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MYAIR: PENALIZED FOR PEEING, SLEEPING LATE, OR FILLING THE WATER CHAMBER
#11
I have three comorbidities that affect the issue:

(1) As the retired chief technologist of Interactive Computer Corporation, I have a devotion to clean data, great analysis, and meaningful results. Pretty much why I love this site and have made donations to the site and the Sleepyhead creator.

(2) As a competitive person, I tend to go for the high-score under any and all conditions.

(3) I am somewhat of a perfectionist who reserves the right to p*** and moan about any subject regardless of how petty and insignificant it may be in the universal scheme of things. (LOL)

What I suggested to ResMed was to tweak the algorithm to allow a grace period to allow for small duration periodic events -- especially since the system will impose another ramp period if ramp is set. If the interruption interval prevents a therapeutic result (e.g. over 10 minutes + ramp) then I would consider it a legitimate mask on/off event. One of the other things that did bug me was accidently hitting the off button accidently as I was reaching for the phone on the nightstand and having it scored as a mask on/off event -- hence the suggestion of a delay. The other issue was the reporting when sleep went past 12:00 p.m. Since the data is to be sent AFTER therapy has been completed, a longer time-delay might improve data capture as I am unaware of any provision for machine polling from the central office.

It is my way of making the opaque transparent by probing the system; especially since ResMed apparently believes that almost all information should be somewhat closely-held and away from the patient. I may not be right, but I am always willing to consider input and discussing the issues. And, I have seen a couple of changes that appear to have been implemented in myAir regarding leak reporting and other matters.

BTW ... Have you ever seen a software patch pushed to the machine? I would be pleased if you could point me to some of the other technical information on the AirSense Autoset you may have seen.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#12
(06-23-2016, 06:31 PM)srlevine1 Wrote: BTW ... Have you ever seen a software patch pushed to the machine? I would be pleased if you could point me to some of the other technical information on the AirSense Autoset you may have seen.

I have never seen any evidence on my machine that software updates have been made. My autoset was purchased before they upgraded them to report RERAs, and if a software update was pushed out I'd expect that to be one of the changes. No such luck.
Ed Seedhouse
VA7SDH

The above is my opinion.  It is just possible that I may, occasionally, be mistaken.

I am neither a Doctor, nor any other kind of medical professional.

Everything put together sooner or later falls apart.
Your brain is not the boss.
Our forefathers took drugs.
He's no fun he fell right over.
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#13
(06-23-2016, 06:31 PM)srlevine1 Wrote: I have three comorbidities that affect the issue:

(1) As the retired chief technologist of Interactive Computer Corporation, I have a devotion to clean data, great analysis, and meaningful results. Pretty much why I love this site and have made donations to the site and the Sleepyhead creator.

(2) As a competitive person, I tend to go for the high-score under any and all conditions.

(3) I am somewhat of a perfectionist who reserves the right to p*** and moan about any subject regardless of how petty and insignificant it may be in the universal scheme of things. (LOL)

What I suggested to ResMed was to tweak the algorithm to allow a grace period to allow for small duration periodic events -- especially since the system will impose another ramp period if ramp is set. If the interruption interval prevents a therapeutic result (e.g. over 10 minutes + ramp) then I would consider it a legitimate mask on/off event. One of the other things that did bug me was accidently hitting the off button accidently as I was reaching for the phone on the nightstand and having it scored as a mask on/off event -- hence the suggestion of a delay. The other issue was the reporting when sleep went past 12:00 p.m. Since the data is to be sent AFTER therapy has been completed, a longer time-delay might improve data capture as I am unaware of any provision for machine polling from the central office.

It is my way of making the opaque transparent by probing the system; especially since ResMed apparently believes that almost all information should be somewhat closely-held and away from the patient. I may not be right, but I am always willing to consider input and discussing the issues. And, I have seen a couple of changes that appear to have been implemented in myAir regarding leak reporting and other matters.

BTW ... Have you ever seen a software patch pushed to the machine? I would be pleased if you could point me to some of the other technical information on the AirSense Autoset you may have seen.

Here is a link to the discussion of how ResMed fixed the climate line fault issue by pushing through a software update.

http://www.apneaboard.com/forums/Thread-...+update%22
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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. 
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#14
Allen E, your response about shoving the mask over to the wife and having her wear it made me bust out laughing!
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#15
Interestingly enough, my DME (Apria) started asking me compliance questions each and every time I ordered supplies. It appears that continuing compliance is a required by Medicare and you need to say you do not have any extra supplies on hand, and say your mask is losing its grip, etc. to justify the resupply. I am not sure that this is a "wink-wink, nod-nod" requirement or someone really does look at the MyAir data.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
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#16
(06-23-2016, 06:31 PM)srlevine1 Wrote: What I suggested to ResMed was to tweak the algorithm to allow a grace period to allow for small duration periodic events


I too had a conversation with one of their architects on several topics and this was one of them. The argument was, taking you mask off deliberately, while it would continue to show the machine being "used" could provide falsified data for the purpose of compliance. For example, power the machine on, breathe through it to get through the "ramp up time" then take the mask off. You could let it sit there for say 3-5 mins, pick up the mask, take a couple of breaths through it, then take the mask off again. Repeat this process numerous times and you could get significant time to indicate compliance when you didn't do it it at all. Apparently some machines (like bricks) you could do this to but other machines have flows, respiration and other data which should make fabrication of the data a tad more difficult.


(06-23-2016, 06:31 PM)srlevine1 Wrote: It is my way of making the opaque transparent by probing the system; especially since ResMed apparently believes that almost all information should be somewhat closely-held and away from the patient.


Don't feel bad, when I asked my DME for software to see what was going on, they were offended and arrogant then they informed me I woudn't understand the data even if I could see it!

From my experience, ResMed has the same basic opinion of it's users.

In my opinion, the data reported on myAir to the users is abysmal at best and more closely falls into the completely useless and misleading catagory.

When myAir reports your sleep time, it's in aggregate. I couldn't figure out why I felt like crap after a "nights" sleep. Then I found sleepyhead and discoverd my sleep cycles are fragmented very badly.

So I feel your pain and I too have experienced the "your a dumb idiot" mentality.

I'd describe what I used to do, but I'd have to kill myself after disclosure! Thinking-about

BTW, after converting from a "BRICK" to this VAUTO, I never registered the machine with myAir... I did get a note saying my old machine had been disassociated from me...

So now, if the insurance co wants to see compliance, I guess they'll have to get it from my Dr or ask me for it... we'll see

This will be interesting as I can't find any requirement to use myAir
Warning: Eating chocolate may cause your clothes to shrink!
[Image: ry6XtE9.gif] <---- That's ME!
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#17
MyAir - Too cutesy, and not enough solid information..... I think I understand the mask off/on issue, but I don't agree with their logic... ResMed is making an assumption that you are taking your mask off/on because you are not sleeping well because of poorly controlled apnea. However, many of us get up at night because nature calls, etc. and those events cannot be lumped in together with poorly controlled apnea. Their logic for this seems somewhat bizarre to me.
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#18
(08-10-2016, 01:11 AM)warmbear Wrote: However, many of us get up at night because nature calls, etc. and those events cannot be lumped in together with poorly controlled apnea.

Well, I must beg to differ. Having to get up a lot to pee can impair your treatment as I know all too well from experience. It is the main obstacle to my treatment and, fortunately, after a long struggle I have it pretty much under control. Getting up once a night is no big deal, but having to get up and pee every couple of hours can really put a crimp in your day.

I think it's fair for MyAir to assign 5 points out of a hundred to it. I disagree with much of their methodology but think they have it pretty well right on mask on/off. Of course when and why you remove the mask varies and it might be a bit oversimplified, but that's the way "MyAir" works - it's meant to give you positive feedback as much as possible to encourage you to keep using their machines.

I generally check "MyAir" once a day for maybe 30 seconds. I check my results from SleepyHead more closely as it shows stuff that matters that MyAir ignores, such as respiration rate through the night.

Mask on/off isn't everything of course. Last night I got 99 because I woke up to pee once, but slept in all for 8.5 hours. The night before I went seven hours without waking up and got 100 - but I feel better today than I did yesterday. All in all giving this aspect 5% of the total score seems reasonable on the part of ResMed. At least to me it does.

Ed Seedhouse
VA7SDH

The above is my opinion.  It is just possible that I may, occasionally, be mistaken.

I am neither a Doctor, nor any other kind of medical professional.

Everything put together sooner or later falls apart.
Your brain is not the boss.
Our forefathers took drugs.
He's no fun he fell right over.
Post Reply Post Reply
#19
(08-08-2016, 09:00 PM)srlevine1 Wrote: Interestingly enough, my DME (Apria) started asking me compliance questions each and every time I ordered supplies. It appears that continuing compliance is a required by Medicare and you need to say you do not have any extra supplies on hand, and say your mask is losing its grip, etc. to justify the resupply. I am not sure that this is a "wink-wink, nod-nod" requirement or someone really does look at the MyAir data.

Apria asks me every time also and I am way beyond their compliance Window. I think that the Apria people are all trained to just ask every time regardless. That way management does not have to worry about whether you were checked on a timely basis.

On the other questions you are asked, I have never been asked those questions and Apria (sadly) has been my DME for 5 years. I think the insurance companies may be pushing DMEs to try to keep people from stockpiling supplies by using them longer than recommended and getting replacements on the recommended interval. Gee, that sounds like someone that I know.

Another thing you can tell them is that the mask should be replaced at the manufacturers recommended interval because the manufacturer has proven that there is bacterial build up in the masks over time that can not be gotten rid of without destroying some of the beneficial properties of the mask. If they tell you that they have a sterilizer that will do the job, ask them if Resmed or whoever the manufacturer is has approved it for use on their masks.

An aside. I have found that ordering supplies from Apria's fleet service generally requires less rigamarole and fewer restrictions. I do not know how I got hooked up with fleet service or if there are requirements that must be met in ordered to be serviced by Apria fleet service. I also do not know where the name "fleet service" came from. I had always connected fleets with the navy or automotive type endeavors. Maybe someone here can answer that.

Best Regards,

PaytonA
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#20
MyAir is to keep you in compliance and encourage you. I used to get up to pee because I had to but after starting CPAP therapy, I wake up for cause. (High pressure or repeated events) So, I shut the machine off and interrupt the current therapy sequence and start from ground zero. You can get a zero in this element and still get "excellent results ".

Having said that, I like to look at MyAir for encouragement. Last night I got a "100%" on MyAir with a AHI = 5.3 with some but insignificant major leaks. Go figure.

OBTW, now when I "want" to start over, I hit the off button and let the auto start enable the machine. Usually I am fighting the machine and need a break. For a brief moment I can see my AHI to this point, settle back and start over, and not get charged for a mask on/off in MyAir.
Dont-know  I am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
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