POLL: Typical AHI for ResMed Users

General Discussion on any topic relating to CPAP and/or Sleep Apnea.

POLL: Typical AHI ... for ResMed Users Only!

AHI of 00.0 - 02.5
67
36%
AHI of 02.6 - 05.0
64
34%
AHI of 05.1 - 10.0
37
20%
AHI of 10.1 - ????
18
10%
 
Total votes: 186

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carbonman
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Re: POLL: Typical AHI for ResMed Users

Post by carbonman » Tue Sep 08, 2009 1:37 pm

-SWS wrote:Carbonman, I agree that the Respironics pressure probes may what doesn't suit you. By contrast your Resmed pressure response more closely approaches CPAP therapy at right around 12 cm. One interesting experiment thus might be to compare your residual AHI and subjective assessment using A10 with that of a few experimental fixed pressures between 11 cm and 13 cm. ...
SWS, I am currently running at 11.8cm. I am going to continue to push the pressure up and see what happens.
....and not to start a knee dance , I do like the ability to adjust pressure at .2cm increments.

I have tried numerous times to run in straight cpap mode, both w/MSeries and S8.
I just can't seem to tolerate it. Another one of those subjective things.

Just an aside observation, here I am a tad over 1yr into therapy and
I'm just really starting to get a handle on what works for me......
how can even the most accomplished sleep doc think you can arrive at the bottom line,
in a one night sleep study.

...and...ah...JNK, my guess is you haven't been on best behavior
since the doctor spanked your tushy on your birth day.
"If your therapy is improving your health but you're not doing anything
to see or feel those changes, you'll never know what you're capable of."
I said that.

jnk
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Re: POLL: Typical AHI for ResMed Users

Post by jnk » Tue Sep 08, 2009 1:46 pm

carbonman wrote:and...ah...JNK, my guess is you haven't been on best behavior
since the doctor spanked your tushy on your birth day.
The best behavior that I'm capable of, I meant.

My problem (well, one of them) is that my tongue (fingers) tend(s) to engage before my brain is fully in gear.

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carbonman
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Re: POLL: Typical AHI for ResMed Users

Post by carbonman » Tue Sep 08, 2009 1:55 pm

jnk wrote:
carbonman wrote:and...ah...JNK, my guess is you haven't been on best behavior
since the doctor spanked your tushy on your birth day.
The best behavior that I'm capable of, I meant.
...OH....I didn't realize that your best behavior algorithm
had a default line in the sand. Is that the JNK behavior offset?

Is it adjustable or fixed......
Does your wife have access to the clinical menu?
"If your therapy is improving your health but you're not doing anything
to see or feel those changes, you'll never know what you're capable of."
I said that.

jnk
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Joined: Mon Jun 30, 2008 3:03 pm

Re: POLL: Typical AHI for ResMed Users

Post by jnk » Tue Sep 08, 2009 2:15 pm

carbonman wrote: ...OH....I didn't realize that your best behavior algorithm
had a default line in the sand. Is that the JNK behavior offset?
My only line in the sand has to do with how wet my trunks are when I sit down at the beach. (A good place to buy pencils, by the way.)
carbonman wrote:Is it adjustable or fixed......
Does your wife have access to the clinical menu?
Based on the clinical menu that only my wife has access to, she would very much like to have me "fixed."

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ozij
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Re: POLL: Typical AHI for ResMed Users

Post by ozij » Tue Sep 08, 2009 3:00 pm

carbonman wrote:
jnk wrote:
carbonman wrote:and...ah...JNK, my guess is you haven't been on best behavior
since the doctor spanked your tushy on your birth day.
The best behavior that I'm capable of, I meant.
...OH....I didn't realize that your best behavior algorithm
had a default line in the sand. Is that the JNK behavior offset?

Is it adjustable or fixed......
Does your wife have access to the clinical menu?
carbonman, that was very funny.
-SWS wrote:. . . I personally find it entirely disappointing that the Resmed Defensive Knee Dancers repeatedly interject that same reproach in threads like this---where people are NOT engaged in that particular behavior.
Hear hear. Glad you were there to handle jeff's recent attack of paranoia -SWS. Or was it St. Vitus' Dance?
jnk wrote: I am still trying to understand the chart, though. If I understand what it shows (and I realize I likely do not), it looks to me like apneas were "faked" to those machines for 30 minutes straight to see what they would do.
Let's call the blower generating those fake apnea the fake patient.

One thing, typical only of this fake mechanical patient, is that no matter what the APAP does, the fake mechanical patient's breathing does not change. Ever. Not one bit. APAP algorithm's base their responses on feedback from the patients' breathing/. The only feedback they are getting from the fake mechanical patient is "what you're doing is not affecting me". So, the APAPs are checked against non-responsive events, by definition.
[qoute="jnk"]And it looks to me like they all acted pretty much the same, didn't they? [/quote] No, they definitely did not. Resmed rose slightly above 10 and came back to it- rather cyclically. Respirionics dropped below 10 and stayed at 8 for a long time. PB froze at 10. Three different responses, coming from different algorithms.
Whatever the algorithms say, that looks like what they did with the fake apneas. But I may be misreading the chart somehow.
You're not misreading the chart, jeff, you're ignoring the most important characteristic of the fake mechanical patient: it is totally, utterly, entirely non-responsive.
So am I understanding what I'm being taught in that they all would have acted very differently if they had been set at 11 cm as their minimum then had fake apneas thrown at them? Some would have raised higher while others would not?
Pecisely. Or for that matter, at 15.
Please forgive me, -SWS. My friend fishhead once gave me a coffee mug that said "#1 Jerk" on it as a gift. I earned
it. I still have it. He still loves me though.
I'm managing to still love you too jeff -- even though you only apologized to -SWS.

O.

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jnk
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Re: POLL: Typical AHI for ResMed Users

Post by jnk » Tue Sep 08, 2009 3:57 pm

ozij wrote:I'm managing to still love you too jeff -- even though you only apologized to -SWS
Thanks, ozij. I have come to take your love for us all for granted. But I apologize to you too!

From now on I will try to have the guts in other threads to confront the posters, directly, who misapply your and -SWS's words when those posters direct newbies away from one brand and toward another based on their assumptions that anyone who needs more than 10 cm of pressure to get good treatment should always choose one brand over another. It was cowardly of me to "go off" here in the safety of abstraction surrounded by those I feel safest with instead of confronting those posters.

Sometimes it takes a community!

jeff
Last edited by jnk on Tue Sep 08, 2009 8:05 pm, edited 1 time in total.

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carbonman
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Re: POLL: Typical AHI for ResMed Users

Post by carbonman » Tue Sep 08, 2009 7:13 pm

jnk wrote:Sometimes it takes a community!jeff
Indeed, it does.
There's a lot to learn.....complicated things to understand.
.....really grateful for all the help along the way.

jnk wrote:Based on the clinical menu that only my wife has access to, she would very much like to have me "fixed."





.................. WAY too much information!
"If your therapy is improving your health but you're not doing anything
to see or feel those changes, you'll never know what you're capable of."
I said that.

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ozij
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Re: POLL: Typical AHI for ResMed Users

Post by ozij » Wed Sep 09, 2009 5:48 am

viewtopic.php?p=401160#p401160
by jdm2857 on Fri Sep 04, 2009 20:24
jdm2857 wrote:I'm not experiencing as much success with the ResMed auto algorithm. I picked up a ResLink module on cpapauction.com so that I can see snores and flow limitations.

I can see that the algorithm responds agressively to snores. I has raised my pressure on a few occasions by 3 or 4 cm in about a minute or so. Hasn't bothered me. But above 10 cm (my min is 12) is does not respond to apneas, and responds gently to flow limitations. From my data, it looks like I have clumps of
apneas without preceding flow limitations or snores, so the machine does not respond. Very frustrating.
O.

_________________
Mask: AirFit™ P10 Nasal Pillow CPAP Mask with Headgear
Additional Comments: Machine: Resmed AirSense10 for Her with Climateline heated hose ; alternating masks.
And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.
Antoine de Saint-Exupery

Good advice is compromised by missing data
Forum member Dog Slobber Nov. 2023

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rested gal
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Re: POLL: Typical AHI for ResMed Users

Post by rested gal » Wed Sep 09, 2009 9:13 am

carbonman wrote:
jnk wrote:Based on the clinical menu that only my wife has access to, she would very much like to have me "fixed."





.................. WAY too much information!
ROTFL!!!!

Crazy people...

...I'm on a messsage board with crazy people.

And I love it!
ResMed S9 VPAP Auto (ASV)
Humidifier: Integrated + Climate Control hose
Mask: Aeiomed Headrest (deconstructed, with homemade straps
3M painters tape over mouth
ALL LINKS by rested gal:
viewtopic.php?t=17435

-SWS
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Re: POLL: Typical AHI for ResMed Users

Post by -SWS » Wed Sep 09, 2009 8:08 pm

Jeff, all is good! Sorry I worded my post in a way that made you feel an apology was necessary. So I apologize for THAT!

Here's my dirty little secret: I presently miss the vast majority of posts. So I didn't realize people were STILL trying to steer newcomers away from the Resmed APAP algorithm if those newcomers happen to have apneas above 10 cm. None of the white papers we have discussed to date support dissuading people away from the Resmed algorithm for that reason. The Resmed algorithm tends to perform very well for patients with apneas both above and below 10cm.

There's no doubt the Resmed A10 design is extremely counterintuitive to many laypersons. It's so counterintuitive that anyone who favors common sense while neglecting or failing to grasp empirical studies, just may continue doling out that same unsubstantiated common-sense advice.

I am very sorry about the frustration. And I can definitely understand it. But I don't think the solution to dealing with any misinformed opinion is to offset that problem by suppressing truthful details that come up in conversation----such as how A10 uses an apnea event as a control-logic trigger event both below and above 10cm. Rather, I think the best way to deal with misinformation is with correct information.

If that counteractive process of providing the correct information seems too repetitive or cumbersome, then perhaps A10 facts, citations, and even caveats (regarding counterintuition) deserves a FAQ under the yellow light bulb up top. As a side note, that counterintuitive A10 design, that so many will continue to fail to grasp, is a testament to an equally counterintuitive brilliant mind IMHO. Berthon-Jones creatively stitched together epidemiology-based event detection with epidemiology-based probability outcomes in a way that continues to work superbly.

And I agree with the essence of Bill Bolton's comment---that ineveitable tweaks and improvements have likely been incorporated all along. However, if/when Resmed control-logic used apnea events as control-logic trigger events above 10cm, then I personally can't see Resmed calling that new algorithm "A10"---since that 10cm statistical demarcation will no longer be employed.

______________________________________________________________________________________________________________
ozij wrote:As I noted in my previous post::
In response to a Hypopnea FAQ Resmed wrote:How do the AutoSet devices handle hypopnea events?
AutoSet devices respond to obstructive hypopnea events when they are associated with flow limitation or snoring. Hypopneas that are central in origin (related to your central nervous system, not physical obstruction) should not be treated with increased pressure.
However, Resmed in describing its algorithm is very consistent in not describing a (ResMed defined) hypopnea on its own as a reason for raising pressure.
The issue of whether Resmed responds to hypopneas: my own opinion is that Resmed will respond to "wave flattening" (or "flow limitations") that are superimposed on hypopneas---and Resmed will respond to "wave flattening" that just so happens to be unaccompanied by hypopneas. Resmed will thus respond to: 1) apneas, 2) snores, and 3) flattened waves (whether or not they are concomitant with hypopneas).

In both cases Resmed is increasing pressure in response to flow limitations. However, in that first case, obstructive hypopneas receive an incidental and beneficial pressure response as Resmed takes aim at the flow limitation instead of the hypopnea (one of Resmed's "three lines of defense").

Resmed will never increase pressure in response to a perfectly rounded hypopnea---which is probably central and assumed normal more often than not by Resmed. Back when Berthon-Jones performed the interview that ozij linked to, some members of the blossoming and standards-shy sleep industry tended to refer to apneas, hypopneas and wave flattening as a "flow limitations" super-category, if you may. Depending on which scientist or researcher you happened to be reading back then, the terms weren't always the same---for lack of standardization.

Anyway, I suspect Berthon-Jones thought of central hypopneas simply as hypopneas. And I think he also thought of any wave-flattened volume or amplitude reduction---short of a frank apnea---as a flow limitation because of that wave flattening. To this day it's wave-flattening, snore, and apneas that Resmed employs as their three lines of defense. And when a hypopnea occurs along with that wave flattening, then I think that accompanying obstructive hypopnea gets a pressure response---but if and only if that accompanying flattened wave happens to present its own sufficient criteria. That hints that not all obstructive hypponeas may receive a pressure response---if that concomitant wave-flattening detection criteria falls even slightly short.

So there you have one possible control-logic scenario that manages to fit all of Resmed's above statements about hypopneas and their three lines of defense.

__________________________________________________________________________________________________________
rested gal wrote:Crazy people...

...I'm on a messsage board with crazy people.

And I love it!
Whew!

If you like crazy people, then you've come to the right place...

-SWS
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Re: POLL: Typical AHI for ResMed Users

Post by -SWS » Wed Sep 09, 2009 8:28 pm

jnk wrote:I am still trying to understand the chart, though. If I understand what it shows (and I realize I likely do not), it looks to me like apneas were "faked" to those machines for 30 minutes straight to see what they would do. And it looks to me like they all acted pretty much the same, didn't they? Which I take as good, myself. Of ALL the brands. It looks to me like once they hit around the 10 cm mark, in that chart, they all stopped raising pressure even though the apneas continued for another 20 or 25 minutes. Whatever the algorithms say, that looks like what they did with the fake apneas. But I may be misreading the chart somehow.
That was a poorly designed bench test IMHO, Jeff.

But it's not the first bench test to break a crucial two-way feedback loop between patient and machine:
viewtopic.php?f=1&t=16570&p=140063&hili ... op#p140063

And forget about allowing any of those algorithms to properly initialize temporal variables at the start of a simulated sleep session with a bench signal like that...

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SnoozyWoozyCat
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Re: POLL: Typical AHI for ResMed Users

Post by SnoozyWoozyCat » Thu Dec 03, 2009 9:08 pm

I have a stupid question. When I check my machine for my daily numbers, it normally indicates a 0.0 AHI and anywhere between a .4 and 2.0 AI. What exactly does the number represent? The overall total for the night or the total events per hour?

-SWS
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Re: POLL: Typical AHI for ResMed Users

Post by -SWS » Thu Dec 03, 2009 10:43 pm

The letter "I" stands for (hourly) index. So the numbers are average events per hour instead of nightly totals.

The AHI will be total number of apneas and hypopneas divided by hours slept.

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SnoozyWoozyCat
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Re: POLL: Typical AHI for ResMed Users

Post by SnoozyWoozyCat » Fri Dec 04, 2009 12:44 pm

Thanks SWS -- you are a wise monkey!

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pdean44
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Re: POLL: Typical AHI for ResMed Users

Post by pdean44 » Mon Mar 15, 2010 5:59 pm

my AI readings have been around 1. *** something on my resmed and the ahi 10 to 13 or so. I wzas concerned because the ahi I have been getting seems so much higher than what others post. I do feel more rested these days.

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