vauto basics

[lazarus]

. . . wish he was a little more flexible and not so rigid with his opinions (like offer both sides) . . .

I think you set a particularly good example of not falling into that trap, if you don't mind my saying so.

And, no, I didn't say that just to further derail Zonker's thread. (I'm sure I'll be able to find a much better way to do that later.)

[Pugsy]

And, no, I didn't say that just to further derail Zonker's thread. (I'm sure I'll be able to find a much better way to do that later.)

Thanks for the kind words.

About derailing Zonker's thread here....I know I did a little bit but if I didn't he would think I didn't love him anymore.
Can't be having that happen.

[Pugsy]

As for the original request...essentially a cheat sheet for understanding bilevel.
I wish I had one but my knowledge came about from reading a gazillion posts about it as well as my own personal experience....trial and error as well.
Plus the experience of others mixed in.
Now ask me a specific question and I can write a small novel.

About REM clusters...they happen....sometimes frequently and sometimes infrequently and sometimes very dense clustering and sometimes maybe only 3 of 4 very short lived events.
I don't worry about them as long as I don't feel like they are messing with how I feel. Most of the time the pressure just goes up and I sleep right through it.
Some nights I don't have any....some nights maybe one small brief cluster.
Everyone knows that I don't panic over a handful of events. I learned a long time ago that sometimes I just happen to need a LOT more pressure during REM. Now I could just use quite a bit more minimum pressure but I simply don't want to use 4 to 6 cm more baseline pressure all night long just to deal with REM clusters that I might see only a couple of times a week with maybe 3 or 4 short lived events composing that REM cluster.

I have never been able to tell any real difference in how I feel the next day with AHI numbers. Wish I could but I can't...doesn't matter if the AHI is 0.0 or 3.0 or 5.0. Heck, one of my very best days in terms of how I felt was after a AHI 9.4 night. Go figure that one.
My main issue is the hours of sleep that I get or don't get and the AHI doesn't dictate my hours of sleep...wish it did.

[palerider]

You still being the grumpiest wise, uh, person on the internet helping people?

Well, I've seen grumpier, and more uh, personish... but sure.

And thanks for anything you did to help keep Zonker alive while I was dead.

Happy to help, it's a worthy cause.

[palerider]

I also disagree with some of his educational content. His anti-APAP tirades that (like many) is not based on APAP performance but misconfigured APAP performance.

Yup... very much so, (and the other bits I didn't quote).

[palerider]

He doesn't like APAP and he doesn't like EPR which makes me wonder why he likes bilevel.
Oh well.....

Someone explain that to me, because all I can figure is that someone that feels that way just doesn't properly understand the concept.

We do have to remember that Jason is a sleep tech, and then remember what we usually think about sleep techs... he does have a lot more clues than most of them though.

[Pugsy]

We do have to remember that Jason is a sleep tech,

Many, many years ago I used to go lurking on the sleep tech forum. I forget the name of it but it wasn't for people like us at all. They would tear outsiders to shreds ....and sometimes ate their own as well.

Anyway, I was surprised at the variety of personal opinions there but whatever the opinion might have been they lived and breathed it....no matter if it was right or wrong in my eyes. The fights that happened on that forum make our little spats here look like childish tantrums. They had some nuclear wars over there.
Made you look like you should be wearing a halo instead of horns. They were brutal against someone that disagreed with whatever the person believed.

Anyway Jason is indeed a sleep tech first and he is entitled to his own personal opinions just like anybody else is.
We just have to learn to use the filters available out there to help sort through what is opinion only and what might be fact.
Unfortunately newbies haven't learned about those filters yet and it's sad when they are doing things that make their life more difficult than it needs to be. Like not using EPR because Jason doesn't like it because it "sometimes" triggers centrals.
If I needed 14 cm pressure you can bet your sweet behind that I would be using EPR. And worry about the centrals only if they popped up. Chances are....they won't. The number of people who actually have that problem with EPR is actually quite small. I know it seems like we see a lot of it here but that's because we see only the people with problems.
The happy, no problems cpap users, don't have a need to hang out here....they are off doing other more fun stuff in their lives than hanging around here with a bunch of unhappy people.

[palerider]

We do have to remember that Jason is a sleep tech,

Many, many years ago I used to go lurking on the sleep tech forum. I forget the name of it but it wasn't for people like us at all. They would tear outsiders to shreds ....and sometimes ate their own as well.

I used to lurk there too.

Like not using EPR because Jason doesn't like it because it "sometimes" triggers centrals.

Yeah, so something like 1 in 7 people may have some centrals because of the extra ventilation...what about the other 6 out of 7? why shouldn't they benefit?

[jimbud]

The happy, no problems cpap users, don't have a need to hang out here....they are off doing other more fun stuff in their lives than hanging around here with a bunch of unhappy people.

Wow! Telling it like it is. I really like you. You are great.

JPB

[lazarus]

The sleep techs, through no fault of their own, are sometimes overly influenced by seeing the reactions to PAP from first-night users, and they naturally form their opinions accordingly. They don't see the centrals go away over the next few days.

EPR and auto CAN confuse the tech's job of first-night observation and formulating the basis for a doc's written prescription, so I don't expect techs to cozy up to those profoundly useful treatment innovations.

But if Slinky were here, she wouldn't be putting up with any bad talk about techs around here!

[zonker]

As for the original request...essentially a cheat sheet for understanding bilevel.
I wish I had one but my knowledge came about from reading a gazillion posts about it as well as my own personal experience....trial and error as well.
Plus the experience of others mixed in.
Now ask me a specific question and I can write a small novel.

About REM clusters...they happen....sometimes frequently and sometimes infrequently and sometimes very dense clustering and sometimes maybe only 3 of 4 very short lived events.
I don't worry about them as long as I don't feel like they are messing with how I feel. Most of the time the pressure just goes up and I sleep right through it.
Some nights I don't have any....some nights maybe one small brief cluster.
Everyone knows that I don't panic over a handful of events. I learned a long time ago that sometimes I just happen to need a LOT more pressure during REM. Now I could just use quite a bit more minimum pressure but I simply don't want to use 4 to 6 cm more baseline pressure all night long just to deal with REM clusters that I might see only a couple of times a week with maybe 3 or 4 short lived events composing that REM cluster.

I have never been able to tell any real difference in how I feel the next day with AHI numbers. Wish I could but I can't...doesn't matter if the AHI is 0.0 or 3.0 or 5.0. Heck, one of my very best days in terms of how I felt was after a AHI 9.4 night. Go figure that one.
My main issue is the hours of sleep that I get or don't get and the AHI doesn't dictate my hours of sleep...wish it did.

sorry, i got so busy chasing jnk's ghost around the forum that i neglected to answer this earlier.

i know that you don't feel the difference in ahi, but i do. but certainly not at this level. if i can stay at .065, i really don't have anything to whine about. now, i'll whine if i get to 1.50 or something. but that hasn't happened yet. so i won't worry about it.

so far, it's still the rem sleep. and the resulting obstructive clusters that come with it. what i find interesting is that it doesn't seem to happen more than once a night and not at the same time. i guess that's another thing to chalk up to "we don't sleep the same way every night", eh?

oh and someone was kind enough to offer a suggestion in understanding bilevel, which they submitted to me via pm. that person suggested that i read the clinicians manual as a starting place. i was kind of embarrassed because it never occured to me!

so i'll do some boning up there to start with and if things don't make sense, i'll ask.

[Pugsy]

so far, it's still the rem sleep. and the resulting obstructive clusters that come with it. what i find interesting is that it doesn't seem to happen more than once a night and not at the same time. i guess that's another thing to chalk up to "we don't sleep the same way every night", eh?

Oh, I thoroughly understand the once a night thing. For me it was usually the 1st likely REM period during the night and sometimes it might be probably the second probable REM where I might see a little clustering.
It was so frequent about 90 minutes after sleep onset that I got to calling it my witching hour.
It's been very rare that I have seen it in those wee hours of the morning when we are more likely to have more REM.

I dunno...and since I really can't control my sleep stages I just shrug my shoulders and move on.
Most nights I don't see any clusters of any kind and the AHI is like it was last night 0.4.

But get this....last night...new record for me. 9 hours of machine use instead of my usual 5 or 6. Now I know I woke up probably around 5 ish (hurting) but didn't get up and went back to sleep for another couple of hours. Pretty sure I got at least 8 hours of sleep. I will check the data later.
Still trying to get the cobwebs out....I am not...nor have I ever been...a morning person.

[babydinosnoreless]

Zonk..Grab a beer and sit back and relax...https://www.youtube.com/watch?v=ts9lNJ2g1IE

thank you for this!

will watch it when i get a roundtuit.

i used to have plenty of roundtuits on hand, but it's getting harder and harder to find one.

Its not often I have to look words up. Thanks for the new word !

[lazarus]

Its not often I have to look words up. Thanks for the new word !

You can take the boy out of Indiana, but . . .

[zonker]

But get this....last night...new record for me. 9 hours of machine use instead of my usual 5 or 6. Now I know I woke up probably around 5 ish (hurting) but didn't get up and went back to sleep for another couple of hours. Pretty sure I got at least 8 hours of sleep. I will check the data later.
Still trying to get the cobwebs out....I am not...nor have I ever been...a morning person.

that's excellent! is it more usual for you to wake multiple times with pain? or is it the not getting back to sleep part?

i'm hoping the pain reduction is working for you and you'll find more sleep!