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Finding AHI at home
#31
5.2 AHI is not bad at all. I agree with Sleepster about changing your pressure settings to 6-11.

Let us know how it goes, especially after your sleep study!! Good job taking control of your health!!
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#32
Thanks for the support guys.

I'm not sure 11 cmH2O is the proper upper limit. I set EPR to level 3 full time and the results were interesting. Higher average pressure but way lower CAI.

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#33
Tonight is the titration study! I hope to sleep this time.
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#34
(10-14-2013, 11:43 AM)DOOM_NX Wrote: Tonight is the titration study! I hope to sleep this time.

Hopefully, you know what your doctor ordered so that you can make sure the tech follows those orders. Here is hoping for a very successful sleep study!!
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#35
Just an update.

The titration study didn't go well. I slept with whiny and leaky combination of an old REMstar Auto C-Flex machine and a ComfortGel mask. I just kept turning and waking. The fact that the titration room was located at the psychiatric wing wasn't helpful, too.

However, I got to get a glimpse on the results of my sleep study. I slept enough for them to determine an AHI of 78 events per hour. Quite close to the 1st hour of my home-test. It was obvious that I needed treatment asap.

So, they lent me a Weinmann SOMNObalance e to continue the auto-titration at home. I'd never heard of Weinmann before. It didn't look as fancy as my mother's S9, so I didn't expect much.

Then they sent me to the local representative to blank the previous data and adjust the pressure settings. After an hour of enlightening discussion with him, my hopes got high for this machine. I also got to try the JOYCE SilkGel mask - oh, it felt so smooth! Silky smooth and soft. It looked way more comfortable than my mother's Ultra Mirage II.

When I came home, I did my research. Apparently Weinmann is the biggest CPAP manufacturer in Germany - and probably the best in Europe. Germans are well-known for their high quality products which are manufactured under strict standards. My expectations kept rising!

After 8 nights of sleep with the SOMNObalance, I seriously consider buying one! First of all, it's whisper quiet. The only thing I hear is my breath through the tube. I can't tell if the S9 is quieter.

Then it's the mask that comes with it. I love this mask! It's super soft and seals easily. No more leaks in my eyes. And because of the gel both at the nose and at the forehead cushion, I can tighten the mask without it being uncomfortable. It's also easier to clean, thanks to the single layer cushion. In addition, it features a pivoting connector which relieves any upward hose tension and keeps the mask seal intact. They call it "ball-and-socket" joint. Last but not least, there are headstrap clips at the forehead support pad, too, so I don't have readjust the staps after detaching the headgear from the mask.

The machine comes with a two stage filtration system. One foam washable filter and one fine filter. The latter is actually an EPA filter by Europe's standards (E10 class). It filters at least 85% of particles at 0.3 μm. It's actually better than ResMed's hypoallergenic filter - which is very difficult to find in Greece. It's good to know I'm breathing cleaner air.

The heated humidifier just clicks into place on top of the device, saving space - although I wasn't supplied with one, so I can't comment on its function.

The machine features RAMP mode (called softstart), auto ON/OFF, exhalation pressure relief (called softPAP) and a mask fit test with adjustable pressure levels. There's a 3-level leakage indicator, too, representing "Low - Good fit", "High - Adjust mask" and "Too high for effective treatment - Adjust mask".

The SOMNObalance can show therapy information on the non-lit screen (sleep time, AHI, obstructive AHI, central AHI, 90th percentile pressure and the percentage of sleep time with too high leakage). Apart from last night's values, it can display the mean values for 7, 14, 30, 180 and 366 days. These statistics are saved automatically on the SD card in a user friendly spreadsheet format (CSV). On Weinmann's website, the user can download a patient oriented software (SOMNOjournal, free registration required) which reads the CSV file and presents eye appealing summary graphs. Detailed flow, pressure, leakage, minute ventilation and OPP (Obstructive Pressure Peak signal used for the central apnea detection algorithm) data is accessible only via the clinician oriented software, WEINMANNsupport. I haven't been able to locate it on the internet yet. To make things worse, it needs an proprietary RS485-to-USB adapter in order to read data directly from the device. I'm gonna try hard to get a CD copy of WEINMANNsupport from the technician and make it available on Apneaboard. However, without the adapter, it's not gonna be of much use.

On the other hand, I've found the Clinician Setup Manual.
And this is the User Manual.

To sum up, I think that the SOMNObalance e is a really well-designed and well-built machine that delivers all the latest generation Auto CPAP features at a lower price than the competition (at least in Europe). It only lacks the bling of the S9, but not its functionality. The only real disadvantage here is that the end user can't get his hands on the data analysis software (or at least easily).
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#36
Thanks for the info. Sounds good.

However, I'll point that being able to read your own data is a really powerful tool to have at your disposal.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#37
(10-23-2013, 08:58 PM)archangle Wrote: Thanks for the info. Sounds good.

However, I'll point that being able to read your own data is a really powerful tool to have at your disposal.

This is true. If I'm not able to get WEINMANNsupport, I will go with the S9.
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#38
Hello, forum!

Today was a busy day for me!

First of all I went to the Weinmann technician to get my summary report printed. Results were pretty much what I've been reading from the CSV file, but I also got to see the minimum and maximum values. I didn't get the chance to view any detailed data though.

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I also asked for the WEINMANNsupport software. He said he would give me the "open" version for free - the version they give to doctors. But it was time to go see the doctor. I would come back after that.

At the doctor's office, she showed me my sleep study results. My condition was very severe. An AHI of 78.7 over 3 and a half hours of sleep. I never got into slow wave (deep) or REM (dream) sleep! She actually said "I was torn into pieces".
She didn't have to talk me into CPAP; I was already more than willing to get my own machine and start therapy.
She also said that if manage to lower my BMI to 33, then I won't even need the machine, given the results from the previous sleep study.
For comparison, I'm showing you my new sleep report against my old one.

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The titration study results showed that 11 cmH2O was the magic number that lowered my AHI to 1. So I got a prescription for an auto-CPAP at the pressure range 5-16 cmH2O.

Then I started calling the local DME vendors from a list. I actually got a pretty sweet price on the S9 AutoSet and I ditched the idea of getting the SOMNObalance e, since they were both selling for 1,050 EUR (1,449.49 USD) with a mask and hose. My insurance covers 75% of the expenses. I made a little better deal and I ended up paying 262.50 EUR (362.37 USD) out of my pocket for the S9 AutoSet + Mirage FX + 4 standard ResMed filters. Then I ordered the humidifier, too, for 180 EUR (248.48 USD) more out of pocket. If I start getting condensation, I'm gonna need to order the ClimateLine tube as well. Funny thing is that the DME had never heard of it.

So, here I am with severe OSAS and a ResMed S9. I actually feel kinda bad for dumping the Weinmann guy. He was so kind and talkative and all. And I didn't get to get a copy of the analysis software. Sad

I'm tired now and I should be sleeping. Thanks to everyone that read so far Smile
Have a great day/night!
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#39
Now for you to get used to it ~~

I just got my CMS50F Pulse Oximeter today. So we'll see how I'm doing all these years later.
*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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#40
Nice! I find the pulse oximeter to be the most annoying thing ever! My finger keeps tingling and distracting me! While it's very useful to have, I'm not thrilled with the idea of using one! Smile

As far as CPAP is concerned, I don't even think about it in my bed. My body must love the outcome!
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