Detecting UAR with a ZEO ?

[kaiasgram]

I just came home from an appointment with a new sleep doctor. Boiling things down here, my main question was whether flow limitation and RERAs could still be disrupting my sleep. Even though my AHI is very good at 5+ months on CPAP, excessive fatigue and sleepiness persist.

Well first thing, they couldn't read my SD card even though I had looked at last night's sleep data this morning before I left for my appointment and the card was working fine. They told me I probably accidentally erased the card. So the doctor had no access to my data.

What he decided to do is send me home with a ZEO for a few nights -- he said if it shows lots of arousals then I likely need more pressure.

So this clinic loans ZEOs out to patients to get diagnostic information ? I've always been a little curious about the ZEO so what the heck, I'll use it for a few nights -- but should I expect that this device could come anywhere close to answering the question about flow limitation and RERAs ?

I'm curious about your reactions to this!

p.s. -- Now my SD card really is unreadable -- I came home and put it back in my machine and my machine is flashing the error message "INVALID CARD."

[Pugsy]

p.s. -- Now my SD card really is unreadable -- I came home and put it back in my machine and my machine is flashing the error message "INVALID CARD."

Yeah, in their effort to get to the data on the SD card they messed with something on the SD card and the S9 is real picky about what is on the SD card. Least little thing not like it expects it to be and you will get the error.
You will need to erase or reformat the SD card or use another. They will likely blame you but it was their error.

Have no idea if the Zeo data will show them what they need. It might because it is fairly accurate.
What will you do if they say "more pressure"? How's the aerophagia thing working out?

[kaiasgram]

You will need to erase or reformat the SD card or use another. They will likely blame you but it was their error.

I bought an SD card at Best Buy a few months ago to keep as a spare -- so no problem, I've already put it in my S9 and it's ready to go. And all my data to date is in my SH files on my computer, including last night. I think I'll send them a screenshot of the summary data so they'll know I had good data right up until the moment it got into their hands!

What will you do if they say "more pressure"? How's the aerophagia thing working out?

The doctor said if it looks like I might need more pressure the clinic would send me home with a bipap machine to trial for a week or so. I didn't know this was an option as sleep doctor number one never mentioned it.

If I do in fact need bipap, I'll first throw up because I'll have to buy it myself and I'm still paying off my first machine. Then I'll pull out my weary credit card and buy a Bipap. I'll look at secondwind and also post a message here. And I should be able to sell my S9 to help offset the cost.

I don't get bad aerophagia if I stay at 8-8.2 cm, much above that and it starts becoming a problem. I was originally titrated with a max pressure of 10, so the other night in anticipation of this appt I decided to set my max pressure to 10 as an experiment (also to see if having a few months of therapy under my belt would make aerophagia less of a problem now). It was almost comical what happened that night, nonstop burping and chipmunk cheeks. Thank goodness the tape I use has "micropores" to let some of that air pass through! The not so comical part was the lost sleep and the abdominal pain. When I looked at my data for that night, I saw that the machine went to 10 often during the night, reinforcing for me the idea that I might need a higher max pressure to improve my therapy and my sleep. I did appreciate that this doctor understands bipap can help relieve aerophagia even for patients at relatively low pressures, something the first doc dismissed out of hand.

[shaunas]

Since you bring the question up about flow limitation and RERAs, Sleepyhead shows I a fair amount of RERAs. I know the definition but is a large number a problem and what is the solution for them? Also, can you tell me what you are looking for in the flow limitation graph?

[kaiasgram]

Since you bring the question up about flow limitation and RERAs, Sleepyhead shows I a fair amount of RERAs. I know the definition but is a large number a problem and what is the solution for them? Also, can you tell me what you are looking for in the flow limitation graph?

I'm hoping to keep this thread about my ZEO question but yes a lot of RERAs can be a problem because they result in arousals that can stress your nervous system and pull you out of deeper stages of sleep. Increasing pressure is usually how they try to treat RERAs. There's actually a current thread about flow limitation graphs that I hope will shed some light on how to interpret the FL graph and the FL numbers reported by Sleepyhead.

[cosmo]

Thats cool that they use Zeo's. I just bought one 2 days ago. If medical professionals are using it, thats a good sign. I showed my doctor today the 2 night's worth of charts during a visit for something else. She never heard of it but seemed impressed.

I don't know about UAR but I have mild OSA and this is what it look like for last night. I did not use a cpap machine since I had to return my tester/loaner.

[kaiasgram]

Thats cool that they use Zeo's. I just bought one 2 days ago. If medical professionals are using it, thats a good sign. I showed my doctor today the 2 night's worth of charts during a visit for something else. She never heard of it but seemed impressed.

Thanks for posting that, Cosmo! I can see the value of Zeo more in a primary care setting or in a sleep medicine dept. for looking at general sleep patterns. I'm just not sure if it's a good choice for diagnosing clinically significant UAR. I suppose if you see disordered sleep architecture in the Zeo report you'd know there's a problem, but how could it tell you what is causing the problem? I'm not very familiar with the ZEO so I'm still interested in what the experienced ZEO users think about this.

I do like this sleep doctor, though, first for just being respectful and giving me a fair amount of time, and second for believing in patient empowerment. He emailed me after the appointment and thanked me for telling him about SleepyHead. During the appointment he also pulled out his iPhone and showed me the "Sleeping U" app which records snoring. He said that UAR is usually accompanied by vibratory snoring, so the app might provide some additional clues. And though he brought up the idea of taking Nuvigil or Provigil he supported me when I said I first wanted to make sure my pap therapy was optimized before going to meds. As visits with sleep doctors sometimes go, this one was pretty good.

[MaxDarkside]

I'm not very familiar with the ZEO so I'm still interested in what the experienced ZEO users think about this.

Not sure myself in how useful the Zeo would be for breathing disorders / events, but only in a general view of sleep architecture.

[lazer]

Keep us posted as to the Zeo and results and how they correlate with possible UARS and your condition. I'm particularly curious as to this as I both have a Zeo which never seems to record "Deep Sleep" but I do cycle in and out of REM with the most extended period of REM showing in the morning hours before and during wake up/alarm time when I barely want to rouse out of bed.

As you know, my AHI and RDI are considered mild and barely qualify me for xPAP. I have noticed some improvement in my sleep post xPAP - most notably my insomnia is for the most part gone now and I generally feel more refreshed during the day but still don't feel as good as I would like to, mainly my moods. So both myself and DME are leaning towards my condition being UARS related.

[edm_msu]

I'm not very familiar with the ZEO so I'm still interested in what the experienced ZEO users think about this.

Not sure myself in how useful the Zeo would be for breathing disorders / events, but only in a general view of sleep architecture.

Max, I consider you an expert with Zeo, so if you are not sure, then it probably is not useful for breathing disorders.

As you know, my AHI and RDI are considered mild and barely qualify me for xPAP. I have noticed some improvement in my sleep post xPAP - most notably my insomnia is for the most part gone now and I generally feel more refreshed during the day but still don't feel as good as I would like to, mainly my moods. So both myself and DME are leaning towards my condition being UARS related.

According to Wikepedia: "Treatment for UARS is essentially the same as that for obstructive sleep apnea." Since you have sleep apnea under control, why wouldn't UARS also be under control?

[jnk]

I'm not very familiar with the ZEO so I'm still interested in what the experienced ZEO users think about this.

Not sure myself in how useful the Zeo would be for breathing disorders / events, but only in a general view of sleep architecture.

Perfectly said, IMO.

My take is that Zeo is an excellent consumer product for getting people to examine their own sleep hygiene (time in bed, caffeine effects, etc.) so that people can coach themselves, or be coached, in an effort to be mindful of the importance of getting sufficient good sleep. But ZEO is very clear that their product is not designed to be used in conjunction with a medical therapy, and it is my opinion that the ZEO dudes would discourage its use for assessing any medical sleep disorder.

At the bottom of the page at the Zeo site, the disclaimer is, in part, as follows: "Zeo Sleep Manager is neither a medical device nor a medical program and is not intended for the diagnosis or treatment of sleep disorders."

Based on that, I would personally question the ethics, education, and integrity of a sleep doc, or any doc, who put stock in a ZEO report. Any doc can make a mistake in such matters. But I would consider using a ZEO to diagnose sleep to be about as effective as using tea leaves or a divining rod.

Then again, I feel about the same for much of what passes for actual approved medical-grade home-sleep-testing equipment, too, when it comes to discerning UARS-type issues. So don't necessarily go by what I say.

[lazer]

As you know, my AHI and RDI are considered mild and barely qualify me for xPAP. I have noticed some improvement in my sleep post xPAP - most notably my insomnia is for the most part gone now and I generally feel more refreshed during the day but still don't feel as good as I would like to, mainly my moods. So both myself and DME are leaning towards my condition being UARS related.

According to Wikepedia: "Treatment for UARS is essentially the same as that for obstructive sleep apnea." Since you have sleep apnea under control, why wouldn't UARS also be under control?

Oh don't get me wrong. I'm in no way saying my treatment isn't under control. We just tend to try to improve on anything and everything we can once we realize and accept we have {insert sleep breathing disorder here} ... thus is why I am interested in anything that I can gain knowledge from to bring the most positive/repetitive/ and lasting results to my therapy.

[kaiasgram]

Thanks to all you ZEO users who weighed in. I used the ZEO for the first time last night, and now I have the most embarrassing question I've ever asked. First you must all promise not to "5150" me when you read my question, okay?***

I can usually tell before I go to bed if it's going to be a pretty good or a pretty questionable night, and I'm usually right. Last night I was good and tired, I'd had a good day, my back did not hurt (unusual these days), and Melissa and Tony won Dancing With The Stars . Went to bed a pretty happy camper and fell asleep in 13 minutes. I woke up just an hour and a half later, head pounding, overheated, feeling all jacked up, it was weird and surprising given my smooth start. My forehead hurt so I loosened the ZEO headband a little, even though it wasn't that tight. For the rest of the night my sleep was trashed, whacky bad dreams, woke up a lot, and I'm a zombie today. In the midst of the nightmarish night I started wondering if it's possible to have an adverse reaction to using a ZEO -- aside from having the headband too tight. Could there be something about the effect of sensors on your forehead commuicating wirelessly with the device that messes with brain waves and actually has the potential to disturb sleep? I'm just so surprised at starting the night so peacefully and having it quickly turn upside down and stay that way. After I took the headband off this a.m. I went back to sleep for a couple of hours without it and got a little more rest.

I feel like I'm suggesting I was abducted by aliens last night. But I remember reading once that talking on your cell phone before going to sleep can actually disrupt brain wave activity in sleep. So I'm asking -- any chance using the ZEO could have a similar effect?

*** for those who don't know, 5150 is a term for involuntary commitment to a mental health facility.

[cosmo]

Maybe you're having a reaction to some sort of cleaner they used? Its been passed around to a bunch of patients I would believe.

Try wiping it down to see if it would help.

[kaiasgram]

Maybe you're having a reaction to some sort of cleaner they used? Its been passed around to a bunch of patients I would believe.

Try wiping it down to see if it would help.

Hmm, an idea Cosmo -- I'll wipe it down before using it again.