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Where A CPAP Newbie Should Start

PostPosted: Fri Oct 24, 2008 7:00 pm
by jules
This is a post where you can start gathering information for this journey. If you want to get answers for a problem you have or want to introduce yourself. please start a new thread/topic. On a later page I have posted a photo of the button to push to start one.

Please be aware this is a forum that welcomes newbies. We were all there once. Even if you see negative posts by a troll here, there is still plenty of good information on the forum.

We hope the trash will be appropriately removed, however, if you see some, please try to ignore it for now, sit back and start learning.

I will try to maintain all the links and information in this first post - the rest of the thread will be comments and originals of things I copied to this post.

This is a post where you can start gathering information for this journey. If you want to get answers for a problem you have or want to introduce yourself. please start a new thread/topic. Later on I have posted a photo of the button to push to start one.

Jules

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Understanding OSA - worth your time

http://www.resmed.com/en-au/clinicians/ ... 40x380.swf

Read the area called New Users at the top of the page

The man with green jacket icon found at the top of the page http://www.cpaptalk.com

Read the area called Our Wisdom -

The yellow light bulb found at the top of the page http://www.cpaptalk.com (next to the man with the green jacket) - on the previous version of this board this was called "Our Collective Wisdom"

For Acronyms & Definitions -

http://www.sleepnet.com/definition.html

also look at the list provided by Snoredog later on this post

Sleep Lab Video by cpap.com

sleeplabvideo

Learn to search

use Google & the syntax "search words" site:http://www.cpaptalk.com,

use search above for a single word,

or use "advanced search" with several words

Rested Gal has collected links to many common topics

such as batteries, hose hangers, mask fixes

http://www.cpaptalk.com/viewtopic.php?t=17435

Panic Attacks with CPAP - check this link that DSM found

http://mindpub.com/PanicAttacksinCOPD_chapter4.htm



Some Helpful Hints and Shopping List


viewtopic/t14746/viewtopic.php?p=124233

viewtopic/t14746/viewtopic.php?p=251830

Problems adjusting? This is a document from Respironics to promote bipap when cpap fails. It includes some flowcharts and worksheets that might help anyone with problems.

http://sleepapnea.respironics.com/clini ... _Monograph[1].pdf

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This is information others have added in this thread that I copied here.

papdad wrote:
Another link: Approach to the Patient With a Sleep or Wakefulness Disorder

http://www.merck.com/mmpe/sec16/ch215/ch215b.html


ozij wrote:
This is about understanding the mouthleak cycle

http://www.resmed.com/en-au/clinicians/ ... clinicians

And this helps in undertanding Resmed's way of looking at obtructions.

http://www.resmed.com/en-au/clinicians/ ... clinicians


jnk wrote:Found this to help me understand "awakenings":


AROUSALS & AWAKENINGS

Arousals – interruptions of sleep lasting 3 to 15 seconds – can occur spontaneously or as a result of sleep disordered breathing (SDB) or other sleep disorders. Each arousal sends you back to a lighter stage of sleep. If the arousal last more than 15 seconds, it becomes an awakening. You are usually not aware of arousals, but may be aware of awakenings.


http://www.sleepapnea.org/about/archive/newsletterw2006.pdf


Snoredog wrote:

DEFINITIONS:

APNEA = cessation of airflow for 10 seconds or greater.

HYPOPNEA =>50% decrease in airflow for 10 seconds or greater with a decrease in oxygen saturation of >3%.

APNEA/HYPOPNEA INDEX (AHI) = apnea plus (+) HYPOPNEA/hour of sleep.

RESPIRATORY AROUSAL INDEX (RAI) = AHI +snoring related EEG arousals/hour of sleep.

AHI/RAI** Scale =<5 events /hour = (none); 5-15 events/hour = (mild); 15-30 events/hour = (moderate); >30 events/hour = (severe).

Respiratory related sleep fragmentation: Sleep arousals due to respiratory events or snoring.

Desaturation = Drop in O2 oximetry distribution saturation by 3% below average saturation.

SaO2 scale: >89%=(none); 85-89%=(mild);80-84%=(moderate); <80% (severe).

EPWORTH SLEEPINESS SCALE =<10=(does not indicate EDS (Excessive Daytime Somnolence));10-15=(indicates daytime somnolence-not excessive);>16 (indicates EDS).

RESPIRATORY EFFORT RELATED AROUSALS (RERAs)=Sleep Arousals due to respiratory events characterized by pressure flow limitations in the airflow indicator channel without significant O2 desaturations.

StageIII and StageIV are combined and referred to as Deep Sleep.

Sleep Efficiency = Normal is >80%

As established by AASM/ABSM 1999.



Normal Sleep Architecture:

Stage1: 5%

Stage2: 50%

Stage3: 10%

Stage4: 10%

Stage REM: 25%


Stage3&4, REM decrease as we age.


Stuff seen on a PSG Report:

Arousal: An interruption of sleep lasting greater than 3 seconds.

BR Arousal index: The number of breathing related arousals(apnea, hypopnea, snoring & RERAs)multiplied by the # hours of sleep.

Bruxism: Grinding of the teeth.

Central apnea: A respiratory episode where there is no airflow and no effort to breathe lasting greater than 10 seconds.

EEG/EOG: Comments about sleep stages, brain waves (EEG), or eye movements (EOG)

EKG/ECG: Comments about heart rate, abnormal heart beats, etc.

EMG: Comments about leg movements and or teeth grinding (bruxism).

Hypopnea: A respiratory episode where there is partial obstruction of the airway lasting greater than 10 seconds. Also called partial apnea or hypo-apnea.

Non-supine: Sleeping in any position other than on the back.

NSR: Normal sinus rhythm.

NPSG: Nocturnal Polysomnogram, or sleep study.

(#)Number of Awakenings: The number of pages scored as wake after sleep onset.

Obstructive apnea: A respiratory episode where there is a complete cessation of airflow lasting greater than 10 seconds.

PLMs: Periodic limb movements.

PLM arousal index: The number of periodic limb movements that cause arousals multiplied by the number of hours of sleep.

PSGT: Polysomnographic technologist.

REM latency: Latency to REM(dreaming) from sleep onset.

RERAs: Respiratory effort related arousals. Episodes that are not apneas or hypopneas, often related to loud snoring, that generally do not cause a decrease in oxygen saturation.

Respiratory: Any specific comments about respiratory events.

RPSGT: Registered polysomnographic technologist.

Sleep efficiency: Total sleep time multiplied by time in bed.

Sleep latency: The first 30 seconds (one `epoch' of recording time) of sleep.

Sleep onset: The first 90 seconds (3 `epochs) of uninterrupted sleep.

Sleep stage shifts: The number of incidents of sleep stage changes.

Snoring intensity: Level of snoring loudness determined by the sleep technologist. Ranging in degrees from mild to very loud snoring.

Spontaneous arousal index: The number of spontaneous arousals (e.g. arousals not related to respiratory events, limb movements, snoring, etc) multiplied by the number of hours of sleep.

Stage 1: The lightest stage of sleep. Transitional stage from wake. top

Stage 1 shifts: The number of times the sleep stage changed to stage 1.

Stage 2: The first true stage of sleep.

Stages 3/4: The deepest, most restorative sleep.

Stage REM: The dreaming stage; Normally occurs every 60-90 minutes.

Supine: Sleeping on back.

Time in bed: The time in the study from `Lights Out' to `Lights On'.

Total arousal index: Total number of all arousals multiplied by the number of hours of sleep.

Total # of PLMs: The number of leg movements in sleep that last greater than 0.5 seconds.

Total sleep time: Total time asleep.

WASO: Wakefulness after sleep onset.

WNL: Within normal limits.


This post has been edited to include all additional info mentioned in the rest of this thread.--Jules

Image

Re: Where a newbie should start

PostPosted: Fri Oct 24, 2008 9:08 pm
by rested gal
Excellent advice, Jules. Good places for any of these newcomers to dig into:

1. people who wonder if they might have OSA

2. people who are facing a sleep study

3. newly diagnosed people, waiting for their equipment

4. new "cpap" users

5. any of us, no matter how long we've been using "cpap" !

Lotta good reading in those links. :)

Re: Where a newbie should start

PostPosted: Sat Oct 25, 2008 7:13 pm
by looking4zzzz
I really liked the first link you listed. It gives an easy to understand explanation of the condition, symptoms, and complications. I know lots of folks who might benefit from seeing that link. Thanks for sharing it.

Re: Where a newbie should start

PostPosted: Sat Oct 25, 2008 7:24 pm
by Paul56
Jules... love that first link you posted! Thanks for sharing. :wink:

Re: Where a newbie should start

PostPosted: Mon Oct 27, 2008 11:06 am
by echo
tagged under "welcome" ;) Thanks jules!

Re: Where a newbie should start

PostPosted: Thu Nov 06, 2008 4:37 am
by turbosnore
As a newbie and foreigner (Finn) Both first and second link were welcome.
Thanks.

Re: Where a newbie should start

PostPosted: Sat Nov 08, 2008 1:56 pm
by papdad
Had found, and lost, the Sleep Terms Definition page previously -- printed it off this time.
Thanks, PAPdad
-- This thread should stay on top.

Another link: Approach to the Patient With a Sleep or Wakefulness Disorder
http://www.merck.com/mmpe/sec16/ch215/ch215b.html

Re: Where a newbie should start

PostPosted: Sat Nov 08, 2008 2:45 pm
by Snoredog
Then they should capture this and keep it in a text file so they know what they are looking at:

DEFINITIONS:
APNEA = cessation of airflow for 10 seconds or greater.
HYPOPNEA =>50% decrease in airflow for 10 seconds or greater with a decrease in oxygen saturation of >3%.
APNEA/HYPOPNEA INDEX (AHI) = apnea plus (+) HYPOPNEA/hour of sleep.
RESPIRATORY AROUSAL INDEX (RAI) = AHI +snoring related EEG arousals/hour of sleep.
AHI/RAI** Scale =<5 events /hour = (none); 5-15 events/hour = (mild); 15-30 events/hour = (moderate); >30 events/hour = (severe).
Respiratory related sleep fragmentation: Sleep arousals due to respiratory events or snoring.
Desaturation = Drop in O2 oximetry distribution saturation by 3% below average saturation.
SaO2 scale: >89%=(none); 85-89%=(mild);80-84%=(moderate); <80% (severe).
EPWORTH SLEEPINESS SCALE =<10=(does not indicate EDS (Excessive Daytime Somnolence));10-15=(indicates daytime somnolence-not excessive);>16 (indicates EDS).
RESPIRATORY EFFORT RELATED AROUSALS (RERAs)=Sleep Arousals due to respiratory events characterized by pressure flow limitations in the airflow indicator channel without significant O2 desaturations.
StageIII and StageIV are combined and referred to as Deep Sleep.
Sleep Efficiency = Normal is >80%
As established by AASM/ABSM 1999.

Normal Sleep Architecture:
Stage1: 5%
Stage2: 50%
Stage3: 10%
Stage4: 10%
Stage REM: 25%

Stage3&4, REM decrease as we age.


Stuff seen on a PSG Report:

Arousal: An interruption of sleep lasting greater than 3 seconds.

BR Arousal index: The number of breathing related arousals(apnea, hypopnea, snoring & RERAs)multiplied by the # hours of sleep.

Bruxism: Grinding of the teeth.

Central apnea: A respiratory episode where there is no airflow and no effort to breathe lasting greater than 10 seconds.

EEG/EOG: Comments about sleep stages, brain waves (EEG), or eye movements (EOG)

EKG/ECG: Comments about heart rate, abnormal heart beats, etc.

EMG: Comments about leg movements and or teeth grinding (bruxism).

Hypopnea: A respiratory episode where there is partial obstruction of the airway lasting greater than 10 seconds. Also called partial apnea or hypo-apnea.

Non-supine: Sleeping in any position other than on the back.

NSR: Normal sinus rhythm.

NPSG: Nocturnal Polysomnogram, or sleep study.

(#)Number of Awakenings: The number of pages scored as wake after sleep onset.

Obstructive apnea: A respiratory episode where there is a complete cessation of airflow lasting greater than 10 seconds.
PLMs: Periodic limb movements.

PLM arousal index: The number of periodic limb movements that cause arousals multiplied by the number of hours of sleep.

PSGT: Polysomnographic technologist.

REM latency: Latency to REM(dreaming) from sleep onset.

RERAs: Respiratory effort related arousals. Episodes that are not apneas or hypopneas, often related to loud snoring, that generally do not cause a decrease in oxygen saturation.

Respiratory: Any specific comments about respiratory events.

RPSGT: Registered polysomnographic technologist.

Sleep efficiency: Total sleep time multiplied by time in bed.

Sleep latency: The first 30 seconds (one `epoch' of recording time) of sleep.

Sleep onset: The first 90 seconds (3 `epochs) of uninterrupted sleep.

Sleep stage shifts: The number of incidents of sleep stage changes.

Snoring intensity: Level of snoring loudness determined by the sleep technologist. Ranging in degrees from mild to very loud snoring.

Spontaneous arousal index: The number of spontaneous arousals (e.g. arousals not related to respiratory events, limb movements, snoring, etc) multiplied by the number of hours of sleep.

Stage 1: The lightest stage of sleep. Transitional stage from wake. top

Stage 1 shifts: The number of times the sleep stage changed to stage 1.

Stage 2: The first true stage of sleep.

Stages 3/4: The deepest, most restorative sleep.

Stage REM: The dreaming stage; Normally occurs every 60-90 minutes.

Supine: Sleeping on back.

Time in bed: The time in the study from `Lights Out' to `Lights On'.

Total arousal index: Total number of all arousals multiplied by the number of hours of sleep.

Total # of PLMs: The number of leg movements in sleep that last greater than 0.5 seconds.

Total sleep time: Total time asleep.

WASO: Wakefulness after sleep onset.

WNL: Within normal limits.

Re: Where a newbie should start

PostPosted: Sat Nov 08, 2008 3:36 pm
by papdad
Snoredog --- copied your definitions and saved them as a word document -- should come in handy.

Re: Where a newbie should start

PostPosted: Sat Nov 15, 2008 11:50 pm
by ThatMaskedMan
This is great. The definition of sleep efficiency seems odd. I think where it says "multiplied by" it should say "divided by", and then at the end add the words, "expressed as a percent."

Re: Where a newbie should start

PostPosted: Mon Nov 17, 2008 8:09 am
by papdad
Bump. Edited 11-8 post to add link.

Re: Where a newbie should start

PostPosted: Sun Nov 23, 2008 10:55 am
by dtrain84
Great info. Thanks - just received a copy of my sleep report from my doc - been "on" cpap about 18 months. hoping to post my results and get some feedback!

Re: Where a newbie should start

PostPosted: Fri Nov 28, 2008 7:11 pm
by goose
Great info Jules -- thanks for posting and keeping track!!!!
cheers
goose

Re: Where a newbie should start

PostPosted: Sun Nov 30, 2008 1:21 pm
by Phreak4u
Okay as many times as I see it on here what does the "bump" apply to?

Re: Where a newbie should start

PostPosted: Sun Nov 30, 2008 1:32 pm
by plr66
Phreak4u wrote:Okay as many times as I see it on here what does the "bump" apply to?

It's just a way of noting that you are "bumping" the thread back up to the top of the list for further attention.