CPAPtalk.com

Posted: **Wed Mar 22, 2023 8:15 pm**

palerider wrote: ↑
Wed Mar 22, 2023 4:11 pm

sreiter wrote: ↑
Tue Mar 21, 2023 10:30 pm
I've been in IT for 40 years.
This is nothing personal, but simply an observation.

I've *repeatedly* ended up attempting to help people that are 'not getting it' in some technical aspect of something relating obliquely to computer use, and I've heard "I've worked with computers for 40 years" from them, probably to tell me to shut up and accept that they know better than I do.

I don't know what that's supposed to mean, honestly. I've worked with computers for 43 years myself, and that really means nothing at all. I started out on mainframes, minis then workstations and multimillion dollar servers, now we're talking about PCs and some somewhat obscure app that runs on a PC, pulling the data from another computer in a medical appliance.

I really can't see what that has to do with decades of experience in a field that's changed so dramatically in those decades.

One of the things, though, that does seem to be consistent, is that in the person's attempt to "give those helping me usable data" they have applied their decades of experience, and done what they thought was desired, instead of just doing what was actually asked, which results in multiple back and forth iterations.

How this applies to you, I can't really say.

Anyway, have a nice day!

I didnt take what you wrote personally. You were expressing your experience, and questioning why someone would bring that up. Totally legit question, even if it were rhetorical.

I only mentioned my years of experience because as you must know with your years of experience, the reason we get paid as much as we do is literally because of that experience ie we usually know what the users want/need before they do. I'm sure you gathered user requirements in a design meeting and mentioned some functionality they never thought of because on some other project some other user somewhere wanted that functionality, whether you were part of the design or dev team, or maybe it was already in production and you noticed it because of a code change or something.

I get in this case; I shouldnt have. But again, per the noOb thread, this wasnt the standard "provide us with x y z one screen shot" (which I did on page 1 or 2), this was a special request, so i tried to be helpful.

Perhaps all those previous experiences came boiling up to the surface and thought "ugh, another one". I cant say either way, but, again, how you handled my screw up and how Robysue1 handled the situation was night and day. He/she/they ???? (apologies, tough to tel by your screen name) handled me being a neophyte ad graciously going out of their way to offer to coach me along is, IMO, how one should handle someone, especially someone who begged for understanding, was apologetic, and was graciousness, as I was with you.

I hope this might provide insight into why IT professionals might veer askew and as way of offering an apology for doing so, their CV as way as to an explanation of way the deviated.

I still hold your knowledge and you giving of your time trying to help me in high esteem, and harbor no ill will

My sincere hope for you all the best

take care and have a wonderful rest of your day (whenever you read this)

Posted: **Thu Mar 23, 2023 9:07 am**

sreiter,

Here is a marked up copy of the last Oscar data you posted:

The stuff in the purple boxes is just the FOT algorithm kicking in. Those are oscillations that are roughly 1cm from valley to peak.

The stuff in the red boxes is what's of interest. You are using straight CPAP mode at 10 cm with EPR turned off. I would expect very little variation in pressure between the inhalations and the exhalations with EPR turned off, but in those red boxes, there are often very short-lived drops that are greater than 1 cm in pressure, and are often pretty close to 2 cm. These pressure drops don't look at all like the usual EPR algorithm's influence on the Mask Pressure graph.

Now in order to maintain as constant of pressure as possible (i.e. with EPR = off), the machine is going to need to increase airflow (slightly) during each exhalation, so some variation would be expected in the Mask Pressure curve. But I am wondering if the sensation you are noticing is being caused by a drop in pressure that occurs when you do a strong exhalation and the machine is taking just a fraction of a second to respond by increasing the airflow to maintain the pressure.

We know that leaks are not causing the problem because there are no significant leaks during any of the times the pressure has those downward spikes of 1.5-2.5cm. That's why I think these drops must somehow be related to how the machine is responding to your exhalations.

Now what I'd like to see is a snippet of your regular sleep breathing when you are not having any events and you have no sensation of waking up noticing the "mask collapsing" sensation. I'd like the zoom-in level to be about the same as this last screen shot and I'd like the same three graphs: Flow Rate, Mask Pressure, and Leak. I want to see if the Mask Pressure curve is smoother when you are sound asleep and have no recollection of the "mask collapsing" sensation.

Out of curiosity: Why do you have EPR turned off?

Posted: **Sat Mar 25, 2023 8:22 pm**

robysue1 wrote: ↑
Thu Mar 23, 2023 9:07 am
sreiter,

Here is a marked up copy of the last Oscar data you posted:

The stuff in the purple boxes is just the FOT algorithm kicking in. Those are oscillations that are roughly 1cm from valley to peak.

The stuff in the red boxes is what's of interest. You are using straight CPAP mode at 10 cm with EPR turned off. I would expect very little variation in pressure between the inhalations and the exhalations with EPR turned off, but in those red boxes, there are often very short-lived drops that are greater than 1 cm in pressure, and are often pretty close to 2 cm. These pressure drops don't look at all like the usual EPR algorithm's influence on the Mask Pressure graph.

Now in order to maintain as constant of pressure as possible (i.e. with EPR = off), the machine is going to need to increase airflow (slightly) during each exhalation, so some variation would be expected in the Mask Pressure curve. But I am wondering if the sensation you are noticing is being caused by a drop in pressure that occurs when you do a strong exhalation and the machine is taking just a fraction of a second to respond by increasing the airflow to maintain the pressure.

We know that leaks are not causing the problem because there are no significant leaks during any of the times the pressure has those downward spikes of 1.5-2.5cm. That's why I think these drops must somehow be related to how the machine is responding to your exhalations.

Now what I'd like to see is a snippet of your regular sleep breathing when you are not having any events and you have no sensation of waking up noticing the "mask collapsing" sensation. I'd like the zoom-in level to be about the same as this last screen shot and I'd like the same three graphs: Flow Rate, Mask Pressure, and Leak. I want to see if the Mask Pressure curve is smoother when you are sound asleep and have no recollection of the "mask collapsing" sensation.

Out of curiosity: Why do you have EPR turned off?

Thank you SO MUCH for taking the time to do this.

Out of curiosity: Why do you have EPR turned off?

I didnt. Either one of my DRs did, or it came that way from the factory.

As a slight aside, I saw my sleep Dr Thursday and I asked him about the sensation. He said he's felt the exact thing I experience when he'd have the power go out and come back on very quickly. He said if it hadnt happen to me with multiple machines he'd say the motor was bad in my machine, which makes sense he'd guess that as that was resmeds thought/why they sent me a new machine when I called them asking WTF?

Here's what the majority of the night looks like - but in between this and the graph I posted before the graph looks like stuff is going on. Let me know if you want me to post that as well, just so you can see something going on with my breathing

Posted: **Sat Mar 25, 2023 8:47 pm**

Robysue1

I wonder if you wouldnt mind looking at this from last night and letting me know if you see anything "interesting". I felt a very similar, or modified sensation. I took my mask off immediately so I knew exactly where the event would be on the graph. When i say similar I mean the mask didnt collapse as hard into my face (although I'm using a mask with memory foam now, so maybe that cushioned the feeling).

graph shows the event @ 10:59 (disregard grey'd area. Its when I took my mask off)

Posted: **Sun Mar 26, 2023 5:19 am**

sreiter wrote: ↑
Sat Mar 25, 2023 8:47 pm
I took my mask off immediately so I knew exactly where the event would be on the graph.

Just turn the machine off to mark a point in time.

Posted: **Sun Mar 26, 2023 9:31 am**

ChicagoGranny wrote: ↑
Sun Mar 26, 2023 5:19 am

sreiter wrote: ↑
Sat Mar 25, 2023 8:47 pm
I took my mask off immediately so I knew exactly where the event would be on the graph.
Just turn the machine off to mark a point in time.

normally i would have but I had shoulder surgery and and cant easily or more to the point quickly get to my machine. I have it set to turn on and shut off when it senses I' am or am not wearing my my. it turns on and shuts off within a few seconds

Posted: **Sun Mar 26, 2023 5:25 pm**

sreiter wrote: ↑
Sat Mar 25, 2023 8:47 pm
Robysue1

I wonder if you wouldnt mind looking at this from last night and letting me know if you see anything "interesting". I felt a very similar, or modified sensation. I took my mask off immediately so I knew exactly where the event would be on the graph. When i say similar I mean the mask didnt collapse as hard into my face (although I'm using a mask with memory foam now, so maybe that cushioned the feeling).

graph shows the event @ 10:59 (disregard grey'd area. Its when I took my mask off)

So, you can see where the pressure in the mask actually dropped when you took your mask off, and you can see that the pressure is being maintained (with minor wiggles as you breathe) before that.

It might help if you'd right click where it says "Flow Rate" vertically, click on 'dotted lines' and turn on zero, then right click again, select 'Y Axis", then override, and put in -75 75 to limit the autoscaling that is happening on the flow chart, and show the zero crossing line.

That makes the flow a bit easier to read.

But, I don't see anything abnormal in there, you had an apnea that woke you up.

There's an unusual spike during exhalation in three of the breaths after the apnea, but I don't know what that might represent, but it might be part of what you're feeling?

Posted: **Mon Mar 27, 2023 6:35 pm**

palerider wrote: ↑
Sun Mar 26, 2023 5:25 pm

So, you can see where the pressure in the mask actually dropped when you took your mask off, and you can see that the pressure is being maintained (with minor wiggles as you breathe) before that.

It might help if you'd right click where it says "Flow Rate" vertically, click on 'dotted lines' and turn on zero, then right click again, select 'Y Axis", then override, and put in -75 75 to limit the autoscaling that is happening on the flow chart, and show the zero crossing line.

That makes the flow a bit easier to read.

But, I don't see anything abnormal in there, you had an apnea that woke you up.

There's an unusual spike during exhalation in three of the breaths after the apnea, but I don't know what that might represent, but it might be part of what you're feeling?

Thank you very much for being generous with your time and you analysis. WOW! Reading the explanation, it seemed way harder than it was. followed you're explanation to the letter. You it made easy. Thanks

thank you again

Posted: **Mon Mar 27, 2023 7:16 pm**

OMG!

someone just thanked palerider!!

(to the op: excuse me, it's a private joke.)

Posted: **Mon Mar 27, 2023 9:33 pm**

zonker wrote: ↑
Mon Mar 27, 2023 7:16 pm
OMG!

someone just thanked palerider!!

:faints dead away:

Posted: **Mon Mar 27, 2023 9:37 pm**

sreiter wrote: ↑
Mon Mar 27, 2023 6:35 pm
Thank you very much for being generous with your time and you analysis. WOW! Reading the explanation, it seemed way harder than it was. followed you're explanation to the letter. You it made easy. Thanks

thank you again

To me, that makes it easier to see what's happening with the flow, I still don't know what those little spikes are during the exhale,
they'd be very brief stops of the exhale, maybe like a hiccough during exhale, a spasm of the diaphragm? (in case it's not clear, the red line in the middle means 'no airflow', anything above the line is inhalation, and anything below the line is exhalation).

Your breathing at the start of that strip looks to be asleep, but very flow limited (probably needs more pressure)

Posted: **Tue Mar 28, 2023 6:12 pm**

palerider wrote: ↑
Mon Mar 27, 2023 9:37 pm

To me, that makes it easier to see what's happening with the flow, I still don't know what those little spikes are during the exhale,
they'd be very brief stops of the exhale, maybe like a hiccough during exhale, a spasm of the diaphragm? (in case it's not clear, the red line in the middle means 'no airflow', anything above the line is inhalation, and anything below the line is exhalation).

Your breathing at the start of that strip looks to be asleep, but very flow limited (probably needs more pressure)

Thank you again (zonker not withstanding

)

My DR changed my machine to APAP at my request. I'll see if that does anything.
I'm also going to go for my 3rd sleep study, but 100% on cpap/tritration study

I'll make sure they're aware if these "anomalies ??" and see if the electrodes pick up anything during these times.

Worst part about all of it is the machine doesnt help 1 bit (well, on rare occasion it help 1 bit) . I never hit delta, so I'm never rested and I have as many central apnea's as obstructive. But that hasnt stopped me from trying to get as much "help" as I can. Maybe one fay I'll find the silver bullet.

thanks again. It really is TRULY appreciated.

All the best!!!

Posted: **Tue Mar 28, 2023 6:13 pm**

zonker wrote: ↑
Mon Mar 27, 2023 7:16 pm
OMG!

someone just thanked palerider!!

(to the op: excuse me, it's a private joke.)

No excuses necessary !!!!

cheers

Posted: **Tue Mar 28, 2023 6:15 pm**

sreiter wrote: ↑
Tue Mar 28, 2023 6:12 pm
My DR changed my machine to APAP at my request. I'll see if that does anything.

With what settings?

Posted: **Tue Mar 28, 2023 6:54 pm**

palerider wrote: ↑
Tue Mar 28, 2023 6:15 pm

sreiter wrote: ↑
Tue Mar 28, 2023 6:12 pm
My DR changed my machine to APAP at my request. I'll see if that does anything.
With what settings?

mode -autoset
max pressure - 12
min pressure - 8
mask full face
response - soft
ramp time off (it was 5 mins)
EPR - off
clim. control manual
tube temp 85
humid - 5
ab filter no
essentials - on
smartstart - on

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