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Maybe I have apnea, maybe not, are all sleep doc jerks?
#41
RE: Maybe I have apnea, maybe not, are all sleep doc jerks?
Get the VAuto. One of the top expert's patients uses a PS of 3, he notes that she? is an exception (low), the bulk at PS of 4-6, and as high as 12, with the doctor himself using a PS of 8.5.

Get a VAuto.
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#42
RE: Maybe I have apnea, maybe not, are all sleep doc jerks?
Thanks so much everyone for the great advice...

One thing that I'm kind of leery of is getting a new machine just before ResMed comes out with some new technology. The machine that I have was the earliest model A10, and it does not do lots of things that the more modern version does. At the time, going without a machine while waiting for stuff on backorder wasn't practical, so I settled. I don't want to settle this time.

According to the ResMed website, the current AirSense 10 AutoSet for Her does all of these things:
  • AutoSet for Her algorithm tailored for female characteristics of sleep-disordered breathing
  • AutoRamp with sleep onset detection
  • CSA, RERA and CSR detection
  • Easy-Breathe waveform with EPR
  • AutoSet Response comfort setting
My machine with S/W version SX567-0205 doesn't do ForHer, does only timed Ramp, doesn't detect RERAs, does EPR, and I don't think it does the "Response comfort setting". Given that I have constant flow limitations and very low AHI and am suspecting UARS, some or all of the features my machine doesn't have might actually be useful to me!

This is the listed feature set for the AirCurve 10 VAuto:
  • Auto-bilevel treatment with enhanced AutoSet technology
  • Easy-Breathe waveform with CSA detection
  • Ideal for non-backup rate bilevel support and OSA comorbidity
  • Adjustable TiControland trigger and cycle sensitivity
That's the bipap that y'all are recommending, right? Does it do RERA detection? What about the ForHer algorithm? Doesn't mention "Response comfort setting" either. Does the AirCurve 10 VAuto have all of the features of the AirSense plus more? Or is there a tradeoff were you give up some of the AirSense features to get the bi-level?

I'm noodling out a plan here... I'm wondering if I can simply rent a latest-version AirSense 10 AutoSet for Her for a month or two in order to collect the extra data? The rent-to-own model of buying a machine is basically a scam for the insurance company to get you to pay a larger share of the cost, but shouldn't it mean that if I want to rent they have to let me? (That actually brings up an off-topic question -- what happens if your machine breaks and is going to be repaired -- do you rent a machine short-term while yours is being repaired?) I have an appointment with the RT at my DME on Monday and we're going to work on fit for a P10 or P30i. Should I ask about renting a modern A10ForHer?



Alternatively , or in addition, I could try to find an AirCurve 10 VAuto used on the side (Berwyn is like a 4 hour drive from me because I live in the next-door-to-Iowa side of Illinois, but I could try looking closer to home. The problem with finding something in particular near me is that out here in sparsely-populated Outter Forgottonia there is just fewer of everything.) That way I could test-drive pressure support without getting insurance involved.

I also need to figure out what other hardware I should invest in for data collection. I should get a recording pulse-oximeter. (Heck in the age of COVID every household should have a pulse-ox!) I'm having decision issues about which one to buy that won't cost an arm and a leg and will work well with OSCAR. (I was all set up to buy the Wellvue Ring when I read the amazon reviews about the batteries puking out, and the person who got burned by one overheating. The Ring sounded kind of gadgety kool, but on the other hand I'm already sleeping with carpal tunnel braces on both arms so having a pulse-ox with a finger clip and wristband should work pretty well as the brace will keep that in place.) Any recommendation about gadgets to monitor sleeping position? Did I mention that my hubs is a physics professor and I have access to an electronics lab and can build my own stuff? He's even teaching digital electronics this semester. Also he's an expert at the maths involved in processing wave forms -- it's the same techniques as are used in theoretical nuclear physics. I've got some ideas about electronics I could rig up and where I could place them, but that's probably re-inventing the wheel and other people have already done it better.

And a different question about data -- back at the beginning I tried to figure out UserFlag1 and UserFlag2, and whether I could use them to flag shorter-than-10-second event-like things, and/or smaller than 50% limits. In other words, try to give a different perspective on my flow limits. I really couldn't figure out what to set the values to in order to find those things, though. Has anybody had those thoughts and figured out how to make it work?
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#43
RE: Maybe I have apnea, maybe not, are all sleep doc jerks?
Yes, the Vauto we are talking about is the AirCurve 10 VAuto. I'm not so sure about how well it flags RERA, mine has yet to flag one in 6 months of use. I know I have RERA's but my VAuto isn't good at flagging them. However, it is very good and managing my apnea.

SPO2 measuring devices are good to have. I had a Contec 550F for a while, but the display faded away in less than 18 months. Haven't bothered to replace it, as it showed things were ok. The Wellue/Viatom O2 ring seems pretty cool. I'd consider one of them. A while back I found a surplus SPO2 board with a Maxim chip that actually measured SPO2. One of these days I'll hack it with an Arduino. Honestly, I think the Wellue is better.

I use UF1 & UF2 as an indicator. My settings are 20% for 9 seconds for UF1, and 50% for 9 seconds for UF2. I was interested in the almost apneas, predominantly the UF2's. For a while I was getting 10 UF2's a session. My reasoning was that there was effectively 90 seconds of 'sub-apneas', or equivalently at 9 10 second apneas. They might not quite be medical apnea, by definition, but if you have a lot of them, they can be very disruptive.

Since I have been using the VAuto, both the UF2's and my apneas have declined quite a bit. I never could get the UF2's under control with my old Respironics machine.
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#44
RE: Maybe I have apnea, maybe not, are all sleep doc jerks?
The reason for the VAuto is you need a higher PS setting than your AirSense can deliver (which is 3 (EPR)). All the other settings are gravy on top.
I do not expect the new machines to be significantly better at detecting RERAS, though recent patents do indicate that ResMed is working on better flow limit recognition.
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#45
RE: Maybe I have apnea, maybe not, are all sleep doc jerks?
Hey, should I be worried that I've started having centrals sprinkled in since I've started wearing the collar and also since I turned EPR on? Not many (1-4 a night maybe) and not every night, but it seems new and different.
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#46
RE: Maybe I have apnea, maybe not, are all sleep doc jerks?
Not a problem. I get them too and all it means is that your ventilation requirements are being met and you occasionally pause for a breath. It is completely harmless at that level.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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#47
RE: Maybe I have apnea, maybe not, are all sleep doc jerks?
At that level of CA, nope not an issue. That's a small speedbump. If they'd drastically jump OK then we can talk more about it, but I don't think it's going to do that. And yes it's due to more efficient exchange/venting of CO2.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#48
RE: Maybe I have apnea, maybe not, are all sleep doc jerks?
Yeah -- actually some of them are when I think I was awake. I have this pattern of breathing that I have noticed that feels like my exhale tails off and then I don't start my next inhale immediately. Looks like this:
[attachment=31418]

The little "shoulders" on the breaths are the pauses. Sometimes the centrals are in the middle of a run of breaths with "shoulders" and it just looks like a longer one:
[attachment=31419]
That picture is me masking up, blowing the machine on (notice that the flow wave starts after the beginning of the picture), breathing for a few minutes with those "shoulders" and then one shoulder just got long.
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#49
RE: Maybe I have apnea, maybe not, are all sleep doc jerks?
On Monday I was able to get a Dreamwear nasal mask (it was a free sample) from my DME. It's not pillows, but a "bar" that fits under the nose. I used it on Monday night up until 6:45, when I swapped the F30 back in. (Last night I also used the F30, as I mod'ed my cervical collar and I wanted to only change one thing at a time.) I was starting with the hope that the cervical collar might be all I need to keep my mouth closed. I had a long burst of leaks during the first part of the night, and since I've never used anything but a FFM I'm not sure if these are mouth leaks? The mask doesn't have a whole lot of support, so it's also possible that I knocked it ajar by changing position, too.

Here's the whole night:
[attachment=31504]

There's this oddness about the flow rate waveform during those leaks -- it's like the zero keeps shifting off where it's supposed to be:
[attachment=31505]

Back on the overview -- the leaky period was 2:15-3:45 or so, but then (except for the bump at 4:40) I managed to go 3 hours in a nasal mask and not register any leaks at all. Pretty epic for someone who went 58 years sleeping with her mouth open!

(Speaking of my mod on the cervical collar, I'm pretty impressed with myself. I cut the collar apart a couple of inches from the edge of the velcro. Then I pushed back the stockinette and cut just the foam -- an inch on each side. This left the stockinette longer than the foam, so I pulled the ends so that they overlap and sewed them all the way around with a simple backstitch. I took out 2 inches, and I could have taken out more. Every time I do one of these things -- the headgear on the new mask is just barely small enough, too -- I wonder if my head is really that much smaller than normal!)
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#50
RE: Maybe I have apnea, maybe not, are all sleep doc jerks?
Hi cathyf
What brand/size cervical collar did you "customize?" I have a long skinny neck -- 13 inch circumference, 3.5 inch from chin to chest. Currently I use the Caldera Releaf Neck Rest, medium size. I'm looking for more collar options for a small neck and head, plus one that's a bit cooler.  Thanks.

Still Tired One
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