they gave me (male) resmed for her unit to rent

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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chunkyfrog
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Re: they gave me (male) resmed for her unit to rent

Post by chunkyfrog » Sat Sep 16, 2017 12:44 pm

Vodka is an excellent deodorizer and disinfectant.
Cleaning your mask requires only a capful and a paper towel.
It may also be a good excuse to get a small bottle into the house.
Nothing like a wee nip to make the sandman feel welcome.
[[[Just kidding--alcohol is a CNS depressant--excess consumption IS harmful]]]

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Pugsy
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Re: they gave me (male) resmed for her unit to rent

Post by Pugsy » Sat Sep 16, 2017 6:45 pm

user232 wrote:I don't know how or if they isolate the actual sleep time when they get the unit back, but I have a feeling they will just use ALL the days data as sleephead does, which basically contaminates it, IMO.
Don't worry about it. Awake breathing events are usually easy to spot and remove from the evaluation process.

The bulk of the evaluation is for pressure needs anyway.
user232 wrote:PressureTherapy Pressure (cmH2O)
W-Avg: 6.09 4.02 6.02 8.66 9.76
EPAPExpiratory Pressure (cmH2O)
W-Avg: 4.97 4.02 4.78 6.22 6.76
Your machine went up to 9.76 cm pressure from the starting point whatever that was...

The fact that the machine increase the pressure meant that it was fighting something...now what...we don't know but the machine won't increase the pressure without sensing some sort of obstructive apnea event trying to happen.
It did a good job holding the airway open because your AHI is low.
We have no idea how many or what kind of airway collapses it actually prevented. The AHI you see is what the machine didn't prevent.

If you didn't have OSA...the pressure wouldn't have increased beyond whatever starting pressure you are using.
So....I think this confirms the OSA diagnosis you were questioning.

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user232

Re: they gave me (male) resmed for her unit to rent

Post by user232 » Sat Sep 16, 2017 8:18 pm

@Pugsy

Thanks for looking at the data. I can't post the charts unfortunately, but, yes the Pressure starts at about 5.0 and ramps up and down all night (generally rising overall). The first spike in the ramp up to 8.0 had 1 Rera event and 1 CA event,
the next spike up near 10 was where the 2 OA events occured. I could see a flat line with the OA tags, longest of which was about 14 sec.

I did notice I wasn't always breathing smoothly back and forth, but kind of fighting against pressure frequently (maybe because it is designed for her, not sure how the algo works, and can't control any parameters).

The OA events and largest spike did occur a bit after I awoke this morning, and laid around trying to get back to sleep.
I can consciously notice myself sometimes halting period breathing in and out, with pauses while resting. Not really intentionally, and not struggling either, my mind just does it every now and then.

So in your opinion, someone without sleep apnea would not have had ANY pressure increases at all? or very little? Is there some kind of threshold to qualify that? Do you think 1 or 2 short OA events are enough to make one tired all the time? I really appreciate the input, and if I can share any data from sleepyhead, I'd be happy to I should add that the oximiter drops below 90 (2) where at completely different times than the OA events, which I find odd.

user232

Re: they gave me (male) resmed for her unit to rent

Post by user232 » Sat Sep 16, 2017 8:24 pm

BTW, I'd love if someone had a link to a pressure chart of a certified 'normal' without OSA patient. I'd be surprised to see it flatline at some base level all night, but it would be very helpful to understand Pugsy's comment(s).

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Re: they gave me (male) resmed for her unit to rent

Post by Pugsy » Sat Sep 16, 2017 8:44 pm

user232 wrote: did notice I wasn't always breathing smoothly back and forth, but kind of fighting against pressure frequently (maybe because it is designed for her, not sure how the algo works, and can't control any parameters).
The for Her part of the machine is the flowers and the second algorithm which is a little different from the main algorithm which I imagine you are using. It's the same algorithm that everyone..male and female...and even the special algorithm isn't really gender specific.
ResMed decided to target market this model for women because we get left out.
So they gave us some ugly flowers but the same algorithms that you guys get.

user232 wrote: So in your opinion, someone without sleep apnea would not have had ANY pressure increases at all? or very little?
Correct. The machine wouldn't have increased the pressure without sensing the need to.
It's more than just apneas or hyponeas though...that are warning signs that the airway is trying to collapse. There's flow limitations and snores which are also warning signs and the machine will increase the pressure to try to prevent them from happening so that they don't get a chance to grow up to be a full grown apnea or hyponea.
user232 wrote:Do you think 1 or 2 short OA events are enough to make one tired all the time?
I think it is unlikely that 1 or 2 short events of any kind are going to be the primary culprit in making someone being tired all the time. Now there could be other things involved that impact sleep quality along with 1 or 2 short events and when we add everything together they can cause fatigue.
user232 wrote:I'd be happy to I should add that the oximiter drops below 90 (2) where at completely different times than the OA events, which I find odd.
If the drop is sudden and goes up suddenly then it probably was a loss of contact artifact. Real desats don't drop within a second or two and do back up quickly either. It's a gradual reduction and graduation climb back up.

It's unlikely that a single OA flagged even for even 30 seconds will cause a drop in oxygen. Wear your pulse ox and watch the screen and hold your breath for 30 seconds. I doubt it will change. We need longer or more of those short apneas back to back to cause real oxygen drops.

There is a way to share the images of your report without being a logged in member.
See this thread.
viewtopic/t156463/Things-to-do-while-wa ... roval.html

IMHO...you have OSA like the sleep study said.
Proven because the machine does try to hold the airway open and prevent the collapse by increasing the pressure.
Your AHI is low because only a handful of events weren't prevented.
We have no way to know how many events were prevented.

FWIW...I screened my sister and her husband with my apap machine a few years back.
Her pressure never budged from the minimum but her husband did go up to around 10 cm.
Come to find out her fatigue was her blood pressure meds...she didn't have OSA...and they changed her BP meds and the fatigue pretty much disappeared.
Now hubby...he has OSA...snores something fierce...she has seen him stop breathing...he refuses to do anything about it.
His brother and sister both have confirmed OSA and there is a strong suspicion the father had it.

I know you were doubting your sleep study because it was brief but while there can be false negatives...false positives would be extremely unlikely because the criteria for the diagnosis is so specific and can't be mimicked by anything else.

And if you expected to have a miracle these 3 days and not have any fatigue and wake up feeling like superman...that's an unrealistic expectation.
It takes a while to just get used to sleeping soundly with all this stuff attached to us.
And you are having trouble adjusting to the machine pressure at the beginning of the night so you probably aren't getting as many hours of sleep as you need and you are probably having several awakenings during the night for various reasons.

Feeling the good numbers isn't a guarantee...wish it was because getting good numbers is the easy part.
There's so much more to feeling and sleeping good besides just preventing the airway from collapsing.

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user232

Re: they gave me (male) resmed for her unit to rent

Post by user232 » Sat Sep 16, 2017 8:51 pm

Really appreciate your comments, Pugsy. Thank You!

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Re: they gave me (male) resmed for her unit to rent

Post by Pugsy » Sat Sep 16, 2017 8:52 pm

user232 wrote:BTW, I'd love if someone had a link to a pressure chart of a certified 'normal' without OSA patient. I'd be surprised to see it flatline at some base level all night, but it would be very helpful to understand Pugsy's comment(s).
Why would a "normal" person be using cpap? Even people without the OSA diagnosis can have a few apnea events here or there
and we only get the diagnosis because we have more than what is considered normal...less than 5 per hour is considered "normal".

I saw it with my sister when I screened her. Unfortunately the computer that had her software reports on it long ago died...it was 7 1/2 years ago.

You are going to have to take my word for it....trust me or don't trust me....that's up to you but if you are still trying to say that the test was wrong and the machine is wrong then you need to decide if you really want to do this cpap thing.
You said you would if you knew for sure you had OSA...how much proof do you need?

Go spend a couple of grand getting an in lab sleep study if that's what you need for "proof". Otherwise it sounds like you don't really want to accept the diagnosis and are looking for a way out. That's what it sounds like to me....

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Re: they gave me (male) resmed for her unit to rent

Post by Goofproof » Sat Sep 16, 2017 8:58 pm

Pugsy wrote:
user232 wrote:BTW, I'd love if someone had a link to a pressure chart of a certified 'normal' without OSA patient. I'd be surprised to see it flatline at some base level all night, but it would be very helpful to understand Pugsy's comment(s).
Why would a "normal" person be using cpap? Even people without the OSA diagnosis can have a few apnea events here or there
and we only get the diagnosis because we have more than what is considered normal...less than 5 per hour is considered "normal".

I saw it with my sister when I screened her. Unfortunately the computer that had her software reports on it long ago died...it was 7 1/2 years ago.

You are going to have to take my word for it....trust me or don't trust me....that's up to you but if you are still trying to say that the test was wrong and the machine is wrong then you need to decide if you really want to do this cpap thing.
You said you would if you knew for sure you had OSA...how much proof do you need?

Go spend a couple of grand getting an in lab sleep study if that's what you need for "proof". Otherwise it sounds like you don't really want to accept the diagnosis and are looking for a way out. That's what it sounds like to me....
He may convince himself he doesn't have sleep apnea, but that won't keep his airway open, he does however have a world class case of De-Nile. Jim
Use data to optimize your xPAP treatment!

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user232

Re: they gave me (male) resmed for her unit to rent

Post by user232 » Sat Sep 16, 2017 9:04 pm

I'd be thrilled if I was convinced this was the source of several problems. I have not problem using it if it improves them (primarily bad fatigue). I just get concerned when the data or experiment(s) are not all that convincing, and it could be masking something else. I trust your experience on that. And if you ask why I'd want to see normal baseline exemplars, well that's how you do statistical comparisons to rule out chance or improper diagnosis. I know it's asking for something not easy to obtain, and I can believe your word. I haven't seen enough examples to really look at the data and convince myself so to speak.

I just get the sense from the sleep specialists that they don't really care much at all, and have an incentive to get you on it for monetary reasons. Maybe it's a bit cynical, but that's how I felt about the treatment so far.

Well, it would be a bit nicer to hear concrete explanations, rather than 'world class denial,' and things like you'll find out by death. Those comments are a bit mean-spirited and certainly not scientific. I appreciated Pugsy's comments, because they made a lot of sense and they had reasonable explanations.

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Re: they gave me (male) resmed for her unit to rent

Post by Pugsy » Sat Sep 16, 2017 9:19 pm

You are taking in inordinate amount of convincing. Get real here.
You want proof that your pressure changes means something by comparing it to someone without OSA sleeping with a cpap...come on now. Where would you expect that to happen? People without OSA aren't going to be using the cpap machine. That is unreasonable request for proof.

You have OSA...you have a diagnosis...they don't do false positives...
will using cpap fix your issues...now that I don't know. If OSA is the only cause of your problem then you stand a good chance of seeing marked improvement but OSA is but one of several problems...well cpap machines can only fix bad sleep if the bad sleep is caused by the OSA...they don't fix bad sleep from other causes...they don't fix thyroid issues...they don't fix anything except OSA related issues.

You can either accept it or keep requiring "proof" and never get any answers to anything.
Your choice because I still don't hear someone wanting to try something that might help.
I hear someone wanting guarantees....and not much in medicine comes with a guarantee.

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