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RERA [help understanding them]
#11
RE: RERA [help understanding them]
Walla Walla's observation and advise was excellent. If you had an autoset machine, the pressure would have automatically risen with the flow limitations that led to RERA. Using EPR is a great tool for fighting flow limitations because the larger difference between inhale and exhale pressure makes it easier to breathe, and this has a known benefit in treating hypopnea and flow limitations.

Most of us do change the pressure on our machines, but we try to first understand why we are making changes, and then observe the resulting data to confirm that our expectations are met. I'm confident that the change to CPAP pressure of 9.0 and EPR 3 will be beneficial. Your upcoming doctor appointment is a standard follow-up, usually in the first 90 days of therapy. The appointment will determine if you are using your machine (compliance) and if you are benefiting from the use of the machine. Rarely do the doctors look at data or concern themselves with "non-events" like flow limits and RERA. In your case, the AHI of 1.46 will be considered excellent results. What we see on the forum is different. We immediately recognize that your therapy is split into 6-sessions, and that at CPAP pressure 7.0 and EPR 1, you have considerable flow limitation, and RERA that affect your quality of sleep. We try to control OA and H events to as low a level as possible. We can reduce OA by increasing pressure, but for the FL and H, increasing EPR is the best approach.

Your DME told you that unless your doctor ordered auto CPAP it would not be covered This is not true. Without your doctor specifying auto-CPAP the DME may dispense any CPAP and meet the prescription, and it costs them about $125 to give you the Autoset instead of the Elite. The insurance billing code for CPAP is the same, so insurance will cover an Autoset without it being specified, but the DME's profits are what are affected. They make money either way, but make more with the Elite.

Here is how to change the CPAP pressure and EPR on your machine: https://www.apneaboard.com/resmed-airsen...setup-info
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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#12
RE: RERA [help understanding them]
(09-22-2018, 01:35 PM)Sleeprider Wrote: Walla Walla's observation and advise was excellent.  If you had an autoset machine, the pressure would have automatically risen with the flow limitations that led to RERA.  Using EPR is a great tool for fighting flow limitations because the larger difference between inhale and exhale pressure makes it easier to breathe, and this has a known benefit in treating hypopnea and flow limitations.  

Most of us do change the pressure on our machines, but we try to first understand why we are making changes, and then observe the resulting data to confirm that our expectations are met.  I'm confident that the change to CPAP pressure of 9.0 and EPR 3 will be beneficial.  Your upcoming doctor appointment is a standard follow-up, usually in the first 90 days of therapy. The appointment will determine if you are using your machine (compliance) and if you are benefiting from the use of the machine.  Rarely do the doctors look at data or concern themselves with "non-events" like flow limits and RERA.  In your case, the AHI of 1.46 will be considered excellent results. What we see on the forum is different.  We immediately recognize that your therapy is split into 6-sessions, and that at CPAP pressure 7.0 and EPR 1, you have considerable flow limitation, and RERA that affect your quality of sleep.  We try to control OA and H events to as low a level as possible.  We can reduce OA by increasing pressure, but for the FL and H, increasing EPR is the best approach.

Your DME told you that unless your doctor ordered auto CPAP it would not be covered  This is not true.  Without your doctor specifying auto-CPAP the DME may dispense any CPAP and meet the prescription, and it costs them about $125 to give you the Autoset instead of the Elite. The insurance billing code for CPAP is the same, so insurance will cover an Autoset without it being specified, but the DME's profits are what are affected.  They make money either way, but make more with the Elite.

Here is how to change the CPAP pressure and EPR on your machine: https://www.apneaboard.com/resmed-airsen...setup-info

Thank you! My appointment is not the follow-up, that was supposed to be in December, but I made it for this Tuesday because I'm still exhausted, still waking often, and still needing naps and I've already discussed all this with a lady from DME, but she said with the data from my machine, my therapy is working as it should and they can't change anything without the doctor changing the order/prescription. I will be talking with the doctor about switching me to autoset on Tuesday, but until then I will try the settings I've been recommended here. Thank you again Smile
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#13
RE: RERA [help understanding them]
(09-22-2018, 01:28 PM)Shel Wrote: Also, one last question about the RERAs that show on sleepyhead. What is the (0) beside them? It is beside every RERA showed on any night.


Shel,
I'm not sure why the RERA's all register (0).  I had to go back and look at my SH graphs for RERA's, and they all have a number in parenthesis, which would mean seconds.
It may be that ResMed machines record these differently than the Respironics that I use.

I believe once you change your Pressure and EPR setting, you should see an improvement in both RERA's and Flow Limitations. Give it a couple days and post another chart.

Sleep-on-pillow
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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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#14
RE: RERA [help understanding them]
All the RERAs recorded by my Resmed machine are followed by (0). It must be a difference between Resmed and Respironics machies as Rose suggested. All my other events have the number of seconds displayed.
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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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#15
RE: RERA [help understanding them]
Me again. I took a small nap with the new settings and for the first time a clear airway showed on my SH data. Is this concerning? Or normal? Sorry if this is a dumb question.
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#16
RE: RERA [help understanding them]
I looked at SleepyHead data for my DreamStation and A10 auto. I have the same results as Rose and Melman. The DreamStation shows has a number in the parentheses while the A10 doesn’t.

Best of luck in getting your autoset.
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#17
RE: RERA [help understanding them]
Better looking results for the short experiment. The individual CA is not a concern. These can occur when you shift position or even have a sleep transition or slight arousal. If you zoom in on it, you will probably see some breathing disruption like a sigh or larger inhale occurs right before the short apnea. This is all very normal and you should not let it worry you as we all have these from time to time. What is a bigger concern is when there are large clusters of CA.
Sleeprider
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____________________________________________
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Optimizing Therapy
Organize your OSCAR Charts
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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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#18
RE: RERA [help understanding them]
(09-22-2018, 08:34 PM)Sleeprider Wrote: Better looking results for the short experiment.  The individual CA is not a concern. These can occur when you shift position or even have a sleep transition or slight arousal.  If you zoom in on it,  you will probably see some breathing disruption like a sigh or larger inhale occurs right before the short apnea.  This is all very normal and you should not let it worry you as we all have these from time to time.  What is a bigger concern is when there are large clusters of CA.

Thank you. I have a pretty severe anxiety/panic disorder esp concerning my health so things naturally tend to freak me out irrationally (I'm in therapy, but not "fixed" yet concerning my panic disorder). Where do I zoom in at to see if it's a breathing disruption? Or should I just not even bother with it and see what happens over the next couple days of sleep?
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#19
RE: RERA [help understanding them]
From Sleepyhead Chart Organization Wiki

The easiest way to zoom in on an event is to simply left-click on the event until the desired zoom level is reached. You can then use the left and right cursor to move forward or back in the time-line. You can also select a time period of events or flow-rate by left-clicking on the graph and holding down the mouse button while selecting. Right-clicking can un-zoom. On laptops with a touchpad or touch-screen, you may be able to zoom in and out by "pinching" the zoom in and out as you do with any page zoom.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
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Organize your OSCAR Charts
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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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#20
RE: RERA [help understanding them]
(09-22-2018, 08:26 PM)Shel Wrote: Me again. I took a small nap with the new settings and for the first time a clear airway showed on my SH data. Is this concerning? Or normal? Sorry if this is a dumb question.

Don’t worry about the Ca you only had one, you probably held your breath whilst you rolled over
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