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Comments on Data Please
#21
(06-07-2016, 08:12 PM)justMongo Wrote: I wonder why SH says: "Please note: This day has missing pressure, mode and settings data."

The latest SleepyHead says the same thing with my DreamStation in every mode but CPAP. I reported it as a bug.
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#22
(06-07-2016, 08:12 PM)justMongo Wrote: I wonder why SH says: "Please note: This day has missing pressure, mode and settings data."


I believe green wings stated in an earlier post that she is using Auto Trial mode on her Cpap machine. That may have something to do with it.
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#23
I am running the "BrokenGL" version of SleepyHead because I have an old laptop running Windows XP.

I also was running my machine in auto-trial mode for the night of that graph. For some reason, SH doesn't detect all the pressure settings when I'm in auto-trial mode.

You can see all the settings below the pie chart. I think.

(06-07-2016, 08:12 PM)justMongo Wrote: I wonder why SH says: "Please note: This day has missing pressure, mode and settings data."

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#24
No, I was running the machine in auto-trial mode. Sorry, I forgot to say that. That graph was from June 3, and the pressure was set at 10.0-15.0. The 7.5 was the ramp start point. There are SH reporting bugs when I'm running in auto-trial mode.

I was just reading about the difference between A-Flex and C-Flex today. It didn't make sense to me. I'll try again tomorrow.

Re the mouth leaking, I switched to from a nasal mask to nasal pillows about 2-3 weeks ago, and my mouth leaks increased quite a bit. They are gradually lessening as I continue to get used to the nasal pillows.

The mouth leaks pretty much never show up as large leaks. I don't understand why they don't, and I'm not sure how hard I should try to correct them. I'm not waking up with a dry mouth.

(06-07-2016, 04:59 PM)rkl122 Wrote: SH is reporting your PAP mode as APAP. It also shows different pressures under the statistics. Are these bugs in SH?

Whatever the regimen, if that night is typical, you're doing better on it than I am with auto and Aflex. In fact, you've given me an idea Green Wings. Before bumping my min pressure, I'm going to turn off the Aflex. Maybe that alone will improve my profile. Thanks, and good luck with the mouth breathing problem. I get that too some nights, usually after rolling to supine. A tooth guard seems helpful, presumably because it forces the jaw a bit forward, widening the airway.

-Ron

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#25
Thanks for that analysis, Rich. I'm going to have to read this again tomorrow when my head is clearer. This was the first time I had heard of FOT. I did a search & now know what it stands for, but that's about it.

Is there a particular machine that you'd recommend?

I ask that mostly out of interest. I really dropped the ball by not doing my research before I ended up with the machine I have.

I think I'd have to have some really good data to convince my sleep doctor to prescribe another machine for me.

I have mostly been playing around with the auto-trial mode to see if that algorithm could control my middle-of-the night apnea clusters.

I was surprised to find that I get better results with fixed pressure around 10.5-12.5. That doesn't do anything for the middle of the night clusters, but the overall AHI is lower. I have several nights of data that look like this:

[Image: UlbGQSx.png]

That events chart looks better than things really are, because flow limitations & snores don't get scored in fixed CPAP mode.



(06-07-2016, 07:55 PM)richb Wrote: Hi Green Wings,

It looks to me like your there is a small problem with the location of the event flags in your SH report. The first H is about 10 seconds long and maybe should have been scored an OA. It seems that your machine doesn't use the FOT technology to score CAs, so I think that either the machine or SH has to guess. Looking at the 2nd pair of event flags, that also looks like an extended OA event. It appears that you tried to take 2 unsuccessful breaths during the extended event. Both of those breaths seem to have the flattened top of an Obstructive Hypopnea breath. What was happening (in my opinion) is that you began to take a breath and your airway closed causing the flattened top. Yes that is a Flow Limitation as well. You might benefit from a more sophisticated machine. One that can better respond to your OA events and provide more diagnostic technology.

Rich

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#26
FOT is a name used by ResMed for their apnea typing algorithm.
PR machines do something similar -- but, they cannot call it FOT.

ResMed uses a 4 hertz, 1 cm-water pressure modulation; and scores the type of apnea based on the flow meter's detection.
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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#27
Thanks for that information, Mongo. I am interested in learning more about how the machines work, but I confess that when the details wander into the area of acoustics (if that's what it is), I tend to scream and run. Smile

(06-07-2016, 10:56 PM)justMongo Wrote: FOT is a name used by ResMed for their apnea typing algorithm.
PR machines do something similar -- but, they cannot call it FOT.

ResMed uses a 4 hertz, 1 cm-water pressure modulation; and scores the type of apnea based on the flow meter's detection.

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#28
(06-08-2016, 09:57 AM)green wings Wrote: ...........I am interested in learning more about how the machines work, ................
Check out the following link. I first saw it in a post from Robysue, and am grateful for it. Table 2 summarizes the different event algorithms by manufacturer.

Auto CPAP machine algorithms, etc.

-Ron
We are such stuff
As dreams are made on, and our little life
Is rounded with a sleep.
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#29
Regarding machines, people seem please with both the Resmed and the Philips Respironics machines that have the capability of multiple settings and modes. I was titrated on PR machines and currently use a Resmed. People get used to their machine after a while and then seem to prefer one after a while. There are lots of posts on machine preference and capabilities. Just don't skimp. You will want the flexbility of BiPap and Auto modes to take advantage of the expertise offered by others on this site.

Rich
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#30
Oh, thank you! I had bookmarked that article a couple of months ago but never discovered Table 2 in it. I had intended to go back to it later, but then I forgot that I had bookmarked it.

I bookmarked another article about the pressure response algorithm that was done in flowchart form, but now I can't find it.

I was reading the bit about Response to OA/Hypopnea events by the Respironics System One RemStar Auto machine in Table 2, and I don't understand all of it.

I almost never say this, but I think this stuff would be easier to understand in equation form.

It says:

"If 2 apneas or 1 apnea/1 hypopnea or 2 hypopneas-increases by 1 and holds for 30 s.

Okay, that first bit makes sense. Two events happen then pressure is increased by 1 cm.

I don't understand the timing of events after that. Does it mean that another pressure increase can happen after 30s if two more events have occurred at that point? And on and on with a pressure increase as often as each 30s until the limit described in the next statement is reached?

*NRAH logic limits max pressure to 11 or 3 higher than preapnea baseline.
*NRAH = nonresponsive apnea/hypopnea logic

??? Does that mean:

If starting pressure = 4-8, pressure can increase up to 11 cm.
If starting pressure = 8.5-17, pressure can increase by up to 3 cm.
If starting pressure is >17, pressure can increase up to max of 20.

Does that sound correct?

If more apneas within 8 min decrease pressure by 2/15 min down to 1 over level that prevents snore then holds pressure for 10 min.


Does that mean "if NO more apneas within 8 min"? I don't understand why the algorithm would want to decrease the pressure if more apneas were happening.

Anyway, if more apneas/no more apneas occur within 8 minutes (8 minutes after the last pressure increase?) then decrease the pressure gradually by 2 cm over a 15 minute period until a pressure is reached that = (Psnore + 1) with Psnore being calculated by another bit of code. Hold that pressure for 10 minutes.



Pressure will continue to increase in response to 2 hypopneas."


Only hypopneas? What happend to two apneas or 1 apnea/1 hypopnea?

I'm very confused. Oh-jeez





(06-08-2016, 11:24 AM)rkl122 Wrote:
(06-08-2016, 09:57 AM)green wings Wrote: ...........I am interested in learning more about how the machines work, ................
Check out the following link. I first saw it in a post from Robysue, and am grateful for it. Table 2 summarizes the different event algorithms by manufacturer.

Auto CPAP machine algorithms, etc.

-Ron
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