Are certain machines better at dectecting hypopneas?

[pivot]

I am having problems getting adjusted to Cpap. When diagnosed w/OSA last month the sleep report stated I only have hypopneas, no apneas. Well. with my Remstar Auto M Series, I still feel that shallow breathing feeling which is what brought me to the Dr. in the first place. I have 2 theories:
1) Either my pressure is too low-it is in Cpap mode starting at 4
2) It is just not detecting my hypopneas.

So.....Are some machines better suited to detecting Hypopneas.

I need all the advice I can get. I saw on another site some machine called AutoSet Spirit w/a reslink module that was supposed to be good for hypopneas. Has anyone heard of the reslink module??

[Wulfman]

Pivot,

Could you please tell us more about how you have your machine configured. A bottom setting of 4 is way too low in my opinion....and depending on your titration (prescription) number, the machine may not be able to get to the number it needs....in time. This is no reflection on the machines capabilities, but in the way it's configured.

Best wishes,

Den

[bdp522]

Welcome to the forum!
I'm no expert but I know that in cpap mode it will just blow at 4 all night. You need to be in apap mode for it to increase the pressure in response to hypopneas. I haven't heard of anyone with a cpap pressure as low as 4.
If you fill in your profile so we can see what machine and mask you are using it will help us give you better answers. The more info you can give from the sleep study the better.(AHI, # of hypopneas, Oxygen levels, etc)
I'm sure someone with more experience will be by shortly to give you more help.

Brenda

[dsm]

In a discussion here last year, I raised an issue in that one brand of auto was reporting data that just didn't resembled the data from another brand of auto despite both being set to the same pressure range (12-16 cms).

I believed then (as I do now) that the discrepancies between data from the two brands was of some concern (certainly to me)

The main issues for me were 1stly the AHI reported by one machine was no where near the number reported by the other. There was something like a factor of 8 to 10 difference. That led me to wonder which machine I should believe.

The other point that concerned me was that one was reporting (for example) a HI of 0.3 & an AI of 4.6

While the other might report (used the next night)
an equivalent pattern of readings (allowing for that lack of matching ranges anyway) with a HI of 4.0 & an AI of say 0.8 - I found that 'reversal' of interpretations disturbing.

One of our regulars at that time pointed out that the differing algorithms between brands meant that what one auto interprets and reports on is going to be different from another. To me that was not a good enough explanation.

Since then I have always described to people here that the data see in your reports is not scientic but it is relative & that if you stick with the brand you have and gather the data that is what counts.

In summary, I am advising that the data you see is an indicator as interpreted by that brand of machine & may differ greatly to another.

Good luck

DSM

[pivot]

I am replying to the poster who asked for more info. During my study I had an RDI (is that the same as AHI) of 52.2, lowest Sao2 was 92.0. They did a split night study and only got to 6 but I still had an RDI of 15, I guess time ran out. My Apap is set I think just 4min-20 max, c-flex at 3. But I want to up the pressure to start at 6.
I thought my profile was filled in-
RemStar Auto M Series, Swift Mirage, Heated Humidifier-no software yet.

By the way, I have had my Apap for a month and have not been able to fall asleep with the machine on yet. I feel like I am breathless-it is scary to fall asleep with the machine on. I really am trying to avoid meds to help me.

[Wulfman]

Pivot,

A beginning setting of 4 would be scary for me, too. I would feel suffocated at that pressure.
I would (at least) bump that bottom number up to 8 or 9.

Hope that helps.

Den

[pivot]

The clinician menu was left in w/my machine and I know how to up the pressure. Do I need to check w/my DME first. I thought I would start w/6 because I usually sleep on my side, but during the titration study it said I was on my back the whole time-so I would think I would have more events on my back. Did that make sense??

[dsm]

I am certain you will find that most of the long time regulars experienced with Autos, will advise you to narrow your pressure range gap 4 to 20 is scary.

the absolute max I would set would be 3 down 2 up from my titration pressure.
What I would most likely set it to is 2 down 2 up if I was using c-flaex (at 2) at the same time.

That wide open range will do you no good.

Cheers

DSM

[Wulfman]

Pivot,

Yes, it does make sense.
As long as you know how to set the machine.....I would "have at it".
If you want to start with 6, go ahead. And, if that isn't enough....keep going.
You shouldn't have to check with the DME......this is YOUR therapy.....the DME isn't the one who has to sleep with it at night.
Sleeping in the supine position (on your back) is supposedly the worst for having events. Side-sleeping is better.

Hang in there!

Den

[dsm]

The machine you have is quite adequate - just needs adjusting.

The Resmed with Reslink will not help you. Reslink is a module that has a built in Pulse Oximeter & that is not going to give you data that helps your breathing.

If 'shallow' breathing is a real issue, you are beginning to be looking at a Bilevel possibly with timed control (Bipap, Bipap S/T, Vpap, Vpap S/T, PB425).

If you have constant sinus difficulties (slow airflow when nasal breathing) and you decided you wanted to try a Bilevel do a thorough comparison beteen the brands before making a choice. They behave quite differently for people with restricted airflow through the nose and some brands may just not suit you.

Cheers

DSM

[rested gal]

Pivot,

Yes, it does make sense.
As long as you know how to set the machine.....I would "have at it".
If you want to start with 6, go ahead. And, if that isn't enough....keep going.
You shouldn't have to check with the DME......this is YOUR therapy.....the DME isn't the one who has to sleep with it at night.
Sleeping in the supine position (on your back) is supposedly the worst for having events. Side-sleeping is better.

Hang in there!

Den

Pivot, I think Den is giving you very sound advice. I agree that you should raise the minimum pressure to 6, and if that doesn't feel like you are starting out with enough air (it probably will feel fine), I'd up it again to 7.

If it were me, I'd probably try a range of 6- 12 or 7 - 12 for a few nights. How high you set the maximum pressure isn't all that important, imho, as long as it's high enough that you are not hitting it. It helps to have the Encore Pro software to get an idea of what the pressure is doing.

Raising the lower pressure up enough so that the machine is not having to move up and down much will usually give better treatment, to my way of thinking.

One other thought, Pivot. Since you are using an M series autopap, ramp may have been turned on. Either turn ramp off or set the ramp starting pressure to 6 or 7 also, whichever minimum pressure you decide to use for the minimum in the range.

[pivot]

What are those machines?? Vpap/Bipap etc.

How do I know if the shallow breathing is a real issue. I have an ENT right now who is "treating" my OSA. He is not a sleep specialist, but he did say during my visit, "well it looks like you are not breathing at all during the night". I feel like I am on my own with my treatment. DO you think I should go to a pulmonary doctory/sleep specialist-because my problem is with shallow breathing.
I really appreciate everyone's advice and suggestions. I could use all the help I can get.