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[CPAP] Do sleep MD's use memory card data?
#11
My pulmonologist looks at the Data report from ResScan for the last 30 days. He now just has me print it out for him.

With CSR and PB I have seen different definitions and I am not sure which ones are correct. The first definition that I found for CSR described the waxing and waning and said that the apneas had to be CA in order for it to be CSR. If it was OA then it was PB. Since then I have seen definitions that say that any kind of apneic event between the patterns of waxing and waning, make it CSR.

Best Regards,

PaytonA
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#12
Hi beet,
WELCOME! to the forum.!

Good luck to you with your CPAP therapy.
trish6hundred
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#13
Hi beet and hwka welcome to the Apnea Board. As you can see from discussions on this Board we (including me) have seen all kinds of Sleep Doctors from the worst to the best. My advice is learn everything that you can and using SRlevine's approach try to have the best discussion you can have with your Doctor. You need the right machine and a proper fitting mask. If you need to fine tune your therapy there are plenty of suggestions here that can help you. Worst case is you have to find a better doctor. beet, yes there are lots of misinformative posts regarding Central Apnea, Periodic Breathing and CSR. Be aware that there are several of us who are quite aware of different manifestations of CA and provide warnings about the relationship between Congestive Heart Failure and Central Apnea including CSR. Be also aware that a rare few of us actually suffer from Central Apnea unrelated to any heart condition. In my case a night on a standard CPAP machine at pressures above 7 cm H20 will produce some very scary CSR waveforms in Sleepyhead. At lower pressures (5 cm H2O - standard CPAP) the wave forms are a night of Periodic Breathing and Central Hypopnea. Lots of desats as well. In addition our xPAP machines can cause CO2 washout especially from IPAP EPAP differentials. This in turn triggers Periodic Breathing, Central Apneas and Central Hypopneas. In most cases adjusting the EPAP and Pressure Differentials minimises this kind of Apnea. Mixed apnea is another problem for some of us. That is a combination of Obstructive Apnea and Central Apnea. The ASV machine is the answer to our need for respiratory intervention. Now regarding Central Apnea and CHF, the appearance of Central Apnea and CSR out of nowhere can signal a worsening of a heart condition and indicates the need for a visit to the cardiologist. The good news is that there are treatments for CHF and that CSR may be one of the body’s attempts to reduce the load on the heart. Finally the caution that use of ASV is contra indicated in CHF patients with an ejection fraction equal to or lower than 45%. So, both of you keep reading and stay in touch.

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

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#14
The difficulty here is determining whether the information recovered from a home xPAP machine is valid.
Sleep Labs of course have the ability to cross-refer any graphical disturbance using sophisticated equipment ..EEG , ECG , Oximetry and a host of body sensors etc to resolve most if not all uncertainties.
This is why I favour listening to your specialist and making the assumption that he/she is on the case and acting in your best interests.
Not to say there are not exceptions...and I have experienced two bottom-feeders -one a specialist the other a provider - but no point boring you with the details except to say they got dumped and I moved on.
I read all the forums - not just this one. I use Sleepyhead every morning - looking for clues. I am a mouth-breather but I just purchased a nasal pillow mask (Philips Nuance) and was surprised by the result and it may become my mask of choice (but too early to say) as I used a few tips gained here and it seems I can adapt.
Surprised how few on these forums seem to be trying oximeters which would certainly resolve - or help to resolve - some of the possible misinterpretations of the software and decrease the anxiety level. After watching a product video I wrote direct to Nonin about their x-Pod product. They do not "supply the public" the writer replied apologetically. I found a distributor subsequently - the price was $985 !
OK - not so surprised any more. But I ordered a CMS50F a week ago - should arrive shortly and hope to junk a number of suspect OA and CA if the SPo2 levels do not confirm. My guess on many of these occasions is poor mask fit - which is supported by high leak rate presentation. FFM masks have an endemic mask fit problem here which is why I am experimenting with the Nuance Pillow mask. I navigate the bed boundaries and hate sleeping on my back and favour mouth - breathing so it was assumed by all that I required a FFM. No more assumptions. All this indicates I am a slow learner. Not really. I was diagnosed moderate to severe in Jan 2013. Went through all the hoops but after they hoovered my wallet I was not getting any of the promised results and compliance fell to zero. Found Sleepyhead and a considerable dose of introspection only a few weeks ago but the results are very encouraging. Might have to change my screen name to Under New Management.


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#15
What kind of desats do you think that should get with real CAs?
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#16
(09-23-2016, 09:00 AM)hwka Wrote: The difficulty here is determining whether the information recovered from a home xPAP machine is valid.

We already know that some of the data scored as Apneic events are the result of breathing changes when transitioning from wakefulness to sleep and the reverse. We also recognize that the machine itself can induce Periodic Breathing and Central Apnea. The machine can recognize these events scores them and Sleepyhead points them out in the graphs. These are not machine errors. Errors occur when interpreting those events as a medical condition. Experience is one of the keys to interpreting data whether it be a PSG or machine data. I have sat with Sleep Techs who could not differentiate different types of Hypopneas in a PSG. They just lacked the training and direction. I also had a Sleep Doc who did not recognize Periodic Breathing and Central Apnea. It took many Sleepyhead printouts to educate my new highly qualified Sleep Doc as to the nature of my condition. Educate yourself. Read the clinicians manuals and the training manuals that are available. Then when you can, I hope you would post some of your data highlighting areas that you suspect might not be valid and other areas that might concern you.

Rich
Apnea Board Member RobySue has posted a Beginners Guide to Sleepyhead Software here:  http://www.apneaboard.com/wiki/index.php...SleepyHead

Download Sleepyhead
Organize your Sleepyhead Charts
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