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pressure plateau
RE: pressure plateau
(05-21-2020, 07:55 AM)Sleeprider Wrote: Okay, you asked for it:
The end users of CPAP equipment with a few exceptions like the members of this forum, are completely in the dark about what differentiates the brands and models of positive air pressure machines.  Philips hides all of this information from the end consumer or patient to a much greater degree than Resmed who also directs most useful technical information to medical providers.  That's why it is so much more work to figure out how things like "Flex" or the auto CPAP algorithm work, while we can see how EPR and the Autoset algorithm responds.  

All marketing and promotions from Philips are directed to their authorized distribution network of DMEs, Online sellers, sleep clinics, insurance companies and physicians.  There have been particular incentives to be an "exclusive distributor" which means competing brands are not even available.  The promotions all tout the technical superiority of the products and how they help to serve patients while making the suppliers and doctors jobs easier and increasing profit margins.  Philips is very active in providing incentives, training, and has provided many sleep clinics with free test machines so that titrations are based on the Philips lineup and proprietary terms like "BiPAP".   All of this is perfectly acceptable because among the entire sleep distribution chain and sleep medicine, the differences between brands of machines is perceived as negligible, and the lowest price and biggest profit return becomes the controlling interest. We are actually fortunate we are not overwhelmed by the numerous new Chinese CPAP entries that can be purchased very cheaply, because insurance will reimburse suppliers for those machines at the same rate as Philips or Resmed.

If an incentive exists for prescribing or dispensing a particular brand, and it actually costs less, than a competing brand, what do you think happens when end-users have absolutely no knowledge to make a choice?  Very few people actually have a clue what they are getting when they are dispensed a machine, and as a result the end-user is left out of the promotions and usually not given a choice.  Recently Philips and Resmed have done some direct marketing to consumers, mainly for travel machines where a choice is actually involved.  Noe of this will change until enough people take the time to educate themselves on the choices and self-advocate for the best choice.  That is what we do here, and our membership is a tiny speck in the PAP marketplace, or if you prefer, a fly in the ointment of the CPAP mafia.



Quote:Philips hides all of this information from the end consumer or patient to a much greater degree than Resmed who also directs most useful technical information to medical providers. 


no doubt ! I spent more time on you tube at first and on these forums....... !! And was getting frustrated with their limited instruction manual.... SMH !!

Quote:Note of this will change until enough people take the time to educate themselves on the choices and self-advocate for the best choice.

For sure !! 

Thanks for this.... and I'm not too proud for you guys to kick me in the pants from time to time !! 

BTW... I've been reading my Flow Rate chart wrong and Fred has corrected me..... I feel like a major JA !! Thing is I know I've been giving the wrong information...... I guess dealing with the Ins Co. and possibly the Dr's being at the mercy of the Ins. Co's... I over reacted. I'm sure the second sleep study is necessary due to the Dr is following my CPAP therapy progress  at their office.. 

Here's the thing.... the biggest concern was I had to tell them alot earlier then the time frame they wanted to make me wait to see how it was going. Evidently they know my CA's need to be managed and so do you. Just before I read one of Freds posts about correctly reading the flow rate chart......... I had a hunch just before I realized I was making a mistake giving advice to other people of the incorrect reading.
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RE: pressure plateau
This is the 2 minute Flow Rate graph report.... of the first one being wake breathing and the second one sleep breathing.

The chart off to the left shows clearways, that Philips Respronics call Centrals, 2.74.... so that doesn't lie. Or maybe it could be overly sensitive?


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RE: pressure plateau
Those are about 7 to 9 minute segments. When is your titration?
Sleeprider
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RE: pressure plateau
Those charts are good for looking at patterns of flow, like periodic breathing and CSR, but don't show the detail we want to see. A 2-3 minute window provides enough detail but most include too long of a period so we only ask for 2 minute views.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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RE: pressure plateau
(05-21-2020, 09:42 AM)Sleeprider Wrote: Those are about 7 to 9 minute segments.  When is your titration?

titration meaning minute ventilation?


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RE: pressure plateau
Titration refers to chemistry when you are 'titrating' to see how much of a chemical is present in an unknown solution. In our case we are trying to 'titrate' out events.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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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: pressure plateau
(05-21-2020, 10:14 AM)bonjour Wrote: Titration refers to chemistry when you are 'titrating' to see how much of a chemical is present in an unknown solution.  In our case we are trying to 'titrate' out events.

I know what it is..... But Sleeprider asked me what is my titration is.... the second sleep study would reveal that.

Titration... blood/oxygen concentration. Ok.
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RE: pressure plateau
Sleeprider was asking when the titration was scheduled. That's what I'm seeing anyway.
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: pressure plateau
(05-21-2020, 11:02 AM)SarcasticDave94 Wrote: Sleeprider was asking when the titration was scheduled. That's what I'm seeing anyway.

UGHH !!  Oh-jeez He did say When not what? Fred through me off, as well.... !!  Lolabove

No date set yet Sleeprider...Dr's office said June 1st, they'd let me know when they'd schedule.
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RE: pressure plateau
(05-21-2020, 10:12 AM)bonjour Wrote: Those charts are good for looking at patterns of flow, like periodic breathing and CSR, but don't show the detail we want to see.  A 2-3 minute window provides enough detail but most include too long of a period so we only ask for 2 minute views.

think I got it now Fred..... had to open the flow rate box horizontally......

Would please you explain why a two minute is the best time frame to correctly read an event?


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