PR APAP System One Series 60 - Data Lying?

[Paralel]

I've recently had some really awful data coming from my PR APAP, it was maxing out its pressure but AHI was 35+ 1/2 CA, 1/2 OA, brought the data into my sleep doctor, he agreed with me that the data suggested APAP was no longer working for me and I likely needed the ASV model, so we scheduled another sleep study to get the titration correct. However, that study showed my apnea was well under control, pulse ox never dropped below 90%, a few OAs and CAs, but nothing serious, AHI was well below 5. He said my slow breathing rate (8-9 breaths per minute), which has been triggered by damage to my CNS as well as pain medication, was showing as false positive OA's and CA's on my machine.

Has anyone heard of this before? Is my machine really lying to me, or did the sleep study fail to show what my machine has been picking up?

[Pugsy]

Was the sleep study with a machine or without a machine? "apnea well controlled" implies using the machine but need to know for sure.
What meds are you taking that might suppress respiration? Usually those are some sort of opiate for pain...do you take it at night every night and did you take it the night of the sleep study?

[Paralel]

Yeah, it was with a RedMed S9 Autoset (they like those machines better at the sleep center)

Yes, I take oxycodone for a chronic pain condition, and I took it the night of the sleep study. All the same meds for the sleep study I take every night.

[cathyf]

It sounds like maybe the sleep lab was able to correct for whatever the APAP is seeing. A sleep study is collecting all sorts in information with all of those electrodes and belts and etc, while the machine is only detecting pressure changes. If the oxycodone is slowing down your respiration enough, maybe the machine is thinking that you have stopped breathing when you are really are just taking a long time to finish exhaling? This is where your sleep doctor earns those bucks he gets paid for interpreting the study -- it's perfectly reasonable to believe that your APAP's data processing is not able to correctly interpret the data that it gets from your breathing while the study can, but the study should show that you have all sorts of odd and exotic things going on to explain the discrepancies, too. I'd be really curious as to what the S9 AutoSet was showing for data lined up with the data from the sleep study equipment. If the S9 was flagging ~35 events/hr while the sleep study data was showing most of that wasn't real, then that's your answer. If the S9 was also showing the low AHI, then it's possible that you are the odd exotic individual for whom the ResMed algorithms works while the PR algorithms don't, and you just need a different machine. If, on the other hand, the machines aren't really capable of taking data from you, then you will need more frequent sleep studies to really know what's going on with your treatment.

But, anyway, it sounds like you are just the lucky guy with the INTERESTING case. The plus side of that is that doctors usually like the interesting cases and will be diligent in tracking down the mysteries.

[fat rat]

Hello,
If the PRS1 has previously documented credible values ​​and slow breathing suddenly no longer recognizes now, the device is probably still defective.

Greetings
fat rat

[Paralel]

Hello,
If the PRS1 has previously documented credible values ​​and slow breathing suddenly no longer recognizes now, the device is probably still defective.

Greetings
fat rat

It's actually the inverse, it used to show proper data, but now with slower breathing, the numbers are all out of whack.

It sounds like maybe the sleep lab was able to correct for whatever the APAP is seeing. A sleep study is collecting all sorts in information with all of those electrodes and belts and etc, while the machine is only detecting pressure changes. If the oxycodone is slowing down your respiration enough, maybe the machine is thinking that you have stopped breathing when you are really are just taking a long time to finish exhaling? This is where your sleep doctor earns those bucks he gets paid for interpreting the study -- it's perfectly reasonable to believe that your APAP's data processing is not able to correctly interpret the data that it gets from your breathing while the study can, but the study should show that you have all sorts of odd and exotic things going on to explain the discrepancies, too. I'd be really curious as to what the S9 AutoSet was showing for data lined up with the data from the sleep study equipment. If the S9 was flagging ~35 events/hr while the sleep study data was showing most of that wasn't real, then that's your answer. If the S9 was also showing the low AHI, then it's possible that you are the odd exotic individual for whom the ResMed algorithms works while the PR algorithms don't, and you just need a different machine. If, on the other hand, the machines aren't really capable of taking data from you, then you will need more frequent sleep studies to really know what's going on with your treatment.

But, anyway, it sounds like you are just the lucky guy with the INTERESTING case. The plus side of that is that doctors usually like the interesting cases and will be diligent in tracking down the mysteries.

The ResMed actually flagged quite a few events, not nearly as many as the PRS1, but there was a separate line below that in the diagnostic software they use which showed what the doctor called 'real' events, and it was far less than the number that the ResMed flagged, and he said the others that flagged were false positives due to the waveform of my breathing. He said this is commonly why people sometimes report significant discrepancies between what their machine says and what independent recording pulseoximetry shows, either the pulseox drops and the machine misses the event (false negative), or records an event when pulseox shows everything is fine, such as in my case, a false positive.

[Guest]

Has anyone heard of this before? Is my machine really lying to me, or did the sleep study fail to show what my machine has been picking up?

I think to answer that we would need to know you leak rate, pressure, and mask make & model. Posting some of your graphs when those readings were recorded would also be helpful.