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[Equipment] Contec RS01 "apnea" monitor
05-11-2014, 12:03 PM
A new gadget? And expensive too??? I'm all over that. Where do I sign up?
(05-11-2014, 11:55 AM)DocWils Wrote: To be honest, I think this is not money well spent. If you are already on CPAP, you are given more than enough information already, and the pulse ox by itself is far cheaper. For a "quick an dirty" diagnosis, it is still too expensive, as with a $100 pulse-ox you can quickly see if if you desat over the night's sleep and by how much - the additional nasal cannulus (it is a single unput type) doesn't give enough additional useful information over basic desat information you get from the pulse-ox, and without a proper heart monitor and chest band, there is not enough information for even a quick diagnosis than you would get with a cheaper recording pulse-ox - the heart rhythm readout is identical to the one on the far cheaper recording pulse-ox, and is by our way of measuring, very unreliable, prone to a lot of noise and poor data (beyond basic beat speed). The tracer is simply no good for any medically useful useful information.
You seem to be vastly misinformed, and perhaps speaking from technology 20 years ago. On the contrary, the nasal cannula in the RS01 is quite helpful. Oximetry isn't always 100% accurate and the nasal flow monitoring serves to correlate and confirm obstructed or lack of breathing, as well as length of time spent with breathing difficulties, and length of time to desat. The chest bad heart rate monitors are extremely uncomfortable and subject to inaccuracies from movement (I have used several high quality chest bands). The heart rate monitor in the RS01 has been extremely accurate and actually graphs blood flow and shows you with an indicator in real time. I have used the RS01 along with a Mio Alpha sports heart rate monitor and the two correlate 100%. I have also validated both with manual readings. This is an excellent device and I can see this saving people a bundle of money vs. lining the pockets of greedy physicians.
05-13-2014, 11:59 AM
Firstly we're not that greedy, and I resent that calumny, secondly, I will stand by my opinion of this device - it is certainly not enough to get a diagnosis, and since CPAP devices are only given out under Rx, you would still have to get either a home test or an overnight, so you've spent a lot of money for nothing. If you suspect you have apnoea, and don't want to spend the money on a test, then a simple recording pulse ox will provide enough information to hazard a guess if you must spend the money to see a sleep doc, at one third the price of this device.
If you are seeing desats at night, that is a pretty good indicator that something is up - if you aren't, then your problem lies elsewhere - by definition, apnoea is accompanied by desats to a level that is considered detrimental (below 90% - well, actually we say below 86%) - a finger pulse-ox taped on correctly will deliver that information. If you are NOT desatting and still feel like crap each day, then it is possible that either your heart, your thyroid or your pituitary gland may be at fault, or some other problem, and neither of these devices will help. A recording heart monitor isn't that uncomfortable, and the 5 leads aren't subject to enough noise to to invalidate the traces. The reason for a heart monitor, and yes, it is a REAL heart monitor, a.k.a an EKG (or ECG if you are so prone to follow that religion) and not just a rate monitor is to determine full heart pattern overnight - we don't just follow how fast your heart beats - a pulse-ox will do that sufficiently, is that we monitor your entire heart rhythm, and look to see if any other forms of distress are being entered into in the process of the desaturation - these are not, as you seem to think, bands that go around the chest (that does something else) but consist of five correctly applied sensors attached to leads to a recording device. Simply getting a heart rate can be done with a $5.00 device. When doing a proper sleep test, we look at waaaaay more than that.
If you are already on a CPAP, then this device is superfluous (for that matter, how do you use the cannulus AND the cpap mask together?).
As a physician, I am concerned that you get correct and informed diagnoses, and it is extremely rare that you can do that without professional guidance and interpretation. Of course, most people think they can, and that we don't know any more than they do, after a nice dig around the Internet, but that simply isn't so, and I will ALWAYS say see your physician.
BTW, we physicians suffer from the same problem - when dealing with our illness and in an area other than our own speciality, we think we know as much as the specialist, and that is also simply never true. Human failing we all have, I guess, but then, I'm not a psychologist, so I couldn't say for 100% surety. I will leave that to the specialists to determine....
05-13-2014, 01:28 PM
Doc you would be absolutely correct if it wern't for the 80/20 rule.
80% of the practitioners in most any field are less than fully competant. If you are lucky enough to get one of the 20% in any field that is important to maintaining your health and he manages to spend adaquate time on your case to provide competant diagnosis and treatment, you are amoung the lucky few. My current PCP thought I had been to a sleep lab the first time I handed him a stack of reports from SleepyHead and my CMS50i. He glanced at hem and glazed over and put them aside. Now I get the feeling he has been studying and can actually understand what I am handing him. I also researched to find a competant sleep specialist and had to fight to see him since he was not in my covered medical group, but they did not have any sleep specialist in the group. They wanted to send me for a sleep test instead of a simple visit.
Contec previously had the CMS-50 D, E, F, H and I. Can Sleepyhead import data from all of them? With some of them, like the 50F, I remember reading that only the old white model would import, not the newer blue model. Anybody have any other findings?
Just found this from a Zonk post ...
Sleepyhead imports from Contec CMS50D+/E/F Oximeters
Sleep Apnea has given me a terrible memory. Please forgive me if I've repeated myself.
05-13-2014, 04:21 PM
(05-11-2014, 09:03 AM)CrazySleeper Wrote: 2. the fingertip out alarm (which can't be disabled) isn't automatically disabled when you connect it to your computer to pull the data so you are forced to listen to annoying beeping;
I think it operates the same as the CMS 50F. See this thread to avoid beeping: http://www.apneaboard.com/forums/Thread-...6#pid65206
05-13-2014, 05:55 PM
(05-13-2014, 04:21 PM)SleepWrangler Wrote:(05-11-2014, 09:03 AM)CrazySleeper Wrote: 2. the fingertip out alarm (which can't be disabled) isn't automatically disabled when you connect it to your computer to pull the data so you are forced to listen to annoying beeping;
Or you can use one small strip of surgical tape to keep it in place
05-13-2014, 06:38 PM
You are right, we are busy as all heck all the time, and in the US it is far worse for those under HMO systems, which, IMHO degrades the quality of care given by putting strict time pressures on the physician and keeps them from really getting to know their patients. Canada's social medicine system is similarly plagued by setting quotas for how many patients a doc must see per hour.
Also, a GP simply isn't sufficiently trained to recognize in detail the way an apnoea diagnosis works or the correct procedures to diagnose it (or the hints and clues needed). This, while not being rocket science by a long shot, is still a specialist area, here in Switzerland either under Pneumology or Neurology, depending on the type of apnoea, and specialists in those disciplines are trained in diagnosis and testing, as are sleep specialists, which generally are in the Neurological department (except, for some reason, at the Unispital, which has its sleep lab in the Pneumology department, perhaps in recognition that the overwhelming majority of sleep related disorders are often simple oxygen deprivation problems, or perhaps it has another simple historical reason - the first doctor to agitate for one was in the Pneumology department).
What GPs can do is see a set of symptoms and put two plus two together and hazard a guess that apnoea is at the heart of a problem (giveaways are complaints of snoring, rises in weight, being tired all day, and elevated blood pressure, plus a larger neck size - these almost always, when presented in combination, will trigger that guess, but sleep medicine is not normally part of their rotation through all the departments during their training) - GPs are prone, by the nature of their job, to take time to come to such a conclusion, by virtue of knowing a patient for a while, and observing the rash of complaints they bring in, and by experience. In the US, fewer and fewer people get to stick with one GP for any length of time, often being shared out between several in an HMO, and this makes it harder to jump to a diagnosis like apnoea. Heck, I AM a doctor, and have been for a very long time, and even knowing my symptoms, it took me a few years to come to the conclusion that I might have apnoea and ask for a referral and testing.
I knew I felt dragged out by 4 p.m. and had no energy, and fell asleep watching the evening news, but I put it down to ageing. My wife moving into the den to sleep due to my snoring wasn't enough to trigger the warning. Instead I looked for, and found, a deviated septum and had it fixed. To no avail, in terms of the snoring. It took my GP and me together, trying to trace down what I thought was a dickey heart to sort of hazard the guess that I might need to hit the sleep lab. Once there, the single test was enough to confirm. But my GP knew me for years, and neither of us had hit on apnoea as a first diagnosis. We are both pretty competent, believe me, and it still eluded us for a long time.
It isn't that 80% of the practitioners are less than fully competent, but that medicine is heavily compartmentalised and even most GPs are specialists (usually Inner Medicine), so, not all possible answers will be at their mental fingertips. In the US, just as here, we are heavily and continuously educated, and cannot maintain a license to practice without that continual education. But in General Medicine, there is a LOT to cover, way more than specialists have to cover, and sleep medicine is one tiny corner, one which most GPs may not get around to while trying to keep up on the myriad of illnesses they must learn about and stay on top of new technology and medical procedures. In fact, I have yet to see a session on sleep medicine on the compulsory continuing education list we must cover each year, and that is something I intend to bring up with the authorities. True, not every GP in the US has their FACP any more than every GP here has their FMH, and trust me, these are tough to get, but in order to remain licensed, they still have to pass a certain number of tests and education elements every year, and it is a whole lot. Plus the mass of paperwork, the dealing with a myriad of insurance companies, the record keeping, the patient reports and diagnostic reports from the specialists, well, it is a lot, to say the least. And it can breed a certain resistance to take certain efforts in a given direction, particularly when they know it is a cost that may turn out to be for nothing. Even here we have a resistance to that - we don't gladly get patients to spend money at all. And apnoea is still not in the forefront of a general practitioner's mind, unless he has encountered it a few times already. A fat person to us means we look at the heart and other organs way before we tackle the idea of apnoea, although almost every fat person has it (opera singers tend not to, for some odd reason. I have a soprano as a patient and by all indications from her body size, she should have it severely, but not at all is the answer for her - I even had her tested at my cost, out of sheer curiosity- I guess all that singing really does keep her throat opened and toned enough to counteract the fat) and we should have it in the forefront of our thoughts. Maybe with time that will be the case, but right now, it still isn't.
Heck, this is a disease that was barely even known about thirty-odd years ago, and now we have "smart shirts" to diagnose it, and of course, CPAP to treat it. I would call that lighting fast growth in learning and recognition of the problem, at least in this profession.
Hi ALL, new member here.
Well this is EXACTLY the machine i want and have been looking for - or something like it. i am glad it exists and glad i found it.
BUT i think most of you here have missed the point of this machine given the new CPAP machines and s/w data out there.
This device is not for people already using CPAP. precisely the opposite ! its for testing or filtering those who suspect they mave have it, to be confirmed later with a sleep study.
or as i want to use it - i want this device so as to test some differing methods and ways of addressing Apnea WITHOUT CPAP. !@! it seems that most doctors when confronted with confirmed Apnea from sleep study, will just point you to CPAP as the only alternative.
BUT this little device will allow me to at least do some home 'filtering' for oral devices as an alternative to a CPAP solutiuon. and thats what i want it for.
i want to test some mouthguards. and maybe i want to test 3 or 4 or more as all a different.
Plus Tongue restraining devices (TRD's) make sense to me. so i want to test these.
Without a CPAP machine, and i am NOT currently using one, you cannot tell if you are having Apneas during the night testing out mouthguards or TRD's. this device will allow that.
And i want to test sleeping on my side to see how that goes.
Oh and i want to lose weight. and see if that works. and at what weight does the Sleep apnea return - ie optimal weight for no apnea ?!
imagine doing sleep studies for all these things. they cost ppl in the USA a small fortune. $3k a pop ! this device will allow you to test all those scenarios for FREE once you buy it. so a good investment IMO.
Also solutions can change over time - 1 yr ago or 6 months ago, a past solution may not be working anymore. ie sleeping on my side may have worked 6 months ago but not now. how can you tell??? this device will do that nicely. same as a mouthguard and a TRD. once worked may not now be working. how to tell?? hook up this device for a night.
You've had a UPPP or tonsilextomy. did it work? how do you really tell without a sleep study. Well.. this machine !!
and its got to be better than a pulse ox. yes its more expensive but it gives full charts and shows AHI's etc. breath analysis and SPO2 etc. very useful IMO.
of course if you do NOT have a CPAP machine. that is the real market for this device. not if you do have one.!
so its a useful device IMO.
08-17-2014, 07:36 PM
(05-11-2014, 09:03 AM)CrazySleeper Wrote: It has adjustable high/low alarms for pulse and SPO2. The alarm emits a loud beeping, enough to wake me up which is exactly what I wanted as I was told I sometimes hold my breath or just stop breathing when I'm sleeping, and the RS01 confirmed this.
Hey Crazy Sleeper,
i want to get one of these units. been looking for something like this. but can you tell me, those alarms ... i do NOT want them. i dont want to be woken up. i want to test my apnea levels using various devices.
so my Question is: are those alarms configurable? ie can i set unit so they do NOT alarm. i assume there is a on/off toggle or button somewhere.
can you pls confirm for me.
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