Respiratory Effort Related Arousal

[OpalRose]

I have for her model but i font see it reported in myair. Is this something doctor or RT can see? Do i have to download Oscar to see it?

I don't use MyAir, but I doubt you would see the amount of detail that the OSCAR software shows.  Yes, please download OSCAR.  Be sure you have a SD card in your machine (which must be inserted during sleep) or you will only see summary data, similar to MyAir.

There are links in my signature line to guide you.

Also, fill out your profile with machine, mask and pressure information.

[Crimson Nape]

As OpalRose has pointed out that you won't be able to see details like the ones you describe.  MyAir is basically a "feel-good" app designed to encourage you to continue your therapy and not to adjust your device.  In order to get any meaningful data, you will need either OSCAR, the preferred choice, or ResScan.  Think of MyAir along the lines of a participation trophy.

[cpapnovice]

I am off to good start, i have 2 machines, both  brand new one for her and one regular airsense 10. both missing sd cards. Is there a reason? Or just regular DME/sleep doctor torture mo?

[Sleeprider]

The SD card used to be packed with the user manual by Resmed. The suppliers (DME) got into the habit of removing it as "unnecessary" because they get all the data they need from the AirView data they subscribe to, and don't want you to be "confused" by the SD crard. Well, you can ask them to give you the SD cars, and most of the time, they will give it to you, or just buy your own. Any SD card from 4 to 32 GB will work fine. We don't like that the card gets swiped, but it's easy to remedy.

[cpapnovice]

thank you. just last question on this subject.  it is impossible for dme/resmed to suppress recording of data? correct?

[Sleeprider]

If you have a SD card, data will be recorded. FAT32 format.

[Gideon]

ResMed could do it by forcing an 'upgrade' to your machine, but why would they risk disrupting every running machine out there. They have issued, afaik, only one upgrade ever, and that was to fix a serious issue in it's machines.

[cpapnovice]

Here is update to my RERA question. I had sleep test done by Virtuox. But as usual due to my inexperience with crooked sleep industry this is what happened. Because RX for sleep test was done on sleep center letterhead, virtuox sent results to sleep doctor and sleep center software is not compatible with virtuox so only rei = 15.6 was reported.  i submitted medical release form to virtuox.  virtuox states on their site https://www.virtuox.net/physician that they provide rdi (see summary). virtuox refuses to provide report to me due to their "relationships" with my sleep center. So bottom line is i am not going to get RDI due to different software my sleep center has. Basically RDI is REI with RERA added. Doctor is telling me RERA cant be diagnosed in home sleep test so this is reason their software does not show it. Is it correct? Doctor telling me RERA can only be diagnosed in sleep center in overnight test. Sounds like BS.  My insurance allows me to have multiple home sleep tests and will pay 100% for it. I am reluctant to order it again even now i understand that letterhead "trick".  Virtuox wants credit card and they can claim i never returned device or claim i sent them empty envelope or damaged device. 
I downloaded OSCAR and my RERAs are 0.18.  Are RERAs on sleep test same as what Airsense for her reporting? if yes, then it makes no sense to repeat home sleep test. Correct?
And as far as SD card, i confirmed with Resmed, it is not DME who removes SD cards, apparently DME tells Resmed not to put cards in. My initial machine came from Apria, major national DME owned by Blackstone private equity.  Apria makes huge margins of DME biz, so it is not about saving few dollars on a card, it is about control. And if you google Resmed DOJ settlement in matter not to related to related to SD cards, i am afraid Resmed will make sure to SD cards will be useless. Or is it some law that requires Resmed to make patient data available to patient? And my second machine came from local DME who confirmed me in writing they order machines specifically with instructions to Resmed to omit SD cards.

[Sleeprider]

All records of tests, reports, diagnostics, prescriptions and other records are covered under HIPAA. Any correspondence or record that was used by Virtuox to transmit your test results is clearly covered under HIPAA.
This is a summary of your patient rights https://www.hhs.gov/hipaa/for-profession...index.html
This is how to file a complaint https://www.hhs.gov/hipaa/filing-a-compl...index.html

RERA is technically increasing airway resistance that can be measured only by an invasive esophageal pressure, used in combination with EEG to monitor arousal. However alternative methods of measuring airway resistance and flow limitation have been well studies and are commonly used. Resmed measures an index of flow limitation that corresponds to airway resistance and scores arousal when a period of increasing flow limitation is followed by an increased respiratory volume or rate indicating an arousal. It is not the gold standard, but it is a good indicator of sleep stage disruption in the absence of PSG / EEG. Your doctor is taking the position that the only valid observation is in a clinical evaluation with full PSG and either measured by esophogeal pressure or perhaps inductance plethysmography, which is the chest band that measures expansion from respiratory effort.

Like many sleep doctors, he sounds self-absorbed and totally consumed by clinical methods, and is uninterested in your input or outcome. Fire him.

[cpapnovice]

I already did. One of benefits of covid, all sleep doctors do telemedecine appointments and i can "see" best doctors in US. It just matter of waiting. Looks like others with OSA figured it out. IMO sleep center in hospital i was and still patient for over decade and have relatively good experience (outside of sleep medicine) , sets patients up for CPAP failure so they can "recommend" surgeries and implants that can bring huge profits. Especially at time hospitals losing huge amount of money, sleep centers may be pressured to bring profits. 
I will file HIPAA complain and leave sleep tests alone, as i am not interested in any invasive procedures or take unnecessary risks outside of my home

Thank you