Question about split night studies

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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OkyDoky
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Re: Question about split night studies

Post by OkyDoky » Wed Feb 03, 2016 8:16 pm

Like I said I have the newer model that he has and I know the machine well. Yes It does take some knowledge and understanding but it's not only for severe conditions. There are other models that have backup breathing rates but these do not. The main difference between these and your AutoSet is that you can breath easier at a lower pressure on exhale. Much like the EPR on your machine which is limited 3cm decrease.
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palerider
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Re: Question about split night studies

Post by palerider » Wed Feb 03, 2016 8:27 pm

MrRavingLunatic wrote:My concern with Palerider's claims and weird story is not that he is using the same type of machine you are using. Its that he completely diagnosed himself without an actual Medical Doctor specializing in sleep medicine in charge. And then bought not just a plain ole AutoPap off of Craigslist and is using it, but bought about as fancy and expensive auto device as you can get, a Resmed autobipap NIV.
dear MrRavingLunatic, there are, as always, a few factual holes in your rants.
1) I didn't buy that machine first, as you'd know if you ever READ anything here, since my history of machines is well documented.
2) the resmed "autobipap" (which doesn't exist, as has been explained), is not a NIV, the machine I have, is NOT an NIV.
3) the machine I have is not, by far, the most fancy and expensive machine that can be bought. (that would be, likely, a trilogy, which is for rather specialized needs, and not made by resmed. it's not even an ASV, a machine that costs, easily, 50% more than what I have. now, if you'd ever read anything here, you'd know that I do have experience with those too, but I have no *need* for one... though there are a few people here that use one, simply because they like how it controls their basic apnea.
Mrinternetkook wrote:I dont know whether to feel sorry for this guy and write him off as an Internet kook or to consider contacting the police. The dude is practicing sleep medicine on himself,
it's good to know you never go into the grocery store/pharmacy and buy any over the counter MEDICATION, and give it to yourself.... good to know that if you have a headache, you go down to the doctors and follow his advice, because otherwise, you're "practicing sleep medicine on" yourself.

do, please, bother the police, maybe a few days in jail for wasting police time and filing a false report would cool your jets.

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palerider
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Re: Question about split night studies

Post by palerider » Wed Feb 03, 2016 8:35 pm

MrGrumpy wrote:Another concern for that guy is he is using a very advanced machine. A Resmed NIV autoBipap....

This guy is self titrating one of the most complicated auto-titrating bipaps there is. A machine that requires some major respiratory therapist/sleep tech knowledge. That machine is not just another S9 or S10 APAP or Phillips Respironics APAP where you sleep on it for a month or six weeks on 4 to 20 and punch a few buttons and get your 95th percentile for the last thirty days and voila, you have your pressure for CPAP mode. That machine is WAY MORE complicated than that.
is there any limit to your ignorance?

have you simply not LOOKED at my sig, or the SH screenshot posted above?

since you appear to be as thick as primordial ooze, I'll 'splain it out for you, I'll attempt to type slow, and use small words wherever possible so you might be able to understand.

the Resmed S9 Vpap Auto (which I use) is *NOT* a NIV, it is, in no sense of the word, a VENTILATOR. it WILL NOT initiate a switch to ipap on it's own, which is a REQUIREMENT for a ventilator.

the vpap auto is, as OkyDoky has attempted to get through to your thick little skull, not much more than a S9 AutoSet that can go to a little higher max pressure, and have a greater difference between inhale and exhale, more than the 3cm that an AutoSet will allow you, using EPR.

every time you post, you show people here how ignorant you are, perhaps you should stop while you're behind.

oh, and your woefully ignorant idea that there is anything even remotely worthwhile about sitting with a machine set at factory defaults for "a month or six weeks" and then looking at the 95th percentile for pressure is simply ludicrous...

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jedimark
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Re: Question about split night studies

Post by jedimark » Wed Feb 03, 2016 9:04 pm

MrGrumpy, while I'm glad you've found the level of medical care you have received with your CPAP treatment satisfactory, sadly many people have not, myself included.

It's true, standard off-the-shelf auto BIPAP/BiLevel aren't all that advanced.. like has probably already been said several times, they allow a wider pressure support than CPAP pressure relief modes (like EPR/AFlex/etc), with enhanced breath modelling algorithms to make it easier to comply for those who would otherwise give up (or need higher pressure than usual.) That's pretty much it!

Auto BILevel's can in fact be configured to mimic APAP machines pretty much exactly. Most people don't end up with a huge pressure support setting on them anyway. Hospitals around here use them by default rather than Auto CPAP's.

ASV/AutoSV/AVAPS is where the smarts start to creep in for those suffering Central/Complex Sleep Apnea/COPD/etc.

A technicality: All standard PAP machines, whether CPAP/BiLevel/ASV/AVAPS are technically "nocturnal" Non-Invasive Ventilators. Their are other classes of NIV machines for breathing support while the patient is awake.
A random source for anyone interested: http://www.esciencecentral.org/journals ... 000110.pdf

I'd hardly call someone who chose to purchase a second hand Auto BiLevel machine over a CPAP machine a psychotic. I'd qualify that as a good purchase decision, provided of course one has researched and understands the difference.

As for "self diagnosing" sleep apnea, some countries do the "sleep study" with a simple criteria set using an oximeter alone. Should you partake of the advanced medical help in countries where it's available/affordable? Of course! that's the best solution, I did that myself, and I still got absolutely nowhere. (three sleep/titration studies on horribly uncomfortable beds, and I did not even manage to SLEEP more than a few minutes, great!)

But in the end, peoples health choices are their own decision. I personally would not have even started the software project SleepyHead if I did not believe people should be educating themselves about it.

This is a forum, people openly share personal experiences. There is a very wide gap between practicing medicine and doing that.

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MrGrumpy
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Re: Question about split night studies

Post by MrGrumpy » Wed Feb 03, 2016 10:00 pm

palerider wrote:
MrGrumpy wrote:Another concern for that guy is he is using a very advanced machine. A Resmed NIV autoBipap....

This guy is self titrating one of the most complicated auto-titrating bipaps there is. A machine that requires some major respiratory therapist/sleep tech knowledge. That machine is not just another S9 or S10 APAP or Phillips Respironics APAP where you sleep on it for a month or six weeks on 4 to 20 and punch a few buttons and get your 95th percentile for the last thirty days and voila, you have your pressure for CPAP mode. That machine is WAY MORE complicated than that.
is there any limit to your ignorance?

have you simply not LOOKED at my sig, or the SH screenshot posted above?

since you appear to be as thick as primordial ooze, I'll 'splain it out for you, I'll attempt to type slow, and use small words wherever possible so you might be able to understand.

the Resmed S9 Vpap Auto (which I use) is *NOT* a NIV, it is, in no sense of the word, a VENTILATOR. it WILL NOT initiate a switch to ipap on it's own, which is a REQUIREMENT for a ventilator.

the vpap auto is, as OkyDoky has attempted to get through to your thick little skull, not much more than a S9 AutoSet that can go to a little higher max pressure, and have a greater difference between inhale and exhale, more than the 3cm that an AutoSet will allow you, using EPR.

every time you post, you show people here how ignorant you are, perhaps you should stop while you're behind.

oh, and your woefully ignorant idea that there is anything even remotely worthwhile about sitting with a machine set at factory defaults for "a month or six weeks" and then looking at the 95th percentile for pressure is simply ludicrous...
Id be dead by now if I didn't use my CPAP gear every night.

MrGrumpy
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Re: Question about split night studies

Post by MrGrumpy » Wed Feb 03, 2016 10:05 pm

That is total absolute bullshit on the "Resmed autobipap does not exist" claim. Ive been issued a Resmed autobipap before. Resmed makes them.

Look Palerider, I still think you are a flake. A total, absolute and complete flake. Ive been doing CPAP (successfully btw for many years) long enough to know what sounds right and what sounds like bullshit. You sound like bullshit. Sorry, but thats the way I see you after reading your story. You are FOS.

Go to a sleep doctor and get it done the official way, the legal way, the way a person in their right mind would get CPAP treatment done. Obviously you have issues with your intense fear of having a sleep study done, which you have persistently refused to discuss...more evidence stacked against you that you have issues beyond "sleep apnea."

Whatever man, just STFU and dont try to give me nor others advice when I am on here.

palerider wrote:
MrRavingLunatic wrote:My concern with Palerider's claims and weird story is not that he is using the same type of machine you are using. Its that he completely diagnosed himself without an actual Medical Doctor specializing in sleep medicine in charge. And then bought not just a plain ole AutoPap off of Craigslist and is using it, but bought about as fancy and expensive auto device as you can get, a Resmed autobipap NIV.
dear MrRavingLunatic, there are, as always, a few factual holes in your rants.
1) I didn't buy that machine first, as you'd know if you ever READ anything here, since my history of machines is well documented.
2) the resmed "autobipap" (which doesn't exist, as has been explained), is not a NIV, the machine I have, is NOT an NIV.
3) the machine I have is not, by far, the most fancy and expensive machine that can be bought. (that would be, likely, a trilogy, which is for rather specialized needs, and not made by resmed. it's not even an ASV, a machine that costs, easily, 50% more than what I have. now, if you'd ever read anything here, you'd know that I do have experience with those too, but I have no *need* for one... though there are a few people here that use one, simply because they like how it controls their basic apnea.
Mrinternetkook wrote:I dont know whether to feel sorry for this guy and write him off as an Internet kook or to consider contacting the police. The dude is practicing sleep medicine on himself,
it's good to know you never go into the grocery store/pharmacy and buy any over the counter MEDICATION, and give it to yourself.... good to know that if you have a headache, you go down to the doctors and follow his advice, because otherwise, you're "practicing sleep medicine on" yourself.

do, please, bother the police, maybe a few days in jail for wasting police time and filing a false report would cool your jets.
Id be dead by now if I didn't use my CPAP gear every night.

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palerider
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Re: Question about split night studies

Post by palerider » Wed Feb 03, 2016 10:57 pm

MrGrumpy wrote:That is total absolute bullshit on the "Resmed autobipap does not exist" claim. Ive been issued a Resmed autobipap before. Resmed makes them.
resmed makes a number of auto BILEVEL machines, however "BiPAP" is a registered trademark of resprionics.
resmed bilevel machines are called VPAPs because of this, as you'd know if your head wasn't in that smelly place.
MrGrumpy wrote:Whatever man, just STFU and dont try to give me nor others advice when I am on here.
excellent advice, I think you should take it.

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Last edited by palerider on Thu Feb 04, 2016 8:50 pm, edited 1 time in total.
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Mudrock63
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Re: Question about split night studies

Post by Mudrock63 » Thu Feb 04, 2016 8:03 pm

I had the two sleep study thing done. Well over $6000 billed to insurance, my share much less. I don't have trouble sleeping, it's the quality of sleep. Did well at both studies. They had plenty of data to work with. AHI at 37. They prescribed a fixed 6.0cm pressure for me. That brought my AHI all the way down to 23. <<<sarcasm.

Through the intervention of some folks on here, I carefully increased my pressures. One setting at a time, with plenty of time between changes to gauge results. My average AHI is now 4.0-6.0, depending on the night. And the machine is MAXED. Turns out, I am probably a better candidate for BIpap.

So I got prescribed a ridiculous low level of pressure that left me at risk of being killed by this, and misdiagnosed as to the type of machine I probably need. This was not a fly-by-night clinic in a strip mall. This clinic is associated with a very respected hospital in the area.

Sure I could probably demand another sleep study. But who's to say they won't fumble the ball again? Truthfully, I have learned from and progressed more under the tutelage of the experienced folks on here than from anyone in the traditional medical community. Most of what I get from them is a deer in the headlights look when I ask questions. Also, an AHI of 5 is perfectly fine to them. But to me, being poked awake 5 times an hour isn't healthy. And my and their goal should be as close to zero as I can get. We'll see. The next step, I think, is getting the machine I should have been given when first diagnosed. If they hadn't had their heads up their asses. Just my opinion and experience. As always, YMMV.

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palerider
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Re: Question about split night studies

Post by palerider » Thu Feb 04, 2016 8:52 pm

Mudrock63 wrote:I had the two sleep study thing done. Well over $6000 billed to insurance, my share much less. I don't have trouble sleeping, it's the quality of sleep. Did well at both studies. They had plenty of data to work with. AHI at 37. They prescribed a fixed 6.0cm pressure for me. That brought my AHI all the way down to 23. <<<sarcasm.
... So I got prescribed a ridiculous low level of pressure that left me at risk of being killed by this, and misdiagnosed as to the type of machine I probably need.
alas, this type of story is heard far too often here. (which, in case anybody was paying attention, was pretty much my original point.)

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MrGrumpy
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Re: Question about split night studies

Post by MrGrumpy » Thu Feb 04, 2016 8:52 pm

Well with all due respect to about everybody thats posted here, with one exception (palerider), it sounds as if everybody has had at least one formal sleep study, most have had a formal inlab sleep titration study as well.

THATS THE NORM.

Is it expensive? Hell yeah. But its Sleep Disordered Breathing and you know doctors, especially specialists, all of them think they are ENTITLED to be driving a Mercedes. So yeah, many of them pick your insurance's pockets.

And yeah, many of you sound very unsatisfied with your experiences with your sleep studies and sleep doctors. And brag, "I have taken matters into my own hands with sleepyhead and with autopaps and with autobipaps."

Thats fine and good and yes, I agree its better than nothing. But its ad hoc. Its not professional. Its not a good way to go about trying to achieve an objective that is very technical and rather...complicated oftentimes.

Instead of ignoring the mediocrity of your sleep doctor's work ethic and the shoddy quality of many of your sleep studies, why not complain? To the authorities?

Ive done it before in the past. Ive trashed several sleep doctors to my state medical board. Ive trashed one respiratory therapist to my state respiration tech board. Ive written my Congressman and my Senators and my state Congressman and my state senators about health insurance and the need for more focus being put on sleep medicine.

What have YOU done in that arena? Probably nothing. I realize a few of you live in the UK countries, where you dont have true due process of the law like we have here in the USA. Also, I realize in some UK countries, you dont have true freedom of speech and press and talking that way to your "exalted ones" can get you in legal troubles.

But not here in the USA. You have no excuses here in the USA. Dont like the system we have for sleep medicine? (I dont) Then do something about it! Write, call, complain. Not to each other here on forums on the Internet, I mean real emails, real letters sent to real people offline. Form a lobby. Not run by a sleep medicine equipment company, one run by...PATIENTS!

Thats how to fix this problem with getting help with sleep medicine, that many on this forum seem to have. Thru the legal and political system.

How many of you vote? How many of you vote consistently? As in the midterms? EVERY midterm?
Id be dead by now if I didn't use my CPAP gear every night.