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Big Thank You!, DS2=>AS10, my first Oscar
#1
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Big Thank You!, DS2=>AS10, my first Oscar
So, I followed the advice I got from multiple people here. Yesterday I bought an AirSense 10 (on my dime, i.e. without waiting for my sleep care center to return my messages, let alone waiting for the FDA/HHS to force PR to provide a key to decrypt my own DS2 data) and configured it according to the advicee I got from you.

Thank you, guys and gals, I cannot praise you enough. You are awesome. Seriously, you guys compressed years of experience and frustration with a "system" that would like to stay opaque and made a ton of super valueable information accessible to everyone.

I was even able to save my sleep data on an SD card right off the bat from the first night and look at it with Oscar (see attachments). Is there something someone can tell about what might be wrong with my sleep or my AS10 setup?

Thank you

fillmore


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#2
RE: Big Thank You!, DS2=>AS10, my first Oscar
The first change I would make is increasing Min. pressure to 6 from 5. EPR 2 will work much better with the increase. EPR needs the correct Min pressure or it's limited in helpfulness. The math: Min pressure minus EPR number equals Y, where Y will never be below 4, the lowest pressure the PAP can go.

Min. pressure and EPR settings work as follows with Min pressure that actually works with EPR operating fully:
Pressure 4 EPR 0 equals pressure 4 as lowest
pressure 5 EPR 1 equals pressure 4 as lowest
pressure 6 EPR 2 equals pressure 4 as lowest
pressure 7 EPR 3 equals pressure 4 as lowest
and so on following at all times pressure x minus EPR number equals y

Right now, your min pressure 5 - EPR 2 = 3 BUT it cannot do this as is, again 4 is your lowest possible. So the edit to 6 pressure minimum corrects this, so EPR works unhindered. I think it will feel better for you with EPR working fully.

Second, Ramp can be a hindrance, blocking therapy for the time duration of Ramp, and it can introduce disruptions to sleep when it expires. I would reduce the time of it and increase the Ramp pressure to 5 at least. This is if you feel you can't do without the Ramp. Best case scenario is turn Ramp off altogether.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Big Thank You!, DS2=>AS10, my first Oscar
(10-30-2021, 10:46 AM)SarcasticDave94 Wrote: The first change I would make is increasing Min. pressure to 6 from 5. EPR 2 will work much better with the increase. EPR needs the correct Min pressure or it's limited in helpfulness. The math: Min pressure minus EPR number equals Y, where Y will never be below 4, the lowest pressure the PAP can go.

Right now, your min pressure 5 - EPR 2 = 3 BUT it cannot do this as is, again 4 is your lowest possible. So the edit to 6 pressure minimum corrects this, so EPR works unhindered. I think it will feel better for you with EPR working fully.

Second, Ramp can be a hindrance, blocking therapy for the time duration of Ramp, and it can introduce disruptions to sleep when it expires. I would reduce the time of it and increase the Ramp pressure to 5 at least. This is if you feel you can't do without the Ramp. Best case scenario is turn Ramp off altogether.

Thank you so much for the detailed explanation, Dave. I just applied the changes you recommended (min pressure 6, and Ramp off). Curious to see how things go tonight. 

Would it make sense for me to go up or down with both EPR and min pressure in lockstep? Assuming the two settings will be consistent in the way you indicated, what are the pros and cons of a higher min press (and a higher EPR)?

Last time I talked to my sleep doctor in September she looked at my (DS2) data and she told me that she would set my machine to constant pressure 9, so I used that number as an indication of a mean value for my min and max pressure. Was my reasoning sound? As AirSense is smart enough to adjust dynamically, I figured that a wide range for min/max would have no downsides, but maybe I'm wrong, maybe there *is* an advantage in selecting a tighter range. I am attaching another diagram that describes the pressure. Not sure if the information in it is significant...


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#4
RE: Big Thank You!, DS2=>AS10, my first Oscar
I'm going to be just a bit more radical and suggest a minimum pressure of 8.0, maximum pressure 11.0, EPR 3. Your events are mainly OA and some H, and generally occur when EPAP falls below 6.0. The higher minimum pressure will give a low pressure of 8.0/5.0 and I actually think we will eventually move it to a minimum of 9.0. The Autoset is responsive enough to prevent most events and I think this change will improve both comfort and results. There are quite a few spikes in the flow rate giving a "grassy" appearance to the chart. This is usually related to some residual flow limitation, and the higher EPR should knock it out. Congrats on the new machine. I'm certain you did the right thing. The only message Philips is going to understand is the loss of market share when enough patients start to fight for the right to their data.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#5
RE: Big Thank You!, DS2=>AS10, my first Oscar
(10-30-2021, 12:16 PM)Sleeprider Wrote: I'm going to be just a bit more radical and suggest a minimum pressure of 8.0, maximum pressure 11.0, EPR 3.  Your events are mainly OA and some H, and generally occur when EPAP falls below 6.0.  The higher minimum pressure will give a low pressure of 8.0/5.0 and I actually think we will eventually move it to a minimum of 9.0.  The Autoset is responsive enough to prevent most events and I think this change will improve both comfort and results.  There are quite a few spikes in the flow rate giving a "grassy" appearance to the chart. This is usually related to some residual flow limitation, and the higher EPR should knock it out.  Congrats on the new machine. I'm certain you did the right thing.  The only message Philips is going to understand is the loss of market share when enough patients start to fight for the right to their data.

Thank you Sleeprider. I have applied your more aggressive settings. Let's see how things go tonight.

About Philips, I filed a complaint with FDA/HHS and they confirmed they got it. Let's see how that goes. Worth fighting for those less fortunate than me (paying for new CPAP on the spur of the moment didn't break the bank for me, but it may be onerous for others)
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#6
RE: Big Thank You!, DS2=>AS10, my first Oscar
here's the Oscar dataviz related to last night using Sleeprider's recommended settings.

Does it look like an improvement? For some reason I woke up earlier. I went to sleep a little bit more without any CPAP after that.

Thanks

Fillmore


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#7
RE: Big Thank You!, DS2=>AS10, my first Oscar
I lied down on the couch for a sec and slept like a log for 2 hours. Maybe it wasn't such a sound night of sleep after all...  Too-funny
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#8
RE: Big Thank You!, DS2=>AS10, my first Oscar
You had a cluster of OA at the beginning of the night, then a pretty clean night. An OA at 02:15 arose out of minimum pressure, and the other one at 03:20 had a flow limitation ahead of it that raised pressure near the maximum. Clear airway events increased with the higher pressure and pressure support. Flow limit dropped to zero for the 95% value. Over all, either setting looks pretty darn good. I think it might be worth continuing at this pressure and see how it settles out. It's really a subjective matter of whether you found the lower or higher EPR more comfortable. If you prefer EPR at 2, then I would drop minimum pressure back to 7.0, if you liked EPR at 3, then just keep things the same.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
Post Reply Post Reply
#9
RE: Big Thank You!, DS2=>AS10, my first Oscar
(10-30-2021, 10:01 AM)fillmore50 Wrote: So, I followed the advice I got from multiple people here. Yesterday I bought an AirSense 10 (on my dime, i.e. without waiting for my sleep care center to return my messages, let alone waiting for the FDA/HHS to force PR to provide a key to decrypt my own DS2 data) and configured it according to the advicee I got from you.

Thank you, guys and gals, I cannot praise you enough. You are awesome. Seriously, you guys compressed years of experience and frustration with a "system" that would like to stay opaque and made a ton of super valueable information accessible to everyone.

Just hang in there.  We are glad you are here and that we all can help you. Welcome
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

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#10
RE: Big Thank You!, DS2=>AS10, my first Oscar
(10-31-2021, 02:44 PM)Sleeprider Wrote: f you prefer EPR at 2, then I would drop minimum pressure back to 7.0, if you liked EPR at 3, then just keep things the same.

Thanks a ton, Sleeprider. I'll keep monitoring the situation.

Fillmore
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