What is the REMStar Auto really doing?

-SWS · Post by **-SWS** » Sat Mar 12, 2005 5:17 pm

wading thru the muck! wrote:OK, now you can all roll your eyes at the guy who thinks he's so important.

Kudos! And you are----even if you did mean that tongue-in-cheek!!!

loonlvr · Post by **loonlvr** » Sun Mar 13, 2005 7:47 am

Well, I changed my range to 8-16 last nite. I was fighting the flu so I was waking up a lot. So the results are probably not indicative But I had no nr, 1.6 oa and around 4 hypopneas. I also loosened the mask as was suggested. I will let you all know tommorrow how I do tonite. And thanks a ton for the help.

Mikesus · Post by **Mikesus** » Sun Mar 13, 2005 8:38 am

Well that would be 5.6 AHI. Definately improving. I did find that my HI and OA went up with the mask pushing my jaw in, so maybe that's what is happening to you, along with some centrals... Still would be interested in seeing you set the auto for your titrated pressure as the low and high.

loonlvr · Post by **loonlvr** » Sun Mar 13, 2005 9:23 am

I am going to set my machine at fixed pressure after a few more nites at 8-16.I will set it at 11. my orginal pressure. My leakage with looser mask last nite was around 50. Is that high.?

derek · Post by **derek** » Sun Mar 13, 2005 9:55 am

A little more data on the Auto's behavior:

I imported loonlvr's charts into a graphics package and expanded (magnified) the scale. I then drew vertical lines down from each start of a pressure rise or fall so that I could see what was the triggering event. My conclusions:

1) That pressure rises generally begins on closely spaced multiple events (where the vertical dash is thicker than normal). I saw triggers from all event types (FL, OA, H, Snore, Leak). There are a few blips in the chart that don't seem to be correlated with any event (pro-active?).

2) That once a plateau is reached, the pressure will generally remain constant until there is a period of 15 minutes with no events, it will then start to decrease. (There were a small number of cases where the decrease started earlier than that, but not many)

3) The period of constant lower pressure after a Non-Responsive (Central?) apnea is 15 minutes.

I'll post a marked up chart if anybody is interested.

loonlvr · Post by **loonlvr** » Sun Mar 13, 2005 10:25 am

cool.

Fascinated · Post by **Fascinated** » Sun Mar 13, 2005 10:52 am

Bravo, Derek.
Great idea - the import etc. I'm interested in seeing the marked up chart.
And do you by any chance have the tables that come under those charts, and loonlvr's permission to post them as well? I'm even more curious now when , i.e. at what pressures, those NR apneas appeared.

derek · Post by **derek** » Sun Mar 13, 2005 11:19 am

Fascinated,
I'm sure loonlvr wouldn't mind me posting the tables, so here they are (in order of the charts posted above):

and

loonlvr · Post by **loonlvr** » Sun Mar 13, 2005 12:29 pm

Post anything that you want derek.. This is a major learning experience for all of us

-SWS · Post by **-SWS** » Sun Mar 13, 2005 1:09 pm

Thanks for posting all this, Derek! We would love to see the marked up graph. The table denotes the NR events at 12 cm or better. That implies the string of non-responsive events would have commenced at 12 cm minus "three increments" in the "lowest pressure cases". That is assuming the table denotes that point in time the NR recognition threshold has finally been met and the NR tick mark is laid down. This is my first time looking at an NR event in Encore Pro, so my assumption about 12 cm minus "three increments" may be off. A closer look at the graph may reveal how much pressure constitutes three increments (1.5 cm?).

The marked up table would be very interesting, Derek! Thanks for offering to post it. Thanks for sharing your data, loonlvr!

derek · Post by **derek** » Mon Mar 14, 2005 6:56 am

I spent a couple of hours yesterday afternoon marking up loonlvr's charts in more detail and actually posted them here. Then I went back to my own charts and found that my conjectures on what the Auto was doing didn't seem to match my own data So, I deleted my post while I try to work out what is going on.

ps - the "down-time" after a NR apnea seems to more accurately measured at 12 mins, not the 15 I mentionned earlier.

Fascinated · Post by **Fascinated** » Mon Mar 14, 2005 9:08 am

Thanks for the tables - and for the time you're taking on the charts. This really is a learning experience!