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A deep report on sleep treatment
#21
RE: A deep report on sleep treatment
(09-18-2020, 09:53 AM)Sleeprider Wrote: Ever wish you had a Resmed Aircurve 10 ASV?

Not really, when Medicare and Access offered me an APAP system with my history with Phillips I did indeed ask for a RESMED system.
 
I could not stand it!!
 
I tried to adjust to the Resmed system for a week and had to call it quits, my medical system supplier said: “We see that a lot, some people are Resmed people and others are Phillips people.” They then swapped the Resmed system for a Phillips Dreamstation APAP system.
 
Although I was NOT 100% happy with the Dreamstation APAP I was much better than with the Resmed system.
 
SO as I can only afford out of my own pocket one system I when with the known Dreamstation ASV.
 
SO unless someone wants to loan me a Resmed ASV system for me to try as my insurance will NOT supply me with either system so I had to buy my ASVs out of my own pocket.
 
Rich
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#22
RE: A deep report on sleep treatment
I have just learned what I was calling air flow is normally called in the biss is VOLUME: AIR VOLUME

Rich
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#23
RE: A deep report on sleep treatment
I just now saw your new-to-me thread, read it all with interest (have not looked, yet, at your fb) and thank you particularly for light your OP and its links shed on consequences of lacks of deep sleep.  

Deep sleep deprived myself, the OP and more touch on my efforts to understand and find a way to ID, tally and respond to any key (micro arousal?) markers amid  the continuous flow limited background that is invisible to my ResMed VAuto's flagging capability--markers that researchers and an additional 2018 ResMed patent application have identified, weighed and ResMed, at least, is recognizing.

Your thread and bio information prompt these three immediate questions that bear on my present efforts.

1.  Your overall knowledge of sleep, computer, tech and mechanical matters, although you are a Respironics user, may enable you to answer this question about ResMed machines.  

Could 1.5 VDC and/or 5 VDC pigtails be installed (DIY) into ResMed AutoSet and VAuto devices, pigtails which would be energized only at and after the exact instant data logging starts?  

I have data logging accelerometers to power up at those two voltages which might be adaptable and, if so, those could be accurately synchronized with the ResMed in a simultaneous startup of data loggers. Any persistent startup and lag time differences in the data loggers could be adjusted out elsewhere, if still necessary. (If the desired low current voltages could be made available, it will still leave need for a seamless, constant power switchover to the accelerometers battery power after startup, a second problem to solve.)

2.  Do you have an idea how to tweak the OSCAR software so as to become able to toggle, off or on, that feature of OSCAR that changes the graph width (time span) after a click and drag? The fly out feature is great but it does not lend itself (AFAIK) to doing  a numerous sequence of variously time-zoomed, screenshot-like snips of small details of one or more displayed graphs.   

3. How reliable did you find sleep staging by the ResMed, er ?, Max device and in which sleep positions has it worked well for you, if you know?

2SB
I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  

Of my 3 once-needed, helpful, and adjunctive devices I have listed, only the accelerometer remains operative (but now idle). My second CMS50I died, too, of old age and the so-so Dreem 2 needs head-positioning band repair--if, indeed, Dreem even supports use of it now.



 
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#24
RE: A deep report on sleep treatment
(09-30-2020, 06:08 PM)2SleepBetta Wrote: I just now saw your new-to-me thread, read it all with interest (have not looked, yet, at your fb) and thank you particularly for light your OP and its links shed on consequences of lacks of deep sleep.  

Deep sleep deprived myself, the OP and more touch on my efforts to understand and find a way to ID, tally and respond to any key (micro arousal?) markers amid  the continuous flow limited background that is invisible to my ResMed VAuto's flagging capability--markers that researchers and an additional 2018 ResMed patent application have identified, weighed and ResMed, at least, is recognizing.

Your thread and bio information prompt these three immediate questions that bear on my present efforts.

1.  Your overall knowledge of sleep, computer, tech and mechanical matters, although you are a Respironics user, may enable you to answer this question about ResMed machines.  

Could 1.5 VDC and/or 5 VDC pigtails be installed (DIY) into ResMed AutoSet and VAuto devices, pigtails which would be energized only at and after the exact instant data logging starts?  

I have data logging accelerometers to power up at those two voltages which might be adaptable and, if so, those could be accurately synchronized with the ResMed in a simultaneous startup of data loggers. Any persistent startup and lag time differences in the data loggers could be adjusted out elsewhere, if still necessary. (If the desired low current voltages could be made available, it will still leave need for a seamless, constant power switchover to the accelerometers battery power after startup, a second problem to solve.)

Sir I am very faltered you think I am a electronic genius, but those questions are FAR FAR above my pay grade.  Way beyond my small knowledge.

2.  Do you have an idea how to tweak the OSCAR software so as to become able to toggle, off or on, that feature of OSCAR that changes the graph width (time span) after a click and drag? The fly out feature is great but it does not lend itself (AFAIK) to doing  a numerous sequence of variously time-zoomed, screenshot-like snips of small details of one or more displayed graphs.   

Again as above.

3.  How reliable did you find sleep staging by the ResMed,  er ?, Max device and in which sleep positions has it worked well for you, if you know?

2SB

These are consumer devices, so I take their readings with a large gain of salt. I look for a trend not minute by minute readings, yet they do seem fairly good of being able to tell my being awake and when I am asleep.

The ResMed Max Sleep system always show less real sleep VS. the sleep machines readings as it only records the time it is on.

If your really wanting to track sleep cycles you might want to use three systems: a wrist monitor , Max Sleep remote monitor and a under the bed sensor system and see how well they all match.  The fitbit and seemly other like them seem to need a minimum or three hours sleep to produce a reading. So it will not make a report with less than three hours of solid sleep.

Rich
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#25
RE: A deep report on sleep treatment
Thank you, Rich. 

I hope you can find the Phillips ASV device you many need and that the APAP one you have is maintaining sleep meanwhile. I sent an inquiry to a site I have used that might have a used one to sell and will let you know if something is available.

You wrote this helpful information, my emphasis added:

"These are consumer devices, so I take their readings with a large gain of salt. I look for a trend not minute by minute readings, yet they do seem fairly good of being able to tell my being awake and when I am asleep.

"The ResMed Max Sleep system always show less real sleep VS. the sleep machines readings as it only records the time it is on.

"If your really wanting to track sleep cycles you might want to use three systems: a wrist monitor , Max Sleep remote monitor and a under the bed sensor system and see how well they all match.  The fitbit and seemly other like them seem to need a minimum or three hours sleep to produce a reading. So it will not make a report..."

-----------

Until getting my AHI down, I had not given more than peripheral attention to sleep stages. Recent receipt and tardy review of ca 2016 sleep study showed my low sleep efficiency, only N1 and N2 sleep and lots of spontaneous arousals; it got my attention. You linked to work of Andrew Varga, MD, a neuroscientist. I see he has done a lot of other valuable research as in the article you linked. It underscores importance of CPAP in reducing both sleep stage and total-sleep fragmentation to  preserve mind and body. Footnotes of his papers hold a lot of leads to check out, too. Thanks again for the link.

It seems all three of the sleep stage detectors you mention are based on motion sensing and their interpretations of that measurement data alone. Accordingly, getting movement data from three input points and areas, as you suggest, will yield a more complete and meaningful picture.  

I  don't know anything about validity of their staging info, but had assumed ResMed's device could/should be best. Am wondering if they, in their commercial (made in China, most likely) embodiments as sleep-wake and staging reporters, aren't glorified pedometers--devices somewhat better than a stopped clock that is correct twice a day--just sold by marketing opportunists soaking up money in market segments where So Clean, new gadgets and cure-alls for the malady or health issue of the day do sell.)
I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  

Of my 3 once-needed, helpful, and adjunctive devices I have listed, only the accelerometer remains operative (but now idle). My second CMS50I died, too, of old age and the so-so Dreem 2 needs head-positioning band repair--if, indeed, Dreem even supports use of it now.



 
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#26
RE: A deep report on sleep treatment
(10-01-2020, 06:00 PM)2SleepBetta Wrote: Thank you, Rich. 

I hope you can find the Phillips ASV device you many need and that the APAP one you have is maintaining sleep meanwhile. I sent an inquiry to a site I have used that might have a used one to sell and will let you know if something is available.

I did get a rebuilt Dreamstation but would love getting second one as a back up.

The APAP was replaced about three years ago when I went back on  a older System one ASV which worked well enough to prove my idea and then I first bought a rebuilt 950 and then had my slightly newer 960 rebuilt. So I REALLY know I need and get much better sleep on ASV.  Thank you for your offer and please do let me know if you can hook me up with a good deal on a Dreamstation ASV.

You wrote this helpful information, my emphasis added:

"These are consumer devices, so I take their readings with a large gain of salt. I look for a trend not minute by minute readings, yet they do seem fairly good of being able to tell my being awake and when I am asleep.

"The ResMed Max Sleep system always show less real sleep VS. the sleep machines readings as it only records the time it is on.

"If your really wanting to track sleep cycles you might want to use three systems: a wrist monitor , Max Sleep remote monitor and a under the bed sensor system and see how well they all match.  The fitbit and seemly other like them seem to need a minimum or three hours sleep to produce a reading. So it will not make a report..."

-----------

Until getting my AHI down, I had not given more than peripheral attention to sleep stages. Recent receipt and tardy review of ca 2016 sleep study showed my low sleep efficiency, only N1 and N2 sleep and lots of spontaneous arousals; it got my attention. You linked to work of Andrew Varga, MD, a neuroscientist. I see he has done a lot of other valuable research as in the article you linked. It underscores importance of CPAP in reducing both sleep stage and total-sleep fragmentation to  preserve mind and body. Footnotes of his papers hold a lot of leads to check out, too. Thanks again for the link.

Your welcome, I really hope what I shared will help.


It seems all three of the sleep stage detectors you mention are based on motion sensing and their interpretations of that measurement data alone. Accordingly, getting movement data from three input points and areas, as you suggest, will yield a more complete and meaningful picture.  

I  don't know anything about validity of their staging info, but had assumed ResMed's device could/should be best. Am wondering if they, in their commercial (made in China, most likely) embodiments as sleep-wake and staging reporters, aren't glorified pedometers--devices somewhat better than a stopped clock that is correct twice a day--just sold by marketing opportunists soaking up money in market segments where So Clean, new gadgets and cure-alls for the malady or health issue of the day do sell.)


I really do think they do a fairly good job, I believe they monitor the breathing and heart rates, which the FitBit does with just the heart rates...I just mean I do not believe they have 100% accuracy, but say 70 to 90%  which is good enough to give a fair idea how your sleeping.

But as you seemed to have a more serious problem than I do and as I am 80% there and if last night is a good indicator   I may, thanks to a tech's help and a slight change in my settings I may be 90/95% there, I figured you might want or need more accurate readout so suggested a two or three device so you could figure out how accurate they were.

I have used three so far, a FitBit, a early model by ResMed and their newer model.  I am at the point where the reports from the Resmed unit is mostly not needed, it just is kind of nice to see a lot of goodr rem and deep sleep reported.

My current problem has been one that both systems could not show, even with AHIs below1.0 and 7.5 hours of good sleep with scores of 95+ with good rem and deep sleep, I was still crashing.

I believe my last problem was fighting the sleep machine...a slight mismatch in breathing rates and air flow or volume, which I hope was fixed last night with the change of turning the back up breath rate off "auto" and setting the reaction rate at a slower one and setting a backup breathing rate as a fixed 10 breaths a minute.

This has been one of the best days of the past couple of months.

I am praying it is just the beginning...

Rich




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#27
RE: A deep report on sleep treatment
Thanks for the posts and information.
I'm feeling better since I started using my new apap. I'm being careful monitoring sleep time too. Sleeping longer is a key for me.

I use a Garmin watch which reports sleep time. It doesn't soundas capable as the Fitbit referred to above. However, it does show "motion" as well as Light vs Deep sleep. Motion--looks like I've run a marathon in my sleep. My Deep sleep varies from just minutes to two hours a night (Once 3 hours!)

I have seen others here who took videos of their time asleep.


Advice given to me was to go with how I feel. I shouldn't obsess with the numbers my machine generates. I've had that tendency from time to time.

I appreciate your post and the contributions of others.
DaveL
compliant for 35 years /// Still trying!

I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

http://www.apneaboard.com/wiki/index.php..._The_Guide

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#28
RE: A deep report on sleep treatment
I agree, the numbers are only guildlines but they do not the whole story.

On and off for the past 6 months I have been having crash days...on the best 3 to 4 hours of good awake time the rest of the days crashed.

I was getting fairly depressed by this as ALL my reading were good to great.

My Sleep machine reported low numbers, a lot of the time under 5, and often under 2 AHIs per night and most of them were hypopneas.

And my sleep cycle reporter reported good sleep as well avg. Sleep Score 95, with good rem and deep sleep cycles.

BUT I was still crashing...there seemed to be no answer.

Then I found my Phillips ASV 950 was running so low on air flow/volume that I was working hard to draw a breath, luckily I have a backup 960 ASV and switching to it was a major change.

I got better, not 100% but crash day were less.

I fought long and hard and hunted down a Dreamstation ASV and that is a better system.

But I have been have bad days with it too.

One of my main faults has been not being able to find a GOOD TECH to advise me.

The simple settings was easy to understand. raise VPAP slowly until obstruction apneas are stopped.

Then raise PS to control and stop centrals and hypopneas.

That seemed very simple and I was able to make it work.

But something was wrong.

Well I think I am seeing a light at the end of the tunnel, and so far no train horns…
 
One of the ongoing problems I have had over the years has been radical behavior by my Phillips ASV machines.
 
Being a repairman and tech I have a good grasp of systems. 
 
I think thanks to finding help at last I have found what was part of the problems I have had with these machines.
 
A good part of these problems are due to lack of any help from my Sleep Doctors and from a total lack of real information from Phillips and other makers.  
 
I now think the problem was not understanding how the ASV system works with the BPM Breaths per Minute setting, there is a few settings, Off, Auto, and then setting for 4 to 30 breaths per minute.
 
From what I had read that the system monitored your breathing rate by using every five breaths and should you skip the 6th breath it will take charge and insure you’re breathing. The Dreamstation ASV I am told now uses three breaths. This SEEMED like the best idea.
 
But I now feel based from what I have felt and have had happen with these machines, that I now believe this system can become a minor trap, IF you’re breathing slows and become more sallow steadily then the machine will follow you down and can even get into a feedback loop pushing both the machine and your breathing too low.
 
I am starting to wonder IF this behavior was/is the cause of the crazy behavior I have run into, and why my old idea of pulling the power plugs to cause a rebooting works. This action clears the machines memory and thus these bad settings made by the auto programing are removed until the next time both of you go into the downward spiral  
 
With my New Dreamstation ASV I have seen this behavior as well, and that it would hold the breathing rate from the night before and when started again for a new night found I was fighting last night’s rate.  It wanted to control my breathing rate, not right.
 
This seems to have been proven at last as I was able to talk with my Sleep Doctors tech: she suggested I turn OFF the BPM auto setting and setting the backup rate at 10, and now that it was a set rate we then changed the response rate to 2.
 
The first night with these settings gave me the best day (yesterday Sept 1 2020) I have had in months.

This is the beginning of today and I hope it will be another good one.
 
Sadly I am not as bright-eyed as yesterday, but I may perk up after lunch.
 
IF this become my normal then I believe what was happening was both the downward spiral and I think I also fought the systems automatically decided breathing rate…which I think was tiring me out even with good reports.
 
An invisible part of a good night’s sleep.
 
I will report on my progress as we go along.

Fingers and toes crossed.

Rich
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#29
RE: A deep report on sleep treatment
(09-30-2020, 07:20 PM)racprops Wrote:
(09-30-2020, 06:08 PM)2SleepBetta Wrote: ... The fitbit and seemly other like them seem to need a minimum or three hours sleep to produce a reading. So it will not make a report with less than three hours of solid sleep.

Rich

Interesting thread.

I use a Samsung Galaxy Watch.  It can record sleep time of 1hr or more....    (for anyone interested in recording sleep info).

Cool
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#30
RE: A deep report on sleep treatment
Hi Rich!

I *think* the doc's job where I live is to find people with OSA, hook them up with a machine, and then make sure they use them.  Dr. Inouye said he had 3,000 patients. He was my second sleep doc, when I moved.
A bunch of people quit.
A bunch of people keep going. They've proven their machines are on enough hours to be compliant.  So the system works.

For me the system sucks.

Instead of ranting (*I could* Wink ) I came here looking for things that would help me feel better.  I needed lots of help to do that. I'd studied big sites; I'd bought the masks that were well reviewed. I had a prescription for a machine and a mask. CPAP. Nasal mask.

All the problems I've resolved were because I finally listened to the people here.  I've been a pain.  I have two many screen shots, and too many posts.

I finally got a ResMed S10 auto-whats-it for her. And my results were far worse than what I had with my old S9. I wanted to throw a switch and bring the good numbers back. However, I took the advice here.  And now I'm feeling rested when I wake up.  I've done this for 35+ years. And Im finally feeling better.

I don't know what the best machine is.

For me I think the weak link is the mask.  They don't last forever.  When I start to feel like crap I look at my mask. I should replace it sooner than I do. When I finally replace it I start to feel better again.

Another link is my mouth breathing.  It would be simple to get a full face mask. But I'm claustrophobic. I don't own one, but I've tried about 8 of them.

My worst equipment provider had 3 packages.  expensive. More expensive. Most expensive.  They had an arrangement with a mask supplier.  Need a nasal mask? Here take this one. No substitutions! (Reminds me of Seinfeld and the Soup Nazi). Mouth breath?  Full Face Mask. This one.

Things got better for me when I started to do research about treatment. And I started paying attention to details.  Sleep hygiene.  How long? How many times did i get up? What can I improve?
Found another forum, but I didn't fit there.  Guess I'm a cranky old hoser! Found this forum...I'mnot cranky any more.

(Bladerunner the Samsung Galaxy Watch sounds interesting. My old Garmin HR watch gives sleep reports, but they're not very good. HR monitoring is good though. When I've checked it, my heart's still beating. Wink )

Rich my goal is to sleep better and feel better. If I have to wear all this crap, it had better work!  I've talked too much. I care.  Let's get on with this and feel better when we wake up! 

Dave
Sleep'n on it.
DaveL
compliant for 35 years /// Still trying!

I'm just a cpap user like you. I don't give medical advice. Seek the advice of a physician before seeking treatment for medical conditions including sleep apnea. Sleep-well

http://www.apneaboard.com/wiki/index.php..._The_Guide

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