Do I need a Sandman??? (could use Snoredog's Advice)

I found and joined this forum just 2 days after Snoredog passed away. From browsing this forum in my attempt to learn as much as possible about my condition and how to treat and control it, I see that Snoredog made a huge difference in the lives of many, including my own (in retrospect). If his daughters see this, I want them to know that I very much appreciate his contributions!

Here's my dilemma. I'll try to make a long story short. I went to my ENT on the advise of my Family Practitioner with strong suspicions that I suffered from Sleep Apnea. A sleep study confirmed very sever sleep apnea with 107 AHI. I got no REM sleep at all. My ENT stated that I got no quality sleep at all until I was on the CPAP. After only about 3 1/2 hours on CPAP during my split study, I awoke feeling better than I can remember feeling in many years. I was anxious to get a CPAP at home and feel that goo ALL the time.

I got on CPAP Dec 10th. My ENT gave me a VERY GENERIC script. Fortunately, he wanted me on Auto CPAP for a trial basis, but he gave no indication of the min or max settings. Based on my sleep study titration of 14, my DME set the min at 6 and the max at 20 (setting me up for failure perhaps?). Fortunately, I found this forum even before I got my temporary rental APAP home. On advice and guidance from the wonderful people on this forum, I have slowly increased my min pressure from 6 to 13. I have eliminated most leaks on most nights (though that is still a "work in progress).

I've been experiencing apnea events every night since I started APAP on Dec 10, except ONE night. That was the night before last and the first night that my pressure was set to 13. I thought I had the apneas licked at that point - just had to get my min pressure high enough for the machine to respond in time to the apneas. I looked at my details this morning (from last night) and much to my diappointment, I had 4 apnea events last night.

http://www.box.net/shared/tfn4gzp5nv

In studying my details more closely, it appears my APAP didn't even attempt to respond to at least 2 (possibly 3) of the apnea events. I remembered seeing a post from Snoredog addressing Resmeds not responding to frank apneas at or above 10 cm:

Snoredog wrote:

4. Lastly, if your machine is a Resmed Autoset, it is a known FACT that it will NOT respond to frank apnea at or above 10 cm. So even when you are using that 11.4 cm pressure, if you experience a frank apnea during REM sleep it will NOT respond to it, and just as explained above your fight or flight response will WAKE you when recovering from that Apnea. Your Resmed Autoset is incapable of addressing those events in the AutoSet mode. The only way you can be assured it is taking care of them is by jacking up the Minimum pressure until the LCD data shows AI=.8 or .6, then even doing that doesn't guarantee a frank apnea might appear during REM. But if that reduces the awakenings from 3 to 1 then that is an improvement. But then you have the side effects of using that higher pressure with GERD.

NOTE: We try to WARN newbies when they come here and want the Resmed machine. It is a intentional part of its design. It is called the A10 algorithm and part of the AutoSet. They do that to avoid false response to central apnea. Not everyone has centrals at or above 10 cm pressure, this machine's design assumes they do.

As stated in my first response, if you are at or above 10 cm pressure, your machine will NOT respond to frank apnea. The only way it can address those apnea showing up during REM is if those apnea are preceded with vibratory snore or flow limitation. But if they are frank stand-alone apnea it will NOT respond.

So if frank apnea is what you are having, then well that is why you are waking during the night, the machine is not responding to them. A Remstar Auto will respond to those apnea during REM, a 420e or a Sandman Auto will respond to those same apnea, with the latter doing the best job at it in my opinion.

- you can try a Full Face mask interface, those allow more snoring and flow limitations to show up, if it does in your case during REM the machine might respond to those frank apnea by accident when addressing snore and flow limitation, but that is only a guess.

I don't fully understand how all this works, but I'm thinking I MIGHT do better with a Sandman rather than a Resmed. I was planning on asking my ENT for a script for a Resmed Autoset II (if I can't get him to cooperate, I'm confident my family practitioner will give me the script I request). I'm having second thought now and wondering if a Sandman Auto would be more suitable for me. Snoredog's post mentions taht a FFM allows more snoring and flow limitations to show up. I do have a FFM mask on order - hoping I might receive it today. So, considering that, maybe I should try the FFM for at least a few nights (if not a week or two) to determine if can eliminate apneas that way. I have the Resmed card reader and software and have gotten used to it, so I would prefer to stick with Resmed if I can make it work. It's been almost a month since I got the Resmed. I'm expecting in the next week or so, my DME will bill insurance for another month's use. I have a new deductible, so ultimately I will pay for it out of pocket. I highly doubt the DME I am using now carries Sandman. It's a small town DME, so he probably only carries Resmed for CPAP (just my guess, I haven't confirmed). I hate to pay too many months rent only to lose the rent because I have to go elsewhere for my permanent machine. Also, what about the humidifier I paid for. I'm using a rental now, but he said when I get my permanent machine, I will get a new humidifer and it's already paid for. What happens if he can't provide a humidifier that works with an Sandman (if that's ultimately what I get). WIll I forfeit the $ spend on the humidifier? It would be nice if I coud get a Fisher & Paykel HC150 Heated Humidifier from my DME (isn't that the one that works with any xPAP?). I doubt however that he carries it.

Sorry for the long post. Posting my thoughts here helps me sort things out. Also looking for any advice/comments???

Bluebonnet_Gal wrote:I found and joined this forum just 2 days after Snoredog passed away. From browsing this forum in my attempt to learn as much as possible about my condition and how to treat and control it, I see that Snoredog made a huge difference in the lives of many, including my own (in retrospect). If his daughters see this, I want them to know that I very much appreciate his contributions!

Here's my dilemma. I'll try to make a long story short. I went to my ENT on the advise of my Family Practitioner with strong suspicions that I suffered from Sleep Apnea. A sleep study confirmed very sever sleep apnea with 107 AHI. I got no REM sleep at all. My ENT stated that I got no quality sleep at all until I was on the CPAP. After only about 3 1/2 hours on CPAP during my split study, I awoke feeling better than I can remember feeling in many years. I was anxious to get a CPAP at home and feel that goo ALL the time.

I got on CPAP Dec 10th. My ENT gave me a VERY GENERIC script. Fortunately, he wanted me on Auto CPAP for a trial basis, but he gave no indication of the min or max settings. Based on my sleep study titration of 14, my DME set the min at 6 and the max at 20 (setting me up for failure perhaps?). Fortunately, I found this forum even before I got my temporary rental APAP home. On advice and guidance from the wonderful people on this forum, I have slowly increased my min pressure from 6 to 13. I have eliminated most leaks on most nights (though that is still a "work in progress).

I've been experiencing apnea events every night since I started APAP on Dec 10, except ONE night. That was the night before last and the first night that my pressure was set to 13. I thought I had the apneas licked at that point - just had to get my min pressure high enough for the machine to respond in time to the apneas. I looked at my details this morning (from last night) and much to my diappointment, I had 4 apnea events last night.

http://www.box.net/shared/tfn4gzp5nv

In studying my details more closely, it appears my APAP didn't even attempt to respond to at least 2 (possibly 3) of the apnea events. I remembered seeing a post from Snoredog addressing Resmeds not responding to frank apneas at or above 10 cm:

Snoredog wrote:

4. Lastly, if your machine is a Resmed Autoset, it is a known FACT that it will NOT respond to frank apnea at or above 10 cm. So even when you are using that 11.4 cm pressure, if you experience a frank apnea during REM sleep it will NOT respond to it, and just as explained above your fight or flight response will WAKE you when recovering from that Apnea. Your Resmed Autoset is incapable of addressing those events in the AutoSet mode. The only way you can be assured it is taking care of them is by jacking up the Minimum pressure until the LCD data shows AI=.8 or .6, then even doing that doesn't guarantee a frank apnea might appear during REM. But if that reduces the awakenings from 3 to 1 then that is an improvement. But then you have the side effects of using that higher pressure with GERD.

NOTE: We try to WARN newbies when they come here and want the Resmed machine. It is a intentional part of its design. It is called the A10 algorithm and part of the AutoSet. They do that to avoid false response to central apnea. Not everyone has centrals at or above 10 cm pressure, this machine's design assumes they do.

As stated in my first response, if you are at or above 10 cm pressure, your machine will NOT respond to frank apnea. The only way it can address those apnea showing up during REM is if those apnea are preceded with vibratory snore or flow limitation. But if they are frank stand-alone apnea it will NOT respond.

So if frank apnea is what you are having, then well that is why you are waking during the night, the machine is not responding to them. A Remstar Auto will respond to those apnea during REM, a 420e or a Sandman Auto will respond to those same apnea, with the latter doing the best job at it in my opinion.

- you can try a Full Face mask interface, those allow more snoring and flow limitations to show up, if it does in your case during REM the machine might respond to those frank apnea by accident when addressing snore and flow limitation, but that is only a guess.

I don't fully understand how all this works, but I'm thinking I MIGHT do better with a Sandman rather than a Resmed. I was planning on asking my ENT for a script for a Resmed Autoset II (if I can't get him to cooperate, I'm confident my family practitioner will give me the script I request). I'm having second thought now and wondering if a Sandman Auto would be more suitable for me. Snoredog's post mentions taht a FFM allows more snoring and flow limitations to show up. I do have a FFM mask on order - hoping I might receive it today. So, considering that, maybe I should try the FFM for at least a few nights (if not a week or two) to determine if can eliminate apneas that way. I have the Resmed card reader and software and have gotten used to it, so I would prefer to stick with Resmed if I can make it work. It's been almost a month since I got the Resmed. I'm expecting in the next week or so, my DME will bill insurance for another month's use. I have a new deductible, so ultimately I will pay for it out of pocket. I highly doubt the DME I am using now carries Sandman. It's a small town DME, so he probably only carries Resmed for CPAP (just my guess, I haven't confirmed). I hate to pay too many months rent only to lose the rent because I have to go elsewhere for my permanent machine. Also, what about the humidifier I paid for. I'm using a rental now, but he said when I get my permanent machine, I will get a new humidifer and it's already paid for. What happens if he can't provide a humidifier that works with an Sandman (if that's ultimately what I get). WIll I forfeit the $ spend on the humidifier? It would be nice if I coud get a Fisher & Paykel HC150 Heated Humidifier from my DME (isn't that the one that works with any xPAP?). I doubt however that he carries it.

Sorry for the long post. Posting my thoughts here helps me sort things out. Also looking for any advice/comments???

I didn't see any snore numbers on the reports you posted and I'm not all that familiar with reading the ResMed reports (I've never really been able to figure them out), but with regard to your question......if your pressure needs are going to be above the pressure of 10 cm., then I think you've answered your own questions (through your research in the previous posts/threads).
The S8 Vantage doesn't offer any exhale relief in Auto mode.....unlike the newer S8 Autoset II. And, neither the Sandman or their previous model PB 420E offer exhale relief if you might need it at those higher pressures. However, you still have the problem with the apnea events above the pressure of 10 cm. Leaks and snores can/will drive ANY Auto crazy trying to keep up. I tend to disagree with Snoredog on his theory behind the full face masks allowing more snoring, but then, that's all I've ever used (FF masks) and have gotten my snoring numbers down to the "almost nonexistent" status.

My recommendations would be the Respironics M Series Auto w/A-Flex (if you may want exhale relief) or the Sandman Auto if you don't need it. The M Series Auto also has more options and operating modes to choose from. The software is also easier to understand, in my opinion.

Den

I think Den gave you a good answer! One thing I'll add - in looking at your report I noticed that your apnea index was very low and that the hypopneas drove it higher. I've heard that the Resmed counts more things as hypopneas than the others so that's probably what you are seeing. So your results look very good.

Based on the above, you may be fine with what you have - just focus more on AI than AHI.

Of the Respironics and Sandman: I have both and each has its strengths and weaknesses. I have software for both and as Den noted, the Sandman software is more complex ... but it is also much more flexible. I can select specific dates (or a range) and it will give me a report of the average and a "waveform" graphic report where you can compare different dates side by side. The Sandman does not have exhalation relief but it does have "ramp". I would get the package with a separate humidifer rather than the build-in version.

I have the Respironics APAP with AFlex but when I used it in APAP mode, it was "chasing" apneas ... eg no matter what pressure I set it at, it wanted to go higher. At a pressure of 14, it went nuts so I backed off to a fixed pressure of 13 and that worked well. With the Sandman, there is a setting to tell it at what pressure to quit chasing apneas so you can experiment with that. I am able to use APAP mode with this one.

Which to get is a very personal decision. I don't think you can go wrong with either.

Mindy

Bluebonnet_Gal, with all due respect to a person who is no longer with us, I must say this. Snoredog posted many strong opinions, strongly expressed. Like all of us, many times he was incorrect. His posts were often a mixture of correct info, incorrect info, and jumps to conclusions presented as "fact" that were sometimes right, sometimes wrong. In other words, he was not infallible.

"We try to WARN newbies"

I'm not part of that "We."

You can click here to see a thread in which GaryGarland had some questions:
"based on e-mails that said above 10 the auto won't act as expected"

Several responses in that thread point to a link where you can read what Dr. Berthon-Jones says (on page 5) about what the A10 algorithm was designed to do, and what it was designed to avoid:
http://www.internetage.ws/cpapdata/resm ... 0906r1.pdf

It's true that ResMed machines use what is called the A10 algorithm. That's a design to prevent pressure response above 10 cm to a sudden apnea. That's a built in safety measure to avoid running pressure up unnecessarily if central apneas occur. Respironics machines also have a safety measure to avoid doing that, but they go about it in a different way...checking to see if three small pressure nudges will improve the airflow. Sandman auto (and PB 420E) also use the safety measure of "10" as the default "max" pressure to be used in the presence of "apnea" -- their default value can be changed, whereas ResMed and Respironics do not have an adjustment for that. But, imho, most people...even those who are prescribed a higher CPAP pressure than "10" should not change that default of 10 anyway.

But Snoredog's conclusion that the A10 algorithm means ResMed autopaps can not "treat" OSA as well as another brand of autopap could, for people who are prescribed more than 10 cm for straight CPAP, is.... well, quite a reach, to put it kindly, imho.

There is much, much more to how autopaps go about preventing apneas in the first place, than just what's the most pressure they can use for an occasional sudden standalone apnea.

This next notion definitely is not "fact" as far as I know --
"a Full Face mask interface, those allow more snoring and flow limitations to show up"

I don't think that's so. Pressure, not the type of mask a person is using (assuming a good fit with any mask), is what affects whether snores and/or flow limitations will happen, no matter what machine is being used. Just my opinion.

Bluebonnet_gal wrote:I've been experiencing apnea events every night since I started APAP on Dec 10, except ONE night. That was the night before last and the first night that my pressure was set to 13. I thought I had the apneas licked at that point - just had to get my min pressure high enough for the machine to respond in time to the apneas. I looked at my details this morning (from last night) and much to my diappointment, I had 4 apnea events last night.

Bluebonnet_gal, you've been methodically doing the right thing, imho... setting your autopap minimum pressure up at, or close to, the pressure you would have been prescribed if using straight CPAP. I think that's true no matter what brand of autopap a person uses. The "minimum" pressure is the most important pressure to "set right", imho. Setting the minimum high enough to preemptively keep most apneas from happening in the first place.

You were pleased to see no apneas on one night, but dismayed to see 4 apneas on the data on a subsequent night. I think we can worry unduly about trying to get ZERO apneas. There are going to be variations from night to night -- variations that will show up with ANY machine. Four apneas are not many at all in a full night of sleep -- especially if they are short. Those could even have been "normal" central apneas that we can experience when we briefly hold our breath while turning over in our sleep.

It's certainly nice to try other machines, and you might very well find you like the features of one machine better than another. A lot about "cpap treatment" is a tradeoff, and a lot about the differences in each brand is a tradeoff. I just don't think it will be the presence or absence of the A10 algorithm that will be a factor in what machine(s) effectively treat your sleep apnea.

Far more important imho, with any autopap, is where you set your minimum pressure. Setting the minimum to PREVENT most apneas right from the get-go. I think you've already nailed that well, Bluebonnet_gal. As long as your AI (apnea index) ...not the AHI..just the AI... is staying well below 5, you most likely have your pressure range set well and are getting very good treatment. I wouldn't be worrying about "A10" at all.

Wulfman wrote:

Snoredog wrote:

- you can try a Full Face mask interface, those allow more snoring and flow limitations to show up, if it does in your case during REM the machine might respond to those frank apnea by accident when addressing snore and flow limitation, but that is only a guess.

I tend to disagree with Snoredog on his theory behind the full face masks allowing more snoring, but then, that's all I've ever used (FF masks) and have gotten my snoring numbers down to the "almost nonexistent" status.

Den

Den, Not sure what you mean by disagreeing that the full face masks allow more snoring, but I take Snoredog's comment to mean that the Resmed more easily detects snores and flow limitation when using a full face mask, therefore it will respond to more apnea events rather than assuming it is a cental.

Wulfman wrote:

Snoredog wrote:

I didn't see any snore numbers on the reports you posted and I'm not all that familiar with reading the ResMed reports

Den

I don't think Redmeds report snore numbers. If they do, I haven't found any info. That is one thing I wish would be included on the Resmed software.

Thanks for your input Den! I will take all input in consideration as I try to make my decision how to proceed. I've very curious how my ENT will respond with my educated questions and how willing he will be to work with me on this. If he's not willing or cooperative, I have other options that I won't hesitate to pursue!

Thanks for your input RG! I always value your input as I think you take the many variables into consideration. I have to say, compared to many on this forum, I have had a relatively easy time adjusting to sleeping with xPAP. Perhaps I'm over anxious, but I can't wait to reach the day where I don't have problems falling asleep during the day. Just this morning, after dropping my son off at school, on my way to work, I was fighting falling asleep at the wheel. I'm determined to optimize my therapy so I will have optimal results! I'm wondering if 4 or 5 apnea events in a night will prevent me from reaching the point where I'm not sleepy during the day. I realize I have very severe OSA and I've had it more than 5 years, possibly more than 10! Apparently it will take more than 3 or 4 weeks for me to repay my sleep debt!

rested gal wrote:Bluebonnet_Gal, with all due respect to a person who is no longer with us, I must say this. Snoredog posted many strong opinions, strongly expressed. Like all of us, many times he was incorrect. His posts were often a mixture of correct info, incorrect info, and jumps to conclusions presented as "fact" that were sometimes right, sometimes wrong. In other words, he was not infallible.

I understand what you're saying and I was thinking the same thing the other day when I first read his post about the Sandman. I was hoping the Resmed wouldn't present this problem for me and I only suspected it after seeing my results this morning where the Resmed didn't seem to respond at all to at least 2 Apnea events. I realize however that it was only one night and I shouldn't jump to any conclusions based on one night. However, I ask again, how many Apnea events are "acceptable"? I don't worry at all about the Hypopneas as I understand a Resmed is very sensitive to Hypopneas and tends to perhaps "over-report" them. If I were feeling GREAT and wasn't getting sleepy during the day, I wouldn't worry about the apneas either. Guess I just have to give it more time?

rested gal wrote:You can click here to see a thread in which GaryGarland had some questions:
"based on e-mails that said above 10 the auto won't act as expected"

This link didn't work. I'm trying to search GaryGarland's posts, but so I havne't found the post to which you are referring.

rested gal wrote:Several responses in that thread point to a link where you can read what Dr. Berthon-Jones says (on page 5) about what the A10 algorithm was designed to do, and what it was designed to avoid:
http://www.internetage.ws/cpapdata/resm ... 0906r1.pdf

I haven't been able to get to this either. I don't know if it's a security issue on my computer at work or if the file is actually corrupted, but it's stating the file is corrupted and it can't be downloaded (not option to just view it).

rested gal wrote:You were pleased to see no apneas on one night, but dismayed to see 4 apneas on the data on a subsequent night. I think we can worry unduly about trying to get ZERO apneas. There are going to be variations from night to night -- variations that will show up with ANY machine. Four apneas are not many at all in a full night of sleep -- especially if they are short. Those could even have been "normal" central apneas that we can experience when we briefly hold our breath while turning over in our sleep.

Thanks for the reminder! I'm overly anxious to get the MOST out of PAP therapy, so I tend to jump to conclusions about my results sometimes! I need these occasional reminders from you guys who don't have a personal stake in my health

rested gal wrote:Far more important imho, with any autopap, is where you set your minimum pressure. Setting the minimum to PREVENT most apneas right from the get-go. I think you've already nailed that well, Bluebonnet_gal. As long as your AI (apnea index) ...not the AHI..just the AI... is staying well below 5, you most likely have your pressure range set well and are getting very good treatment. I wouldn't be worrying about "A10" at all.

As I stated in another post to this thread (that I believe I was typing at the same time you were responding RG) I'm very curious how my ENT will respond with my educated questions and how willing he will be to work with me on this. If he's not willing or cooperative, I have other options that I won't hesitate to pursue!

Bluebonnet_Gal wrote:

Wulfman wrote:

Snoredog wrote:

- you can try a Full Face mask interface, those allow more snoring and flow limitations to show up, if it does in your case during REM the machine might respond to those frank apnea by accident when addressing snore and flow limitation, but that is only a guess.

I tend to disagree with Snoredog on his theory behind the full face masks allowing more snoring, but then, that's all I've ever used (FF masks) and have gotten my snoring numbers down to the "almost nonexistent" status.

Den

Den, Not sure what you mean by disagreeing that the full face masks allow more snoring, but I take Snoredog's comment to mean that the Resmed more easily detects snores and flow limitation when using a full face mask, therefore it will respond to more apnea events rather than assuming it is a cental.

Wulfman wrote:

Snoredog wrote:

I didn't see any snore numbers on the reports you posted and I'm not all that familiar with reading the ResMed reports

Den

I don't think Redmeds report snore numbers. If they do, I haven't found any info. That is one thing I wish would be included on the Resmed software.

Thanks for your input Den! I will take all input in consideration as I try to make my decision how to proceed. I've very curious how my ENT will respond with my educated questions and how willing he will be to work with me on this. If he's not willing or cooperative, I have other options that I won't hesitate to pursue!

I've interpreted the "full face mask and more snoring" to infer that since there is not a "direct" nasal interface, the pressure being spread over a larger area inside a full face mask allows more snoring when using the same pressure. I don't think that conclusion is a valid one. However, it MAY be the case for some people.
I'm "confused" as to why ResMed (apparently) doesn't include any snore indexes (numbers) in their software reports......particularly when their responses to events are driven by snores, flow limitations and apneas.
I don't believe there would be any differences in the detection of flow limitations, either.....based on the type of masks used.
However, with that said, since these machines use airflow to interpret "events", there can and will be differences between individuals and the masks they use (and their breathing patterns). I doubt if we all breathe the same, snore the same, etc. So, you have to take some of this with a grain of salt. The machine and it's algorithms, however, WILL interpret that airflow.....and that can make for results that could be good or not-so-good. If a person is prone to lots of flow limitations, they can count on a lot higher AHI number with a ResMed Auto as opposed to a Respironics Auto.


Den

Hi,
I have an auto. You can look at my data uploads and see some of the difference that I experienced with the auto's algorhythm. My numbers have only improved since my last upload. That is until it took a tumble off of the bedside table last week. (Don't get an integrated humidifier--but that is another issue) I have much fewer centrals since I changed the program to pressure decrease=slow(vs fast). I am very pleased with the autos programming. I have not used the autoset.

Thank you, Rested Gal. With all due respect to Snoredog, I agree completely with what you said with regard to his posts.

There are many, many people on this forum, able and willing to help anyone who asks. You are, without a doubt, one of those!

The forum is still the same very helpful place it has always been. You are so right when you say we are sometimes right and sometimes wrong, as was Snoredog.

Snoredog's posts (the "right on" ones and the "not so right on" ones) ar all available through the search.

We have paid our respects. We need to move on.

Wulfman wrote: I've interpreted the "full face mask and more snoring" to infer that since there is not a "direct" nasal interface, the pressure being spread over a larger area inside a full face mask allows more snoring when using the same pressure. I don't think that conclusion is a valid one. However, it MAY be the case for some people.
I'm "confused" as to why ResMed (apparently) doesn't include any snore indexes (numbers) in their software reports......particularly when their responses to events are driven by snores, flow limitations and apneas.
I don't believe there would be any differences in the detection of flow limitations, either.....based on the type of masks used.
Den

Perhaps someone with more experience with Resmed will post to solve the question of whether Resmed includes snore indexes and if not, why not? I really don't think they're included though. If they are, they're hidden, OR there is a setting on the machine that I need to change to enable it to report snores.

Wulfman wrote: However, with that said, since these machines use airflow to interpret "events", there can and will be differences between individuals and the masks they use (and their breathing patterns). I doubt if we all breathe the same, snore the same, etc. So, you have to take some of this with a grain of salt. The machine and it's algorithms, however, WILL interpret that airflow.....and that can make for results that could be good or not-so-good. If a person is prone to lots of flow limitations, they can count on a lot higher AHI number with a ResMed Auto as opposed to a Respironics Auto.


Den

Again, I really appreciate your input! I still don't fully understand all of this, but in time, hopefully I will. I'm the type of person that will keep "studying" until I DO understand! This is the best place I've found for my "studies".

Bluebonnet_Gal wrote:Perhaps someone with more experience with Resmed will post to solve the question of whether Resmed includes snore indexes and if not, why not? I really don't think they're included though. If they are, they're hidden, OR there is a setting on the machine that I need to change to enable it to report snores.

ResMed's software does not report snores. I don't know why not. There's no setting to make snores appear on reports. ResMed machines do take action when snores happen.

Hi Bluebonnet-Gal,

I'm so happy that you're on the CPAP journey with us. I remember my first few weeks on this forum and with my new "sleeping partner". It was daunting, but at the same time such a relief to finally get some sleep. As the others have said, there's a lot of variables to the process of getting your therapy just right for YOU. You seem to be on the right track. Good for you!! Your data indicates that you have dropped from an AHI of 107 to less than 1 (figuring 4-5 apneas during an 8-hour night). That's fabulous! More importantly, you KNOW that you're doing everything the best that you can - the data tells you that. Folks with a non-data-capable machine have to go purely on faith. Now, the hard part (how well I remember!) is to wait for your body to heal. I don't understand why, but many report feeling terrific after their titration study, and then pretty tired once they start CPAP therapy on their own. While I don't have an explanation, I think once you start sleeping regularly, your body has a whole lot of catching up to do, and it's going to do it on its own schedule. In my case, I slept A LOT, for several months. I went to bed early almost every weekday, and would sleep ~12 hours on the weekend nights. Try to give yourself some slack in other areas of your life for a while, so that you can focus on your healing process.

About the Sandman (and 420E). One thing I recently discovered is that an Autopap machine is not designed or intended to stop an apnea once it has started. It will increase the pressure after the apnea is over, to prevent the NEXT one. That's why it's so important to get the lower pressure right.

Good luck,
Cathy

Thanks RG - I didn't think Redmed's software reported snores!

tangents wrote: I don't understand why, but many report feeling terrific after their titration study, and then pretty tired once they start CPAP therapy on their own. While I don't have an explanation, I think once you start sleeping regularly, your body has a whole lot of catching up to do, and it's going to do it on its own schedule. In my case, I slept A LOT, for several months. I went to bed early almost every weekday, and would sleep ~12 hours on the weekend nights. Try to give yourself some slack in other areas of your life for a while, so that you can focus on your healing process.

About the Sandman (and 420E). One thing I recently discovered is that an Autopap machine is not designed or intended to stop an apnea once it has started. It will increase the pressure after the apnea is over, to prevent the NEXT one. That's why it's so important to get the lower pressure right.

Good luck,
Cathy

Thanks for the words of encouragement Cathy - they help SOOOO MUCH! It really helps to know that other's have gone through the same and it takes time, etc, etc

Finding this forum is the best thing that could have happened when I started PAP therapy. I shudder to think where I'd be now if I hadn't found you guys!

HUGS to all!


Gail