Doctor's Findings

So I recently went to my sleep doctor who specializes in neurology. I discussed their study finding with a pressure of 9 versus me playing around with pressures to get my apneas as low as possible. I was in auto trial mode most of the time with a range of 11-15 and 95% of the time at 14. He told during my study, I actually had negative events at 9. I then asked if maybe the Sleepyhead data was giving false readings versus being all wired up. He said perhaps and suggested I not watch the results so much. I have noticed that I don't have any RERA's while at the 9 pressure and did have them on the auto trial. He also wrote me a script for Provigil. Of course I take the generic since it's much cheaper. I am only taking 1 a day versus the prescribed 2 since I don't want to risk not sleeping at night. Just wanted to share my story.

If you doubt SleepyHead's reporting you can use Encore Pro to confirm.
Windows only software. Send me a PM if you want to try it.
Must be the latest Encore Pro version though because Encore Basic won't work with the DreamStation machines unless there is a later version of Basic out there that I haven't been able to find.

Thanks, I found the software and will give it a try. I shouldn't doubt Sleepyhead because both that and the DreamMapper app give the same results as in OA's, CA's and Hypopnea's. I guess the doctor is just basing his findings from the one night sleep study being wired up versus software data.

Jasba64 wrote:So I recently went to my sleep doctor who specializes in neurology. I discussed their study finding with a pressure of 9 versus me playing around with pressures to get my apneas as low as possible. I was in auto trial mode most of the time with a range of 11-15 and 95% of the time at 14. He told during my study, I actually had negative events at 9. I then asked if maybe the Sleepyhead data was giving false readings versus being all wired up. He said perhaps and suggested I not watch the results so much. I have noticed that I don't have any RERA's while at the 9 pressure and did have them on the auto trial. He also wrote me a script for Provigil. Of course I take the generic since it's much cheaper. I am only taking 1 a day versus the prescribed 2 since I don't want to risk not sleeping at night. Just wanted to share my story.

You were not at 14 for 95% of the time....95% of the time you were at 14 or below. You might have been at 14 for only 5 minutes (or less) during the night.

Jasba64 wrote:I guess the doctor is just basing his findings from the one night sleep study being wired up versus software data.

Yep, that's what he is doing but I don't know about you but I had a lot of trouble getting good solid sleep during my titration sleep study.
My OSA is worse in REM and I only got 6 minutes of REM during the entire 8 hour sleep titration study..
I came out of the titration sleep study with a RX prescribed at 8 cm...and that works great for all the sleep stages except REM.
I found out that I sometimes need 16 to 18 cm in REM sleep. I simply didn't get enough REM during the titration study for it to be know that sometimes I need a lot more pressure. It's fairly common...worse in REM and need more pressure or even worse in REM and not need more pressure.
Sleep in a foreign environment isn't the same as sleep at home in our own beds. Sometimes the sleep lab settings advised will work just fine but sometimes they don't for any number of reasons.

And as LSAT pointed out...95% number simply mean you were at OR BELOW that number for 95% of the time.
95% numbers are easily skewed by relatively short periods at higher numbers. If you want to think about overall averages look at the median average number on your SleepyHead report or change SH so that it reflects weighted average vs median average in the statistics.
I never use 95% numbers base on one or two nights for any real evaluation because they are so easily skewed. Now long term yeah..but long term as in months...like 6 months.

People often make the mistake of thinking the 95% numbers (leak or pressure) mean that's where you were at for 95% of time and it's simply not the case.
They either don't know about the "or below" part of the definition or forgot about it.

This thread may help you visualize what I am talking about as it shows how easily 90/95% numbers can get skewed higher.
viewtopic.php?f=1&t=61734&st=0&sk=t&sd= ... holy+grail

Or the same thing with leak numbers
viewtopic.php?f=1&t=108724&p=1036669&hi ... t#p1036669

I don't know what to tell you about your doctor being so dead set on 9 cm fixed....Your machine won't flag Flow Limitations in fixed cpap mode so you don't know if you are even having any FLs and they impact how you feel.
I guess the the proof is in how well you sleep and feel.

xxyzx wrote:i imagine all software interprets things a little differently

Not really. It's not the software doing any interpreting at all. All the software does is report what the machine has collected in terms of data. It's not the software determining those events...it's the machine flagging them and all SH does is tell you what the machine found.

SleepyHead should match up with name brand software within a rounding up or down number. SH goes to hundreths and the name brand goes only to tenths.

xxyzx wrote:is there a list of all the software that is available and by machine?
i once saw a list of about a dozen and also encountered a few in europe that might not be on that other list which i should have printed off but did not

Somewhere maybe there is a list. I have one in my head that is probably fairly complete for the machines that are primarily used here in the USA.
As far as I know SleepyHead is the only software that covers multiple brands.
All the rest are brand specific. ResMed has ResScan and Respironics has Encore and F & P has a couple because they changed software when they released the Icon series. I forget what DeVilbiss has but I think just the one.

Just remember the software doesn't do the analyzing...software just reports whatever the machine has stored after it (whatever machine is used) has done it's analyzing of things.

As Pugsy said, the program does not interpret data--it merely displays it.
Due to copyright and patent infringement concerns, each program will display data differently.

Jasba64 wrote:So I recently went to my sleep doctor who specializes in neurology. I discussed their study finding with a pressure of 9 versus me playing around with pressures to get my apneas as low as possible. I was in auto trial mode most of the time with a range of 11-15 and 95% of the time at 14. He told during my study, I actually had negative events at 9.

Did the doctor explain how you can have NEGATIVE events?

This makes no sense and makes me wonder if the doctor has a clue how this works.

No, he never explained that. The only thing on this pressure I am happy with is that I no longer have RERA's and I don't wake up as often. I still wake up ever few hours.

(((Definition: negative events--doesn't have a clue, but has to say SOMETHING)))

There is no such things as negative events. You can have zero events but negative is not possible.

Jasba64 wrote: He told during my study, I actually had negative events at 9.

Common sense tells me it's simply saying negative for events, as in none were present.
Good luck with your treatment and with improved sleep.