some newbie questions

[wingfield65]

hello all,

I've been browsing around the forum a bit and see quite a number of very helpful and informative responses. as such, I thought I'd post a question or two and see what folks think. I realize and even accept that one answer would be to see my sleep doctor again. point taken; but I'd still appreciate folks comments.

I am a 50 year old male that was diagnosed with "moderate OSA" in 2008. at that time my pre CPAP AHI was 13 with average O2 of 95.6% with a nadir O2 of 74%. a CPAP was recommended with 7cm H20. like many on the forum, I had a difficult time adjusting and eventually just gave up on it. since that time, both parents and my brother have been diagnosed with OSA ( I don't know the specifics). this has got me thinking about it again. since 2008, a few things in my life have changed. I've lost around 10# and have kept it off. I've also had 2 sets of sinus surgery unrelated to the OSA; but due to some continued sinusitis issues I was having (btw - I breath much better now during the day :>).

here are my questions.

(a) as I've gotten a bit of a renewed interest and relooked at my 2008 exam, it doesn't seem all that bad on the stats. what are folks thoughts on the numbers I've shared? (yep, I get it that we're not doctors, I'm just asking for folks opinions relative to their own experience / numbers and knowledge).
(b) any thoughts as to whether my weight loss and sinus surgery could have improved my situation since 2008?
(c) should I decide to jump back in, can I use the 8 year old machine and simply clean out the humidity chamber and hoses?? I plugged it in and it still works fine.

thank you all for your comments.

David

PS - my machine is a Respironics REMstarPro M series : model 1051158 with a heated humidifier.

[robysue]

(a) as I've gotten a bit of a renewed interest and relooked at my 2008 exam, it doesn't seem all that bad on the stats. what are folks thoughts on the numbers I've shared?

The stats you cite are:

I am a 50 year old male that was diagnosed with "moderate OSA" in 2008. at that time my pre CPAP AHI was 13 with average O2 of 95.6% with a nadir O2 of 74%.

That's a pretty low nadir O2 reading. As in a really low reading. But the relevant questions that are not answered by the data you post are:

How much time did you spend with an O2 level below 90%?

Is the nadir O2 = 74% a possible artifact?

You also ask:

(b) any thoughts as to whether my weight loss and sinus surgery could have improved my situation since 2008?

The short answer is: Maybe or maybe not. There's just no way to tell if losing the 10 pounds was enough to control your apnea or not.

You have to understand that not everybody's apnea is caused by being a bit overweight (or even a lot overweight). I've got moderate OSA (diagnostic AHI = 23) and I'm a 5'1" female who weighed between 105 and 110 pounds when I was first diagnosed with OSA. So excess weight is certainly not the cause of my apnea.

There's only one way to really tell whether losing the weight was enough to bring your mild OSA under control. And that's to have another sleep test. Given the family history of both parents and a brother all being diagnosed since you were diagnosed, it sounds like there may be more going on than just weight issues. OSA does run in families. And while the correlation between OSA and weight problems is strong, the causation is much more muddled: There is evidence that untreated OSA can cause weight problems in people who are at normal weight when the OSA first develops. And, of course, there's also evidence that weight gain can cause some people who don't normally have an issue with OSA to develop a problem with OSA.

(c) should I decide to jump back in, can I use the 8 year old machine and simply clean out the humidity chamber and hoses?? I plugged it in and it still works fine.

The biggest problem that I see is that you will need a new mask. And a mask requires a script. And depending on where you happen to live, your 8 year old script may not be enough to allow you to purchase a mask. (In NY you now need a new script every single year in order to purchase masks.)

The next thing you should be aware of is that the REMStar Pro M-series does record efficacy data, and at the time it recorded what was considered full efficacy data. But to read all the data that your machine records, you need a specialized card reader and the Encore software.

[wingfield65]

Hello Sue,

thank you for answering some of my questions. I very much appreciate it.

How much time did you spend with an O2 level below 90%?

3.6 minutes out of 4.8 hours of sleep.

The biggest problem that I see is that you will need a new mask. And a mask requires a script.

I have a spare mask / nosepiece from 8 years ago. but just curious, why a new mask. can I not just clean the old one, or is there a different issue you're concerned about.

The next thing you should be aware of is that the REMStar Pro M-series does record efficacy data, and at the time it recorded what was considered full efficacy data. But to read all the data that your machine records, you need a specialized card reader and the Encore software.

I feel like you're telling me this for a reason. is there an implication here; other than that I could order said card reader and software and check out the data?? btw - could I use the opensource "sleepyhead" software that I've seen referenced on some posts?

thank you again for your thoughtful responses.

David

[robysue]

The biggest problem that I see is that you will need a new mask. And a mask requires a script.

I have a spare mask / nosepiece from 8 years ago. but just curious, why a new mask. can I not just clean the old one, or is there a different issue you're concerned about.

Even sitting around in a drawer, the material in the cushion seal can loose its resiliency and become much harder to seal correctly.

The next thing you should be aware of is that the REMStar Pro M-series does record efficacy data, and at the time it recorded what was considered full efficacy data. But to read all the data that your machine records, you need a specialized card reader and the Encore software.

I feel like you're telling me this for a reason. is there an implication here; other than that I could order said card reader and software and check out the data?? btw - could I use the opensource "sleepyhead" software that I've seen referenced on some posts?

Sleepyhead does not work with the M-series machines. You would need Encore. There are ways to get Encore for free, but Encore is a pain in the butt to use.

The main reason I'm bringing this up is that the M-Series data is good data, but not as good as the more modern machines. In particular, when you look at the M-Series data in Encore, you do have a table that indicates when each event happens, along with a leak curve. But the M-Series does not try to distinguish between CAs and OAs. And it does not record the flow rate data, so you can't drill down an look at the actual breaths or determine how long a particular event lasted.

But the bigger issue is the proprietary data card: If you want to look at the detailed data, then you have to have a proprietary card reader for that card as well as a working card. And because the M-Series was discontinued about 6 years ago, those cards and card readers are kind of hard to find now.

And then there are a few new patient comfort features that may or may not be of use to you: The newer machines can be used with heated hoses, which some people find more comfortable. The humidifiers can also take the ambient conditions into account and hence minimize the risk of rainout.

All that said, the M-series is a machine that can deliver excellent therapy and if you want to just use it because you've already got it, that's fine. If you want to try to look at the detailed data in Encore, we may be able to help. Certainly we can point you in the right direction to find a copy of Encore. But whether you will be able to find the card reader is another issue.

[wingfield65]

Wow! I'm just amazed at the knowledge you've been kind enough to share. thank you.

any comments on the time below O2 of 90% question that I answered.

thank you.

[robysue]

Wow! I'm just amazed at the knowledge you've been kind enough to share. thank you.

any comments on the time below O2 of 90% question that I answered.

thank you.

Unfortunately neither I nor my husband had any serious O2 desats with our untreated OSA. So other than knowing that there is concern for O2 levels that drop below 90% and that there's a lot of concern for O2 levels that drop below 80%, I really can't help you.

You might want to start a new thread with the title: Questions about O2 desats on diagnostic study. You can provide a link to your first post in this thread so that you don't have to retype all the background information.

[palerider]

Wow! I'm just amazed at the knowledge you've been kind enough to share. thank you.

any comments on the time below O2 of 90% question that I answered..

three or four minutes < 90% without cpap over four+ hours isn't anything to worry about