Why I always insist on a data-capable machine and software

[rested gal]

As I turns out, his 95% pressure has NEVER exceeded 10!

Which means that 5% of the time, the machine does have to use pressures above 10 -- perhaps the pressure of 12 that was prescribed if straight CPAP were being used, instead of the autopap he's using. Since a PSG sleep study is looking for one single pressure to use for "worst case scenario" (usually on one's back AND in REM...all at the same time) that may be why 12 is what he was titrated to at the sleep lab. Good for him, having an autopap. And good for him that you were already an experienced "cpap" user, knew the DME game, and were able to help him not get stuck with a "hours only data" machine.

On the other hand, I was one of the lucky ones--My new Autoset confirms that my 14cm was practically spot-on

My guess is that most sleep study titrations are practically spot-on for an effective treatment pressure. My belated-in-life sleep lab titration (two consecutive full titration nights, actually) was/were also spot-on correct about what pressure my autopap use for the two years before I ever had a real sleep lab titration. Just adding my personal "pressure" anecdote to the mix here.

[-SWS]

Well, here's my anecdote. I couldn't sleep in the lab very well. I certainly slept nothing like I sleep at home. But I finally fell asleep in the wee hours of the morning. I slept just enough to get a good sleep cycle in. The sleep tech had to stay over to allow that full sleep cycle---so I could walk away with a pressure. The determined pressure was 10cm---and it was spot on.

My thanks to that sleep tech who worked longer than scheduled to get me that 10cm pressure value. Home software? Indispensable anyway.

[jnk]

. . . I will revise my comment . . .

I applaud you for doing that. I think that sets a good example for the rest of us any time we post something that could easily be misunderstood or misread to mean something we didn't intend. That, in my opinion, is a much better approach than simply saying "I stick by my statement," which is what some might do in that circumstance.

evidence of it every time I visit the forum

A help forum attracts those needing help. Those not needing help with their therapy, who got a good pressure Rx and are happily PAPping away every night, have no reason to even find out about this forum. That makes the anecdotal "evidence" of reading this forum less than useful for estimating good-lab-titration success or failure, in my opinion.

And as one respected professional who posts here has pointed out, a good many of those coming here for help end up finding out that their residual troubles are about aspects of sleep unrelated to PAP therapy. That may be why tweaking doesn't always pay off for everyone here.

I have a number of friends on PAP therapy. Most of them got handed a machine that they now use every night, without problems, and they love it. I have checked their data to confirm their low leak and low home-machine-estimated AHIs. I am therefore glad they have full-data machines. But I have no reason to suggest they get software at this point, since they are having no troubles.

But I understand, ro(o)ster. Every rooster I've ever known has tended to dig in his heels when cornered against the chicken wire. I've had my share of spur cuts over the years, believe you me. I still likes me my yard bird, though.

[Wulfman...]

I'm not going to try to split hairs......or chicken feathers........
In my nearly six years of reading this forum, there have been a "shit-load" of people who didn't have very good experiences with their sleep studies (or their titrated pressures).......me included. That split-night study was the worst night of sleep I think I've ever had. But, I guess they got enough data to determine that I had an untreated AHI of about 46. Unfortunately, they weren't very accurate with my pressure. They stopped at 16 cm. and then my @$$#^%& sleep doctor decided to add two more centimeters to that and wrote my prescription for 18 cm.......and 2 L of oxygen.
Bypassing the local DMEs, I bought all of my equipment AND SOFTWARE from CPAP dot COM and after trying that pressure for about 45 minutes, I decided to try something "reasonable"......and set the machine to 10 cm., which actually turned out to be pretty close. (I ended up at 12 about a year later)

Anyway, since the data capable machines (either straight CPAP or APAP) aren't that much more expensive than the "dumber" ones, it just makes good economical sense to get the data capabilities from the get-go. The differences in cost can be justified by not having to make repeated trips back to the doctor or having additional sleep studies.


Den

[jnk]

. . . since the data capable machines (either straight CPAP or APAP) aren't that much more expensive than the "dumber" ones, it just makes good economical sense to get the data capabilities from the get-go. . . .

Important point.

Good to hear from you.

[rested gal]

Anyway, since the data capable machines (either straight CPAP or APAP) aren't that much more expensive than the "dumber" ones, it just makes good economical sense to get the data capabilities from the get-go. The differences in cost can be justified by not having to make repeated trips back to the doctor or having additional sleep studies.

Den

Good sense, indeed. Yes.

[roster]

My belated-in-life sleep lab titration (two consecutive full titration nights, actually) was/were also spot-on correct about what pressure my autopap use for the two years before I ever had a real sleep lab titration. Just adding my personal "pressure" anecdote to the mix here.

The sleep tech had to stay over to allow that full sleep cycle---so I could walk away with a pressure. The determined pressure was 10cm---and it was spot on.

And the two of you know your titrations were spot on because ......... ?

Because you have days or weeks of data from your machine/software at home that confirm the settings. You would no more trust a sleep lab titration than I would!!!

Ironic. But people are often in "violent agreement" and it takes some time for them to realize it.

OP stands as written and to repeat, contrary to accusations imagined and thrown about, there was nothing in the OP that was critical of sleep technicians - in fact they could use it as a defense of suboptimal titrations.

[roster]

Sorry, just saw my PDF will not post on this site. No idea how to post my data.

Here is a thread discussing how to post an image - viewtopic.php?f=1&t=60687&p=569401&hili ... ge#p569401

Only post the one page "Daily Details" to get some good feedback from members. Most like to crop their name out of the image to maintain privacy of their medical records. Unless your name really is Lucy N. Ethel.

[roster]

In a few hours I will be 62 years old (if I survive!).....

And Happy Birthday!

[GTOJim]

Anyway, since the data capable machines (either straight CPAP or APAP) aren't that much more expensive than the "dumber" ones, it just makes good economical sense to get the data capabilities from the get-go. The differences in cost can be justified by not having to make repeated trips back to the doctor or having additional sleep studies.

Den

Good sense, indeed. Yes.

A bit off topic.

I just wish all the DME's felt the same way. Unfortunately as most of us know, many DME's pass off the cheapest machine possible to new CPAP users who don't know any better.

Some DME's only care about the bottom line, getting the most profit. I'm sure this type of DME could care less about repeated trips back to the doctor or additional sleep studies. They get their money and get the customer out the door with the new equipment.

After 5 years my Auto CPAP died. I had to fight with my DME to get an S9 Auto, DME stated my insurance would not cover it even though my doc specified an auto on my prescription.

[GTOJim]

In a few hours I will be 62 years old (if I survive!).....

And Happy Birthday!

Happy Birthday, hope you have many more in the years to come.

[-SWS]

My belated-in-life sleep lab titration (two consecutive full titration nights, actually) was/were also spot-on correct about what pressure my autopap use for the two years before I ever had a real sleep lab titration. Just adding my personal "pressure" anecdote to the mix here.

The sleep tech had to stay over to allow that full sleep cycle---so I could walk away with a pressure. The determined pressure was 10cm---and it was spot on.

And the two of you know your titrations were spot on because ......... ?

Because you have days or weeks of data from your machine/software at home that confirm the settings. You would no more trust a sleep lab titration than I would!!!

Ironic. But people are often in "violent agreement" and it takes some time for them to realize it.

OP stands as written and to repeat, contrary to accusations imagined and thrown about, there was nothing in the OP that was critical of sleep technicians - in fact they could use it as a defense of suboptimal titrations.

Nobody in this thread recommended against the software, Rooster. In fact, I can barely remember ANYONE on this message board recommending against software. I doubt there's a CPAP user group anywhere in cyberspace as pro-data as the choir you are currently preaching to.

Keep up the good fight anyway... But try not to make it sound like a political mudslinging commercial.

But here's one of very many examples on this message board demonstrating WHY tracking treatment efficacy is a good idea:
viewtopic.php?f=1&t=60761&st=0&sk=t&sd= ... 45#p570378

And here's my own central "hiccup" that I'll want to keep an eye on during upcoming years---making sure a serious cardiopulmonary problem is not in the works:
viewtopic.php?f=1&t=58711&p=552752&hili ... ll#p552606

[rested gal]

And the two of you know your titrations were spot on because ......... ?

Because you have days or weeks of data from your machine/software at home that confirm the settings.

And you mention that because....... ?

You're scratching around for high quality chicken feed when you've spilled a bag of cracked corn, my fine feathered friend.

No one has been pecking away at the value of being able to monitor one's own therapy at home.

The whole point of jnk's objection (and my agreement with his objection) was to your use of the word "often" in your OP (original post)

Even titrations at the best sleep labs often prescribe settings that result in poor therapy.

You would no more trust a sleep lab titration than I would!!!

Oh, I wouldn't bet on that. More hyperbole from the roster/rooster.

Ironic. But people are often in "violent agreement" and it takes some time for them to realize it.

Probably longer than it takes you to realize how over-the-top the word "often" was in your "OP."

OP stands as written

No surprise by now.

and to repeat, contrary to accusations imagined and thrown about, there was nothing in the OP that was critical of sleep technicians - in fact they could use it as a defense of suboptimal titrations.

Huh??? So now you're imagining that some people in this thread have been accusing you of being critical of sleep technologists?

The only criticism I was putting forward was the same one jnk had. That this statement in your Original Post was probably incorrect...due to your use of the word "often" :

Even titrations at the best sleep labs often prescribe settings that result in poor therapy.

Sure ruffled your feathers. Oh well.

[SleepingUgly]

http://www.ncbi.nlm.nih.gov/pubmed/8970366

http://www.journalsleep.org/Articles/291110.pdf

[lucynethel1998]

Sorry, just saw my PDF will not post on this site. No idea how to post my data.

Lucy,
Save it page by page into a jpg... and post it on a free site... for example photobucket. Then either post links to the images or the images themselves.

Unless I have lost it completely, my software only allows me to print out/save as a PDF?