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Haven't mastered what the charts show
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me50 Offline

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Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

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Sex: Undisclosed
Location: USA

Post: #11
RE: Haven't mastered what the charts show
(10-23-2013 12:34 AM)robysue Wrote:  
(10-22-2013 10:07 PM)me50 Wrote:  I wondered what it meant in the programs b/c if my settings are 12-20 and it says my median is 15.9 and 95% is 19.9 and the 95% indicates what the pressure was at or below 95% of the time I was just trying to see what the median was telling me. I am trying to get my ducks in a row for my appt. with the sleep doc

thx

The fact that your median pressure is 15.9 means that 50% of the time the machine is running your pressure is AT or BELOW 15.9 cm. And 50% of the time the machine is running your pressure is AT or BELOW 15.9 cm.
The fact that your 95% pressure is 19.9 cm means that 95% of the time the machine is running your pressure is AT or BELOW 19.9 cm and 5% of the time your pressure is AT or ABOVE 19.9 cm.

Since 20 cm is the top pressure your machine can deliver, the fact that your 95% is effectively at 20cm is something you may want to bring up with the sleep doc. It's not that it's a definite concern---particularly since your AHI < 5. However, many times sleep docs are willing to switch people at pressures over 15 cm to bi-level machines in part because of comfort issues (the drop to EPAP is more substantial than that provided by either the Resmed EPR system or the PR A-Flex or C-Flex+ systems), but also the bilevel machines can deliver up to 25 cm of pressure if needed.

See the first sentence I bolded. Did you mean at or above 15.9?

See the 2nd sentence I bolded. I saw my sleep doc in early October and expressed concerns that my pressure was at the top of the machine capability. On Oct. 11, I had a 2nd sleep study. Doc's orders were that if I got to pressure 16 to put me on a BIPAP to see what happened but that wasn't done.

At pressure 15, during the sleep study, for 3.5 minutes I had 1 hypopnea, 1 apnea, AHI 34.3, 34.3 Supine REM AHI, 17.1 Central.

At pressure 16, for 29 minutes ONLY, I had 0 AHI. 29 minutes is nothing. We all know that things change during sleep and since I am basically at 20 most of the time, I feel as though 29 minutes with 0 AHI is nothing and wonder why I wasn't either put on BIPAP as ordered OR the Sleep Tech didn't monitor it longer? I didn't have to leave when I did but I was told she had enough info.

So, that money was spent on a sleep study and they didn't see how a BIPAP would do. I did tell my doc that I was concerned that I am at the top of my machine capabilities. I took a report from SH but he said, you should get data from ResScan. When I came for my appointment in Oct. I didn't bring my SD card as I was told they didn't have the program to read it. Today, I found out otherwise. Had I known, he would have been able to see that I was at the top of my machine capability and that it wasn't due to leaks.

So, when I go back in November, we shall see. I will be pushing for BIPAP because I am concerned that if there are occasions I need more than 20, I won't have that option currently.

I know BIPAP is harder to get used to and I don't know if I am smart enough to manipulate it like I can with my current machine, but I just don't feel very secure and this is my life!! I am my own best advocate!

Thanks for taking the time to answer my concerns.
10-23-2013 12:53 AM
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robysue Online
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Posts: 1,240
Joined: Oct 2013

Machine: PR Dreamstation BiPAP Auto
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: PR Dreamstation humidfier
CPAP Pressure: min EPAP = 4; max IPAP = 9;
CPAP Software: SleepyHead EncoreBasic EncorePro

Other Comments: Papping since September 2010

Sex: Female
Location: Buffalo, NY

Post: #12
RE: Haven't mastered what the charts show
(10-23-2013 12:53 AM)me50 Wrote:  [quote='robysue' pid='47538' dateline='1382506441']
The fact that your median pressure is 15.9 means that 50% of the time the machine is running your pressure is AT or BELOW 15.9 cm. And 50% of the time the machine is running your pressure is AT or BELOW 15.9 cm.
See the first sentence I bolded. Did you mean at or above 15.9?
My bad. Yes. I meant AT or ABOVE on the second sentence here.

Quote:I saw my sleep doc in early October and expressed concerns that my pressure was at the top of the machine capability. On Oct. 11, I had a 2nd sleep study. Doc's orders were that if I got to pressure 16 to put me on a BIPAP to see what happened but that wasn't done.

At pressure 15, during the sleep study, for 3.5 minutes I had 1 hypopnea, 1 apnea, AHI 34.3, 34.3 Supine REM AHI, 17.1 Central.

At pressure 16, for 29 minutes ONLY, I had 0 AHI. 29 minutes is nothing. We all know that things change during sleep and since I am basically at 20 most of the time, I feel as though 29 minutes with 0 AHI is nothing and wonder why I wasn't either put on BIPAP as ordered OR the Sleep Tech didn't monitor it longer? I didn't have to leave when I did but I was told she had enough info.
When you say you didn't have to leave, does that mean you were free to stay longer or does it mean that you were not bumping right up against the usual early 5 or 6 am standard wake-up time for the sleep testing center? Most sleep centers are not set up to allow their patients to stay past their standard wake up time and it could be that they ran out of time.

Quote:So, that money was spent on a sleep study and they didn't see how a BIPAP would do. I did tell my doc that I was concerned that I am at the top of my machine capabilities. I took a report from SH but he said, you should get data from ResScan.
So download ResScan and use it for future reports to had to your doc. Smile While I use SleepyHead for day to day use, when I want to print stuff off for my doc, I boot up Encore (the software for PR machines) and print stuff out in it so that the reports look official.

Quote:When I came for my appointment in Oct. I didn't bring my SD card as I was told they didn't have the program to read it. Today, I found out otherwise. Had I known, he would have been able to see that I was at the top of my machine capability and that it wasn't due to leaks.
I wish I could say I'm surprised. But I'm not. By the way, the S9 does not tend to chase leaks by increasing pressure anyway.

Quote:I know BIPAP is harder to get used to and I don't know if I am smart enough to manipulate it like I can with my current machine, but I just don't feel very secure and this is my life!! I am my own best advocate!
For me the BiPAP was much easier to get used to. It felt much more natural to breathe with. Most of the bipap users I know on other forums would agree. Since many of us wind up with a bilevel machine that can be run in an auto bi-level mode, you may want to learn a bit about the differences between the auto algorithms used by the Resmed VPAP Auto and PR BiPAP Auto machines.
10-23-2013 07:14 AM
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me50 Offline

Advisory Members

Posts: 2,559
Joined: Aug 2013

Machine: resmed S9 VPAP Auto
Mask Type: Nasal mask
Mask Make & Model: Wisp and Silicone Head gear
Humidifier: resmed H5i
CPAP Pressure: 18/8
CPAP Software: SleepyHead

Other Comments:

Sex: Undisclosed
Location: USA

Post: #13
RE: Haven't mastered what the charts show
(10-23-2013 07:14 AM)robysue Wrote:  
(10-23-2013 12:53 AM)me50 Wrote:  [quote='robysue' pid='47538' dateline='1382506441']
The fact that your median pressure is 15.9 means that 50% of the time the machine is running your pressure is AT or BELOW 15.9 cm. And 50% of the time the machine is running your pressure is AT or BELOW 15.9 cm.
See the first sentence I bolded. Did you mean at or above 15.9?
My bad. Yes. I meant AT or ABOVE on the second sentence here.

Quote:I saw my sleep doc in early October and expressed concerns that my pressure was at the top of the machine capability. On Oct. 11, I had a 2nd sleep study. Doc's orders were that if I got to pressure 16 to put me on a BIPAP to see what happened but that wasn't done.

At pressure 15, during the sleep study, for 3.5 minutes I had 1 hypopnea, 1 apnea, AHI 34.3, 34.3 Supine REM AHI, 17.1 Central.

At pressure 16, for 29 minutes ONLY, I had 0 AHI. 29 minutes is nothing. We all know that things change during sleep and since I am basically at 20 most of the time, I feel as though 29 minutes with 0 AHI is nothing and wonder why I wasn't either put on BIPAP as ordered OR the Sleep Tech didn't monitor it longer? I didn't have to leave when I did but I was told she had enough info.
When you say you didn't have to leave, does that mean you were free to stay longer or does it mean that you were not bumping right up against the usual early 5 or 6 am standard wake-up time for the sleep testing center? Most sleep centers are not set up to allow their patients to stay past their standard wake up time and it could be that they ran out of time.

What I mean is that I woke up around 4 AM or so and she told me she had enough data and that I could get unwired and go home. She had another patient that she disconnected first b/c he had to go to work and had a long drive. I could have tried to sleep longer. We didn't have to leave our rooms until 7 AM for a continental breakfast and had to be gone by 8 AM. As it stood, I slept horribly and spent most of the weekend sleeping and I honestly believe that the majority of the reason is b/c my pressure was too low. Also, last night, I slept for 4 hours 8 minutes and had no AHI's (waking up 2 times) so I feel 29 minutes at one pressure wasn't enough to see what was happening and, she knows her time frame and if you look at the titration chart I posted in another post, I believe she might have been able to increase the pressure faster since my sleep time at each pressure was short. Just my opinion. I was there at 8 PM and she didn't start the study until 10:30 PM and most of that is b/c she wanted to talk about her mom that recently died and how she got sick b/c she was taking care of her and how she quit smoking, etc. etc. And, she did not follow the docs orders to put me on BIPAP if I got to 16.

Quote:So, that money was spent on a sleep study and they didn't see how a BIPAP would do. I did tell my doc that I was concerned that I am at the top of my machine capabilities. I took a report from SH but he said, you should get data from ResScan.
So download ResScan and use it for future reports to had to your doc. Smile While I use SleepyHead for day to day use, when I want to print stuff off for my doc, I boot up Encore (the software for PR machines) and print stuff out in it so that the reports look official.

I have ResScan and the doctor's office have ResScan and he could have downloaded my SD card IF they hadn't told me that they didn't have the program to do that (they do) so I took him detailed data from Sleepy Head.

Quote:When I came for my appointment in Oct. I didn't bring my SD card as I was told they didn't have the program to read it. Today, I found out otherwise. Had I known, he would have been able to see that I was at the top of my machine capability and that it wasn't due to leaks.
I wish I could say I'm surprised. But I'm not. By the way, the S9 does not tend to chase leaks by increasing pressure anyway.

Quote:I know BIPAP is harder to get used to and I don't know if I am smart enough to manipulate it like I can with my current machine, but I just don't feel very secure and this is my life!! I am my own best advocate!
For me the BiPAP was much easier to get used to. It felt much more natural to breathe with. Most of the bipap users I know on other forums would agree. Since many of us wind up with a bilevel machine that can be run in an auto bi-level mode, you may want to learn a bit about the differences between the auto algorithms used by the Resmed VPAP Auto and PR BiPAP Auto machines.
(This post was last modified: 10-23-2013 10:03 AM by me50.)
10-23-2013 09:57 AM
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