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Noob here, help appreciated!
#1
Noob here, help appreciated!
Ok, so... I dont know if this is frowned upon here or not, but I cant afford a sleep study, and at the moment I dont have insurance (and probably wont atleast a few more months). Ive known Ive had an issue for years and a couple nurses Ive dated in the past have warned me about it. I work in commissioned sales, and my tiredness has been preventing me from talking to customers and thus, hurting me financially. There are times when Im so tired I slur my speech it seems.

So I bought a cheap used machine off Craigslist to see if it atleast somewhat helps. And man, honestly it made a huge difference these last few days that Ive used it. Its a clean but older Philips Remstar Auto, and i have a Swift FX nasal pillow mask using the large size (which seems to work ok, though I dont consider my nose very large. The small seems restrictive and I have have no medium.)

Can someone just help me interpret some of this data I pulled from OSCAR and recommend any adjustments? The time spent in apnea is concerning to me. I started out with the default setting of 5min max 15, and changed it to the following night to 7min. It dropped down to 6.5 from 9 the first night, and last night it went back up to the 7's

Im still learning- real new to these machines. Should I increase the pressure? Any suggestions are appreciated. Thanks!


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#2
RE: Noob here, help appreciated!
Welcome to the forum.

The sleep study has three purposes:
1. to show that you have sleep apnea.   The charts you have posted do show that.
2. to identify settings to optimize your therapy.  We can and will help you with this.
3. to identify what levels of apnea you have prior to treatment.  This is missing and might have some important info regarding the central apnea that you are showing.  Don't worry, we will work with what we have.


Your obstructive events are clustered together.  This generally indicates that you are tucking your chin towards your chest thus causing these clustered events.  This can be that your pillow is too high.  We suggest a Soft Cervical Collar or an anti-snoring or sleeping collar to fix this.  See the Soft Cervical Collar link in my signature to read further and see some before and after charts for this.  This is the most important thing to work on.

You are not apparently using Flex, please confirm this.  Flex will likely make your Central Apnea worse so, at least for now, don't turn it on.
Your Central Apneas are likely Treatment-Emergent Central Apneas.  These occur because you are now breathing better and flushing carbon dioxide from your bloodstream.  High CO2 in the blood is a major trigger to breathe and these centrals typically go away in the next 2-3 months.  We will work on minimizing them going forward. (thus minimizing the amount of flex that you are using.)

You have a lot of Hypopneas, Flow Limitations, and RERAs.  These are treated with "Pressure Support" an increase in pressure from your exhale pressure (not feasible here) so increased pressure is what we will work with.  RERAs, Respiratory Effort Related Arousal), are a series of Flow Limitations that end with arousal.

Set your Min Pressure to 7.  I expect to make further adjustments later.

Then we need to see what the above does for you.

Also, please adjust your charts.  They contain important information that you did not include.  See the article on organization in my signature.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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New to Apnea? Helpful tips to ensure success
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Dealing with a DME
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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. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Noob here, help appreciated!
Ok, so I followed the instructions to my best ability. I did not see the flow rate chart in mine. Maybe its not in the data from this older machine.

So these numbers are a little different. This is from last night. I actually bumped the min pressure to 7 on the second night (oct 4). A-Flex is on and set to 3. I agree with you that I probably tuck my head. I have a habit of sleeping with my arm under the pillow and I think it angles my head downward.

Are the numbers in parenthesis at the end of events the number of seconds it lasted? Ive got numbers going into 65 range on the first night (oct 3) under obstructive events.


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#4
RE: Noob here, help appreciated!
SJRTX, I will leave the therapy coaching to Bonjour for now. Your PRS1 60 Series Auto does provide a flow rate, so it should be there. (might be 50 series. Check model 550P or 560P). Anyway, you say this machine is doing a lot of good. My recommendation is that you keep an eye out on Craigslist or Offer-up in your area and try to get a Resmed Airsense 10 Autoset. They come up fairly often, and it's going to do a lot better at getting ahead of your apnea and hypopnea events. The System One machines are okay, and I used one, as well as the preceding M-Series. The problem with Philips machines in general is that they are slow to respond in auto mode. The Autoset is still an auto CPAP but actually delivers bilevel (BiPAP) pressure for inhale and exhale, and is much faster to respond to flow limitation and will prevent the apnea and hypopnea events.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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Optimizing Therapy
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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. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Noob here, help appreciated!
I think you're right about the model. This is in the text file in data directory located on my SDcard:

SerialNumber=P013369147A55
ModelNumber=550P
ProductType=35
DataFormat=UDF
DataFormatVersion=2
Family=xPAP
FamilyVersion=2
SoftwareVersion=V1.24
FirstDate=1570391187
LastDate=1570391602
BasicKey=0eb9010b2fef
DetailsKey=a50b02a9fd04
ErrorKey=000a0400bbce
PatientFolderNum=0
PatientFileNum=2
EquipFileNum=1
ValidCheck=5cc7


Ill keep an eye out for what you recommend. I just needed something quick so I didnt research this stuff too much. I spend a lot of time outside on a hot car lot and it was killing me being tired in addition to dealing with Texas heat all day.
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#6
RE: Noob here, help appreciated!
That is the 50 series that was manufactured 2008 to 2011 and was replaced by the 60 series that enabled use of a heated tube and had some improvements to the main-board. They look the same, but your machine is pretty old and had a reliability issue that was pretty easy to fix. The Dreamstation replaced the System One in 2015. I can't guarantee the 50 series tracked detailed flow data, so that may not be there.

Resmed will produce much more comfortable results and is effective in a way that...well we just don't see many problems with people having continued high obstructive apnea with the Autoset. FWIW, when I first started CPAP I also used the Swift II and then the Swift FX nasal pillows. You're going to like the Airfit P10 when you get there.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files

How To Deal With Equipment Supplier


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. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Noob here, help appreciated!
(10-06-2019, 06:33 PM)Sleeprider Wrote: That is the 50 series that was manufactured 2008 to 2011 and was replaced by the 60 series that enabled use of a heated tube and had some improvements to the main-board. They look the same, but your machine is pretty old and had a reliability issue that was pretty easy to fix.  The Dreamstation replaced the System One in 2015.  I can't guarantee the 50 series tracked detailed flow data, so that may not be there.

Resmed will produce much more comfortable results and is effective in a way that...well we just don't see many problems with people having continued high obstructive apnea with the Autoset.  FWIW, when I first started CPAP I also used the Swift II and then the Swift FX nasal pillows.  You're going to like the Airfit P10 when you get there.

You know, I decided to look back on CL for a Resmed and the same guy that sold me this one has one for sale for only $25 bucks more. (Resmed CPAP Autoset II W Mask, Hose, Heated humidifier, Instructions - $175)

Wish I had known this then. But Ill either buy another one in a couple months or just pay for all of this via insurance in a few months hopefully, provided the deductible isnt prohibitively expensive.

I do have a question that you might be able to answer- assuming I treat myself with this machine for now, but once I have insurance and want to go the official route, will having been on this machine skew the results of a sleep study?
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#8
RE: Noob here, help appreciated!
SJRTX,
The ResMed Cpap AutoSet II is an older model. It is an S8. You don’t want this.

What you want to look for is ResMed AirSense 10 AutoSet.

See the link in my signature line below...”Machine Choices”
OpalRose
Apnea Board Administrator
www.ApneaBoard.com
Dreaming


https://www.sleepfiles.com/OSCAR
http://www.apneaboard.com/wiki/index.php...ganization
Using Attachments to Post ScreenShots.
Mask Primer
Machine Choices



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.  INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: Noob here, help appreciated!
(10-06-2019, 08:18 PM)OpalRose Wrote: SJRTX,
The ResMed Cpap AutoSet II is an older model.  It is an S8.  You don’t want this.  

What you want to look for is  ResMed AirSense 10 AutoSet.

See the link in my signature line below...”Machine Choices”

Thanks. I realized that after I posted, and did some more browsing on craigslist. Looks like Ill have to pony up about $400-500 on average for one of those. Not too bad though if its worth it as you all say it is.
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#10
RE: Noob here, help appreciated!
Since you are out of pocket look at the next machine up The ResMed VAuto. It has similar capabilities but with the capability of higher PS and higher pressures. The PS is more important than the higher pressures
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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