9 Years of APAP and now BPAP is recommended

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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palerider
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Re: 9 Years of APAP and now BPAP is recommended

Post by palerider » Thu Oct 30, 2014 4:51 pm

and, fwiw, sleepyhead *never* *ever* tries to write anything at all to the card... as pugsy said, you're protecting the card from the OS putting indexing files (or something) that you didn't ask it to put on there because it knows best...

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Rastaman
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Re: 9 Years of APAP and now BPAP is recommended

Post by Rastaman » Thu Oct 30, 2014 5:33 pm

Pugsy wrote:Actually the write protect thing is more for the ResMed S9 users as some computer's operating systems add a little file to the SD card and while it doesn't really hurt anything the S9 machines don't want it there and won't accept the card if that file is there.

Respironics machines don't care but it is probably a good idea to get into the habit.
Damn! This is like "you don't need internet security for your Mac but maybe you should get it just in case." Hmm. I didn't get a Mac until I was 41 and I'm now 44, for now. Hmm. I want to not write-protect it if it doesn't matter but they're quite clear on that website that you better be extra careful and for various reasons. eg. Make a new folder, etc, etc.

I kind've wanted an S9 but once I realized it would be non-auto at the DME and I noticed he had already brought out a Phillips Respironics Auto Bi-pap, I said "This will be just fine actually. Looks cool to me!" To which my salesman never missed a beat. He ran with the ball after telling me that if I really preferred Resmed I would get a regular VPAP. End of discussion. I love my APAP's. I have two of them. But I'm getting better therapy, so far, from the Bi-pap. And they even lowered the pressure to "12"????? I have severe sleep apnea btw. I have something like 124 events per HOUR on my original test which diagnosed me with a pressure of 13. Now, it's 12 with a 7 for lower pressure. Slept like a friggin' baby last night. Oxygen levels during my study 9 years ago were 70%!! (Yikes!) My brain is now only partially recovered. Trust me. I'm literally surprised when function is where it "could" be.

I'm glad there are so many knowledgeable users here. There are a ton of you. I do miss Rested Gal. Where did she go? I read about someone referencing her not too long ago and they wondered the same. Anyone know?

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Pugsy
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Re: 9 Years of APAP and now BPAP is recommended

Post by Pugsy » Thu Oct 30, 2014 5:59 pm

Rested Gal took a well earned vacation from the board. I think she earned it.
She does still stop by every now and then to say hi.

It's not the end of the world if don't do the write protect thing for any number of reasons.
1...your Respironics machine won't care if there is weird little file on that card...trust me...I put a weird little file on my SD card and it didn't care
2...your machine stores almost all of the data on its internal storage for a month...so if you mess up a card you only lose wave form/flow rate graphs because that one file the machine doesn't store because it's too big.
3...you are going to have most of it in your software anyway
4...make a back up of your SD card once a week and store it on your computer somewhere...remember the machine also stores a good chunk of data
5...it isn't the end of the world...the machine stores the summary data for a year...so anything needed to prove compliance is on the machine and is available at any time even if you never used a SD card.

You could do like me...I never write protect mine...even my S9. Of course I don't use a Mac or Win 8.xxx and the only 2 times I have had the S9 spit out my card was when I messed with the SD card contents and even then it wasn't a big deal..my data was the software already.
I live on the wild side.

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palerider
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Re: 9 Years of APAP and now BPAP is recommended

Post by palerider » Thu Oct 30, 2014 6:12 pm

Pugsy wrote: 4...make a back up of your SD card once a week and store it on your computer somewhere...remember the machine also stores a good chunk of data
the new sleepyhead (0.9.8-1 or better) backs up the PRS1 data the same way that it has been backing up resmed s9 data for some time... helpful that.

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Re: 9 Years of APAP and now BPAP is recommended

Post by Rastaman » Thu Oct 30, 2014 6:17 pm

Thankyou !! Born in Iowa. Live in Texas forever. Since I was 2.

Damn, you're taking away my panic attacks! I feel so warm and fuzzy. Halloween is tomorrow. I dared Texas to have a high of 50. I double dog dared it! I said that I don't think it can do it even for a day. So far I am right. My girls are looking forward to the holiday. They are 6 and 10. My son thinks he's too old for it. He is 14. I'll bet you money he dresses up just to get candy! His Mom is going to borrow his Freddy Krueger outfit from last year for work tomorrow. I think that will be funny!

Wait til I get a load of the Sleepyhead results. I don't know what to expect. I got the open GL one. Seems like a decent edition. Looking forward to finding out more about that. I hope the font isn't too small if I try to upload results to this board. I've seen some mighty small Resmed data and I can't read a thing! I think I have the most recent Open GL version.

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Pugsy
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Re: 9 Years of APAP and now BPAP is recommended

Post by Pugsy » Thu Oct 30, 2014 6:19 pm

palerider wrote: the new sleepyhead (0.9.8-1 or better) backs up the PRS1 data the same way that it has been backing up resmed s9 data for some time... helpful that.
Tis true, I forgot that little tidbit.

Bottom line is some people get all in a panic at the thought of erasing the SD card and it's only with the S9 that this might happen. If a person is that sort ...by all means try to adhere to the write protect thing but if they realize that it's not the end of the world...they can do like I do.

Heck... I also had the dog eat one of my SD cards. I didn't really lose anything at all. It was after I had already downloaded to the software anyway. Just popped in a new SD card and I was back in business.

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palerider
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Re: 9 Years of APAP and now BPAP is recommended

Post by palerider » Thu Oct 30, 2014 6:23 pm

Rastaman wrote: I hope the font isn't too small if I try to upload results to this board. I've seen some mighty small Resmed data and I can't read a thing! I think I have the most recent Open GL version.
some folks follow a bad set of instructions on how to post screenshots, and instead of posting a straight (f12 from sleepyhead) screenshot, they do cutting and pasting and then resize it so it fits better on the screen.... of course, that makes the text so small that nobody can read the data.

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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

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Rastaman
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Re: 9 Years of APAP and now BPAP is recommended

Post by Rastaman » Sat Nov 01, 2014 11:36 am

I just uploaded 3 days of data into Sleepyhead and it's quite interesting. Definitely, very detailed. So far my average AHI is 4.34 but last night it dropped to 2.86! Not bad at all. I think I had an issue last night leak-wise because the straps on my mask got attached to my chin strap. I'm still getting used to this new F&P Eson nasal mask. So far so good for the most part. It fits my head quite a bit differently than my previous Comfort Gel Original. But compared to an Mirage Activa it seemed "about the same" for less $$.

Is it just me or are the price of masks going way down? Everything is now under $100. When I was buying a couple of my masks several years ago they were like $100 - $140 for nasal and about $180 for FFM. Cpap.com has most of the ones I'm looking at (Phillips Respironics) for very reasonable prices! My DME rep. said that cpap.com was the leading seller of cpap products and even recommended them for bacterial filters, which I thought was pretty amazing really. Something about the code being the same as my new BiPap but he gave me one anyway and told me where to buy more for less than they charge. They charge $8 a piece.

While I'm thinking about it, and I've mentioned this already, but the machine itself is going to be about $980 on a contracted rate through my insurance. Seems like a fair deal considering how much an APAP costs. My DME website prices are very comparable to cpap.com in terms of most items. And apparently, they will call me once a month to see if I need anything. I might, I might not. I needed a new chin strap but forgot to get that on DME "day". The only flaw with the whole experience to be honest. Anyway, so far so good with Sleepyhead software and the new machine. It says i'm at 100% compliance so far which is 4 hours per day. I'm averaging about 7.5 hours of sleep per night, sometimes more, sometimes less.

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Rastaman
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Re: 9 Years of APAP and now BPAP is recommended

Post by Rastaman » Sat Nov 01, 2014 12:08 pm

Got a question:

I notice that my machine says I got a constant pressure of 12 - 17 cmH20 of air. My understanding was that my constant pressure was 12 and that the lower pressure would be 7 and yet the average EPAP is 12.0 and the average IPAP is 17.0 Is this in error? My understanding of the Bi-level Pap is that it has one pressure for inhale and one for exhale but doesn't use the auto feature at this time since it's "set" for 12.0 I saw my prescription and it said 12 and 7 on it. And yet my Average AHI is 4.34 and last night it was 2.86

On my S8 Autoset Vantage I was getting AHI's from 3.5 up to 10.4 Over the week before I switched I was getting pressures of 12.2 to 13 with one night at 15.4 (It was set for 10 to 16 for the range;3 above and below my original set pressure of 13 cmH20 of air.)

Something tells me I may have the wrong settings possibly. Maybe he saw 7 and thought 17? Could be an honest mistake. Probably on my part. I probably thought I saw a 7 and it was 17 which would make a lot more sense. But isn't this implying that it's set for auto mode and not at a fixed 12 like I thought? If my previous pressure was 13, it's odd to me that now it would be 17. But anything is possible. I was thinking it would be set at 12 and drop to 7 during exhale. Sounds like it drops to 12 on exhale. I'll see my sleep doc on Wednesday anyway so she'll know immediately if all settings are correct because I'll bring my data card in on that visit. (Much easier than bringing the whole machine like I used to have to do)

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Rastaman
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Re: 9 Years of APAP and now BPAP is recommended

Post by Rastaman » Sat Nov 01, 2014 12:53 pm

Oh crap! I'm now looking at my documents that I brought home from the DME and it says IPAP 12 and EPAP 7. And Ramp time at 20 (not 15 mins I have it for now) with Biflex at 2. Nothing is listed for Set Press, Cflex, RRBPM, IPAP Min, IPAP Max, EEP, Set VT or Rate. I think my DME rep got my settings wrong and thought I was 12 and 17, not 12 and 7. NICE! I can fix this myself on the setup menu, correct? I am very puzzled now indeed. Good thing I kept my print outs! I think that DME rep not only put in the wrong numbers but transposed them as well. Funny that I got 2.86 on my AHI but I had lower rates than that at about 12 - 13 anyway. Good grief!

On my S8 Autoset Vantage I had to hold two buttons down (Down and right) and then I could access the correct menus. Do I need to go to that much trouble? Or should I just wait until Wednesday for my Sleep Doctor to notice the error? I have no idea how she'll handle that either. I could have to come back with my machine for her to do it, or she might send me to the DME to fix it, or she might advise me to do it myself. Hard to imagine but possible. What should I do here?

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Pugsy
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Re: 9 Years of APAP and now BPAP is recommended

Post by Pugsy » Sat Nov 01, 2014 1:22 pm

Ramp time and/or use is optional.
CFlex is only available in CPAP mode.
In bilevel mode (either fixed or auto) it has to be BiFlex...it's optional exhale relief...
With BiFlex turned off there are manual exhale relief settings available like rise time when in fixed bilevel mode.

Is your machine set to bilevel mode or auto bilevel mode?
Since you have essentially been using 12 exhale and 17 inhale...and your AHI is 2 to 3 ish...I don't know what is going to happen with 7 exhale and 12 inhale...that might allow a bunch of OAs to slip past the defenses..and it also might not.
Your AHI...what is the event category breakdown?

If you can post an image of the detailed data from one night we would have a better idea if the machine is in auto mode or fixed mode.

Do you know how to go to the clinical setup menu to see exactly what it has been set at in terms of mode and settings? If not, this explains how.
http://www.apneaboard.com/pr-system-one ... structions

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Rastaman
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Re: 9 Years of APAP and now BPAP is recommended

Post by Rastaman » Sat Nov 01, 2014 1:46 pm

Pugsy wrote:Ramp time and/or use is optional.
CFlex is only available in CPAP mode.
In bilevel mode (either fixed or auto) it has to be BiFlex...it's optional exhale relief...
With BiFlex turned off there are manual exhale relief settings available like rise time when in fixed bilevel mode.

Is your machine set to bilevel mode or auto bilevel mode?
Since you have essentially been using 12 exhale and 17 inhale...and your AHI is 2 to 3 ish...I don't know what is going to happen with 7 exhale and 12 inhale...that might allow a bunch of OAs to slip past the defenses..and it also might not.
Your AHI...what is the event category breakdown?

If you can post an image of the detailed data from one night we would have a better idea if the machine is in auto mode or fixed mode.

Do you know how to go to the clinical setup menu to see exactly what it has been set at in terms of mode and settings? If not, this explains how.
http://www.apneaboard.com/pr-system-one ... structions
Funny. I did a google search and got that same website and already changed the settings. I even put the ramp to 4.0 and 20 mins, for now. I want it to be as was prescribed so that when I present that data I can say the settings were off for 3 days but I've been using it "correctly" for 4 nights since. And there will be data on the card for the 29th - 4th by the 5th. The first two days my AHI was just over 5 but one day got the average down to 4.34

The machine is in fixed Bi-Level mode. I've never posted an image of my data before. I use a Mac so I know it's shift + command + 4 but after that I'm not sure where to put the cursor. I assume the graphs are the detailed information? Let me give that a try. Seems I need multiple pics (3 in this case) to get all of the graph because it won't let me scroll down while sizing the shot. I'm given the option to save these to drop box. So, I did that. Here are the links.

https://www.dropbox.com/s/3exc6o41dkxxt ... 6.png?dl=0

https://www.dropbox.com/s/3p416r1vm7j0n ... 9.png?dl=0

https://www.dropbox.com/s/kbuskjk86v4tf ... 6.png?dl=0

Here are also the other details:

https://www.dropbox.com/s/avt5fek6r2438 ... 0.png?dl=0

https://www.dropbox.com/s/lk89i74mx64b3 ... 3.png?dl=0

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Re: 9 Years of APAP and now BPAP is recommended

Post by palerider » Sat Nov 01, 2014 3:41 pm

*please* just hit "f12" and then go into the data directory. (see the location from the 'help/about' menu) and post that.

arrange the charts so the first ones are event flags, flow, pressure, leaks, snore. and anything else you want.

it's much better to have all the data on one screen, (including the details data on the left).

thanks, and I hope your tonight is good!

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Accounts to put on the foe list: dataq1, clownbell, gearchange, lynninnj, mper!?, DreamDiver, Geer1, almostadoctor, sleepgeek, ajack, stom, mogy, D.H., They often post misleading, timewasting stuff.

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Rastaman
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Re: 9 Years of APAP and now BPAP is recommended

Post by Rastaman » Sat Nov 01, 2014 4:39 pm

palerider wrote:
*please* just hit "f12" and then go into the data directory. (see the location from the 'help/about' menu) and post that.

arrange the charts so the first ones are event flags, flow, pressure, leaks, snore. and anything else you want.

it's much better to have all the data on one screen, (including the details data on the left).

thanks, and I hope your tonight is good!
Hmm. I don't see anything about the data directory on the "Help Browser" screen or the subsequent "User Manual". Somehow I did skip the Event Flags which are at the top of the screen. But everything you mentioned is there. F12 turns up the sound on my computer but doesn't do anything as far as let me re-size a screen snap shot. I do have a data tab on the drop down menu but there is nothing there to F12 or copy either. Everything on the first three links above is flow, pressure, leak rate, etc. I just can't get the resizing snapshot to encompass the whole list at once. The side scroll simply will not work after the snap shot is initiated. Shift + Command + 4 is the only thing I got to work even remotely. And then I had to do it in 3 snapshots to get all the data. I tried pasting that into an Image (next to URL above) but when I previewed it you couldn't see the graphic at all. So, I had to use the URL option.

Not sure how to accomplish this task since F12 simply turns up the volume on my computer. I even went to the folders using finder and there is no data folder under Sleepy Head. Not one specifically named that anyway. Where should I be looking on the "Help browser" tab? (The options are Welcome, Stastistics, Daily, Overview, and Help Browser)

Here is my Event Flags (graph) https://www.dropbox.com/s/4iwxrerhk17ft ... 5.png?dl=0

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Rastaman
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Re: 9 Years of APAP and now BPAP is recommended

Post by Rastaman » Sat Nov 01, 2014 4:46 pm