UK advice please (PLMD new dx)

[JustBreathe234]

Well I think I chose well. Saw Doc and he said i could just take a loan CPAP away to try, and be monitored. I think Rik or Jas said that's like a sleep study anyway? The machine is the ResMed Airsense 10 autoset. I'll see the technician again in 2 weeks for results and to decide if to buy the machine but can call her anytime inbetween if there's issues. I'll probably switch my NHS care to there tbh. They have 17 technicians whereas where I was going has 1. Big difference! They do regular follow ups, have a specific sleep disorder centre and she was shocked I had such an old style mask - Resmed Mirage Quattro.

So good luck me trying it tonight. Can I hook into an app with it do you know? The sleep centre has linked with it but how would I?

[rick blaine]

Hi JustBreathe234,

Sounds like a flexible and reasonable practitioner.

And yes, using a machine that collects data in detail is, in effect, a continuous sleep study.

With such a 'data compliant' machine, when you go for a follow-up, whether it be after two weeks or after a year, they don't give you a diagnostic sleep-study kit (thing on the finger, tube round your chest, cannula in the nostrils), and have you go through all that again. They just take the SD data card from the machine, plug it into their computer, and see in great detail how you've done.

You didn't know that was possible because the machine you had before, the Icon, didn't collect that much data. (And that does raise the question: how did the sleep-medicine department do follow-ups?)

MyAir gives some information – but not as much as the shareware.

You have to register on-line with ResMed to get started. See here:

https://www.resmed.com/us/en/consumer/a ... myair.html

However, you should know that the above website will be off-line on Sunday, 10 November, and Monday, 11 November, for site mantenance. Details here:

https://myair.resmed.com/CountrySelecti ... rectPage=0

The machine itself gives some data via its 'Sleep Report. You can see on page 21 of the manual how to access that. And you can download the manual for free. I'd give you the link, but I don't have it to hand. Perhaps some kind soul will add it here.

[JustBreathe234]

Honestly I can't wait to go to sleep tonight. lol Hope I'm not disappointed.

Previous sleep dept used to get you to take your data card in, but even then they could really only see time used. TBH they never followed me up even, machien never been serviced since 2013... The Tech today asked me if they also did a sleep study once you had the machine to make sure it's all set up right and I said no. Honestly feel like I've been a bit sold down the river by previous NHS Dept. Really not sure my treatment was ever optimised from the start but I spose that was a few years ago anyways. I should fairly easily be able to get re referred to (East Grinstead) these new guys who seem a whole lot more thorough and accessible in time. Plus they don't hand out F&P stuff.

I'm used to an unserviced 11 pressure and this machine has been set for 8 - 15 so will be interested to see how it goes with those levels. I tried it there and it felt a bit stronger but not sure what pressure it was on. Might go back to leak issues. haha

In that this is a loan machine, can I still register with ResMed? Would it matter I will be getting another machine in a few weeks?

[JustBreathe234]

I'm a Mac user so seems I can't use OSCAR? Have downloaded Sleepyhead. Dang the myAir Resmed app isn't available in the UK. Boo.

[rick blaine]

I know the people at ResMed UK a fair bit because (a) I'm a member of their club (discounts on stuff) and (b) I chat with them when I buy parts for my Quattro. (My bit of the NHS no longer stocks them.)

But I don't use a ResMed machine (as you can see from my profile below), and I'm not signed up with myAir – so I don't know what the 'rules' are for temporary use or for an on-loan machine.

If you can't use OSCAR, you may still be able to use its predecessor, SleepyHead. And if that is still available, then use it. As far as I know, it's 95 pc the same. (It's what I use. I haven't migrated to OSCAR.)

If you have the software, you can read the SD card as often as you like. And your reading the card won't do anything to affect the sleep centre's later reading of the card.

[Disregard this:] The one thing with the Autoset that's a must to do is, before you put the SD card into your computer, move the little slide button on the card to 'protect'. And before you put the card back in the Autoset, move the slide back to 'open'. [Correction: this precaution applies to the ResMed S9. and does not apply to the Autoset. See the following post.]

And just so you know: the algorithms in the Autoset 'look at' a moving four-minute window. Then, depending on what they 'see', they either leave things alone, or move the pressure up – by 1.5 cm. Then, during the next four-minute window, they either 'see' that that worked, and they leave the pressure as it now is, or they increase it by another 1.5cm. And so on, until the apneas and snores, etc, are prevented.

And there's a similar process for the pressure coming down again. 'Nothing's happened for a while – I wonder if it's ok to lower the pressure by 1.5 cm – let's see what comes of that ... '

Given that you had a fixed pressure of 11 cm before, having a minimum of 8 is a good place to start. And given that you have Ehler-Danlos, setting a maximum at 15 is sensible.

The idea of an auto-adjusting machine is to give you more pressure when you need it, and a bit more comfort when you don't need the extra pressure. And still give you the minimum pressure, because you do need that.

If you find that the higher pressures – by which I mean up around 14 and 15 – wake you up – the simplest thing to do is just turn the machine off ... and then turn it on again. That will send it back to 8 cm. Hopefully, you won't have to do that very often – if at all.

[Pugsy]

Write protection or locking the SD card prior to putting them in the computer is ONLY needed for ResMed's S9 models.
The AirSense/AirCurve 10 models don't need to have that extra step done.
Only the S9 models had a problem with the little text file some operating systems would put on a SD card causing them to reject the card.
Respironics machines (or any of the other brands except ResMed) never had a problem with that text file and now the newer ResMed models don't have a problem. So the write protect warning really only applies to S9 model users. Doesn't hurt to write protect it but it's an extra step that is unneeded.

I doubt if you would be able to register the loaner with MyAir and get your data that way. Registration is tied to serial numbers and it's very possible that the loaner serial number machine will already be tied to someone else. It takes a lot of hurdles to jump through to get a machine registered to someone new....and more than likely much longer than you would have the machine anyway.
No great loss though...what it would show you is what you can see on the machine's LCD screen.
The default is for a 30 day average but the time frame for the sleep report can be changed to 1 day if you wish.
Just remember anytime power to the machine is interrupted it will default back to 30 day reporting.

There is a Mac version of OSCAR but you can use the SleepyHead version you downloaded if you wish. OSCAR is based on SleepyHead anyway. Only real advantage to OSCAR might be download speed so that the importing of the SD card contents won't take as long.

[JustBreathe234]

<r>There's an EU ResMed site on my laptop I've registered on that I can see results like you would in the app. You just put in the serial number and number of the machine. I assume you can change that to a different machine as necessary... I'll try find the OSCAR Mac link if you think that's better than Sleepyhead. I'll check back here before unlocking the SD card, in case I fluff it up. <br/>
<br/>
That's good advice about the higher pressures. Pretty sure mine used to be up to 13 or so but I had it lowered due to issues with my stomach hernia. I tried it in the living room as a dry run and it's quite different from the full on permanent pressure so hopefully it doesn't just up to high too fast and give me a jolt. <E>:P</E></r>

[Jas_williams]

Oscar woks absolutely fine on a Mac unless you have a fairly old version

https://www.apneaboard.com/OSCAR/OSCAR-v1.0.1-macOS.dmg

[Dog Slobber]

I've been using OSCAR / SleepyHead on my Mac for a while.

OSCAR requires 10.12 (Sierra or better)

If your OS is older than you can use SleepyHead 10.7(Lion or better)

[JustBreathe234]

I'll stick to this thread for contunuity I guess.

Well, I much better night but I'm still very tired and fatigued late afternoon having done nothing. Looking at results I think I'm having leak issues which I'm not sure how to address if I'm asleep when they are happening.

You comments on results please? Thank you.

[zonker]

I'll stick to this thread for contunuity I guess.

thank you for sticking to the thread. i encourage others to do the same. it's just easier for the experts to find you.

now, as i'm NOT an expert, i'll bow out.

[rick blaine]

Hi JustBreathe234,

When they gave you the on-loan Autoset, did they also give you a mask – a mask of a different design from the one you are used to? That might explain the leaks.

You said in an earlier post that for the last few years you have been using a Mirage Quattro. And while that design is as least nine years old, it is popular, and seems to adapt itself to a wide range of people.

If these results come from the new machine plus a new design of mask, you might try the new machine with the old design. See what that does.

Other than that, an AHI this low is not to be sniffed at.

[JustBreathe234]

The results are from the new machine and old mask. I've tightened up the straps a tiny bit and think that's helped. Where should AHI be to be good?

Also, all I've wanted to do all day is sleep. Is this as I'm finally not being disturbed all the time? I'm confused.

[rick blaine]

When I first started researching CPAP, I found one doctor saying the treatment goal was an AHI of 10 or less – and only if you had one of a handful of serious illnesses was the goal 5 or under. That was ten years ago.

Most practitioners in the NHS now work to 5 or under, regardless of other conditions.

Most of the regular contributors to this forum – and also the author of Sleepyhead – have better ambitions than that – and say 2 or under.

As to wanting to sleep more, some people do find that, once they get CPAP to work well, they go through a period of sleeping more. But it is usually only for a period.

[JustBreathe234]

So I've worked on mask fit which is alot better and got a 99% on the ResMed Air feature today. Woo, go me. Not half as tired today but very little energy still. I'm assuming that will come with time?

One thing that bugs me is some people with severe OSA can carry on with just some high blood pressure and feeling a little sleepy perhaps. I have what's termed mild apnea and cannot continue life even. Docotrs were very concerned about my oxygen numbers in hospital and insistent I need to use CPAP for even the smallest nap. How is that possible?