There is a new hose head in the family

[BasementDwellingGeek]

My sister had her visit with the DME. I did attend. I wasn't impressed. Perhaps I intimidated her? Never discussed EPR, seemed most concerned with cleaning schedule and about replacing the consumables as soon as the insurance company would allow.

On the good side, an S9 Autoset was issued! The Rx was for 6-16. The DME rep is a former sleep lap tech. She had a copy of the sleep lab report and I asked to make a copy. She said she would email it. I was skeptical but she came through and emailed the report to my sister. In the past I've had to sign release forms to get my own data. I don't recall one was ever presented.

When my sister had her split study the lab tech said she might have to come back. Having access to the the report I can see that Rem stage in Supine position was not achieved during the tritration phase. Hmmm, do you think that is why the lab tech suggested a return trip might be in order?

“[No] discernible alpha rhythms when awake with eyes closed”. It wasn't noted on my study, conducted at a different lab. Is that significant or normal?

N1, N2, N3 and REM were achieved under therapy. Sleep efficiency improved from 52% pretreatment to 73% with treatment. Prior to treatment she never got past N2.

I found it interesting that there was no PLM noted during the diagnostic phase (152 minutes total, sleep period of 135 minutes but only 80 of actual sleep) but did emerge on CPAP. There is no indication of the particulars. More to earn! I'm thinking that a PLM index of 18 is not something I want to have. Is it REM related or deep sleep related? Happen randomly? Related to pressure? Does that 18/hr really mean 70+ in one 15 minute session. I'll discuss it with her and make sure she discusses it with PCP.

When I shared my assessment of her report she replied, "Not sure what it all means, but if I can sleep without tossing and turning and not feel sleepy all day, I am happy." Isn't that what it is all about? Or is it the hokey pokey and shaking?


Cool, too, is the alternate scoring to only include Hypopneas with desats >= 4%. 42 begat 18. Desaturating only on half of your hypopneas can't be a bad thing.

109 Respiratory Arousals pretreatment, indexed to 82/hr. Spontaneous or Non-Respiriatory/Non PLM Arousal were 29 and 21.8 Even with treatment there were 63 spontaneous arousals, split 54/9 nrem/rem.

Way interesting was N3 and REM, both missing in the diagnostic session checked in at 22% and 33%, respectively during tritration.

There were a few, 7, RERAs as well.

O2 level only dropped to 89% during diagnosis. I wonder if she had a few more hours how low that might have gone.

This is a little disconcerting: During the titration there were 52 Apneas, 2 mixed and the rest split almost 3 to 1 Central to OA. There were also 48 Hypopneas. Also, when indexed and classed by body position the ratio is almost 4 to 1 in favor of supine over non-supine. Seems position is a big factor. Maybe I can introduce her to Max's bondage device.

Ooh, a little further down the report PLM gets better treatment. 8 in N2 and 60 in N3. When indexed per hour/stage they come out at 6.9 and 73.5. None in REM. Even further down are some event line graphs. PLM is typically both legs with an extremely rare both legs plus arousal. I may dig up my 2 axis accelerometer data logger to keep an eye on that.

Another section on O2. A tad odd: 82 was the minimum, while awake! Min non-REM 89, REM 92.

While I was there I had her download and install sleepyhead. We went through the process of importing data. The trying it out session didn't record enough data to load. But she at least got through the steps. That was Thursday. This morning we did a Skype session and I tried walking her through what means what. I think we got the basics covered and she is on her way to better sleep. The first night's AHI was 16.15, UGH! I have never been over 3 with treatment. Night 2 was much better at 6.48, still not stellar but way better than 93 or 56, depending on Hypopnea scoring, without treatment.

[nanwilson]

There's two in my family also, son was diagnosed last October and set up with a PR System one (thanks to Mom ) The resp techs kept upping his pressure whenever he complained about anything, he ended up with pressures of 17 until he came home at Christmas for a visit and Mom got him down to 14 ..... and that is where he is today He stopped going to the clinic and now poses me with any questions he needs answered. He monitors his therapy on his own and has actually helped out a friend of his with his new set up. Knowledge is power!!
Good luck to your sister on her quest for better sleep..... she has an expert on her side so should do very well.
Cheers
Nan

[Sir NoddinOff]

BasementDwellingGeek: You're the kind of person DMEs and sleep techs have nightmares about. Just kidding. Your sister is lucky to have you along for the ride.

[chunkyfrog]

I don't suppose you can submit a bill to her insurance.
You may have earned more than some who were paid.