Gmorning

[tweed]

hi i am new... i slept with a machine last night for the first time...

when diagnosed my AHI was 35
last night with the machine it was 6.8...

also being diabetic i noticed a drop in my morning fasting numbers.
which is worth using the machine in itself...

my machine is a resmed elite II auto
i am using the nose pillows... i think my equipment is all posted in my
signature but i am not sure yet...

so should i expect better AHI's in the morning?
also i had to get up about 4:30am to ahhh ... you know...
i did not turn the machine off just let it run till i got back maybe
a minute or two... would that affect the AHI number?

anyway thats about it for now.

[Wulfman]

hi i am new... i slept with a machine last night for the first time...

when diagnosed my AHI was 35
last night with the machine it was 6.8...

also being diabetic i noticed a drop in my morning fasting numbers.
which is worth using the machine in itself...

my machine is a resmed elite II auto
i am using the nose pillows... i think my equipment is all posted in my
signature but i am not sure yet...

so should i expect better AHI's in the morning?
also i had to get up about 4:30am to ahhh ... you know...
i did not turn the machine off just let it run till i got back maybe
a minute or two... would that affect the AHI number?

anyway thats about it for now.

Welcome to the forum.

There is no such thing as the "ResMed Elite II Auto".
You might want to look at it again.
The data-capable machines are the "Elite II" and the "Autoset II".
If it's the Elite II and it's Ramping up from a lower pressure, that doesn't make it an Auto.....it'll stop increasing pressure when it reaches the set pressure.


Den

[BleepingBeauty]

hi i am new... i slept with a machine last night for the first time...

when diagnosed my AHI was 35
last night with the machine it was 6.8...

also being diabetic i noticed a drop in my morning fasting numbers.
which is worth using the machine in itself...

my machine is a resmed elite II auto
i am using the nose pillows... i think my equipment is all posted in my
signature but i am not sure yet...

so should i expect better AHI's in the morning?
also i had to get up about 4:30am to ahhh ... you know...
i did not turn the machine off just let it run till i got back maybe
a minute or two... would that affect the AHI number?

anyway thats about it for now.

Hi, and welcome to the forum.

The goal for all of us is an AHI of less than 5 (which is considered effective therapy). But in order to rely on the AHI data, you have to have leaks under control. Pay attention to the AHI data, but also the leak rate.

When you get up during the night for a bathroom break, shut the machine off. Letting it run won't affect the AHI data, but it definitely will affect the leak rate. It's important to maintain a good seal on the mask so that you're getting the full prescribed pressure; if there are big leaks, the machine won't be able to compensate for them by raising the pressure, and you won't be getting effective therapy. Control the leaks first, and then consider the AHI data.

Sounds like you're off to a great start!

[ozij]

If it's the Elite II and it's Ramping up from a lower pressure, that doesn't make it an Auto.....it'll stop increasing pressure when it reaches the set pressure.


Den

And it will stay at the set pressure all night long.

A machine left running during your break won't register more apneas or hypopneas -- but it will register a large leak -- so it's better to turn it off.

AHI stands for Apnea + Hyponea Index (that's, that total events, divided by the time you sleep). Apnea is a total lack of breathing, hypopnea is some breathing, but much too shallow. The machine is there to reduce those events by supplying pressurized air to stent your airway -- and it certainly seems to be doing that for you.

Welcome to the forum and good luck, tweed.
O.

[rested gal]

Hi tweed, and welcome to the forum.

when diagnosed my AHI was 35
last night with the machine it was 6.8...

also being diabetic i noticed a drop in my morning fasting numbers.
which is worth using the machine in itself...

Sounds like you're already seeing benefit from using CPAP, tweed. That's great!!

I want to mention something because you'll keep coming across posts on the message board that talk about an AHI under 5 as being indicative of effective CPAP treatment. That's true -- when speaking of other brands. I personally think it's good to strive for an AHI under 5 with other brands. But that's not a realistic number to use as a goal for many people using ResMed machines. Your AHI of 6.8 is fine, imho, with a ResMed machine.

The AHI (apnea/hypopnea index) is the number of apneas and hypopneas that sneaked through despite therapy. The total number of those events is divided into the number of hours the machine was being used for that session. That gives an average per hour. Doesn't mean you were having that many apneas and/or hypopneas every hour... it's an average per hour.

The important part (imho) of the AHI to look at when using a ResMed machine is the "AI" (apnea index.) If the AI is very low, like under 1.0, you're doing great! The "HI" (hypopnea index) is usually considerably higher than the AI.

When I use several different brands of machine and compare my AHI, ResMed machines show me double or triple the AHI I see from other machines. My AI (apnea index) is equally low with treatment from any brand. It's invariably the "HI" (hypopnea index) that is much higher for me when using a ResMed machine. I feel just as rested and refreshed after using a ResMed machine that reports for me an AHI of 6.0 as I do using other brands that report an AHI of 1.0 or less. So, the higher AHI I see when I use a ResMed machine doesn't bother me at all. I know it's most likely because of the difference in definitions for events that each manufacturer builds into their machines.

With a ResMed machine I think rather than looking only at the AHI, one needs to also look at the separate AI and HI numbers to get a good idea of how treatment is going. If the AI (apnea index) is 1.0 or less, and the bulk of the AHI is comprised of the HI (hypopnea index), and the overall AHI is less than 10, I'd consider that to be just as effective treatment as if I were seeing an AHI or 3 or 4 from another brand of machine.

This is because each manufacturer uses their own definitions for what amount of flow limitation there has to be to label it a hypopnea. ResMed might label some flow limitations as hypopneas, where Respironics (or another brand) might still call it "flow limitation."

That doesn't mean one brand misses seeing some hypopneas and another is better at identifying them. Nor does it mean one "reports" better than another. It's purely a difference in where the different manufacturers choose to draw an arbitrary line in the sand for "hypopnea."

Velbor's chart -- several manufacturers' "definitions":
viewtopic.php?p=353046#p353046

So, next time take a look at the separate AI and the HI numbers you are getting, tweed. The AHI of 6.8 you saw from last night might have been made up of, say:
AI 0.4
HI 6.4

Personally, when I use a ResMed machine, I mentally cut the HI in half and then refigure my AHI. When I do that, I get a more realistic comparison with the kind of AHI I see when I use other brands.

If you do that (cut the HI in half) with the example numbers I used above, you'd be looking at an AHI of 3.6 -- nicely below that oft talked about "AHI should be less than 5."

Main thing is how you feel -- hopefully better and better as you get more "cpap" time in. Assuming you have an Elite II CPAP machine, you have an excellent machine for treatment and for monitoring your numbers!

[tweed]

Welcome to the forum.

There is no such thing as the "ResMed Elite II Auto".
You might want to look at it again.
The data-capable machines are the "Elite II" and the "Autoset II".
If it's the Elite II and it's Ramping up from a lower pressure, that doesn't make it an Auto.....it'll stop increasing pressure when it reaches the set pressure.


Den

my bad... it is and escape II auto

http://www.resmed.com/us/products/s8_es ... c=patients

[Wulfman]

Welcome to the forum.

There is no such thing as the "ResMed Elite II Auto".
You might want to look at it again.
The data-capable machines are the "Elite II" and the "Autoset II".
If it's the Elite II and it's Ramping up from a lower pressure, that doesn't make it an Auto.....it'll stop increasing pressure when it reaches the set pressure.


Den

my bad... it is and escape II auto

http://www.resmed.com/us/products/s8_es ... c=patients

I was afraid you were going to say that......

Since the Escape II Auto is supposed to be a non-data-capable machine, how did you come up with this?

last night with the machine it was 6.8...

You NEED to make them swap it for the Autoset II (or at least the Elite II). Otherwise, you'll be soooorrrrry.......


Den

[DreamDiver]

Welcome!

[ozij]

Den,
The Escape II Auto apparently shows total AHI on the screen.
From the user's manual:
http://www.resmed.com/us/assets/documen ... er_eng.pdf

How to Change the Settings on your S8 Escape II Auto
You can change settings (such as Ramp/Settling Time) on the S8 Escape II Auto
by using the keypad and LCD. When the S8 Escape II Auto is in standby mode
you can display a series of screens (a menu) on the LCD screen in order to view
and change the settings for a particular function.
Data regarding your therapy such as AHI and pressure can be accessed through
this menu when required by your clinician/physician.

[Wulfman]

Den,
The Escape II Auto apparently shows total AHI on the screen.
From the user's manual:
http://www.resmed.com/us/assets/documen ... er_eng.pdf

How to Change the Settings on your S8 Escape II Auto
You can change settings (such as Ramp/Settling Time) on the S8 Escape II Auto
by using the keypad and LCD. When the S8 Escape II Auto is in standby mode
you can display a series of screens (a menu) on the LCD screen in order to view
and change the settings for a particular function.
Data regarding your therapy such as AHI and pressure can be accessed through
this menu when required by your clinician/physician.

Thanks, ozij. It's still not enough data to justify that they are going to collect the same amount of money from this person and the insurance provider........when they could have provided the Autoset II or the Elite II.


Den

[tweed]

Thanks, ozij. It's still not enough data to justify that they are going to collect the same amount of money from this person and the insurance provider........when they could have provided the Autoset II or the Elite II.


Den

well sure glad i signed up for this forum ... good GAWD!! we have equipment snobs here to... for a minute i thought i logged into one of my favorite shooting sites...

here is the FACT... i was just diagnosed... i did what my doctor told me... i am not interested in geeking this whole apnea thing to the point of making charts and
graphs and being anal about being under 5 or what my machine can or can not do ... i just want to breath as much as i can throughout the night. I do have a life.

thank you rested gal for the welcome and an informative post thank you to the rest of you for the welcome.

[ozij]

I think you may have missed the point, tweed.

Some machines tell you more about your breathing than others, and when it comes to trouble shooting, information is important.

The Escape II Auto that you have will never show you AI separate from HI.

Many of us are here because we realized our doctors were not as knowledgeable as we needed them to be -

O.

[Wulfman]

Thanks, ozij. It's still not enough data to justify that they are going to collect the same amount of money from this person and the insurance provider........when they could have provided the Autoset II or the Elite II.


Den

well sure glad i signed up for this forum ... good GAWD!! we have equipment snobs here to... for a minute i thought i logged into one of my favorite shooting sites...

here is the FACT... i was just diagnosed... i did what my doctor told me... i am not interested in geeking this whole apnea thing to the point of making charts and
graphs and being anal about being under 5 or what my machine can or can not do ...i just want to breath as much as i can throughout the night. I do have a life.

thank you rested gal for the welcome and an informative post thank you to the rest of you for the welcome.

Oh......a "shooter"...... (One of my other interests.)

So, let's talk about shooting and reloading.......
Does it matter (to you) which cases, powder, primers and bullets you put together......just to get that thing out of the end of the barrel?
How about whether your scope has a parallax problem? Does that matter?
Do you chronograph your loads? Doesn't matter how fast they're going if they make it to the target, does it?
Does it matter what kind of grouping you can achieve? I mean, as long as you can hit a piece of 8 1/2" x 11" paper.....should be good to go, right?

You see......."everything is relative".
You're in the vast majority of people who are diagnosed and are handed this equipment to keep their airway open while they sleep. Problem is, there's only about a 50% compliance rate with this therapy. The other half end up in closets, in yard sales and on Craig's List. A HUGE number of those in the half that ARE compliant have no idea how their therapy is working and then wonder why......when it's NOT working. You don't HAVE to use the data if you choose not to.....but it will be THERE (with a data-capable machine) if you have problems or want to know how things are going.

Welcome to the forum.

By the way, what calibers do you shoot?


Den

[Arizona-Willie]

Welcome aboard, Tweed.

I don't think anyone here < means > to be an equipment " snob " --- they just get a bit enthusiastic over their favorite

All the major brands work.

It's like a choice between Ford or Chevy. Chocolate or Vanilla.

Once in awhile there has even been a flame war or two. Egos do come out sometimes.

However, you can get some very good advice from folks here.
Many have been involved in the subject for years and are very knowledgeable.
More than some so-called " sleep doctors ".

Most people here consider a " data capable " machine a must.
Many of us download our data every morning via the SD card.
We keep close watch on how we are doing.

Many also use pulse / oximeters to keep track of our oxygen saturation level.
And we track that data also.

Sleep apnea is a very serious condition that can be life threatening.
There have been some famous athletes who died from sleep apnea.

But a lack of oxygen from not breathing well enough during sleep damages our organs.
It can be a very severe thing. It works over time. People don't realize their organs are suffering damage until it's too late.

You're fortunate that your doctor got you started. But the DME cut corners on you and gave you a cheapie machine and made more money than if he gave you a data capable machine.

Even if you don't want to be " anal " enough to track your data NOW ... it never hurts to have a data capable machine with the card and card reader and software. You may change your mind down the road.

And the DME bills your insurance the same no matter which machine he gives you so he makes more if he can pass off an inferior machine.

I don't know about you .. but I figure it's my life ... and I'm worth the best.

[DreamDiver]

good GAWD!! we have equipment snobs here to... ...i just want to breath as much as i can throughout the night. I do have a life.

tweed,
I hope you'll stick around. If you do, you'll find that there can be some good-natured ribbing and differences of opinion. Den and ozij always bring up well-considered points - time taken out of their day to share their experience and perspectives with others. As to members 'having a life'. Hmmm... by saying you have a life, it is easily construed that you believe others who spend more time here may not have a life. Den, ozij and Rested-gal all spend countless hours on this forum. Some belong to other OSA fora too. I sometimes wonder if they ever sleep. Lively opinions make for excellent discussion. Yours included.

Be sure to read through some of the Wiki. (See the yellow light bulb at the top of the forum.)