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[CPAP] Do sleep MD's use memory card data?
#1
My sleep doctor, the director of the sleep clinic at a very prestigious medical center, only refers to the daily statistics transmitted via the modem of my ResMed A10. He did not even want to read the data from my memory card to get the detailed, minute-by-minute statistics. He has no interest in seeing how my events correlate in time with pressure, respiration, etc (even after I requested his advice on whether I should reduce my maximum pressure to reduce the pressure on my mask required to avoid leaks).

I'm curious whether this is typical, or whether a substantial fraction of sleep specialist MD's do analyze the detailed graphs.
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#2
Here is one point of data: I mentioned it to mine. He said something to the effect that "that is useless, I don't even have the software to read it". That data is all based on statistical analysis of flow data. It is a lot less dependable than what comes out of a sleep lab. I'd probably be reluctant to use it for medical diagnosis too. My respiratory therapist is quite happy to look at, but she is not a doctor and has no access to a real sleep lab.
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#3
Be glad your doc is looking at anything other than time used. Most sleep docs are flooded with patients. Looking at detailed data on a regular basis would be far too time consuming. That is what Respiratory Therapists are for. A good one can help you with the data, the mask, everything.
PaulaO2
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#4
There is some truth in what was said above. I have consulted with two RTs, both frequently work with apnea parients. One shared that some will look at the data, but he also shared that the data feom the machinen is just one small piece of the Puzzle. Consilt with the RT, then et a script from your doc as needed.
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#5
The RT at this facility (who scored my sleep study for the MD) says he's only allowed to give general advice and is not allowed to give advice to patients based on their individual data.

Since I have an APAP machine, I don’t need any further RX. I'm essentially on my own, with the help of this forum, of course.
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#6
(09-21-2016, 09:48 PM)beet Wrote: My sleep doctor, the director of the sleep clinic at a very prestigious medical center, only refers to the daily statistics transmitted via the modem of my ResMed A10. He did not even want to read the data from my memory card to get the detailed, minute-by-minute statistics. He has no interest in seeing how my events correlate in time with pressure, respiration, etc (even after I requested his advice on whether I should reduce my maximum pressure to reduce the pressure on my mask required to avoid leaks).

I'm curious whether this is typical, or whether a substantial fraction of sleep specialist MD's do analyze the detailed graphs.

My sleep doctor, also the director of the sleep clinic at a very prestigious university medical center, looks at whatever I bring him and answers whatever questions I have. As for dealing with data, I print out sample reports and circle things I am interested in. He will load the SD card to look at the detailed data if I give him the dates of interest.

I guess it is all a matter of attitude and presentation. I would try again, send him some printouts and your questions in advance and ask if a personal face-to-face consultation is required. If you do not know the right questions, post some of your data and check some of the wonderful posts in this forum. Best of luck.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#7
I assume that in such a litigious society as ours if the modem data raised a flag he would be right on it.
No flags - no need for time wasting.
We all need to trust the specialists.
This type of forum is great in that it provides a valuable service for sleep apnoea patients.
However this does raise a point in that a little knowledge can be a dangerous thing.
Recently on a number of similar forums there is considerable anxiety about PB and Cheyne Stokes.
Certainly if you have any suspicions you must raise them with your reviewer or specialist.
Cheyne Stokes is a very serious condition but is wide open to misinterpretation using data recorded to disk from home machines.
A comforting thought ought be that it is highly unlikely that such a serious condition would exist in an otherwise healthly patient and the rule of thumb should be if you feel ok and your AHI is reasonable then you are likely not experiencing a problem.
I recently looked ay my Sleephead data and was shocked to see an AHI of 67 !
I had way over a hundred incidents of CA , OA , RERA , PB and classic Cheyne Stokes presentations.
I looked up Cheyne Stokes - I had heard the term but had never experienced them to my knowledge.
They were classic presentations ...continual waxing and waning with periods up to 20 second OA's in between.
But I felt better than usual.
The chart also presented a Large Leak and that turned out to be the problem...a poorly fitted mask on an individual that cannot tolerate sleeping supine for more than a few minutes , and tosses and turns under a FFM.
Why the machine misinterprets this data incorrectly no one knows.
I understand that Sleepyhead used to list CSR in its menu but no longer does so perhaps because of this uncertainty.
I would never minimise the risks and concerns of patients with a genuine CS report but it is comforting to know that it is quite a rare condition.
Never say never...but I am also confident that your sleep doctor at a "prestigious medical clinic" would be well aware of how quickly his career would disappear if he was lax or negligent.
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#8
I agree with Paula 02.
I asked my DR. if he had looked at my data. He said no, He said: If he asked DME to send him the data, They send over a giant stack and he doesn't have time to go through them.
It's all unfortunately a racket.
That's why you need to self educate yourself. I would bet
there are plenty of people on this board that know way more than 90% of sleep doctors about sleep apnea.
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#9
Knowing what I know now, if my sleep doctor (or the PA) didn't look at some of the example data, I'd be finding myself a new sleep clinic. AHI is calculated over the whole night and does not include RERAs in the calculations. All my events occur during near REM and REM and are mostly RERA. So the calculated AHI is inaccurate for what is occurring. While an AHI of 1.2 is actually still very good for someone who has apnea events and few RERAs all night long, for me it's a worse picture. This may differ from you, so it helps to look at the raw data from your study as well as your Sleepyhead output.
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#10
(09-22-2016, 06:35 AM)hwka Wrote: However this does raise a point in that a little knowledge can be a dangerous thing.
Recently on a number of similar forums there is considerable anxiety about PB and Cheyne Stokes.
Certainly if you have any suspicions you must raise them with your reviewer or specialist.
Cheyne Stokes is a very serious condition but is wide open to misinterpretation using data recorded to disk from home machines.
A comforting thought ought be that it is highly unlikely that such a serious condition would exist in an otherwise healthly patient and the rule of thumb should be if you feel ok and your AHI is reasonable then you are likely not experiencing a problem.
I recently looked ay my Sleephead data and was shocked to see an AHI of 67 !
I had way over a hundred incidents of CA , OA , RERA , PB and classic Cheyne Stokes presentations.
I looked up Cheyne Stokes - I had heard the term but had never experienced them to my knowledge.
They were classic presentations ...continual waxing and waning with periods up to 20 second OA's in between.
But I felt better than usual.
The chart also presented a Large Leak and that turned out to be the problem...a poorly fitted mask on an individual that cannot tolerate sleeping supine for more than a few minutes , and tosses and turns under a FFM.
Why the machine misinterprets this data incorrectly no one knows.
I understand that Sleepyhead used to list CSR in its menu but no longer does so perhaps because of this uncertainty.
I would never minimise the risks and concerns of patients with a genuine CS report but it is comforting to know that it is quite a rare condition.
Never say never...but I am also confident that your sleep doctor at a "prestigious medical clinic" would be well aware of how quickly his career would disappear if he was lax or negligent.
You bet I was surprised to see CSR/PB in both ResScan and Sleepyhead (reacting to the same data and in the absence of large leaks). I waited for two weeks for a trend and I was still showing episodes of CSR/PB which is suggestive of CHF (Congestive Heart Failure, Edema, kidney issues, etc.).

My sleep doctor and pulmonologist said to talk to my cardiologist (arrhythmia) and I was given an echocardiogram and blood tests -- my BNP was 236 against a normal baseline of 35. Definitely some retained fluid -- easily fixed with a mild diuretic.

So it does pay to react to the data -- if there are multiple occurrences of flagged events over time in the absence of large leaks.

But that is life's crapshoot -- with a multiplicity of factors and interpretations.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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