EDIT: Oh, yeah, advice on adjusting back to local time when I get home would also be welcome. I just got back to California from London, 8 hour time change. One thing to watch out for. The airlines strongly encourage sleep on all long distance flights - a sleeping passenger does not ask for drinks,...

I am finally at the stage of dealing with the DME and getting my machine. I have been obsessing over which machine I would want. I have convinced myself that I want the Resmed S9. The issue is the closest DME only has respironics machines. They are both top of the line machines, I just feel like I ...

I don't understand why your doctor would think it's OK for travel but not for home use. If it's as effective as CPAP for you, which could only be established by a sleep study, it should be equally OK to use it at home as when traveling. If it's less effective than CPAP, then he's basically making t...

I, too, am substantially apnea positional (I have proven this to myself with my own data) and I dare say I might be able to get away with not using CPAP if I can stay on my side. But I do roll on my back, so the only way to stop that would be borderline bondage There are some tests I intend to run ...

I have used it three nights and I can state unequivocally that it works well for my moderate apnea. The design is excellent and the engineering behind it is logical. Even though I am offering my subjective results the incontrovertible fact is that the system should perform well. It is defintely wor...

Hi - I will tell you one thing, though you might not be happy about it, but whatever else your doctor is or does, he's definitely on the right track about surgery for apnea - it rarely works... may seem to do the job for a little while, then reverts within the year and often makes things worse when...

Yeah, agreed. I would be much happier to find the root cause of the tiredness and deal with that. But I also have to be realistic. I have been to two doctors now who tell me that my apnea is being treated effectively by the CPAP. My AHI is like 0.6/hour. There is no reason that I can see to disbeli...

I did go back to another sleep doctor, but he isn't really interested in pursuing the whole tiredness aspect of it. He didn't really review the Sleep Study, he didn't have me take another sleep study. He's just assuming that the CPAP is taking care of the apnea, and he's got me on Nuvigil. The prob...

And that's where this documented placebo affect comes into play in a way that is significant to a certain number of real patients: Because of the placebo affect a certain number of patients who are given a CPAP machine that is delivering ineffective therapy in the sense of reducing the AHI will sti...

Do the people who try cpap and fail still get the 25% placebo effect? Jim The closest they came to a "fail" criterion was low usage. Low use of placebo showed a slightly negative effect on average, with 0 well within the 95% confidence limit. Low use of CPAP did show a positive effect on average, b...

But the sleep medicine community at large (from the sleep docs and their assistants to the DMEs and their RTs) seem to have a bizarre set of attitudes towards leaks: If you complain that you're not feeling better and you're using the machine enough, then the hypothesis seems to be "You're leaking t...

This paper sounds so uncontroversial that it's going to be too boring for me to read! I thought it was quite interesting, though not particularly controversial, but I do like scientific papers. The only result that seems novel is the one called out in the abstract, the quantification of the placebo...

One of the themes I see in the comments in this forum is an assumption that the paper authors were arguing that a partial placebo effect in one measure of one effect of CPAP is a reason stop using CPAP. That would be stupid, and I don't think the authors are stupid. The actual paper is filled with ...

Actually, I think I recall reading that the Epworth is not a great measure of sleepiness, in that it has low correlations with other measures of sleepiness (e.g., MSLT). But maybe those aren't good measures either. Without a "true" measure of sleepiness, it's pretty hard to identity other good meas...

Well, I haven't gotten the article yet, but Arcangle hit on a couple of things that were already going through my mind, including that a statistically significant effect is not necessarily a clinically meaningful one. One of the themes I see in the comments in this forum is an assumption that the p...