Should I tell doc/nurse I am using ResScan?

[Tee]

I have my first follow up appointment at the sleep center. Should I tell the nurse I see that I have been looking at my data or is it better left unsaid?

[BlackSpinner]

Take control and take no prisoners. Tell them what you are doing and that you expect respect and support. If they can't provide the service for which you hired them then you fire them.

[Slinky]

I would let them do their download and see what they download and what they have to say. Then if you have a question about a particular item in one of your downloads that you have a question about or want to discuss pull that at-home printed page out, show the item to the doctor and ask your question. At that point if he/she asks you can tell them. If not, why bother? The time will come sooner or later when you will make them aware that you have it.

In my own situation my sleep doctor was well aware BEFORE I even had my script that I insisted on a fully data capable PAP and would be buying the software AND if I didn't get what I wanted I wouldn't accept anything. BUT "we" knew each other somewhat before I ever saw him in the capacity as my sleep doctor from my volunteer time at the hospital where he was involved w/their sleep center as was the sleep lab's manager from a sleep study and MSLT I had had done several years previously.

Most sleep doctors don't require or have any interest in anything beyond the first page of statistics covering the entire period since your last visit or if this is your first follow-up since receiving your PAP. His medical file for you would end up being two feet thick in a year if they downloaded every page since your previous visit.

[Tee]

I have been looking at my data about once a week and see that I am having apnea, so if she doesn't make changes, then I will for sure bring up that I am looking at the data.

I read a bunch of stuff on this site when I first got my cpap, so if I remember correctly, my machine can be set to automatically increase my pressure when needed, right? I see that I am having more episodes in the early morning, around 4am, which is waking me up. If I am thinking correctly, if I am fine at the pressures I am at most of the night, then why increase it for the entire night, but have the machine increase it when needed? Seems to make sense to me.

[pap4life]

You don't say what your AHI numbers are from your weekly peeking at the software, so hopefully they are under 5 or so. Normally AHI under a 5 is somewhat considered controlled by therapy. If you are feeling better with more energy since starting ,but the 4am arousals are troublesome, bring it up (absolutely) I would make sure that they are aware of that. If discussion persues about that topic, then certainly bring up the point about using the software. As someone already said, if they are truly concerned about your well being, then they might compliment you on your own self health advocacy. IF your using software to monitor your own well being upsets them (some do/will) perhaps you might shop for health care somewhere else. Your health care should be a TEAM effort when you use medical professionals.

[Pugsy]

my machine can be set to automatically increase my pressure when needed, right? I see that I am having more episodes in the early morning, around 4am, which is waking me up. If I am thinking correctly, if I am fine at the pressures I am at most of the night, then why increase it for the entire night, but have the machine increase it when needed? Seems to make sense to me.

Yes, makes perfect sense.
I use an auto adjusting pressure machine. APAP for short. My settings are 10 minimum and 20 maximum. I discovered that for the majority of the night I do quite well with pressures 10 to 12 BUT I also have some events in the wee hours of the morning that require a pressure of 18 or 19. My OSA is worse in REM and those wee hours of the morning happen to be when we have more and longer cycles of REM. May or may not be why you see events at 4AM often.

I sure wouldn't want to use 18 all the time. Pressure changes don't bother me so this works well for me. You may not need such a drastic change but it sure is nice not to have to use a higher pressure all the night to prevent a few random super duper stubborn events.

[jamiswolf]

Hi Tee,
I don't bother discussing data with my Doctor (after the first time) because he discounts machine data...puts no value in it. Not all Docs feel that way, but be prepared in case he merely ignores your data. Sometimes compliance is all they want to see. Sad but true.

I just wanted to add a comment about your early morning apneas requiring more pressure. There could be a positional component. I require significantly more pressure when on my back. Perhaps you change positions during your sleep and end up on your back. Of course if you start on your back, you can probably ignore this.
Cheers,
Jamis

[rested gal]

Tee, what pressure range (min pressure, max pressure) has been set for your autopap?

Pugsy's response is what jumped to my mind, too:

My OSA is worse in REM and those wee hours of the morning happen to be when we have more and longer cycles of REM.

What Jamis wrote is also a strong possibility:

I just wanted to add a comment about your early morning apneas requiring more pressure. There could be a positional component. I require significantly more pressure when on my back. Perhaps you change positions during your sleep and end up on your back.

Either of those things could be allowing more apneas to happen. Both things together (being on one's back AND in REM) are worst case scenario for letting apneas sneak through.

Autopaps are designed to raise pressure slowly, so if the minimum pressure is set too low to effectively prevent sudden airway collapse situations (REM and/or supine sleep position) where a lot more pressure may be needed for some people. The usual way to eliminate more of the obstructive apneas is to set the minimum pressure on the machine another cm or two higher.

Of course, all this stuff can be a trade-off. If the present AHI is nice and low, and raising the minimum pressure setting causes difficulties (mask leaks or aerophagia, for example) then accepting a few "near morning" apneas sneaking through is no big deal and you'd want to leave things as they are.

But if a slightly higher minimum pressure setting still lets me sleep fine, that's what I'd do -- if it were me. I'd raise the minimum pressure another cm or two or three.

I personally think the minimum pressure setting on an autopap is the most important setting to "get right":

Results: 1st night with Auto A-Flex (topic started by TSSleepy)
Two nights graphs posted using pressure range 4 - 20 and 10 - 20
viewtopic.php?p=349073#p349073

November 2008 Just got an APAP (topic started by turbosnore)
viewtopic.php?p=319619#p319619

October 2008 Turning off Aflex and Cflex (topic started by DoriC)
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September 2008 New Guy - Need Help w/Settings (topic started by alanhj13)
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Wulfman, DreamStalker, and ozij talk about autopaps making changes slowly:
December 2008 Why adjust APAP. Isn't it auto? (topic started by oxygenium65)
viewtopic.php?p=323218#p323218