2 newbie questins while Doc is on vacation.

[jtoast]

Hello all!

I'm new here but have been doing quite a bit of research over the last several days (read through your wiki and the green jacket links along with other sites and resources) and would like to pick the communities brain regarding questions I haven't been able to find an answer to. Feel free to post a link as an answer if I somehow missed a FAQ while searching. I just got my sleep study results but my doctor is on vacation for the next two weeks or I would ask him.

Questions: 1) My second test mentions "A tendency towards paradoxical breathing with marginal oxygenation even in the absence of overt sleep-disordered breathing." I looked up paradoxical breathing and it seems to be that my chest rises when I exhale and goes down when I inhale (opposite of normal.) I assume this is causing my lowered O2 levels even in the absence of events. Is this a common sleep apnea symptom that will hopefully resolve itself over time if I use my machine or is this a separate concern?

2) My Dr. wrote my prescription for a ResMed S9 (auto) with heated humidifier and a SoftGel Mirage mask. Unfortunately my dr. is really only a PA and far from an expert on sleep disorders and the wait for his supervising MD would be several weeks. He said that he "looked up CPAP machines and wrote the script for what seems to be the current best on the market." This of course prompted me to run to the internet to do some research which seems to confirm that this is an excellent, fully data capable choice for my condition. Given my results below, are there any other machines out there that would better?

Below are the results of my two tests just in case any of the info is needed to answer my questions:

First test without CPAP:

NREM Sleep: 92% (2%N1, 90%N2, 0%N3)
REM sleep: 8%
# Rem episodes: 3 (170Min latency)
Total time: 526 Min (latency 9 min; efficiency 89%)
Total respiratory Episodes: 164
Apnea Index: 11.6 events/hour
Hypopnea Index (4% desaturation): 9.3 events/hour
Apnea/hypopnea index: 20.9 events/hour (supine 53.1 events/hour)
Lowest SaO2: 85%
baseline: 100%
Mean: 96%
PLMS: 0/hr
Cheyne-stokes: No
Cardiac Events: none

Second Test:

NREM Sleep: 80% (2%N1, 78%N2, 0%N3)
REM sleep: 20%
# Rem episodes: 6 (66Min latency)
Total time: 535 Min (latency 3 min; efficiency 96%)
Total respiratory Episodes: 41
Apnea Index: 0 events/hour
Hypopnea Index (4% desaturation):4.8 events/hour
Apnea/hypopnea index: ovarall events/hour
Lowest SaO2: 82
baseline: 97%
Mean: 90%
PLMS: 0/hr
Cheyne-stokes: No
Cardiac Events: none

[msla]

Jtoast,
S9 Auto is good. Edit: Assuming that since you did not list a pressure or range that the machine is on full auto. Some people have noted that using the full range of pressure from 4-20 cm may take some getting used to and they are happier with a narrower range of pressure. This can be adjusted when you take your data card in to be read after several weeks. At the lower levels you may feel starved for air and the lower limit can be raised. Many people on a fixed pressure are started with the ramp feature set at 4 and increasing over a short period of time to the upper limit. After using the CPAP for a while , many if not most turn off the ramp feature.You might want to request that the prescription for the mask be changed to "mask of patient's choice." Some times it takes a while to settle on the best fitting mask that you are comfortable with.

Welcome to the Hose head society.

Rolf

[Hawthorne]

I get the impression that the OP does not have a machine yet. He has the prescription for an S9 Autoset and the results of his sleep study.

Am I correct?

[chunkyfrog]

jtoast:
Unless your titrated pressure is unusually high, GRAB that Autoset before somebody changes their mind!

[Janknitz]

Looks like the PA did some great research and chose the top of the line best machine out there on the current market. The only thing that I would recommend changing is to make the prescription for "mask of patient's choice" as that mask may or may not work for you in your own bed and sleeping conditions every night

You want to be able to choose any mask, so that you can find the best mask for you to use long term. The mask is 90% of being able to tolerate CPAP therapy.

[jtoast]

It is correct that I do not yet have a machine. I have a copy of my sleep study and my prescription in my hand and am currently researching equipment and equipment providers before I go any further. I've found that very few providers are willing to discuss things. Everytime I ask about return policies, repair and warranty, outright purchases, support, etc they all think I should settle for "don't worry about that...we will deal with it if it happens." It seems to annoy them that I'm not settling for generic, noncommital answers...lol.


Adding the phrase "mask of patient choice" is a good idea. I will get that change made. Other than that it sounds like the S9 is a good choice.

thanks for the advice.