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Plmnb - the journey continues now with ST-A.
RE: Plmnb - the journey continues now with ST-A.
(02-28-2020, 08:36 PM)Sleeprider Wrote: Phoebe, could you check if your machine settings has an Auto EPAP option? Another member starting therapy on an international machine (Lumis 150) which has AVAPS has Auto EPAP on his. http://www.apneaboard.com/forums/Thread-...#pid336986  You might want to follow this.

EDIT: Please ignore
Clarification of the Australian models are now correct on my spreadsheet
http://www.apneaboard.com/forums/Thread-...#pid337178
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RE: Plmnb - the journey continues now with ST-A.
Still on COPD, i started to digest this paper. Predicted/real waveforms of COPD pacient match perfectely one case i know well/well diagnosed.
It might also have patterns and details which maybe look similar to plmnb's; at least in some intervals (details on expiration, for instance.. )

https://www.researchgate.net/publication...ng_Disease
Mper
I am not a doctor. Nothing that I say here is medical advice
All my posts include only outcomes/learnings from my own/other therapies and medical literature



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RE: Plmnb - the journey continues now with ST-A.
mper6794, very interesting article and graphics. The Figure 8 is hauntingly familiar.

We find ourselves treating the symptoms of an unknown underlying cause which I've said before could be upper airway or pulmonary. In addition, it is somewhat intermittent. The whole thing is complicated by extremely poor sleep hygiene and lack of investigative interests on the part of Plmnb's medical team, and, not to beat a dead horse...smoking. Hopefully we get symptom relief, but I think the point that the search for medical answers should continue is important to remember.
Sleeprider
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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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RE: Plmnb - the journey continues now with ST-A.
Coffee Morning guys and gals.

Sleeprider, I just checked my machine and it does not have the therapy setting AVAPS.  I don't think it has the AUTO EPAP setting either.  

mper6794, as Sleeprider said, interesting article on the COPD angle.  Figure 8 does have the similarities in wave forms to mine, although it is an intermittent similarity.  It looks nothing like last nights readings for instance but does to other nights I have had.

For instance the last few nights MASK PRESSURE wave forms are not flat topped.  And the FLOW RATE forms are not "car compactor" in shape at all. 

EDIT:  If it were asymptomatic COPD wouldn't the spiro test detect an issue? 

I have been playing with my settings on my own and once I get another night in I will present a chart and the settings I have the machine set to.

I guess I should do some web hunting on COPD and differences between daytime COPD and night time COPD?  I guess I could also ask at this next drs. appointment about this angle.

Thank you Geer1 for the chart suggestions.

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: Plmnb - the journey continues now with ST-A.
I would not worry about the speculation or chatter that there are some similarities between the graphs in that article to some of your bad flow charts. I'm glad your latest results are looking better and feeling better. That is what we were hoping to hear. Feel free to post an updated full-night chart. This is very encouraging.

Thanks for looking at the machine settings. The Lumis ST-A is apparently an even more advanced version of iVAPS that includes an auto-adjusting EPAP. The person using it is in Australia, and it should be interesting to see how it works.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
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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RE: Plmnb - the journey continues now with ST-A.
QUESTION:

What is the significance of the 95% reading that is always asked about?  And what is the significance of that number versus the other measurements such as the "median".

Im horrid at math so can we keep it simple please  Shy

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: Plmnb - the journey continues now with ST-A.
From website https://www.mathsisfun.com/definitions/median.html:
Median: "The "middle" of a sorted list of numbers. To find the Median, place the numbers in value order and find the middle number. ... The middle number is 15, so the median is 15. (When there are two middle numbers we average them.)"
1 2 3 4 5...3 is median or middle

95% I think is where the setting in question is at X 95% of the operation time.

To clarify about iVAPS vs. AVAPS: AVAPS is the common ventilation mode that's not specific to a manufacturer, iVPAPS is a ResMed variation on AVAPS where "intelligence" is added

OR in the words of website www.inspiredrc.com PDF
"The VPAP ST-A's VAPS mode is called “iVAPS”, or “intelligent volume assured pressure support”, while the BiPAP AVAPS VAPS mode is referred to as “average volume assured pressure support”. ... The BiPAP AVAPS goal is to maintain the set tidal volume, while the goal of the VPAP ST-A is to maintain set alveolar minute volume."
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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RE: Plmnb - the journey continues now with ST-A.
BTW, here are the current settings of my ST-A.  Below them are the averages (?) for the past week.  Anything jump out at anybody?  (FWIW, I feel like I breathe better at the high Rise Time and the settings of LOW for Trigger and Cycle, well I THINK I do anyway.  With my still doing the "yoga" maybe I unknowingly don't).  I realize I should just wait for this next dr. appointment but you know my patience level.  Rolleyes

Therapy: iVAPS
Height: 56 inches
Target Pt Rate: 14
Target Va: 5.1L/Min
EPAP: 15
Min PS: 5.0
Max PS: 15.0
Ti Max: 2.0s
Ti Min: 1.0s
Rise Time: 700ms
Trigger: Low
Cycle: Low


Pressure: 25.9
Exp Pressure: 14.00
Leak: 60L/min
Vt: 500 ml
RR: 14
MV: 7.3L/min
Ti: 1.5s
I:E 1:1.7
Spont Trig: 80%
Spont Cycle: 61%
AHI: 3.9
Total AI (?) 2.4

Plmnb
Huhsign  WARNING: It may take a while to sink in...I tend to get befuddled at times.
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RE: Plmnb - the journey continues now with ST-A.
I can take that one (I wonder if this will be a crosspost with someone else) EDIT: Yes it was! ;-)

If you take a set of numbers and sort them into increasing order, the middle value is the "median" value.
The median is important because 50% of the numbers will be less than (or equal to) the median and 50% will be greater than (or equal) to the median.
So the median value represents a middle-ground value.

If we now slide along and look at the larger numbers in that list, we can reach a value that has 95% of the (lower) values to the left of it and 5% of the (higher) values to the right of it.
That's the 95% value that you often hear about.

If we slide even further to the right in our fictional list of numbers, we reach a value where 99% of the values are to the left and only 1% are to the right.
That would be the 99% value you sometimes hear about.

The 99% value is handy because sometimes we may get the occasional rogue values that are too big to be true and are probably errors in the readings.
If we were to look at the maximum value, the maximum would contain these rogue values and give a misleading impression of values being huge.
By only looking at the 99% value (instead of the maximum value) we get a better feel for the "meaningful maximum" that ignores those rogue values in the top 1%

The 95% value is handy for similar reasons. It ignores the top 5% and is another convenient way of getting a feel for the "meaningful maximum" by ignoring erroneous large spikes that are probably just noise and not trustworthy.

Does that help?

EDIT2: I could get pedantic and start talking about the terms "less than", "less than or equal to", "greater than" & "greater than or equal to" but that would not help to convey the general feel for the terms: median, 95%, 99% and maximum.

EDIT3: The current version of OSCAR sometimes claims that a value is the "maximum" value when it is actually a "99%" or maybe a "95%" value.
The upcoming release of OSCAR is changing so that the terms are used consistently and correctly. I believe it's fixing a legacy thing from the Sleepyhead days.
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RE: Plmnb - the journey continues now with ST-A.
IMO comfort rules. If better comfort results from these settings, keep it. Numbers guide while comfort rules.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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