Help with Patient led titration?

Rachael · Post by **Rachael** » Sat Feb 24, 2007 12:02 pm

First off, thank you all so much for your wisdom and advice. I am well into my second month of pap-ing and it seems to be going okay.

I have a Respironics M series auto, a humidifier, and two nasal masks, both give me sores on the bridge of my nose, but in different places, so I alternate. One is a comfort gel and one is a ... shoot, I forgot. It's a resmed, just a normal nose mask I guess.

I don't have apnea, I have upper airway resistance syndrome, and the auto seems to just hang out at the lower level of my range, it's always at the lowest setting when I wake up, and only occasionally bumps up as I am falling asleep, but I don't have a card reader or software yet, so I don't know the details. My doctor agreed to let me try patient-led comfort based titration, I never got to the second half of my split study because I didn't accumulate enough sleep, and the overnight tech didn't catch the UARS. I probably should do a titration study, but if I can figure it out on my own that seems better. I was rated severe with an arousal index of 35.

So my questions for all of you smart folks are:

How do I go about getting a card reader and software? I have a card.

Do any of you use a sleep assessment tool other than the Epsworth sleepiness scale that you think is useful for tracking my progress? Or should I create my own? Is there benefit to using something with history? Or do I care since I am only doing this for my own benefit?

I already changed the range on my auto from the 4-20 that my DME set it at to 6-14, though I don't think my pressure has ever gone above 7 or 8. Hard to know without a card reader. Somehow the DME lost my original card and the data from my first 4 weeks.

So, the next step is to change my bottom end to 7, and record my subjective sleep results for a week or two, and then up to 8, etc.

What would you all track?

Thanks again.
Rachael

NightHawkeye · Post by **NightHawkeye** » Sat Feb 24, 2007 12:27 pm

Rachael wrote:How do I go about getting a card reader and software? I have a card.

Here ya go:
https://www.cpap.com/productpage-bundle ... undle.html

After you look at the data, the changes you need to make may be obvious.

Regards,
Bill

Rachael · Post by **Rachael** » Sat Feb 24, 2007 12:33 pm

Thanks!

Linda3032 · Post by **Linda3032** » Sat Feb 24, 2007 2:01 pm

Could someone with the M series machine tell Rachael how to access her LCD data?

Rachael, you machine is storing info on what pressure you are averaging. It also shows apneas you might be having. Not as much info as the card reader and software, but important data nevertheless.

pedroski · Post by **pedroski** » Sat Feb 24, 2007 2:40 pm

Hi Rachael,

Another thing to get is James Skinners software:

MyEncore doesn't fully work with M Series machines (and the required Encore Pro 1.6). Might I humbly suggest trying Encore Pro Analyzer? http://james.istop.com/EncoreProAnalyzer/

-james

Unfortunately it doesn't work on Resmed machines, but for you it will be a big help.

Also your idea of keeping a log to record subjective sleep data is a great idea to help you nail your treatment.

Good luck.

Peter

Gerald · Post by **Gerald** » Sat Feb 24, 2007 6:27 pm

Buy the card reader and the Encore software from Cpap.com and download (free) the Analyzer software from James Skinner.

James has done a good job on his software....it's quality work. Send him a few bucks after you've used it and benefitted by what he has done.

The above is all you need. You'll be amazed by what you see......and how you'll be able to manage your own treatment.

RoseY · Post by **RoseY** » Sat Feb 24, 2007 7:07 pm

Linda3032 wrote:Could someone with the M series machine tell Rachael how to access her LCD data?

Rachael, you machine is storing info on what pressure you are averaging. It also shows apneas you might be having. Not as much info as the card reader and software, but important data nevertheless.

You just need to press either of the arrows on the control panel to scroll through the LCD data. It will show average pressure, AHI, leaks, hours of use, etc.

Rachael · Post by **Rachael** » Sun Feb 25, 2007 12:01 pm

Thanks everyone.

My 90% pressure is 7 (it was 5 when my bottom was at 4)
My AHI is 1.2, but since my AHI was 0 at my sleep study I don't get why I should be having any? Centrals caused by pap? this number hasn't changed since I upped my pressure. Is it those strange half-asleep random stops in breathing I get as I drift off? Does the apap count snores? So much I would like to know! My hope with the card reader is I will get a sense of when the events I am having are happening, and thus more clues as to what is really going on.

My leak rate is 29, which looks like about the leak rate of my masks. I snake a finger under my mask a couple times a night to itch my nose, so I think leak-wise I am doing okay. I lucked out in being a total nose breather, and the stuffiness that I have always had cleared up 100% once I got my pap. Actually it's the most dramatic change of pap for me, a clear nose.

Linda3032 · Post by **Linda3032** » Sun Feb 25, 2007 1:17 pm

Rachael, if your 90% pressure is 7, you might want to drop the high of 14 down to 8 or 9. Even though your AHI is very low, by dropping down the pressure, you might do even better.

According to the info you gave us, I think you're doing very well.

Rachael · Post by **Rachael** » Sun Feb 25, 2007 3:20 pm

Thanks Linda.

The problem is, the machine can't tell if I am having RERAs, and I am waking up a lot at night and don't feel as great as I had hoped. So as I try to search for the pressure that solves the RERAs I am just trying to avoid pressure so high I have centrals. Short of another sleep study there is no way to be certain I am not having arousals, but I figure if I am not waking up, and I feel good, that's good enough right?

Help with Patient led titration?

Help with Patient led titration?

Re: Help with Patient led titration?