Silverlining Software Accuracy and PB 420 reliability

[bigheadr]

I went to see the sleep nurse practitioner today for my CPAP followup. I showed him the data that I collected over the last month with my Silverlining Software and he said that I shouldn't believe anything that this software says because he claims that they had studied this software and said that it was inaccurate. He also, said that he was skeptical about the PB 420 family because they had brought in 10 and all of the 10 that they had needed to be returned to PB because of problems. He refused to give me an APAP prescription because he said that non of these APAP algorithms worked. Do anyone out have heard of these problems with the Silverlining and PB420?

[chrisp]

My 420E and software work just fine. Find another Doc. He obviously doesn't know how to operate a cpap. Maybe he couldn't find the secret button under the G in Goodknight . LOL

:twis ted:

[bigheadr]

Also, on the accuracy of Silverlining software, the nurse practitioner said that he doesn't believe the number of hyponeas since the definition of hyponeas has something to do with oxygen levels which the PB 420 isn't capable of measuring. He said not to believe any data from this software about snoring. He lowered my pressure to 6 from 7 and he told me to slowly increase my humidifer to see if this will help the snoring. He said that there is no reason why I need to tape my mouth shut every night. He showed me data from the CPAP titration test that said that I didn't snore for 6 hours with the pressure at 6. So we will see tonight.

[chrisp]

[WillSucceed]

Chrisp wrote:

He is just protecting his turf.. Auto unit = no need for sleep studies in the future.

Sleep studies provide information that autoPAP units do not: oxygen saturation, carbon dioxide saturation, observation/analysis of sleep disorders other than OSA. While it is entirely possible that the tech. is just protecting his turf, I think it is optomistic to think that there is no need for sleep studies.

While we (patients) are becomming increasingly more informed, we are not, I believe, able to safely diagnose all of the things that could be going on when one of us is having sleep problems. As much as I'm annoyed with my Sleep Quack, (and have since replaced him) I would not deny myself access to a medical professional/Dr. to assess/review/treat any sleep issues that I might have.

This thread worries me in that new people on this forum might interpret it as implying that they don't need a doctor to assess their condition and, could go undiagnosed/untreated. I don't think that this is Chrisp's intention, I just don't want anyone to not get the assessment/treatment that they need as a result of over-confidence in autoPAP.

[chrisp]

My wife took me to the doc , my GP, and told him I had sleep apnea. 2 months and a sleep study later. The doc told me I had Sleep Apnea.

2 years later I took my wife to the sleep doc and told him she had sleep apnea. He laughed and said she didn't have the profile. When I showed him the results of my little experement done with my auto his eyes opened and his jaw dropped. She got her sleep study and he told her that she had sleep apnea.

We aren't stupid but we are just a bit tired of all the talk that only pros can diagnose and treat sleep apnea. Some think its against the law to change their pressures. Give me a break.

I say give yourself a break and get an auto. Unless you live in the land of free medicine then go for it. Some think they MUST have a titration study done yearly to make sure their pressure is correct. I use an auto. I pay for mine so I must avoid the EVIL DME route.



Like Rush Limbaugh says... For entertainment only.....



:twis ted:

[ozij]

I entirely agree with WillSucceed - sleep studies should not be waved off, they give data - improtant data for some cases - that autopaps don't. Chrisp, you and your wife are lucky not to need oxygen with your therapy. Not every case of sleep apnea is that simple and that clear cut.

But this: "He refused to give me an APAP prescription because he said that non of these APAP algorithms worked." is suspect and ridiculous and sounds like turf (or pocket) protection.

As for the SilverLining software: Which data did you bring along? Raw data, or an Excel output? Silverlining has a bug in its Excel output. see my non-techie expalanation of the bug and how I discovered it in Detective Story
If you don't have mixed apneas, your Excel data is fine.

Nobody (at least nobody who studies the subject, and that includes the inventors and makers of the equipment) assumes that autopaps catch all events and identify them all correctly. (And look for -SWS posts if you want the numbers for false positives and false negatives, and info about the algorithms in general). That doesn't mean they are worthless.

O.

[Nev]

bigheadr said:

the nurse practitioner said that he doesn't believe the number of hyponeas since the definition of hyponeas has something to do with oxygen levels which the PB 420 isn't capable of measuring.

The definition of hypopnea is a reduction ion inspiratory airflow usually taken as more than 50% reduction. An apnea is theoretically a complete cessation of aiflow, but is usually taken as a reduction of more than 75%. Reductions in airflow of these magnitudes will result in a drop in oxygen in the bloodstream (how quickly I don't know?) but the apnea or hypopnea is defined as the reduction in airflow into the lungs, not the resulting drop in oxygen levels.

I reckon the 420E with Silverlining software is just great. It has totally wiped out my snoring from day one (to my wife's delight) and has reduced my AHI to e.g. 0.6 for the fortnight. ended 24 July.

[bigheadr]

The data that I used was the data that came from the Silverlining software. I didn't use Excel. Chrisp, how did you get a prescription for an APAP? The Sleep Nurse Practitioner had their RT check out my 420S and the RT adjusted the 420S to 6. The RT told me that the 420S pressure was fine although looking at the pressure that he set it for, it is set at 6.3 rather than 6.0. I believe that he was using a manometer since I was in his office when he set the new pressure.

[rested gal]

6 or 6.3...not enough difference, imho, to worry about one way or the other.

The point of having an autopap instead of a straight cpap (again, imho) even with a prescribed pressure of 6 is that the autopap can be set for a range of pressures including that "6"... perhaps set it for 6 - 10. Or even 5 - 10, if a person felt comfortable breathing through a mask at a pressure as low as 5.

To me, the importance of a machine that can be set for a "range of pressures" is in having a bit of ceiling room above a prescribed pressure (especially people who have been prescribed a low pressure like 6 or 7) just in case a person's pressure needs changed during the night, from night to night, or down the road in the future.

If a person needed a pressure of 7 or 8 at times, or in the future, an autopap could automatically use that when needed. A fixed single pressure with cpap ain't gonna use more when needed.

If a person started having sleepy symptoms return, the Nurse Practitioner (or the doctor) is probably going to "guesstimate" that they need another cm or two and turn it up. Or, heaven forbid, the doctor will send you off for another expensive overnight sleep lab titration to find that you need just another cm or two. Autopap could have been taking care of that all along.

[gailzee]

The n.p. probably gets a bigger commish from the old dogs they have lying on the shelf.

Fight for the apap, and insist on a new scrip. Get it from cpap.com. I did both the DME route (and I won't bore you with the details), and now that I know what I Know I'd buy from cpap.com. anytime. My insurance was overcharged by hundreds...and they go along willingly. Go figure them. That is a separate side issue.
I had one local DME tell me he'd never get me a 420E, and when Pressed, he actually had to admit he never had sold/rented one. So I said bye to him PDQ.

Stick to what you want, and if possible and you can, demand it. Bottom line it's your health, your money, your time, and a lousy 2 line scrip from the dr.

It's just too bad we need a scrip, more people on this board, know more than the 2 doc's I dealt wit when it came to apap or sleep apnea problems.

IMHO of course.

Good Luck![quote="bigheadr"]I went to see the sleep nurse practitioner today for my CPAP followup. I showed him the data that I collected over the last month with my Silverlining Software and he said that I shouldn't believe anything that this software says because he claims that they had studied this software and said that it was inaccurate. He also, said that he was skeptical about the PB 420 family because they had brought in 10 and all of the 10 that they had needed to be returned to PB because of problems. He refused to give me an APAP prescription because he said that non of these APAP algorithms worked. Do anyone out have heard of these problems with the Silverlining and PB420?

[chrisp]

You don't need a Rx for APAP. Just an Rx for cpap. Send it to cpap.com . You will hear all sorts of can'ts when you visit your local DME. My first auto I did have an Rx for. Got it from my family doc. He said I'd be much happier with an auto and started writing .

:twis ted:

[bigheadr]

With the 420S set at 6.3, I have been having less apnea and hyponeas as well as snoring than at 7 which is interesting. But my wife still is complaining about my snoring. I still want to try a 420e to see if it will lower my snoring even further. I don't understand why lower my pressure would give better results. I thought that it would be the opposite. I also, raised the temperature of the heated humidifer. My next step is to talk to my family doctor to see if he would write a prescription for an AutoPAP or find another sleep doctor that isn't closed minded about using an AutoPAP. If I do get a prescription for an AutoPAP, I think that I will set the range between 4 and 10.

[Chitowndude]

As a doc, I gotta tell y'all I'm impressed with the sophistication and knowledge on this site. However, in defense of the sleep docs, it's not just 'protecting their turf'. It's also 'covering their ass'. Not all patients are a sharp as you guys, there are people out there who will think that if they tape over the holes on their cpap masks, they'll get better results. I'm not kidding. After all, lot's of people think Sara Palin can save the world.

[Wulfman]

As a doc, I gotta tell y'all I'm impressed with the sophistication and knowledge on this site. However, in defense of the sleep docs, it's not just 'protecting their turf'. It's also 'covering their ass'. Not all patients are a sharp as you guys, there are people out there who will think that if they tape over the holes on their cpap masks, they'll get better results. I'm not kidding. After all, lot's of people think Sara Palin can save the world.

We're fully aware of the spectrum of knowledge with the people who use this therapy and have discussed it at great length.

Actually, she COULD save the world.......with a little help. At least she's had more experience than the present occupant of the Oval Office had before he took it over. If you ain't scared yet, you will be.


Den