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07-07-2015, 07:29 PM
Oops, scuse me -- the S9 says nothing at all about centrals or unclassifieds.
07-07-2015, 07:30 PM
(07-07-2015, 07:25 PM)TyroneShoes Wrote:(07-07-2015, 06:59 PM)storywizard Wrote: Native Dancer has a S9 VPAP..it may not differentiate between apneas, my S9 Adapt lumps all apneas together as Unclassified Apneas...
No its OK...we are all bad...lol
Sometimes there are Apneas that the machine cannot classify, especially the older S9 models...I am looking to replace mine as I would like clearer data..
I may have solved this. I had not thought of it before, but throughout the night, I now and then have to lift the bottom of my mask and insert my thumb very briefly to rub my nose or upper lip in order to relieve a tickle. The motion lasts no longer than a couple of seconds, and I many even hold my breath when it occurs. The act would not register as a leak, but may perhaps register a tandem H/UA on the graph. Could this possibly explain the "unexplained"? Also, in the past few nights, I have changed my pressures several times, but the UA's have not lessened or altered to any degree. But if this is truly the problem, I don't know how to achieve a useful AHI reading, and may have to ignore it, as long as my O2 remains at 98. Or else ...ignore the tickle?
I'm not saying I scratch the itch 48 times, though, no way, and this may not be the total answer. Or any answer at all. But it is the only one that occurs to me.
07-08-2015, 09:12 AM
These are definitely apneas - look at the duration. I don't know about your particular VPAP but the Adapt classifies all apneas as unclassified. The explanation is that the backup rate will kick in to take care of central apneas, so any which show up must (by elimination) be obstructive. This is actually explained in the VPAP Adapt clinical manual. I suspect this is what's happening in your case. If it was me, I'd raise the epap pressure a tad to see if that reduces the incidence of these apneas and the associated hypopneas.
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I'll take your suggestion, but my s9 registers only the generic AHI's. Sleepy says no OA or CA. Thanks again. Jim
07-08-2015, 02:41 PM
SH has no inherent abilities to generate data. All it does is take the xPAP data and place it into a GUI that makes it easy to understand. So it is limited to what the xPAP can deliver to it.
I have found that I can minimize the CA false positives when I am awake, simply by never holding my breath, which is something most of us naturally do when changing position so that it does not knock the wind out of us. I just keep a steady breathing pattern. I also avoid deep breaths; if you have two deep breaths in a row, then a NORMAL breath, then two more deep breaths in a row (I realize this is not a practical occurrence) the xPAP determines whether the NORMAL breath might be a hypop by comparing it to those other 4 breaths. It assumes THEY are normal, and that the NORMAL breath isn't, and flags the NORMAL breath as a hypop.
(07-08-2015, 07:31 AM)nativedancer Wrote: I may have solved this. I had not thought of it before, but throughout the night, I now and then have to lift the bottom of my mask and insert my thumb very briefly to rub my nose or upper lip in order to relieve a tickle. The motion lasts no longer than a couple of seconds, and I many even hold my breath when it occurs. The act would not register as a leak, but may perhaps register a tandem H/UA on the graph. Could this possibly explain the "unexplained"? Also, in the past few nights, I have changed my pressures several times, but the UA's have not lessened or altered to any degree. But if this is truly the problem, I don't know how to achieve a useful AHI reading, and may have to ignore it, as long as my O2 remains at 98. Or else ...ignore the tickle?
Wish that I had 02 basal sats of 98% on CPAP. My basals have never exceeded 95% but I've had some nights where as much as 49% of the time I was over 95%.
They got me up to 93% at 12cm (my optimal titration pressure) but the standard is that so long minimum Sp02 is>90%, at least for titration purposes, you are fine.
With that in mind, and with such high average Sp02 assumed of 98%, and without knowing your lowest desats (I try to ignore that a bit and accord more respect to Avg,. Low Sp02 for the night) perhaps a decrease in pressure would work. But I would hardly think that scratching your nose for a few seconds should affect AHI much, especially if <10 seconds.
You may have some latitude due to your high average sats of 98%. Sleep lab told me so long as average sats >90% not to be concerned. Average (basal) sats of >94% are considered somewhat 'excellent'.
But the intuitive answer is usually to raise pressure to clear events, unless clear airway. Hope this helps you a little, maybe not upon second thought. I would therefore defer to DeepBreathing's remarks. But at least I have conveyed some information re 02 sats/desats, which others may find useful.
I use supplemental O2 at 4 overnight, then back to 2 during the day. Without the extra juice, my desats would be terrible.
I'm grateful to each of you for the input, and your expertise. I just wish I had a firmer grasp on things. But hey, not very long ago I didn't even have the sporadic comfort of my SH.
(07-08-2015, 04:02 PM)nativedancer Wrote: I use supplemental O2 at 4 overnight, then back to 2 during the day. Without the extra juice, my desats would be terrible.
Got you mixed up with someone else. I will make a note that you are on supplemental oxygen. Perhaps you might consider placing a reference thereto under 'Other Comments'.
Sorry that I can not contribute more to the thread as it may be beyond my knowledge or experience.
07-08-2015, 07:53 PM
Beyond me too, TedBurns. Glad to have the company, though.
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