plainly see them. Once they have the OA and Hypops cleared out in Obstructive Apena thats your pressure. No min no leeway on max. I dont have CA so no experience with with that other than the occasional one the machine marks.
01-18-2015, 12:27 PM
(This post was last modified: 01-18-2015, 12:27 PM by TyroneShoes.)
(01-17-2015, 08:08 PM)Ghost1958 Wrote: Dont feel bad for tinkering...
Oh, I don't feel bad about it at all. I am a born serial tinkerer (actually, not much embarrasses me either...have you seen my posts?
But I get serious about knowing when to stop tinkering, hence, the thread.
(01-17-2015, 06:37 PM)TyroneShoes Wrote: Part of being good at being an Engineer is knowing what NOT to try (hence, this thread), and I give RG the benefit of the doubt, because he seems too smart not to have learned that.
You don't want to give R_G the benefit of the doubt. One of his puppies will run off with it and you will never find it again.
how do read the graphs on sleepyhead? where do I go to learn how to read them?
(01-18-2015, 02:18 PM)rml313 Wrote: how do read the graphs on sleepyhead? where do I go to learn how to read them?
See the Beginner's Guide to SleepyHead:
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
(01-17-2015, 12:13 AM)Sleeprider Wrote: May I just reply to the original question?
I started this journey in 2008, and I'm a newbie. Yes I pretty much did like you, and then got complacent. I rode the APAP wave for 7 years with the same machine, logging almost 20,000 hours on a M-Series Auto. Along the way, I occasionally checked the charts and made minor tweaks. There is always room for improvement.
Finally in December, I was shamed into upgrading my old P.O.S. and got a 60 series Auto. I was able to cut my AHI in half with that, but I'm still dragging a bit, and now that I can see them, i've got a bunch of CAs to deal with.
So today I got a PR S1 Auto BiPAP Series 60. Very cool machine, and I'm going to learn to use it tonight.
Just saying, the journey may pause, and that's good. Things need to settle, but stay engaged and look for improvements. It was just "this close" to passing me up. This journey is one we are obliged to continue for the rest of our lives. Things change and we need to adapt and learn new tricks.
By helping others, you will advance your own knowledge and progress. You've already well along that path from what I've seen.
Ok, so I know I have gone on about my apnea diagnosis being a shock and having a hard time dealing with it but that's not *exactly* true. I am the oldest of five - I have three brothers and a sister. All three of my brothers are on CPAP treatment (or supposed to be - as one is resistant and I don't believe he uses his machine any more).
Anyway, in the past week as I've become familiar with all the posts on this board, the helpful info, the changes/adjustments/updates etc. I am horrified that none of my brothers are actively participating in assessing how their treatment is going. I think they just took their CPAP machines - hook up every night and then went merrily on their way with the exception of getting a new mask every now and again.
I texted one of my brothers telling him about this board, about my new machine and he texted me back "I have CPAP envy" lol.
But I've gotta get them on the grid here - I'm worried.