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Hi, introduction and my experiences
#11
Hi Sam,

You have no apneas, which is good. What's no so good is the number of hypopneas. These are partial closures of your airway which still affect your sleep and the oxygen concentration. Desirably hypopneas should be eliminated as well. Can you provide a screen dump showing the flow rate and pressure, please? It should also show the details panel (with the pie chart). That will give better information for making a further recommendation.
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#12
Thanks for answering,

Please see below screen dump of details tab, I'm not sure which one is flow rate and my pressure is fixed at 11 with a 3 minute ramp from 3.5 to 11.
if you can tell me which graph you want for flow rate if I have not included it below


Attached Files Thumbnail(s)
       
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#13
I've done a bit of research and it appears my sleep cube does not record flow :-(
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#14
Hi Sam

I am a new member from Scotland! I have found this forum to be very active and helpful - just like this thread!

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#15
I do not know where we might find this information but it would be worthwhile finding out what DeVilbiss uses as its requirements for scoring hypopneas. If we think back to the Resmed S8 machines and then the S9 machines. WQith the S8 machine, I could get my apneas very low but still had hypopneas all over the place. When I went to the S9, the hypopneas disappeared.

Resmed decided they had been over-reporting hypopneas and changed the requirements for scoring them. Is this over-reporting a problem with the DeVilbiss?

Best Regards,

PaytonA
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#16
Hi Dick,

Nice to see another UK member on here, I'm only a beginner really. visited doc in december, monitored once in feb, issued with CPAP in march.

I've had several masks and the one I am using now is the best yet, mind you as the machine was ramping up to 20 all the time its not surprising they leaked.

I'm sorry to say that the treatment down here is pretty poor, some of the things I have been told are pretty unbelievable. from the pressure increases as it leaks..... all masks are designed for people with flat faces. etc.. saw the consultant for the first time 7 months after treatment started and he did not have any information.... they then reduced my machine to a constant 11cm/h20.. mask does not appear to leak and I dont appear to have any obstructive apnea's but more hypopnea's than is good.

first month with the machine I felt really good and wide awake in the day, that is getting worse week on week.. I even bought my own add on for my machine so i could use sleepyhead software which shows my sleep patterns are pretty consistent. I've recently had a call to ask for my smart codes mind you I had to ring the clinic to remind them they were supposed to be doing a reading, I have the same software they use and it does not say much at all, basically says comply with the requirement to keep my driving licence..

I'm going to give them one more go before I use my private medical insurance and go to someone who knows what they are doing. or can be bothered, the nurse who seems to run it all has mentioned thyroid goitre's and even throat cancer and yet not once has anyone said open wide and say ahhhh... a bit disapointed now I have bought the software and logging to find the machine does not record flow..

hopefully may be better news when I go to the hospital next... somehow based on every visit so far it wont be..



PS they told me that a new mask should last 12 months, the one i had for 3 was looking pretty tatty and unlikely to last much longer.. it appears different areas prescribe different machines.. I was told I might need a BIPAP whatever one of them is...

be lucky

Sam
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#17
Sam: I am assuming that your devilbiss auto has smart flex and that you are not using it currently. . If all you are getting are hypopneas at your pressure of 11, here is what you can do:
1) Initiate smart flex at setting of 1 and raise your pressure to 12 at the same time.
2) Evaluate the effect on hypopneas for 7 days.
3) If some hypopneas are still there then go to smart flex setting of 2 and raise pressure to 13.
4) Evaluate for 7 Days.
5) If hypos are still there then go to smart flex 3 and pressure of 14.

If hypos are still not down to acceptable level, then you May need a bilevel machine.
Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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#18
Or you may just need a new machine from a different manufacturer. DeVilbiss, at the time this machine was manufactured, may not have optimized their scoring logic for hypopneas to more accurately reflect the real world. If that is the case all you need is a newer machine from ResMed or Philips or maybe even DeVilbiss.
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#19
(11-14-2015, 07:17 PM)AshSF Wrote: Sam: I am assuming that your devilbiss auto has smart flex and that you are not using it currently. . If all you are getting are hypopneas at your pressure of 11, here is what you can do:
1) Initiate smart flex at setting of 1 and raise your pressure to 12 at the same time.
2) Evaluate the effect on hypopneas for 7 days.
3) If some hypopneas are still there then go to smart flex setting of 2 and raise pressure to 13.
4) Evaluate for 7 Days.
5) If hypos are still there then go to smart flex 3 and pressure of 14.

If hypos are still not down to acceptable level, then you May need a bilevel machine.

Thanks for the input, yes it does have smart flex and that was switched on but it always ramped top to 20 and that caused me lots of problems with mask leaks.
I will try the steps you suggest and see how it goes.

This morning I woke to find I was wearing the mask but the hose had come off, probably as I woke up anyway.. acording to the machine my AHI was 31.5 over 4.2 hours, all of which were hypopnea. still not sure how it works out the difference the hypopnea score was 8.1 (thats about 20% higher than recently)

they also mentioned at my last visit to the clinic that if the current settings do not work I may need a different machine (bilevel) but they would probably do a proper sleep study first.

The only study so far has been using a home test kit for one night, well two as the machine did not work on the first night.

I might give them a ring tomorrow and find out what is going on..
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#20
(11-14-2015, 11:28 PM)PaytonA Wrote: Or you may just need a new machine from a different manufacturer. DeVilbiss, at the time this machine was manufactured, may not have optimized their scoring logic for hypopneas to more accurately reflect the real world. If that is the case all you need is a newer machine from ResMed or Philips or maybe even DeVilbiss.

I only got this machine in March and it was brand new. I'm really not very happy with the clinic and the way they work, or not as seems to be the case.
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