Doing my own sleep study - surprising results

[snoredog]

Jerry, in the early days of cpap, they just gave you a machine set at 10cm and sent you on your way. It worked for a majority of patients (no titration study). You don't have to worry too much about triggering centrals by blindly increasing the pressure as long as you stay under 12cm, I'd use caution going any higher than 12cm.

Think Resmed once funded an apap study that showed over 70% of SDB events eliminated with a pressure of only 8cm.

Autopaps and snores: As Perry mentioned no sense getting a machine that triggers heavily off snores if you have had a UPPP and no longer snore. That is a very valid suggestion. The Spirit is one that comes to my mind, looks seriously at snores and responds with pressure.

By comparison if you read the Remstar Auto patent and how it functions internally you'll find that a snore can play a major role in how a machine responds with pressure. The way I read that patent, the snore control module can take complete control over the machines system processing like when it is trying to find the ideal pressure to eliminate the snore (where it then stores that found treatment pressure to later treat other snore triggers in the background).

If your pressure is creeping higher and higher on an autopap (in an attempt to treat the snore) then I wonder what would happen if you combined a treatment such as LAUP that reduced or eliminated the snores, the result might just be lower autopap pressure.

The difficult part is trying to understand what that solid gold snore line means in relation to how one feels. I know I have a snore problem which contributes to my poor sleep, Pillar doesn't appear to reduce snoring at all. So it looks like LAUP or injected snoreplasty are the only other options.

[Jerry69]

Jerry, in the early days of cpap, they just gave you a machine set at 10cm and sent you on your way. It worked for a majority of patients (no titration study). You don't have to worry too much about triggering centrals by blindly increasing the pressure as long as you stay under 12cm, I'd use caution going any higher than 12cm.

Think Resmed once funded an apap study that showed over 70% of SDB events eliminated with a pressure of only 8cm.

Autopaps and snores: As Perry mentioned no sense getting a machine that triggers heavily off snores if you have had a UPPP and no longer snore. That is a very valid suggestion. The Spirit is one that comes to my mind, looks seriously at snores and responds with pressure.

By comparison if you read the Remstar Auto patent and how it functions internally you'll find that a snore can play a major role in how a machine responds with pressure. The way I read that patent, the snore control module can take complete control over the machines system processing like when it is trying to find the ideal pressure to eliminate the snore (where it then stores that found treatment pressure to later treat other snore triggers in the background).

If your pressure is creeping higher and higher on an autopap (in an attempt to treat the snore) then I wonder what would happen if you combined a treatment such as LAUP that reduced or eliminated the snores, the result might just be lower autopap pressure.

The difficult part is trying to understand what that solid gold snore line means in relation to how one feels. I know I have a snore problem which contributes to my poor sleep, Pillar doesn't appear to reduce snoring at all. So it looks like LAUP or injected snoreplasty are the only other options.

No titration study, huh. But, I assume they did a study to diagnose SDB? Although, I'm not sure that is necessary Seems if you have symptoms that suggest SDB, then why not go on PAP at 8 cm and see if the symptoms are reduced or eliminated. Can't hurt, can it? My sleep doctor is on PAP and he told me he'd never had a sleep study. He does know how to download from a Smartcard into Encore Pro, however. But, he didn't know my Remstar Pro II would give any reports except compliance.

I'll swear, I think there are people on this forum that know more about SDB and PAP than most DME's and sleep doctors. And, what is my basis for saying that: only what others on the forum have reported about their DME's and sleep doctors.

Jerry

Jerry

[Jerry69]

My 2nd night at 10 cm gave the same results as the first night.



I have begun to mouth exhale, some. Don't know if that has to do with the slightly increased pressure 8>10. But, I'm going to search the posts for remedies. Jump in if you have a good one. I'm allergic to the adhesive on medical tape, so I can't use that remedy for very long.

Jerry

[Wulfman]

Lookin' GOOD, Jerry!!!

Did you use the same mask as the night before or did you change masks like you indicated you might? If you used the same "rig", I'd leave well enough alone.....if it was me. If you continue with these numbers, I'll be interested to know if you experience any improvement in how you feel in a few weeks.

There have been numerous posts about what people use to seal that air leak from their lips, but since I use a FF, I haven't paid much attention to them. Perhaps someone else will come up with a suggestion that you're not allergic to.

Best wishes,

Den

[Jerry69]

Lookin' GOOD, Jerry!!!

Did you use the same mask as the night before or did you change masks like you indicated you might? If you used the same "rig", I'd leave well enough alone.....if it was me. If you continue with these numbers, I'll be interested to know if you experience any improvement in how you feel in a few weeks.

There have been numerous posts about what people use to seal that air leak from their lips, but since I use a FF, I haven't paid much attention to them. Perhaps someone else will come up with a suggestion that you're not allergic to.

Best wishes,

Den

Den,

I slept 2 hours with the new Aura, but it was leaking, so I switched to the Swift. Had only one hypopnea with the Aura (3 the balance of the night). If you are a numbers guy, it is great to be talking in terms of 4 hypopneas and no apneas all night! The numbers are not everything, but if you can fix them that's one less variable to deal with. Like working on a car engine: start changing out suspect parts until you find the culprit.

I revived an old thread to discuss the Aura/Swift/Breeze. In short, I think I fixed the leaks with the Aura/Everest. I hope so, as it is a comfortable interface.

Yep, time will tell if I begin to feel 18 again. Unlikely, I'm 69, but if I could feel 60 again, well, I'd take it.

Jerry

[Snoozie-guested again]

Very interesting and great results, Jerry!

One question, how are you changing your own settings?

I am also finding out by using the 3 interfaces that I have, that I seem to get the best results with the Swift and Aura. I still find it more difficult to breathe with the Aura, though. Haven't been able to figure that out yet, but finding it to be a comfortable piece of equipment.

[Jerry69]

Very interesting and great results, Jerry!

One question, how are you changing your own settings?

I am also finding out by using the 3 interfaces that I have, that I seem to get the best results with the Swift and Aura. I still find it more difficult to breathe with the Aura, though. Haven't been able to figure that out yet, but finding it to be a comfortable piece of equipment.

Thanks, Snoozie. I can change pressure using Encore Pro software with the Smartcard in the reader or at the CPAP machine. At the machine, I hold the two top buttons down while I plug in the machine. This brings up several adjustments on the LCD screen, including pressure. I have a Remstar Pro II with C-flex. All the machines work differently, I suppose. If you happen to have the same machine as I do, I can send the the manual. If not, it won't do you any good.

I only slept 2 hours with the Aura last night, but I didn't notice any restriction on breathing when going to sleep. I'm going to use the Aura again tonight, as I bent the wires in the pillows this morning and got it to seal better.

Jerry

[Snoozie]

Thanks, Jerry. I do have the same machine as you, but I am not so sure my Dr. would appreciate my changing settings without his approval, although he really doesn't know a whole lot about the whole realm of things concerning CPap. I am getting my pressure changed from 6 to 8, so I will see how it does, although I really would like to be able to try various settings to determine what is best for me. At least he is willing to listen and work with me - more than I can say for some.

Don't you have to report your results to a Dr or DME? I have to send my card in every month or so, and they will know if I tamper with my pressure, but thanks for letting me know! I was curious and now at least I know if everything else fails, I can try on my own if I have to.

Good Luck!

[Guest]

I have to send my card in every month or so, and they will know if I tamper with my pressure, but thanks for letting me know!

Its your machine. Its your health. Its your pressure. It isn't tampering. Its no more complicated than changing the temperature on your thermostat in your house. You've probably noticed by reading thru all the info on this forum people control their own therapy, read their own data and adjust their own pressure. If you prefer to go to the doc that's your choice. But please don't think its something you can't or shouldn't do on your own if you want to. It saves the time and expense of a doctor's appointment. Many have reported their doc only checked the card for compliance info anyway. Many have found they know more than their doc about the effectiveness of their treatment and get better treatment because they are doing their own monitoring and making adjustments accordingly.

[rested gal]

If you prefer to go to the doc that's your choice.

Excellent post, Guest.

Some people are more comfortable relying entirely on their doctor, and by extension their DME, in everything about cpap treatment.

Others of us are quite comfortable making our own cpap treatment decisions -- often through having educated ourselves via the message boards.

A little knowledge can be a dangerous thing in many medical matters, but not particularly so in using cpap machines. Personally, I think apathy, incompetence, ignorance, and just plain being too busy on the part of many sleep "professionals" can be far worse. A "set 'em and forget 'em" mentality.

There have been studies showing that cpap users who are given a minimum amount of instruction are perfectly capable of working with their machines at home and tweaking their own pressure effectively:
_______________
Can Patients with Obstructive Sleep Apnea Titrate Their
Own Continuous Positive Airway Pressure? Michael F. Fitzpatrick, Christi E. D. Alloway, Tracy M. Wakeford, Alistair W. MacLean, Peter W. Munt,
and Andrew G. Day

Departments of Medicine and Psychology, Queen’s University, Kingston, Ontario, Canada
___________________

Snoozie, if you prefer to have your doctor's blessing for your own peace of mind, it might be that all it would take is for you to simply ask your doctor, "Would it be all right if I make some setting changes on my machine myself to see how I feel at other pressures?" Since you've said this about your doctor -- "At least he is willing to listen and work with me" -- chances are very good he'll say, "Sure."

[dsm]

Jerry:

<snipped> (long post is the one on Sun Dec25)

Perry

Perry, just wanted to thankyou for a remarkably well written & thought out post.

I have often wanted to say similar in relation to interpreting AUTO results but decided it was too much of an 'emotional' issue to some & there was too big a risk of offending some.

What is so important to understand is why people use AUTOs ...
Reason 1 2 and 3 is to reduce the exhalation pressure so as to make therapy easier.

Many people seem to believe that AUTOs *instantly* adjust their pressure to correct events that may occur at a cms lower than their titration recommended level when this is just not the case at all. An AUTO is usually in a 'react' mode, rarely, in anticipate & control mode. That is just the way they work. They lower the pressure, then if something occurs they try to interpret the event, slowly adjust up in the hope of preventing the next such event.

I do believe there is a 'love affair' with AUTOs that may well be misplaced.

Cheers

DSM

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): Titration, auto

[wading thru the muck!]

I do believe there is a 'love affair' with AUTOs that may well be misplaced.

dsm,

Who want's to "LOVE" a straight cpap? LOL!

[Wulfman]

Wader,

I GOTTA "love" mine.....it's the only one I've got.....like my wife.......
AND, we (CPAP and I) "suck face" every night for about 7 hours!

"Love" is a relative thing......kinda like AIR.....you don't pay much attention to the benefits.....until you don't have any.

Best wishes and Happy New Year.

Den

[wading thru the muck!]

I GOTTA "love" mine.....it's the only one I've got

Yeah, but isn't using a plain cpap like kissing your sister?

...Just kidding

I agree with dsm's opinion that many expect more from their APAPs than it can give, but considering an APAP can always become a CPAP, what do we have to lose? Besides, isn't it better to let the algorithm "play" with our pressure instead of doing it ourselves? LOL!

[Wulfman]

Yeah, but isn't using a plain cpap like kissing your sister?

Uhhhhhh......wouldn't know....... (yes, I DO have a sister.....she lives in Minnesota)

But, yes, I also agree with dsm. My feeling is that APAPs serve their purpose of determining if and what a fixed pressure should be (unless a person has unusual circumstances that won't work with a straight CPAP).

One person's "algorithm" is another person's "manual adjustments"....

Den