420E setting question

I haven't been back either. I also have noticed my runs have decreased also.

Your numbers are very very good. Mine are higher, but still much better than the study.

My sleep doc didn't even ask me to come back, I asked him, he mumbled oh, ''in a few mos'', really interested huh?

I can imagine he'll glance at my data, put it in a folder and out I go..........

Well, we all know we're following our own health plan.............

Of course, disclaimer: tell ur dr. (and do what you know is right for your own health)...IMHO of course........

UKnowWhatInSeattle wrote:-SWS,
I haven't been back in to see the sleep doc yet ( )...

However, I have been seeing much lower "run" counts than I was. I'm typically in the range of 18-51 for the last two weeks instead of the 150+ I was seeing at first.

Here is what my detected events look like for the period 2/12 - 3/10:
Apneas: 6 (0.0 Index/h)
Apneas/CA: 7 (0.0/h)
Hypops: 49 (0.2/h)
Hypop/FL: 13 (0.1/h)
AV (snores): 168 (0.8/h)
FL - Runs: 1929 (9.6/h)

So, I think I'm doing pretty danged well.

I probably posted this before under one of the DME threads, but when I started having runaway pressures, I called my RT immediately the next morning. Waited days to receive a reply and was told< "Gee I don't know, but I'll try to find out". Five days later still no response. By now I had asked the forum and was told how to reset the unit. Weeks later, after complaints to the HQ for my DME about not getting a response on what could be a seriously detrimental problem to my health, I went in for a download to take to my Sleep Dr. and had reset the 1FL to 1. My new RT there knew about the problem I'd had from the long discussion with him after my complaints. Wellllll, when I got home I checked the 1FL and it had been set to 0, without him mentioning a word.

And I also found I immediately slept better and felt more refreshed after changing this setting. I think it was about a week or so after starting on the 420E as well, when I first began to get the runaway pressures up to 17 and even 18.. My titrated pressure was 8 btw. and I'd never been above 11.

As SWS explained it, I think, the machine interprets shallow breathing (not taking deep breaths) as an obstruction and when the breaths don't get deeper it keeps raising the pressure. However, during one of these "episodes" I sat on the bed for 5 minutes breathing normally, wide awak and watched the pressure climb every minute by .5. I did this because I was told it takes the machine about 1 minute to recognize a change in breathing pattern and to adapt accordingly. But it did not recognize my normal breathing as "normal".

I will watch my pressure on the 420E and see that it doesn't go way out of sync like yours did. If so, I will do what you did.....I don't thnk that'll impact the overall effectiveness or setting #'s, do you?

Do you have the software to follow B4 you turned off the FL1?

txs........

gz

Janelle wrote:I probably posted this before under one of the DME threads, but when I started having runaway pressures, I called my RT immediately the next morning. Waited days to receive a reply and was told< "Gee I don't know, but I'll try to find out". Five days later still no response. By now I had asked the forum and was told how to reset the unit. Weeks later, after complaints to the HQ for my DME about not getting a response on what could be a seriously detrimental problem to my health, I went in for a download to take to my Sleep Dr. and had reset the 1FL to 1. My new RT there knew about the problem I'd had from the long discussion with him after my complaints. Wellllll, when I got home I checked the 1FL and it had been set to 0, without him mentioning a word.

And I also found I immediately slept better and felt more refreshed after changing this setting. I think it was about a week or so after starting on the 420E as well, when I first began to get the runaway pressures up to 17 and even 18.. My titrated pressure was 8 btw. and I'd never been above 11.

As SWS explained it, I think, the machine interprets shallow breathing (not taking deep breaths) as an obstruction and when the breaths don't get deeper it keeps raising the pressure. However, during one of these "episodes" I sat on the bed for 5 minutes breathing normally, wide awak and watched the pressure climb every minute by .5. I did this because I was told it takes the machine about 1 minute to recognize a change in breathing pattern and to adapt accordingly. But it did not recognize my normal breathing as "normal".

Janelle wrote:As SWS explained it, I think, the machine interprets shallow breathing (not taking deep breaths) as an obstruction and when the breaths don't get deeper it keeps raising the pressure.

Don't think that was my explanation, Janelle.... That just might have been what Rested Gal said raising conjecture about her own breathing pattern relative to her own 420e IFL1 over-trigger problem. I think there is really no definitive way of knowing exactly what caused 420e "runaway pressure" with the very few posters who experienced it. I think each person can only guess at their own breathing pattern, but I also think it's definitely not a sound conclusion to generalize that these are common instances of "shallow breathing".

In my opinion all that can be safely said is that these few instances were all caused by what PB recognizes as "flow limitation runs". But that's just my opinion.

I understand your point, SWS, but wouldn't "shallow breathing" (not taking deeper/longer breaths) be considered by certain algorithms/programming as a flow limitation? If X equals what is considered normal flow (normal deep, manlike breaths) and less than X is the way many women breathe--very quietly with not as much flow????

Just asking and trying to understand the overall picture and science of Flow Limitations.

Janelle, I don't know for certain. However, like many of you I suspect that shallow breaths can, indeed, fool the 420e. None of us have a good way of measuring our own breaths, let alone figuring out exactly what it is about our breaths that happen to fool the IFL1 trigger. You recognize that you breathe "shallow". You can speculate that your "shallow" breaths were the culprit that fooled IFL1. However, you have no way of knowing which constituent component(s) of your breathing patterns actually caused IFL1 to over-trigger. Many 420e users likely have what you would recognize as "shallow breathing"---yet very few of us actually cause the 420e to over-trigger. Was it really "shallow breathing" that caused the over-pressure? Maybe it was, but maybe it was something altogether different.

I do know the 420e will attempt to differentiate obstructive sleep events by looking at airflow volume as well as the waveform shape of the patient's airflow. Eclipsing and/or resonating tissue helps to shape the waveform toward this distinction. This is not a fool proof method of differentiating obstruction or limitation, however. There's just no way to safely generalize that "shallow breathing" is the predominate cause of IFL1 over triggering. It's perhaps sound conjecture on a case-by-case basis, but not exactly a sound generalization. In any case it is but conjecture.