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Restarted CPAP after 8 years -data from last night
#1
I just had a surprisingly good night after dusting off my machine, which I shelved 8 years ago.

I am attaching the data (sorry the format is antiquated) which includes SPO2 and heart rate in the hopes the experts here will be able to comment and help me understand where I'm at.

I got woken by a mouse about 2:40 am so the record has a small break but
it is otherwise complete.

I am especially anxious to know what people here think of the sporadic low SPO2 readings which look so low that, if true, I'd be dead!

Thanks,
Spotty
drive.google.com/file/d/0B1ZlKa1Knz2cMjBEQXdSWERJYVU/view?usp=sharing
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#2
Looks like you need to boost minimum pressure. Your having quite a bit of hypopnea and flow limitations at lower pressures. The machine is responding by increasing pressure, but not before allowing some events to sneak through. You are pretty much event free when the machine ramps up. I'd suggest 8-12 for pressure based on the little I'm able to see here.

Looks like you're using a M-Series Auto. Time to update and upgrade. I retired mine just last year and was surprised at the difference in the newer units.
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#3
(11-11-2015, 10:29 AM)Sleeprider Wrote: Looks like you need to boost minimum pressure. Your having quite a bit of hypopnea and flow limitations at lower pressures. The machine is responding by increasing pressure, but not before allowing some events to sneak through. You are pretty much event free when the machine ramps up. I'd suggest 8-12 for pressure based on the little I'm able to see here.

Looks like you're using a M-Series Auto. Time to update and upgrade. I retired mine just last year and was surprised at the difference in the newer units.

Sleeprider - I really appreciate your response and advice, which sounds very reasonable. I will boost those pressures tonight and see.

Please will you tell me what differences surprised you when you got your new machine?

Spotty

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#4
(11-11-2015, 09:43 AM)spottymaldoon Wrote: I just had a surprisingly good night after dusting off my machine, which I shelved 8 years ago.

I am attaching the data (sorry the format is antiquated) which includes SPO2 and heart rate in the hopes the experts here will be able to comment and help me understand where I'm at.

I got woken by a mouse about 2:40 am so the record has a small break but
it is otherwise complete.

I am especially anxious to know what people here think of the sporadic low SPO2 readings which look so low that, if true, I'd be dead!

Thanks,
Spotty
drive.google.com/file/d/0B1ZlKa1Knz2cMjBEQXdSWERJYVU/view?usp=sharing

First of all, I'm just curious as to what possessed you to start using your CPAP after an 8-year lull?

Second, I hate to be the medical stickler here, as I understand this site is all about patient empowerment; however, I do believe there is value to the data collected in a real sleep study, and a doctor to give you an initial prescription. That said, I'd recommend using your insurance (if applicable) to get a new sleep study and hopefully an updated machine. I just started therapy this year, but I can't even imagine how much better the machines must be now compared to 8 years ago. Plus, so many aspects of your sleep health could have changed during that time.

As for the data itself, I would need to see all metrics to comment further, but I agree with other members' assessments that the minimum pressure is too low. You seem to do better at slightly higher pressures, though I do not recommend changing maximum pressure yet. The good news is that most of your events are hypopneas, which are not as traumatic to the body as apneas, though they are obviously affecting your SPO2 levels. Again, a slightly higher min pressure should dramatically reduce them.
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#5
Hello again, Possum - I do have the option of a sleep study and shall likely do that before changing machines as you suggest. Thing is, in those bygone days, I didn't find the machine helped me much; despite having persevered with it for many months. This combined with the sleep clinic's diagnosis of my apnea as "marginal" convinced me to put that machine on the shelf.

Recently I've been waking up feeling super-tired and, very occasionally, with a headache which faded as I took deep breaths - before taking the next and obvious step of having a new study, I decided to fire up the old machine and see if it helps me now. I have only last night's data and I did feel unusually bright this morning.

Thanks
Spotty
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#6
spottymaldoon,
Definetly pursue getting a sleep study done. It is likely that your apnea has gotten worse over the 8 year absence.

If your insurance allows, get a new machine, or check Supplier #2 for used or open box "new" machines.

This link will give you some idea of the newer machines available and what to avoid.
http://www.apneaboard.com/wiki/index.php...ne_Choices
OpalRose
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#7
Spotty, you asked what I noticed about the new machines compared to the M-series. I had pretty good results with my old machine issued in 2008. It had nearly 20,000 hours on it when retired, and it clearly didn't owe me anything. I used a PRS1 560 which is the newer auto cpap. The settings were easier to access and the "feel" was just a bit different. While my AHI was acceptable using the old machine, the one measured both CA and RERA which the old one did not. In spite of measuring additional event types, I experienced a reduction of events using the new one and felt more rested. Data is much easier to get on the newer machines with SD cards instead of the unwieldy Smartcard, and Sleepyhead program is available for the newer machine. It is far superior to Encore.

I obtained an auto bilevel 760 shortly after getting the 560, and it is a whole different level of comfort. I think the Resmed exhalation pressure reduction (EPR) is similar to bilevel, and helps explain why that brand has really taken off in popularity. It is greater than the pressure reduction with A-flex or C-flex. Anyway, the current generation of machines, and even the discontinued previous generation of PRS1 are easier to use, quieter and IMO more comfortable than the old M-series, and they produce data that is easier to use and gives you improved feedback to optimize your treatment. I think for someone like yourself that has compliance issues, it is important to see the benefits.

As for comments by others that clinical titration is superior, I disagree. The person who understands what they are looking at, and becomes engaged in their therapy will generally have a lot more success than the person that relies on the single titration result from the clinic. It's not a bad starting point, but it's rarely actually the optimum pressure(s) in my experience. YMMV, I was never subjected to a titration study and hope never to have one.
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#8
If available where you are I would first opt for the home kit which will usually pick up moderate to severe OSA but might miss mild OSA. But I would start with that as that may be all you'll need to get a new script and new machine. Where I live in the US this is now the standard practice. Insurers generally won't pay for a sleep study in clinic or hospital without doing home study first. In my case, home study was enough to diagnose OSA and get me off to APAP land.
Coffee

Happy Pappin'
Never Give In, Never Give Up


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. 
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#9
(11-11-2015, 02:04 PM)Sleeprider Wrote: Spotty, you asked what I noticed about the new machines compared to the M-series. I had pretty good results with my old machine issued in 2008. It had nearly 20,000 hours on it when retired, and it clearly didn't owe me anything. I used a PRS1 560 which is the newer auto cpap. The settings were easier to access and the "feel" was just a bit different. While my AHI was acceptable using the old machine, the one measured both CA and RERA which the old one did not. In spite of measuring additional event types, I experienced a reduction of events using the new one and felt more rested. Data is much easier to get on the newer machines with SD cards instead of the unwieldy Smartcard, and Sleepyhead program is available for the newer machine. It is far superior to Encore.

I obtained an auto bilevel 760 shortly after getting the 560, and it is a whole different level of comfort. I think the Resmed exhalation pressure reduction (EPR) is similar to bilevel, and helps explain why that brand has really taken off in popularity. It is greater than the pressure reduction with A-flex or C-flex. Anyway, the current generation of machines, and even the discontinued previous generation of PRS1 are easier to use, quieter and IMO more comfortable than the old M-series, and they produce data that is easier to use and gives you improved feedback to optimize your treatment. I think for someone like yourself that has compliance issues, it is important to see the benefits.

As for comments by others that clinical titration is superior, I disagree. The person who understands what they are looking at, and becomes engaged in their therapy will generally have a lot more success than the person that relies on the single titration result from the clinic. It's not a bad starting point, but it's rarely actually the optimum pressure(s) in my experience. YMMV, I was never subjected to a titration study and hope never to have one.

Sleeprider - Thanks a lot for taking the time to give such a detailed answer. I notice that pricing has changed very favorably since 2007 and your suggestion of the DS760 is attractive. Like you, I prefer to take as much personal charge of my own therapy as possible - I'm the only one accountable if there's a slip-up.
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