my data from last night

[Gcfcos]

please can someone tell me whether these results are ok? to me it seems like im not getting my obstructive apneas? the lady at the clinic said the only ones i have to concentrate on keeping an eye on are the obstructive episodes and she says not to worry about the others.

[Thatgirl]

Are these all from last night? You need a higher pressure than fixed 15. How long have you had your machine? You would probably fair better on bilevel.

[Gcfcos]

Are these all from last night? You need a higher pressure than fixed 15. How long have you had your machine? You would probably fair better on bilevel.

yes all from last night. been very tired all day today and dropping off to sleep all over the place. had the machine since 15th feb this year and started off at the beginning on 10cm of pressure

[palerider]

please can someone tell me whether these results are ok? to me it seems like im not getting my obstructive apneas? the lady at the clinic said the only ones i have to concentrate on keeping an eye on are the obstructive episodes and she says not to worry about the others. ]

nope, that big number of the pie chart should be under 5.

[rick blaine]

Gcfcos,

You started another thread asking about the diagnosis. I'm sure the longer-term members here would say it'd be more helpful if, rather than making a fresh start, you continued on a previous thread.

I've been thinking since your question about diagnosis, and about your previous sleepyhead post - and I'm cautious about offering an opinion after seeing only one or two nights. And all that I know about you is that you're 30 (approx.), that you're 5' 8", and you weigh 20 stone (280 lbs).

I think it's quite clear you have sleep apnea. What is unusual is the shape or pattern of your response to CPAP. With quite a high pressure, you are fine for quite long periods. And then there are these absolutely ugly splodges.

It's a head-scratcher. The kind where there's more than one factor involved. So examine all of them.

It's a guess, but one thing I think is happening is that you change position - perhaps while dreaming - and that change of position puts you in a place where your head and neck is so cricked or set that no amount of pressure works. Or you're on your back, and then your weight predisposes against rolling to one side.

With regard to your weight, I would say you should tackle that urgently. A diet of 800 to 1000 calories a day. Same as if they said 'we won't operate till you get your weight down'. It is that kind of serious.

Now, you did ask, on another thread start, would losing weight make a difference? And the answer is: it might. BUT there's no guarantee. And there's no guarantee how much of a difference. But (a) it's worth trying anyway, and (b) It's a good general health outcome for you anyway.

Again, on the position theory, it could be that you're one of these people who needs to sleep with a cervical collar. There's lots of posts about that here. Use search facility above.

It could be you need to raise the head-end of your bed by putting a couple of bricks under the legs. That works for some people. Again, lots on that in search.

As far as the machine goes ... I think you're getting to the point where even an auto might not make much difference (you may remember I suggested that as a self-financed option), and the next step would be a bi-level machine. But as to getting a fixed bi-level - or even auto bi-level - out of Dorset trust ...

If I were your consultant, I'd want to have you in for a sleep lab study - including motion sensors, myelograph, and videotape. And I'd start the paperwork for making the case to the trust for an unusual case expenditure.

[rick blaine]

Or they could have you in for a lab, simulate the effect of an auto bi-level, and see if that works for you. And then you could buy one.

I don't know the UK price for a ResMed bi-level pressure unit. Last time I looked, the equivalent Philips Respironics machine was £835.

[Krelvin]

Why a new thread? Don't need to create a new thread a day just add to the last days thread.

You should only be making changes and then seeing how they workout for the next couple days at a time. Every night is not the same.

[Gcfcos]

Gcfcos,

You started another thread asking about the diagnosis. I'm sure the longer-term members here would say it'd be more helpful if, rather than making a fresh start, you continued on a previous thread.

I've been thinking since your question about diagnosis, and about your previous sleepyhead post - and I'm cautious about offering an opinion after seeing only one or two nights. And all that I know about you is that you're 30 (approx.), that you're 5' 8", and you weigh 20 stone (280 lbs).

I think it's quite clear you have sleep apnea. What is unusual is the shape or pattern of your response to CPAP. With quite a high pressure, you are fine for quite long periods. And then there are these absolutely ugly splodges.

It's a head-scratcher. The kind where there's more than one factor involved - more than one thing to fix.

So do all of them.

yes im on slimming world and have lost 2.5 stone so far

It's a guess, but one thing I think is happening is that you change position - perhaps while dreaming - and that change of position puts you in a position where your head and neck is so cricked or set that no amount of pressure works. Or you're on your back, and then your weight predisposes against rolling to one side.

With regard to your weight, I would say you should tackle that urgently. A diet of 800 to 1000 calories a day. Same as if they said 'we won't operate till you get your weight down'. It is that kind of serious.

Now, losing weight might make a difference - but there's no guarantee it will. It's a good health outcome anyway.

Again, on the position theory, it could be that you're one of these people who needs to sleep with a cervical collar. Lots of posts about that here. Use search.

It could be you need to raise the head-end of your bed. A couple of bricks under the legs. Also on search.

As far as the machine goes ... I think you're getting to the point where even an auto might not make much difference (you may remember I suggested that as a self-financed option). But as to getting a fixed bi-level or even auto bi-level out of Dorset trust ...

If I were your consultant, I'd want to have you in for a sleep lab study - including motion sensors, myelograph, and videotape. And I'd start doing the paperwork for making the case to the trust for unusual case expenditure.

yes im on slimmimg world and have lost 2.5 stone

[Gcfcos]

Why a new thread? Don't need to create a new thread a day just add to the last days thread.

You should only be making changes and then seeing how they workout for the next couple days at a time. Every night is not the same.

i had made a few threads and forgot which one i was still commenting on so just made a new one

[palerider]

Or they could have you in for a lab, simulate the effect of an auto bi-level, and see if that works for you. And then you could buy one..

you don't "simulate" the effect, lab machines have multiple modes, so they ARE bilevels, and plain cpaps, and auto cpaps, and ASVs and NIVs, all in one box.

[rick blaine]

Gcfcos,

Good news on the weight program.

When I said the pattern in your chart is unusual, what I particularly meant is that: "This isn't the chart of somebody who's getting no treatment. This is the chart of somebody who's getting quite a fair bit of treatment."

(For comparison, my 90 per cent level is 11.5, and 14 wakes me up.)

"And clearly, the pressure of 14 - and now 15 - is doing some good - even if it's Not Quite Enough.

"But when the pressure isn't quite enough, usually - and I do stress usually - the times when it isn't quite enough are evenly spread thru the time period.

"This chart is absolutely clear of ALL events for long periods. And then there are these patches where there's a car-crash of 'em."

That's the anomaly.

Another rise in pressure might be the next thing to try. Pressure needs in the range 15-20 aren't unheard of (you'll find plenty of people on other threads saying that's their number). But I think the question still is: what's causing the change?"

Anyway ... if you haven't picked up enough general info about XPAP by now, a corollary to going up to 16, 17, whatever is that that it can be quite an effort to breathe out against that kind of pressure.

The answer the machine manufacturers came up with is: the bi-level machine. Set to, say, 16 for breathing in, and dropping rapidly to 10 to let you more easily breathe out. (Which, btw, you might appreciate is quite an engineering feat.)

And as I said earlier, your doctor would need to agree that fixed CPAP isn't working, and make the case for that.

I, for one, woould say that a peak AHI of 75 is ample justification.

[rick blaine]

palerider,

If you want to desk-edit my every word, I'd have to ask you: "How long did you spend 'on the rim'?"

Last time out, you called me on 'model (number)' vs 'REF (number)' - when both are used quite widely, and some might say interchangeably.

We could have a philosophical discussion about the differences between 'simulate', 'emulate', 'imitate', 'replicate', and 'from the outside, deliver all the same performance parameters and values as' - but would it make that much difference? He knew what I meant.

And in any event, can you say for certain what kind of equipment they have in the Dorset Hospital sleep lab? Or how up-to-date it is? Do you even know if they have a sleep lab?

Now, we can start a pointless argument from here on, palerider. Or, me having made my point, I can leave it there. And you - you might be content with me saying, 'I take your point.' And you might leave it there.

You've been contributing to this forum longer than I have. I will follow your example.

[palerider]

palerider,

If you want to desk-edit my every word, I'd have to ask you: "How long did you spend 'on the rim'?"

your panties, they're all in a bunch, I suggest you grab them firmly and pull, you'll feel much better.

Last time out, you called me on 'model (number)' vs 'REF (number)' - when both are used quite widely, and some might say interchangeably.

fine, mr "must be right and don't say anything to clarify my statements" look on the back of a resmed machine, or bottom of a respironics (not sure of the location on others) and try to find the word "MODEL". tell someone to "tell me the model number" and they won't have any more luck than you will... so they'll read off some number at random.

frequently it'll be IP21, or IPX1 because that's a nice number sitting right after the ResMed name. guess what? that's not a model number, it's the international Intrusion Protection rating for solids and liquids....

so, pointing out that they need to look for the REF number, which the labels DO show prominently, is quite valid.

We could have a philosophical discussion about the differences between 'simulate',blah blah blah

if you can't understand the difference between a simulation of something, and the real thing, then I can't really help you. a simulation is a fake, they don't fake bilevel in the lab, they use a REAL bilevel in the lab. it may not matter to you, just like telling people to look for numbers they won't find on the machine apparently doesn't matter to you, but it may very well matter to the person you're talking to.

Now, we can start a pointless argument from here on, palerider. Or, me having made my point, I can leave it there. And you - you might be content with me saying, 'I take your point.' And you might leave it there.

You've been contributing to this forum longer than I have. I will follow your example.

do you feel better, now that you've had your bitch session? let's hope so.

[Gcfcos]

Morning guys, sorry if I've caused any arguments here! Must apologise for my brief posts above, they weren't meant to be that short but I was going to bed and just wrote them quickly. On a brighter note my events last night were down to 6.8 so that's a good drop from 24 and 14 I got the previous nights. Still woke up feeling like crap Mind!

[Gcfcos]

Well last night events were back up again to 16! Woke up feeling like crap and still feel sleepy 3 hours later. Going to phone the clinic in a minute as getting real upset with it now. I'll post last nights graphs on here later when I get a chance