Anybody else noticed this on the modern machines?

[Tip10]

Hey Mikey,

Question for you. You state you have measured the flow rate. Using exactly what? Oh, I see several manometers and a water manometer. Questions for you. Which of these have been recently calibrated to NBS standards? Exactly what was the specific gravity of the medium used in the water manometer? Exactly what accuracy do these instruments possess and exactly how skilled (or in this case, likely unskilled) is the operator of said instruments?

I ask these questions to illustrate one simple point -- that being that you have absolutely no clue as to the true accuracy of anything you are observing and/or measuring yet you seemed convinced that one of the measurements is "correct" and the other flawed. You are using uncalibrated instruments, operated by relatively unskilled labor in less than laboratory conditions using unknown substances, all of which can and will compromise the accuracy of the measurements. How did you arrive at that conclusion that those measurements are accurate?

I'd venture to say that your measurements MAY be no more or less accurate than the inaccuracies you claim to be observing -- we simply do not know.

Sorry -- move along now -- only thing here is a train wreck....

[BernieRay]

...
Will you mind your own business ...

Making that comment on a public forum that is meant for people to help each other is amazing to me. For me, if I don't want someone in my business, I start off by not bringing my business into their house.

Have you consider using a pencil and paper to get your frustration out? It would serve the same purpose for you and it would greatly reduce the animosity that you are creating for yourself.

I fail to see how all the energy you are spending here is helping you find a more suitable machine. I'm fairly confident that you could sell your S9 and buy a used S8. You would then have what you want and probably some money to boot.

[ResmedUser]

Hey Mikey,

Question for you. You state you have measured the flow rate. Using exactly what? Oh, I see several manometers and a water manometer. Questions for you. Which of these have been recently calibrated to NBS standards? Exactly what was the specific gravity of the medium used in the water manometer? Exactly what accuracy do these instruments possess and exactly how skilled (or in this case, likely unskilled) is the operator of said instruments?

I ask these questions to illustrate one simple point -- that being that you have absolutely no clue as to the true accuracy of anything you are observing and/or measuring yet you seemed convinced that one of the measurements is "correct" and the other flawed. You are using uncalibrated instruments, operated by relatively unskilled labor in less than laboratory conditions using unknown substances, all of which can and will compromise the accuracy of the measurements. How did you arrive at that conclusion that those measurements are accurate?

I'd venture to say that your measurements MAY be no more or less accurate than the inaccuracies you claim to be observing -- we simply do not know.

Sorry -- move along now -- only thing here is a train wreck....

Hi dumbass,

Water manometers are very simple instruments to use. They do not require calibration. The other gauge I have I bought from CPAP.com and it is easy to calibrate using a simple small screwdriver. It is not very hard to do, you know you dont have to make things more complicated than they really are by using words like "said instruments." Why not just say "the instruments?" You like making things more confusing and more complicated than they really are?

Of the other S9 APAP, CPAP.com calibrated it by raising it to 11.2.

Would you like to come here and do the measurements for me, because you are so much smarter than I am?

Mikey

[SleepingUgly]

No. I spoke to him last about two weeks ago and was already having problems with my CPAP gear and explained it to him there. I am not under "increased stress" I am under fucking SLEEP DEPRIVATION!"

Will you mind your own business and stop trying to insist its psych related. There are people out here that if their CPAP is not right, they get cranky and mean as hell. And I am one of them. I was like this ALL THE TIME before I got put on CPAP and it went away totally after successful CPAP. It came back in December, steadily after my original machine broke.

Do you understand that? Everything is NOT psych related! If you cannot sleep normally, you are screwed! Geeeeez

Regardless of whether the CPAP caused the problems or not, any changes in behavior, personality, and mood fall under your psychiatrist's purview. A psychiatrist is still an MD, so if you explain to him about how anything greater than .1 cm of pressure deviations makes a huge difference, and that the CPAP overactivates your antidepressants causing agitation and sleeplessness, the psychiatrist will know what to do to help you. He can help you while you're continuing to try to get the CPAP working to your satisfaction. It doesn't have to be one or the other. Why suffer needlessly?

[tschultz]

Mikey, I've read through this whole thread I really think you are making too much of a small issue and not taking care of the real problem being what works for you. Based on your other comments I am quite sure you will disagree with what I have to say but I'm going to give it a try anyhow.

As someone that has specialized in data acquisition and instrumentation for the past 25 years or so, and has successfully done more than 350 designs ranging from cryogenics to nuclear control loops, I can with a great deal of certainly say the following;

I am quite sure that even the equipment used during your titration had very similar specifications to the equipment offered by the various companies. Your prescription value is only an educated wild ass guess based on a single night's sleep, there is way more possible error in that value than any machine is ever going to have. Others have tried to tell you that it is not so important what the pressure number actually is, but does it WORK FOR YOU at a given setting? I am sure that you could take 100 units from any other manufacturers and compare them to the same pressure gauge and they would have a typical bell type curve distribution of actual values, some being much closer to the actual setting than others.

Please do some basic research on metrology and/or instrumentation this is something you will find is very common of all measurement devices and not just CPAP equipment. If the measured value was outside the specified tolerances then I would agree you can be upset, but it clearly is well within specified tolerances.

What you are seeing is a basic problem on any and all digital measurement systems; the displayed value has error components that are made of actual sensor error, digitization errors, a finite digital resolution, and most likely calculation errors as well. The problem is that you see a value of 11.0 and not the 10.6 that another instrument may show. If you assume for an instant that had both these different instruments only showed whole numbers they would both agree and display 11.

While I do understand your frustrations, I must say please don't get too caught up in the details and miss the forest because you are looking at a single tree. Everyone here is simply trying to help you but you seem to be taking some of your frustrations out on them. Don't shoot the messenger just because you don't like, or agree, with what you are being told. At the same time consider what you have been told and adjust your thinking accordingly; as a general rule if the majority are all saying the same thing then it most likely has at least some validity.

Adjust your settings (or have your DME do it) to whatever works best, based on several nights of sleep with data collected and reviewed, and best of luck with your ongoing treatment. I do hope you get things working soon.

[ResmedUser]

No. I spoke to him last about two weeks ago and was already having problems with my CPAP gear and explained it to him there. I am not under "increased stress" I am under fucking SLEEP DEPRIVATION!"

Will you mind your own business and stop trying to insist its psych related. There are people out here that if their CPAP is not right, they get cranky and mean as hell. And I am one of them. I was like this ALL THE TIME before I got put on CPAP and it went away totally after successful CPAP. It came back in December, steadily after my original machine broke.

Do you understand that? Everything is NOT psych related! If you cannot sleep normally, you are screwed! Geeeeez

Regardless of whether the CPAP caused the problems or not, any changes in behavior, personality, and mood fall under your psychiatrist's purview. A psychiatrist is still an MD, so if you explain to him about how anything greater than .1 cm of pressure deviations makes a huge difference, and that the CPAP overactivates your antidepressants causing agitation and sleeplessness, the psychiatrist will know what to do to help you. He can help you while you're continuing to try to get the CPAP working to your satisfaction. It doesn't have to be one or the other. Why suffer needlessly?

Because he does not care and thinks its the sleep medicined doctor's job. Ive been thru this before with him once or twice, although nowhere near as bad as this time.

Mikey

[NightMonkey]

I'm fairly confident that you could sell your S9 and buy a used S8. You would then have what you want and probably some money to boot.

I have much less confidence in Mikey's financial aptitude while in his current unfortunate state of mind. As he reported in an earlier post, he was ripped off by paying $1300 for his S9.

I am very serious. I just paid $1300 for a new machine myself. I gave up dealing with my local DME and my insurance company when I needed a new machine that works as well as my original machine. And you get screwed over as the patient. I had some money stashed away and spent it on new gear, because I value my health and want to maintain what my original machine has given me for three and a half years. That is worth $1300 to me.

Mikey

Mikey, Use (not abuse) the forum members and avoid mistakes like that in the future.

[roster]

Mikey,

You have spent a good bit of time posting about the supposedly improper calibration of your machine.

More importantly what is your efficacy data showing? AHI, AI, SI, Leak, etc.?

[Tip10]

Ah yes -- ignorance is bliss Mikey.

And please tell us Mikey exactly what the minor scale graduations on your wonderful manometer are? And exactly how were they arrived at? And while you are at it exactly how were they produced and marked on said manometer? And what, pray tell was the traceable NBS standard used to produce said graduations. And, what is the stated accuracy of said graduations?

And Mikey, someone who doesn't understand the difference between PSI and cmH2O really should be very careful using terms like dumbass.

Have a simply marvelous day Mikey -- Oh, wait, you won't allow yourself to, Sorry.

[BernieRay]

The F&P HC200 water manometer is marked in .5 cm of H20 graduations, but can easily be used to measure at higher resolutions. I've used mine to make 0.1 cm changes.

Water column manometers, when used correctly, are extremely acccurate, do not need to be calibrated, and can be used to calibrate dial style meters. And they can be used correctly very easily.

[DreamDiver]

... your measurements MAY be no more or less accurate than the inaccuracies you claim to be observing -- we simply do not know.

Sorry -- move along now -- only thing here is a train wreck....

I've had my S9 'professionally' metered, and the manometer at the sleep doctor's office said the same thing my home-made manometer did. We compared side-by-side. For CPAP, the pressure was exact. For APAP, the pressure was low. I and the RT saw the same readings on both manometers. We simply cannot know, as you suggest, what is going on. I'm not sure I'd discount Mikey's findings if he says pressure is low in CPAP mode. Science works two ways: it's not just the burden of proof. It can also be the burden of disproof. E.g., lack of scientific data proving that smoking is bad for your health is not proof that smoking is not bad for your health.

@Mikey - I get the frustration, but you won't get much help here if you keep insisting we're all useless. Regardless of how crummy you think you feel, I know at least three people on this board (not myself) who certainly feel worse than you. And they are more than civil to other board members. Please redress your attitude.

Good night all.

[ResmedUser]

The F&P HC200 water manometer is marked in .5 cm of H20 graduations, but can easily be used to measure at a higher resolutions. I've used mine to make 0.1 cm changes.

Water column manometers, when used correctly, are extremely acccrate and can be used to calibrate dial style meters. And they can be used correctly very easily.

Darn straight, water manometers are highly reliable and dont require calibration in the traditional sense. My DME guy was explaining to me when he was in nursing school and in Neuro classes, they had to take the internal pressures of brain patients. They were required to do it using water manometers, not regular gauges.

Water manometers are simple and do not lie.

Mikey

[SleepingUgly]

Because he does not care and thinks its the sleep medicined doctor's job. Ive been thru this before with him once or twice, although nowhere near as bad as this time.

If he doesn't care, you need to find a new psychiatrist. But if he just thinks it's the sleep doc's job, then you need to convey it the way you conveyed it to us. In fact, just print out this post with your quotes in it and give it to him:

Look, I do not understand what is so difficult to understand. My original CPAP pressure, titrated in a sleep lab years ago by a sleep technician/RT, is 11.0. I got an APAP that blew 11.1 while set at 11. I did wonderful at that. Now when I would adjust the thing a few tenths of a point below 11, my OSA symptoms would begin coming back bad. Vice versa, at an increased pressure of just a few tenths of a point, I get sharp stomach pains and it overactivates my zoloft and I become agitated and cannot sleep well.

I think I am going to start looking for other ways to treat my OSA. I could still lose another forty pounds. I might look into that jaw procecure where they break and reset your jaw to fix your airway. Ive also been told I have some excess tissue in the back of my throat. Seems like Resmed and Respironics are not paying attention to quality control like they used to and just going for the money and screw the patients.

Anybody know of a German made CPAP manufacturer? They still do things right.

Tell him that in the past 3 days, you've posted 80 messages (and counting), many of which consist of you expressing anger, and that you're getting into cyber-fights with people.

Show him your profile information:

Username: ResmedUser
Gender: Male
Location: Near death
Age: 42
Interests: NRA/CMP High Power rifle shooting, hunting, reloading, lap swimming, backpacking, sun tanning when its warm out

Do this as soon as possible, while continuing to try to optimize your CPAP therapy. The two together will work synergistically.

[ResmedUser]

Because he does not care and thinks its the sleep medicined doctor's job. Ive been thru this before with him once or twice, although nowhere near as bad as this time.

If he doesn't care, you need to find a new psychiatrist. But if he just thinks it's the sleep doc's job, then you need to convey it the way you conveyed it to us. In fact, just print out this post with your quotes in it and give it to him:

Look, I do not understand what is so difficult to understand. My original CPAP pressure, titrated in a sleep lab years ago by a sleep technician/RT, is 11.0. I got an APAP that blew 11.1 while set at 11. I did wonderful at that. Now when I would adjust the thing a few tenths of a point below 11, my OSA symptoms would begin coming back bad. Vice versa, at an increased pressure of just a few tenths of a point, I get sharp stomach pains and it overactivates my zoloft and I become agitated and cannot sleep well.

I think I am going to start looking for other ways to treat my OSA. I could still lose another forty pounds. I might look into that jaw procecure where they break and reset your jaw to fix your airway. Ive also been told I have some excess tissue in the back of my throat. Seems like Resmed and Respironics are not paying attention to quality control like they used to and just going for the money and screw the patients.

Anybody know of a German made CPAP manufacturer? They still do things right.

Tell him that in the past 3 days, you've posted 80 messages (and counting), many of which consist of you expressing anger, and that you're getting into cyber-fights with people.

Show him your profile information:

Username: ResmedUser
Gender: Male
Location: Near death
Age: 42
Interests: NRA/CMP High Power rifle shooting, hunting, reloading, lap swimming, backpacking, sun tanning when its warm out

Do this as soon as possible, while continuing to try to optimize your CPAP therapy. The two together will work synergistically.

Who cares? Whats wrong with my profile? The gun part scares you? Thats what it is I bet...youre another wussy American that does not believe in the Second Amendment. My shrink does not give a flip what I do or think. He's basically turned it over to the sleep doctor, for all practical purposes.

You are afraid...

Mikey

[SleepingUgly]

Whats wrong with my profile? The gun part scares you? Thats what it is I bet...youre another wussy American that does not believe in the Second Amendment. My shrink does not give a flip what I do or think. He's basically turned it over to the sleep doctor, for all practical purposes.

You are afraid...

The "near death" part of your profile should concern your "shrink". You're sure that your psychiatrist isn't interested in you, and I'm sure that there's nothing more I can say to you, so I'll just wish you the best of luck. I hope you get the help you need to get back on track.