How reliable and trustworthy is data from a CPAP machine?

I've been on APAP for 6 months.

During a recent visit to my Sleep Dr to talk about the APAP issues I've having, my Dr told me that data from a CPAP machine is unreliable and that he doesn't trust it. He said he only trusts data from his sleep lab.

So, he relies on data from a 2hr sliver of sleep I had in a sleep lab and ignores the 6 months of data collected by my ResMed AirSense 10 AutoSet.

I use an SD card and Oscar to regularly look at my data. I'm guessing the data is both reliable and trustworthy considering how it's used in this forum.

That said, I've also learned from here that interpretation of the data is very important. For example, the ResMed may flag a Central Apnea that perhaps is not really a Central Apnea.

Anyway, my question is: how reliable and trustworthy is data from a CPAP machine, and specifically the data from my ResMed AirSense 10?

The data from the machine is extremely reliable. Always has been. Lots of testing has been done comparing what the machine flags and what might get flagged in a sleep lab setting. It's been proven many times.

Now there is a limitation with the machine data in that the machine only measures air flow and can't have any way to know if you are asleep or awake. Awake breathing is very often very irregular when compared to asleep breathing and sometimes the machine might flag awake breathing irregularities as some sort of apnea event. In the sleep lab setting you are wired up with EEG leads which lets the tech know if you are asleep or not and when they see irregular breathing in the sleep lab they can quickly check to see if you are asleep or not.
Anything looking a bit "off" while awake they disregard because if we aren't asleep then breathing irregularities don't matter.

Now the machine can flag irregular breathing while awake as any sort of apnea event category but most often it is the central apnea flag that we see. If we aren't asleep it doesn't matter....other than we wonder why we might be spending a lot of awake time while using the machine.

If you are sleeping soundly for the most part then the data the machine is giving you is going to be really close to what you would get during an in lab sleep study. I trust it completely to be extremely accurate except on the nights where I know I didn't sleep so great for some reason or other. A while back I had a night with AHI being reported of 9.4 which is extremely high for me. I normally will see an AHI of 0.5 to maybe 2.0. When I saw the 9.4 I took the time to go looking at all those flagged events (nice normal mix of centrals, OAs and hyponeas) and 95% of them were so blatantly awake breathing flags that I had to just shrug my shoulders and move on.
I already knew that I slept horribly that night because of back pain. I had overdone things with my gardening that day so I just hurt really bad that night and did a lot of tossing and turning and I remember lots of awakenings.

So....while there might be a situation where the data is a bit unreliable...it is easily explained as to why and machine data shouldn't all be lumped in the basket of being unreliable and sleep lab data being the gold standard.

As for the machine flagging centrals that aren't real centrals....again not necessarily true. If you hold your breath for 10 seconds while awake with the machine/mask on it will flag a 10 second central apnea but you won't be asleep. If you aren't asleep it doesn't matter but it is still technically a central apnea which by definition is no air flow for at least 10 seconds but the airway is open.
Doesn't matter that you were holding your breath.....you weren't breathing and that's what a central apnea flag is...no air flow and no effort for at least 10 seconds.

The machine only reports what it senses but it has no way to throw out any awake breathing irregularity caused flags. It is a limitation of the machine.

It is normal to wake a handful of times during the night but as long as you don't spend a prolonged amount of time awake and doing a lot of tossing and turning....the data shown is going to be highly reliable and within 2 or 3 % of correlating with what a sleep lab study will show.

Sounds like your doctor is looking for more sleep studies and therefore more $$$$$$.

LSAT wrote: ↑

Sat May 08, 2021 5:07 pm

Sounds like your doctor is looking for more sleep studies and therefore more $$$$$$.

If you noticed he said "his" Sleep Lab!

squid13 wrote: ↑

Sat May 08, 2021 5:14 pm

LSAT wrote: ↑

Sat May 08, 2021 5:07 pm

Sounds like your doctor is looking for more sleep studies and therefore more $$$$$$.

If you noticed he said "his" Sleep Lab!

sounds like a boat payment to me.

barney999 wrote: ↑

Sat May 08, 2021 3:56 pm

he only trusts data from his sleep lab.

Sounds like he's got a vested interest in not trusting the data from cpaps.

Ignore him.

zonker wrote: ↑

Sat May 08, 2021 6:59 pm

squid13 wrote: ↑

Sat May 08, 2021 5:14 pm

LSAT wrote: ↑

Sat May 08, 2021 5:07 pm

Sounds like your doctor is looking for more sleep studies and therefore more $$$$$$.

If you noticed he said "his" Sleep Lab!

sounds like a boat payment to me.

Yachts are *expensive* So are greens fees.

barney999 wrote: ↑

Sat May 08, 2021 3:56 pm

During a recent visit to my Sleep Dr to talk about the APAP issues I've having, my Dr told me that data from a CPAP machine is unreliable and that he doesn't trust it. He said he only trusts data from his sleep lab.

Time to contact your insurance and find another dr. in your network. This one is in it for the money.

What issues are you having with your APAP?

Vent:

While I understand a doctor's unease about patients having too much information that they may not understand, this is an example of The Guild protecting The Guild. OSCAR is amazing and has put some agency into the hands of the patient. Combine that with the wisdom here and you have an informed healthcare consumer. The condescension and God complex of this doctor is maddening and that vacation home isn't paying for itself, either, obviously. Also, from a statistical point of view, 6 months is a hell of a lot better than 2 hours aside from a real outlier case. Has this guy ever heard of regression to the mean?

End vent.

Pugsy wrote: ↑

Sat May 08, 2021 4:28 pm

The data from the machine is extremely reliable. Always has been. Lots of testing has been done comparing what the machine flags and what might get flagged in a sleep lab setting. It's been proven many times....

Thanks very much for the detailed info, which has given me a much greater understanding about CPAP data. This is very helpful!

LSAT wrote: ↑

Sat May 08, 2021 5:07 pm

Sounds like your doctor is looking for more sleep studies and therefore more $$$$$$.

I don't know the motivation of my doctor, but I will say that, although he's younger than me (I'm 71), he seems like he's lost his fast ball and is sort of just mailing it in. I don't have a lot of options where I live, but I'll be looking for an alternative.

CPAPinCAL wrote: ↑

Sat May 08, 2021 9:25 pm

...OSCAR is amazing and has put some agency into the hands of the patient. Combine that with the wisdom here and you have an informed healthcare consumer.

You're exactly right about that! I'm extremely thankful for these resources. I've learned a lot here by just reading the topics and comments over the past number of months. I just started participating here a few days ago.

Prior to being diagnosed with severe sleep apnea 6 months ago, I knew absolutely nothing about sleep apnea, CPAP or anything else related to it.

After being diagnosed, I actually had no intention or desire to learn anything about it. But, I quickly learned that once I was given a machine and mask, I was basically on my own. That was very disappointing.

Although my sleep quality is much better now that I'm much more informed, it's been a pretty bumpy ride, especially the first couple of months. I still have issues that I'll be asking for help with.

I'm not sure what I would have done if not for forums like this and videos from Jason (LankyLefty).

SAG wrote: ↑

Sat May 08, 2021 8:49 pm

barney999 wrote: ↑

Sat May 08, 2021 3:56 pm

During a recent visit to my Sleep Dr to talk about the APAP issues I've having, my Dr told me that data from a CPAP machine is unreliable and that he doesn't trust it. He said he only trusts data from his sleep lab.

What issues are you having with your APAP?

I'll start a new topic to explain the issues, which involves Oscar data and I believe machine settings. They'll take a bit to explain.

I also need to read up on how to provide my Oscar data, which I hope to do within the next couple of days, hopefully tomorrow.

I think you're going to be a great asset to the forum

Please don't start a new topic though - we really need to be able to follow your story even if daily topics change within it, and it should make more sense in the end that way.

barney999 wrote: ↑

Sat May 08, 2021 10:55 pm

I don't know the motivation of my doctor, but I will say that, although he's younger than me (I'm 71), he seems like he's lost his fast ball and is sort of just mailing it in. I don't have a lot of options where I live, but I'll be looking for an alternative.

if you share where you live someone here may know a worthy doc

see if this helps
http://health.usnews.com/doctors/specialists-index