Callen's questions...

Perhaps you haven't tried enough settings changes...

Rubicon wrote: ↑

Sun Apr 30, 2023 10:49 am

Perhaps you haven't tried enough settings changes...

I concur. I've been thinking about changing my settings once or twice per night.

In all seriousness. I have no idea what I'm doing. If I did, then I wouldn't be here.

If you have any suggestions, then I'm all ears.

Are these session times correct?

Rubicon wrote: ↑

Sun Apr 30, 2023 11:09 am

Are these session times correct?

No, much of the smaller (<30min. - 1 hour sessions) are not actually me sleeping.

Especially when I was first getting used to it.

Callen wrote: ↑

Sun Apr 30, 2023 11:18 am

Rubicon wrote: ↑

Sun Apr 30, 2023 11:09 am

Are these session times correct?

No, much of the smaller (<30min. - 1 hour sessions) are not actually me sleeping.

Especially when I was first getting used to it.

Oh wait... Let me see. I see what you mean.

Yes, those are the correct times.

The low-hanging fruit:

You've got 23 settings changes in 31 days.
Your compliance is poor.

The sleep log will be very helpful towards establishing strict sleep hygiene.

The diagnosis of OSA was based on the 2023 PSG. It noted

AHI 8.5 during ~6.0 hours of sleep

6 central apneas
11 mixed apneas
19 obstructive apneas
16 hypopneas
52 events total

IMO you got maybe 6 events that are actually bona fide events and might benefit from CPAP (although I doubt it) Of course that would be AHI 1.0 and "normal" so why bother.

For instance



The first OA (red block) is scored in the middle of FLBs that look like a breath hold in preparation for position change. The second OA is in the middle of jumping around. Neither will respond to CPAP.



The blue event is a mixed apnea. Well no it ain't. These people wouldn't recognize a mixed apnea if it bit them in the butt. If anything it would be a central apnea, and normal phenomena cause it follows some deep breaths. The OA is not only in the middle of jumping around, the epoch is scored wake. Can't be OSA. Could be OWA (if there was such a thing.

Again, this looks like auto-scored that wasn't confirmed.

Now, in the "mixed apnea" they may have seen activity in the chest lead and said "Aha! Breathing effort!"

You know what that is?

Guess:



CBA!!

There may be some areas of CAP (cyclic alternating pattern). A cleaner study might be able to better determine that. CAP is a NREM phenomenon where sleep is generally unstable w/o scorable events in the "traditional" sense.

Rubicon wrote: ↑

Sun Apr 30, 2023 4:00 pm

There may be some areas of CAP (cyclic alternating pattern). A cleaner study might be able to better determine that. CAP is a NREM phenomenon where sleep is generally unstable w/o scorable events in the "traditional" sense.

Well. I'm honestly not sure what to say. My understanding is sleep can be negatively impacted by increased WOB even if no arousal is associated. As found in Upper Airway Resistance Syndrome. Apparently not. Wishful thinking on my part... I take it there are no SDB or other problems during REM, either?

Did you see my spO2 and HR data? Are the spikes in HR artifacts from movement? They appear to coincide with my sats dropping. I can only assume you'll be unimpressed by them as well.

Is there even a point in repeating a sleep study? Should I just cancel my appointment with the new Sleep Medicine Doctor that was scheduled for the end of May?

FFS. I guess I'll just accept the N diagnosis and loathe the rest of my existence. Fk this.

Rubicon wrote: ↑

Sun Apr 30, 2023 4:00 pm

There may be some areas of CAP (cyclic alternating pattern). A cleaner study might be able to better determine that. CAP is a NREM phenomenon where sleep is generally unstable w/o scorable events in the "traditional" sense.

https://pubmed.ncbi.nlm.nih.gov/1755238 ... tes,Sleep.

This?

Rubicon wrote: ↑

Sun Apr 30, 2023 4:00 pm

There may be some areas of CAP (cyclic alternating pattern). A cleaner study might be able to better determine that. CAP is a NREM phenomenon where sleep is generally unstable w/o scorable events in the "traditional" sense.

Are you familiar with UARS?

Today, I crossed the Rubicon.

I just spoke with the RPSGT who performed and scored my study. I asked her if it was scored by the algorithm, and she said, "No, I don't let the computer do it. I score them myself." So, I dipped my toes into the water and informed her an RPSGT friend, whom I trust, reviewed my study. And they noted many errors in the scoring and stated the "technical quality was poor." She was not a happy camper and retorted that she had 20 years of experience, and she was sorry they felt differently about the study. It ended with her telling me that she was going to tell my neurologist about what I had said, which I thought was odd of her to say. There was no bridge to burn. Instead, I crossed the river.

Also, the chin EMG didn't show up because it wasn't in the "data map", and technical support at Cadwell told me they didn't think there was any way to provide me with the data, but they were going to speak with the software engineers and get back with me. So, there's that.

Callen wrote: ↑

Mon May 01, 2023 4:13 pm

retorted that she had 20 years of experience

Six months of experience 40 times

Ooooh!
When a tech gets defensive so quickly, it might not be the first time.
So, this person is now threatening to talk to your neuro . . .
---Probably about your 'tude.
Like she has none, herself?

Was this an accredited facility? If so, this is going to get much better (or worse, depending on your point of view). As part of accreditation requirements the physician has to sign an attestation that he/she has personally reviewed the record and verified that it is accurate.