CPAPtalk.com

Please review this thread for the items to include in your screen shots.
viewtopic/t103468/Need-help-with-screen-shots.html

Short version..hide the calendar and pie chart on the left but include the AHI and event category breakdown and the statistics below the AHI bar graphs.
On the right side...these graphs
Events
Flow rate
Pressure
Leak

and if using a ResMed machine only maybe the flow limitation graph if it looks very busy. Respironics users won't have a flow limitation graph.

Your soon to be late DME has told you a whole bunch of BS.
Medicare does indeed cover a heated hose and your looking at or even changing anything in the settings doesn't make the contract invalid. Medicare doesn't care what you do with the machine as long as you use the machine. Total pack of lies.

Let's see what your reports look like once you get the correct machine at hopefully some better settings from a DME office that knows what they are doing and actually give you what you were supposed to be given.

RestlessinWoolley wrote:okay here is try 2 on the graph, hope you can see it better, I just included the basics..

there's a good example of what we'd like the charts to look like... for a very good reason.

:sigh:

palerider wrote::sigh:

To be fair I didn't ever really show him what we wanted and I meant to but forgot I guess. I thought for sure I had included the "examples" thread but I didn't. That's why I didn't blast him too much because I forget that you guys can't read my mind.

I tried to get rid of the pie chart, but I am still learning the program, only the 3rd day i've really messed with it.




I will be having a stern talk with my DMEs main office as from what you say I have been given a pack of lies, does not surprise me, as to even walk in their door you have to have an appointment, and will shoo you off and say to call even if I have a question. I'm not a very happy person with them right now..Will see if their Seattle office is any better. I just want a mask that fits comfortably, and works, and my correct machine, after that I could care less who supplies me my replenishment stock monthly, and getting aftermarket parts when the OE parts are just as cheap is totally shocking.

To turn off the pie chart, Click on File - Preferences - Appearance - Then uncheck Show Event Breakdown Pie Chart.

This Was a typical night with the Large Simplus Mask




Thanks OKY I've done that for future posts

It's obvious that a fixed pressure of 6cm is not doing the job. If your Rx was for a bilevel, there would have been 2 pressures one for inhale (IPAP) and one for exhale (EPAP). Do you have any idea what the prescribed pressures were?
If it were me I would place the machine that you have on APAP minimum 8cm and open the maximum to 20cm to see where the machine goes. That will help you get a better idea of the pressure you need. And then you can fine tune it. Monday talk with your sleep doctor and get a copy of your sleep study and prescription. Those are your medical records and will answer some questions for you.

The pie chart can normally be turned off in the Preferences/Appearance tab but I had an instance where I couldn't get it to stick in SH when I removed the check mark to turn it off. I never could figure out why..so just chalked it up to another little bug that affects some people and not others.
At any rate hiding the calendar is sufficient on your reports to allow the needed AHI bar graphs and statistics to show up on the left side so we can see what we need to see easy enough and that's the main thing.

LinCare...I call them Lin(Idon't)Care. They were my first choice for a DME back when I was starting therapy because they had an office about 1/2 from where I lived at the time but I fired them before I ever got a machine from them. They point blank lied to me about something and I don't take to being lied to at all. So I told them to keep their machine and I would take my business elsewhere ...and the rest is history.

Oh...there's no law that says a patient can't change anything on their machine...patient's aren't breaking any laws at all no matter what it is they might change.
Now I don't want someone to go changing something just because some faceless name on a forum somewhere says they should ...I prefer that anyone considering changing something be educated about what they are doing and why they are doing it and what to expect.

Changing to auto mode with minimum to equal maximum doesn't change your pressure at all..it just turns on the FL flagging. The machine will still crank out a fixed pressure of 6 cm and the pressure graph will look the same.
I personally think that the pressure at 6 cm isn't quite sufficient for the OAs and hyponeas but the mention of the centrals gives me cause to want to take a more wait and see position before offering any ideas about what pressure might work better.
And a bilevel machine would maybe be more of what we would expect someone to be trying with a history of maybe more centrals than we would be happy with. A few centrals are normal and not a big deal but when there's more than a handful we have to at least keep one eye on them.

I really doubt that all those snores are real and would like to see what happens once you get the machine the doctor prescribed and use the pressures that were prescribed and maybe get a mask that you know isn't vibrating all over the place.

When you get the new machine you can still use SH and even use this same profile...SH doesn't care if you have different machine reporting going on.
I think I have maybe 6 or 7 different machines under one profile in my SH.

But if you want to change something...you aren't breaking any laws at all no matter what you might change. Don't fall for that BS and if you want a heated hose for some reason...Medicare will pay for it after the replacement period criteria has been met...3 months..see the very first entry on the chart below. If you want it sooner...probably just easier to buy it out of pocket...from some place like cpap.com or check EBay or Amazon to see the prices.
I guarantee it will be cheaper than DME prices. Let me know if you want more information about how the heated hose works. I love them....in the winter I crank it up so I don't get cold nose syndrome and in the summer I turn the temps way down...and I never changed the humidity setting. I just let the machine sort it out....rain or not. It's not a sauna type of heat...it's just warmer than typical room air but cooler than your own body temp.

This is the Medicare replacement schedule.

I am a bit leery of setting the machine wide open because of the centrals seen and mentioned on the sleep study apparently and the fact that bilevel because of centrals was advised. We don't know which bilevel was advised...it may have been a regular bilevel or it may have been an ASV type of bilevel because maybe the centrals were made worse by pressure. We don't know what pressures were advised.
For that reason....because there's a lot we don't know just yet about the centrals...I wouldn't give the machine a chance to go to 20 or anywhere near 20 until I knew for sure some answers about the central/clear airway events.
In this situation I would be super cautious just in case those are cpap pressure related centrals.
Like if apap mode was used...limit the max to 10.

I forgot about the mention of centrals in the first post. The nights you have posted don't look like a lot of centrals but because of the history I wouldn't go opening it up at this time. So I think using APAP mode with Minimum 6 and Maximum 8 might be on the safer side. Especially since you will have more answers on Monday.

Yeah there was a huge fiasco after my final night stay. I was supposed to hear from them within 14 days but never did so I had to call and ask and shortly after I received a short note from the clinic stating my "starting pressure" 6cm and positive for central apnea and my paperwork was forwarded to the DME I selected that I didn't know at the time had sold all contracts to Lincare. Nothing more. And I'd hear from them within a week to get set up with my machine. A week went by and another so I called the clinic again to say I never heard from the DME and then they said they had sent to to lincare as they were the closest DME to me that could supply. Well after another 2 weeks I finally get a call for an appt the following day. A half hour before I was supposed to arrive inget called saying don't bother my machine wasn't in stock and it could be after the new year before they get one. Well I called my clinic back to try someone else and they leaned on lincare and a few days later was called in to get a machine. Now I feel they just wanted to get rid of me because I was being a pest. My sleep doctor and my pain clinic as soon as they heard severe central apnea been bugging me to get on the machine as soon as possible. So yeah, it wasn't fun getting started. I was basically tossed my first mask and in my earlier posts had to fight for a new one and at replenish fight again to get a smaller mouth pillow. So yeah I'll fire them if I can't get satisfaction Monday even if I have to give them the machine (it's wrong anyway apparently) and take my insurance elsewhere.

I really appreciate all the input. I hate dealing with insurance for stuff like this. Too reminiscent of my 4 week stay in the hospital and upon leaving trying to get my insurance to cover a walker and a wheel chair for my recovery time years ago.

I am just glad my pain clinic finally understood NME that I handy been sleeping well for over 15 years and I had only been getting worse to the point if I sleep on my right side in just a way I wake up in convolutions can't breathe and gasping for breath. My first night study I had a full blown attack warranting the technician to hook up a nasal cannula and feed me oxygen as my o2 levels dipped to 60. Instill fight low 02 but it stays in the 90s. Even on my second night I had a minor attack while on the machine and it started pumping me full of air and releasing. Only side effect was a nasty case of gas on the morning. Lol

We will hopefully get this settled Monday.

I should mention I have been on powerful steady amounts of opiates for a number of years and recently due to medicate limits my script amount was cut in half. But that started in january, the only real change in meds has been starting a thyroid medicine mid January for my low thyroid.

And nothing against my sleep center. They are great. They are just one of the busiest in the area being within the hospital system they get patients from around the state with complex sleep issues. And as she put mine, mines one of the more complex she's had to deal.wirh because I have central, and osa.

May have found my Snore issue. When I pulled my humidifier tank out to clean and fill it, I usually just fill it, i clean it weekly. I noticed the top seal was a bit wonky. I pulled the I inlet seal and top seal and the seal between devices and cleaned all of them and reinstalled. Wish me luck. I'm.so tired right now I am hoping not to share at the ceiling till 4am. My nephew's BD tomorrow and I still have to get him a gift and have the energy to do it. Thanks again. For all the advice.

The opiates could be playing a part in the centrals. It wouldn't surprise me at all since they depress respiration and the centrals are brought on by an imbalance in gasses which the brain needs a correct balance for the brain to send the "breathe" command to the body.
The same imbalance can be caused by cpap pressure too.
How bad of an imbalance can impact the type of cpap therapy you end up needing.
This video explains complex sleep apnea quite nicely but it's more about cpap pressure causing the imbalance. You can substitute depressed respiration for the cause too.
https://www.youtube.com/watch?v=CU-XTcf ... e=youtu.be
It mainly talks about using the ASV type of bilevel device as treatment but sometimes regular bilevel will get the job done.

Let's see which bilevel you end up with and go from there.

Hopefully you have found and removed the cause of the snores on the reports. If not then the next question would have been do you have a dog in bed with you that snores. I got some really ugly snores reported when my little Pug would lay on my shoulder and it took me quite some time to figure it out because he didn't always lay on my shoulder.

Well no change on the Snore flagging, so I was looking deeper into sleepyhead, these were VS2 not VS. dug thru the options and VS2 is for System One Snore Flagging..I shut it off for now, but I am going to try putting in the OEM filter back in as when it slides in is a lot more snug then the OEM pollen Filter with the aftermarket secondary filter, if that doesn't change anything then I know for sure its the mask vibrating. Or the System One was far more sensitive than the Dream Machine. I did try switching it over to auto last night for a few minutes, with both high and low set on 6cm but the machine was doing some goofy stuff that was probably normal but ill wait to get the correct machine and setup right before I do any more monkeying..

@Okie. I made a small number of the mask liners today. If they work good I'll make up a pile hem the edges so they can get tossed in the laundry. And I could maybe put some drops of essential oils on them to help me relax.