Treatment Evaluation Question?

[JohnnySouth]

Trying to make sure I understand something: I have the ResMed S8 Escape - for two weeks today - is there any monitoring software for that? I am trying to understand just HOW my treatment success is/can be evaluated at this point. I mean I sleep with the darn thing on all night each night - but I am still adjusting to it - and waking often - and sometimes mouth breathing I believe, etc. Overall, it is getting better and better - or so it seems - but HEY - I'm asleep - what do I know?

Is acquiring the oxygen measuring device another option?

[Brent Hutto]

I am trying to understand just HOW my treatment success is/can be evaluated at this point. I mean I sleep with the darn thing on all night each night - but I am still adjusting to it - and waking often - and sometimes mouth breathing I believe, etc. Overall, it is getting better and better - or so it seems - but HEY - I'm asleep - what do I know?

You need to define "success". If you want to know whether CPAP is making you feel better and function more effectively, then numbers recorded by the machine aren't going to help. You need some reliable measure of how you feel that can be tracked over time.

You mentioned monitoring oxygen saturation. If one of the important things you are using CPAP treatment for is to eliminate desaturations that are dangerous (in the sense of a chronic risk to your health) then it might make sense to go to the trouble and expense of oxymetry equipment. Otherwise, that's probably a low priority because the equipment is relatively expensive.

Monitoring software that downloads numbers from your machine is useful for two things (other than compliance). You can watch for a trend or individual nights of elevated leaks from your mask and/or mouth so as to maximize the effectiveness of CPAP. And you can get the machine's estimate of how many apparent respiratory disturbances you are experiencing. In my opinion, these latter numbers are important only as potential explanatory factors for whatever changes in quality of life (and specifically excessive daytime sleepiness) or oxygen saturation you might observe.

It is tempting to set a goal of reducing the AI/HI/AHI numbers reported by the machine to as low as possible. If these numbers represented truly validated quantities known to impact risk of adverse health outcomes perhaps that would be a valid intermediate goal. But given that they are really just proxy measures of RDI (which to my knowledge has not been established as a risk factor for stroke, heart disease) and subject to considerable potential bias for certain individuals, I'd argue that they're only worth worrying about to the extent that you can establish in your own monitoring that reductions in those indices are associated with improvements in more meaningful outcome measures.

As for the question about the S8 Escape, if it has a card reader and you can see AI/HI/AHI/Leak/Hours on the LCD display then the Autoscan software will offer downloading and monitoring of those quantities.

P.S. I just checked on Resmed's site and the answer is no, you can not monitor leakage and events with the S8 Escape. For that capability you'd need the S8 Elite, apparently.

[Lee Lee]

Johnny,
I had that machine for a while. According to the Resmed website, your DME can monitor your data.
However, let me just tell you that my DME (which is a national chain) has no clue of how to read the data. They actually don't even have the software to read it.
My Doctor, who is very respected in a large Metropolitan area also has no idea of how to read it. I have done everything possible to get someone to tell me if is even working right! I have lost 42 pounds and would love to know how this affects my apnea.
So call your provider, and ask if they can do it.
Best of luck, and just hang in there.
Lee Ann

[Brent Hutto]

Lee Ann,

If yours was the S8 Escape then you didn't miss anything by not being able to get the "data" downloaded. All that's being recorded is the number of hours you're using the machine each night. When Resmed says that the clinician can "download data" it justs means that can tell you're being compliant. Generally speaking, we already know how long we had the mask on so that's a gimmick without a purpose.

[EDIT] Let me add that in a metropolitan area with 30+ DME's and several very busy sleep doctors, mine sent me to the one single DME in town that he thought he can count on to give him the 30-day download report that he requested from my Resmed machine.