Not new to CPAP; mixed apnea and desperate for correct equip

[Guest]

if it would be for xxyzx everyone would get an "auto"-ASV without any kind of data-capability and an Oxymeter attached to it - plain and simple.

if the mortality would rise due to heart failure that would be the making of the democrats. The world can be really easy sometimes.
In the end it was xxyzx who kept saying "One size fits all - ASV and an oxymeter for everyone", wasn't it?

Wait for the moment he reads up on the intubated ventilation ... might get his new "thing".

[Pugsy]

Folks....I got a private message from the OP in this thread.
She's very upset about the tone and wanted me to delete the entire thread.
Obviously I can't do that.

I admit I am partly to blame because I have tried to clarify mr know it all's incomplete information. I am really torn between ignoring him totally but his rants and attacks on me personally are uncalled and his assuming facts not in evidence and offering ideas that simply are inappropriate at this stage of things could potentially cause undue stress or anxiety or down right hurt someone so I haven't kept my mouth shut here.
I don't know what to do.

At any rate...I don't know if Aspen will be back or not. Some people can't handle the bitching that has gone on in this thread and I make my apologies for my part in it but I don't know what to do.

Yeah, Aspen may indeed need ASV...I don't know and won't have any sort of idea until we see some sort of documentation from something...sleep studies/software reports, etc.
Hell, she might even blatantly need one but the cold hard fact of life is she doesn't have one right now and no amount of saying "she should get ASV" is going to make one fall out of the sky and land on her door step.

She's got a machine...may or may not be suitable for her needs but let's at least try it and see what happens. It's the only hand at this stage of things..it may or may not be a good hand but it's all we have.
I prefer to actually try to help...even if it fails we have at least tried.

So now I wait to see if Aspen contacts me again. I will do it privately if needed if the tone here is too upsetting and I won't be directing any responses to mr know it all here anymore. It's like talking to a brick wall and I am done with it.

My apologies to everyone for my part in the ugliness.

[Pugsy]

if it would be for xxyzx everyone would get an "auto"-ASV without any kind of data-capability and an Oxymeter attached to it - plain and simple.

if the mortality would rise due to heart failure that would be the making of the democrats. The world can be really easy sometimes.
In the end it was xxyzx who kept saying "One size fits all - ASV and an oxymeter for everyone", wasn't it?

I hear you and agree.
He's spouting off potentially dangerous stuff which scares the hell out of me and doing it without knowing any facts at all. No medical history...no actual sleep study results...no nothing in terms of actual facts in evidence.
That's why I haven't been able to ignore some of what he said.

[TASmart]

I strongly support the forum owners make an exception and ban XXYZX - He is out of control disruptive, distorted, and dangerous. He will destroy this forum if allowed to continue. Jonnie Goodman are ya listening?

[aspen]

OH MY! Pugsy, it's all good! I was referring to some attempts I MADE at 4 a.m. this morning to respond to posts. I wasn't logged in, it went through as guest, I repeated it, then logged in ... blah blah. I wanted you to delete all my feeble attempts to respond to posts.. And it looks like NONE of them went through?

4 a.m. is NOT a good time for me .

Anyway, no, it's all good. I certainly see some infighting but hey, welcome to the world and the 'net.

First night with Dream Station. I do not want to like this machine. It is more cheaply made (the hose looks and feels like I should be able to get it at a dollar store). The display doesn't dim, and it's not nearly as user friendly. SO MUCH SCROLLING! I had to set the base pressure higher than the resmed, because the increases aren't fast enough (and according to my suspect app, I'm still not hitting REM but I'll get that sorted when I figure out the sleepyhead software). At this point, that's my only technical concern with the Dream Station -- slow titrations upwards. And maybe I'm wrong? PLus there is no information on the screen at all. And from what I saw with the APP, not much more. I was a scientist and geek out on the technical bits.

BUT (and it is a big one), the different algorithm on the exhalation relief (cflex vs. EPR) is MUCH better for me. Apparently the increase in pressure after EPR on the resmed machine is triggered by one starting to inhale. That bit is a problem with me because sometimes I just don't inhale. I had experimented the last night with the Resmed, just by holding my breath. It pokes at you, waiting to increase the pressure, but doesn't get going UNTIL YOU BREATHE. When this happens when I'm asleep, I just wake up. Whether it's central or an airway collapse, I'm awake.

The Respironics algorithm intiates the pressure increase after exhalation in a time based fashion. When it expects you to take your next breath, it increases the pressure. So no bottoming out for me. This may make a bigger difference for me that I'd imagined.

Now to figure out the software. I have the card reader etc. but a busy couple of days. I'm hoping, before I return one or both units, I can get downloads on each, plus put myself in situations that make my current equipment bottom out to see how the APAPs handle it.

I really appreciate everyone's help! And I'm so sorry Pugsy for not being clear in my pm to you this morning!

[Goofproof]

OH MY! Pugsy, it's all good! I was referring to some attempts I MADE at 4 a.m. this morning to respond to posts. I wasn't logged in, it went through as guest, I repeated it, then logged in ... blah blah. I wanted you to delete all my feeble attempts to respond to posts.. And it looks like NONE of them went through?

4 a.m. is NOT a good time for me .

Anyway, no, it's all good. I certainly see some infighting but hey, welcome to the world and the 'net.

First night with Dream Station. I do not want to like this machine. It is more cheaply made (the hose looks and feels like I should be able to get it at a dollar store). The display doesn't dim, and it's not nearly as user friendly. SO MUCH SCROLLING! I had to set the base pressure higher than the resmed, because the increases aren't fast enough (and according to my suspect app, I'm still not hitting REM but I'll get that sorted when I figure out the sleepyhead software). At this point, that's my only technical concern with the Dream Station -- slow titrations upwards. And maybe I'm wrong? PLus there is no information on the screen at all. And from what I saw with the APP, not much more. I was a scientist and geek out on the technical bits.

BUT (and it is a big one), the different algorithm on the exhalation relief (cflex vs. EPR) is MUCH better for me. Apparently the increase in pressure after EPR on the resmed machine is triggered by one starting to inhale. That bit is a problem with me because sometimes I just don't inhale. I had experimented the last night just by holding my breath. It pokes at you, waiting to increase the pressure, but doesn't get going. When this happens when I'm asleep, I just wake up. Whether it's central or an airway collapse, I'm awake.

The Respironics algorithm intiates the pressure increase after exhalation in a time based fashion. When it expects you to take your next breath, it increases the pressure. So no bottoming out for me. This may make a bigger difference for me that I'd imagined.

Now to figure out the software. I have the card reader etc. but a busy couple of days. I'm hoping, before I return one or both units, I can get downloads on each, plus put myself in situations that make my current equipment bottom out to see how the APAPs handle it.

I really appreciate everyone's help! And I'm so sorry Pugsy for not being clear in my pm to you this morning!

Way to go, good post! Welcome Jim

[Pugsy]

No problem...I was totally confused though...obviously because I didn't see anything from you as a guest in the thread.

There is some half assed data on the LCD screen on the machine. You just have to turn it on so that you can see it.
In the clinical menu there is a menu choice for "Show AHI"...that needs to be turned on to see the data available on the screen.. The default from the factory is off. To be honest...not much in detail but some....basic overall AHI and how good the leak management was. It shows time without large leak...so if it shows 100 that's 100% of the time you never hit large leak territory.
Do you know how to get to the clinical set up menu area? If not...
http://www.apneaboard.com/dreamstation- ... structions

The slower response time in general for apnea prevention (compared to ResMed's) we can work around it a bit by tweaking the settings a bit. Mainly just give the machine a little more baseline pressure.

I am itching to see some reports so when you get SH up and running...see if you can share a report (oh...you can use one user profile for both the ResMed and Respironics in SH if you still have the ResMed with the SD card).

How to post images.
https://sleep.tnet.com/reference/tips/imgur
and how to organize...3 pages to read so be sure to hit them all. DON'T do the full screen toggle thing...there's a bug in SH with it and some people get it and the screen won't back out of full screen easily...big PITA to fix it.
https://sleep.tnet.com/resources/sleepyhead/shorganize

SH will give you a lot more graphs than we need so look here for some examples to start with.
Just do the basics and if we need something else we will ask.
viewtopic/t103468/Need-help-with-screen-shots.html

You can get the basics all on one screen shot...saves time and work.

Question for you because it was unclear from your past comments. The centrals that were mentioned ...were those happening before you started cpap therapy or did they just pop up after you started cpap therapy or when they were doing the titration sleep study (if you had one)?
Was was the procedure(s) done to establish sleep apnea? Home study...in a lab...when were the centrals first spotted?
Was there ever any mention of how many? Were they related only to sleep onset or happening all through the night even while sound asleep?

A handful of centrals might not be that big of a deal...it all depends on how many and how long they lasted and do they disturb your sleep.

Do you by chance have a copy of the initial sleep study results? It would really help me to have a better idea what is going on in your situation if I had more detailed history. You can send it to me privately if you have it and if you wish. I don't mind PMs at all.

[aspen]

There are a lot of graphs. Could someone please take pity on this very confused person and send me a link to what and how to screen shot the results? Apnea numbers low, about half and half clear airway/obstructive. I see the screen shot F12 button but the screen is truncated.

I'd like to print out details for me, but also what would I show here to get some help?

It looks like the majority of my apnea was at the same time as I tried to go into REM sleep (and failed, and woke up x 2). (Determining using my Sleep Cycle graph as well).

Had a brief time of periodic breathing, whatever that is. Important?

Thank you all .

[Pugsy]

See my post immediately prior to yours for links on how to do the images along with examples of what we like to see.

PB is periodic breathing is just a waxing and waning of the air flow that lasts for at least 2 minutes.
CSR is Cheyne Stokes Respiration which is a form of PB but not the only form of PB. It constitutes a certain patter and depending on the pattern and if there are any events associated in that pattern we pay close attention. Sometimes CSR is known to be associated with people who have heart disease...but the presence of CSR doesn't necessarily mean that a person has heart disease....so sometimes it scares people needlessly. We don't ignore it but we don't panic either until some detailed detective work is done. More on that later once I see your reports.

In general if the PB time is very brief...nothing to worry about though especially if no apnea events were flagged during that time frame. It might just be awake breathing irregularities getting flagged.. It's when we start seeing a lot of it and it looks a lot like CSR that we start paying more attention.

What operating system on your computer? I have Windows and use the Snipping Tool for screen shots...much easier and I get things cropped at the same time and I can find it easily because I save them to my desktop.

[aspen]

Calling for a truce on this thread. Please go play elsewhere, both sides .

[TASmart]

Sorry Apen, but it is an unmoderated forum.

as for xxyzx I am far from liberal, never voted Democratic in my life and mostly lean towards libertarian. As far as retarded, three degrees would dispute that, and I like to think my posts dispute that to anyone who can read at at the kindergarten level. I know that leaves you out, but hey that's the way the cookie crumbles. I will end this now as I am trending to direct insults and profanities faster than I can contain my emotions.

[aspen]

Sorry Apen, but it is an unmoderated forum.
.

Okay! Just makes it a loooong thread to plod through looking for info in a sleep deprived state.

[TASmart]

In the words of Curley hey xxyzx I crap bigger than you.

[aspen]

So I've now spent two days using the Dream Station. I have a SIGNIFICANT improvement. AHI looks about the same, but I'm not randomly jerking awake any more. I woke up once last night because my arm was asleep. Today for the FIRST day in ... 17 months? ... I'm not hitting a wall of fatigue at this time. I'm still not sleeping very long but getting more out of it, for whatever reason. I am hoping that over time, and adding in sleep hygiene techniques, I can reach 7 hours .

I'm feeling hopeful that I DON'T need an ASV or even a bipap at this point. As pointed out earlier, without significant lung disease it's almost impossible to get one in this province. The difference (and apparently it can be a big one) is in the EPR vs. Cflex. The second algorithm definitely works better for me.

I will continue with this one through next week to make sure, and will test it out (there are some medications that really affect my ability to remember to breathe; going to take them one night to make sure this can handle it).

Downloading the SleepyHead software helps with the annoyance that the data management on the Dream Station is sort of pathetic. The fact that the hose feels like crepe paper I guess I'll just have to live with .

Thank you SO MUCH to Pugsy, who helped me figure out the SleepyHead software and get it running. This is a great and very helpful forum!!!

[TASmart]

So I've now spent two days using the Dream Station. I have a SIGNIFICANT improvement. AHI looks about the same, but I'm not randomly jerking awake any more. I woke up once last night because my arm was asleep. Today for the FIRST day in ... 17 months? ... I'm not hitting a wall of fatigue at this time. I'm still not sleeping very long but getting more out of it, for whatever reason. I am hoping that over time, and adding in sleep hygiene techniques, I can reach 7 hours .

I'm feeling hopeful that I DON'T need an ASV or even a bipap at this point. As pointed out earlier, without significant lung disease it's almost impossible to get one in this province. The difference (and apparently it can be a big one) is in the EPR vs. Cflex. The second algorithm definitely works better for me.

I will continue with this one through next week to make sure, and will test it out (there are some medications that really affect my ability to remember to breathe; going to take them one night to make sure this can handle it).

Downloading the SleepyHead software helps with the annoyance that the data management on the Dream Station is sort of pathetic. The fact that the hose feels like crepe paper I guess I'll just have to live with .

Thank you SO MUCH to Pugsy, who helped me figure out the SleepyHead software and get it running. This is a great and very helpful forum!!!

Great! Sure is nice to get a good nights sleep isn't it! I know in my case, knowing that certain meds effect your desire to take a breath sue makes me cautious, always try to look up known effects, and the Sleepyhead makes it good to see what's going on with sleep. Best wishes and good sleeping.