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The problem with an HST w/o sleep staging is that one doesn't know if the guy is asleep or not. This is a short study, and by history and looking at a surrogate it's clear your sleep continuity is abysmal. The company line is you need 7.8 hours of sleep (not sleep study, not time on CPAP) to be rested (there are Short Sleepers, AAMOF I am one) and you are nowhere near close.

There are contradictions galore. You said

Diagnosed mild/moderate sleep apnea

nowhere does it say moderate. AAMOF it shouldn't even say mild. With RDI 2.7 it should say "normal". It says "intermittent hypoxia"-- LSsOS! There's NO hypoxia!

The Remmers algorithm looks just at flow to determine AHI, but how many of those events were there when you were actually asleep? How many of those were normal centrals?

The RDI is based on desats, you got 12 (Maybe. Could just be artifact. Instead of normal you could be really normal).

SwirlySauce wrote: ↑

Wed May 24, 2023 6:14 pm

I'm still miffed that the sleep clinic recommended and sold me a DreamStation over a Resmed when I had asked about which is better in 2019. I think their margins are higher on DreamStations.

Other than the foam thing, what's the problem with Respironics?

Going back to the title of this thread

Need a new plan for BiPAP / CSA

seems to me this whole thing is like one of those image puzzles where you find all the errors (guy with 3 arms, water flowing uphill, 2 + 2 = 5, etc.).

I think you're gonna get a lot more benefit by reading everything that Robysue/Robysue1 ever posted rather than trying any more DWing.

Rubicon wrote: ↑

Fri May 26, 2023 2:19 am

What means L3?

NM, Level III.

I thought you meant you had typo 13 more pages of the report handy.

Rubicon wrote: ↑

Fri May 26, 2023 2:19 am

SwirlySauce wrote: ↑

Thu May 25, 2023 8:11 pm

I did email the person at DreamSleep that sent me the L3 study report ...

What means L3? If you got more stuff like this



by all means slap it up here.

Meanwhile, we'll run whatchu brung.

L3 = Level 3

DreamSleep only sent me those 2 pages that I PM'd you unfortunately. Still waiting to hear back on raw data files

Rubicon wrote: ↑

Fri May 26, 2023 2:39 am

SwirlySauce wrote: ↑

Wed May 24, 2023 6:14 pm

I'm still miffed that the sleep clinic recommended and sold me a DreamStation over a Resmed when I had asked about which is better in 2019. I think their margins are higher on DreamStations.

Other than the foam thing, what's the problem with Respironics?

FLEX is worse than EPR

Rubicon wrote: ↑

Fri May 26, 2023 2:53 am

Going back to the title of this thread

Need a new plan for BiPAP / CSA

seems to me this whole thing is like one of those image puzzles where you find all the errors (guy with 3 arms, water flowing uphill, 2 + 2 = 5, etc.).

I think you're gonna get a lot more benefit by reading everything that Robysue/Robysue1 ever posted rather than trying any more DWing.

I'll have to look up Robysue's posts. If apnea isn't causing poor sleep continuity then what is? I could maybe point to coffee/alcohol/Vyvanse but I've been a crap sleeper long before those ever came into the picture.

Edit: Although now that I think about it I never had issues with waking up throughout the night (that I was consciously aware of) when I was younger. Thats only been the last few years where I find myself randomly waking up in the early AM. I can usually get back to sleep quickly though. Maybe too much stress or simply getting older, or meds

Here are some charts pre-Resmed. Either SleepHQ is bugged or my data is but most of my imported charts for DS aren't displaying any data at all. These ones seem to be OK -

https://sleephq.com/public/bc6a6522-0cb ... 88f56a8d07
https://sleephq.com/public/72a105d2-87d ... fc104b31bf
https://sleephq.com/public/d746b803-71d ... 4d5068810e
https://sleephq.com/public/c1453f7e-2e4 ... a69e2e6eb7

There is no flow limitation graph on the Respironics machine's reports because Respironics machines don't do FL graphs like the ResMed does.
Instead Respironics flags any FLs up on the events graph like it flags OAs, or hyponeas, etc.

As for missing sleep stages....these machines don't do sleep stages at all...none of them. They can't tell sleep from awake.

SwirlySauce wrote: ↑

Fri May 26, 2023 10:01 am

If apnea isn't causing poor sleep continuity then what is?

Already answered.

You need military sleep hygiene and complete sleep history including a 2-week sleep log.

In addition, if I was in your boat I'd be looking for a good AASM credentialed CBT-I guy.

Interestingly, NPSG is generally not indicted for insomnia, so you have to be careful how you word the request (although I don't know Canada).

Maybe... simply getting older...

You're silly.

Rubicon wrote: ↑

Fri May 19, 2023 3:26 am

Speaking of which, of all the machine and settings changes, are there any where you feel truly rested (not sleepy)? You mention fatigue, but fatigue is not sleepy so what you're trying to fix may not be CPAPable.

AAMOF, if your ESS is 3 (as noted on the report) you are not sleepy.

SwirlySauce wrote: ↑

Wed May 24, 2023 6:14 pm

Is an EENT the same as ENT?

Not really, but that's what I meant. Bad habit I've needed to break for... well, a long time.

Anyway, there looks to be more palate stuff in a DS SleepHQ. Did anybody look down your throat? That's Sleep/OSA Exam 101.

Rubicon wrote: ↑

Sat May 27, 2023 3:02 am

SwirlySauce wrote: ↑

Wed May 24, 2023 6:14 pm

Is an EENT the same as ENT?

Not really, but that's what I meant. Bad habit I've needed to break for... well, a long time.

Anyway, there looks to be more palate stuff in a DS SleepHQ. Did anybody look down your throat? That's Sleep/OSA Exam 101.

Not that I recall...Like, with a scope or just a "stick out your tongue" looksie?

What does this palate stuff point to exactly?

SwirlySauce wrote: ↑

Mon May 29, 2023 9:16 pm

Not that I recall...Like, with a scope or just a "stick out your tongue" looksie?

Anything would have been minimum expectation.

What does this palate stuff point to exactly?

Expiratory, vs inspiratory, flow limitation.

Rubicon wrote: ↑

Tue May 30, 2023 4:35 am

SwirlySauce wrote: ↑

Mon May 29, 2023 9:16 pm

Not that I recall...Like, with a scope or just a "stick out your tongue" looksie?

Anything would have been minimum expectation.

I remember them measuring my neck circumference, weight and height. I don't recall any mouth stuff though but its been a few years.

What does this palate stuff point to exactly?

Expiratory, vs inspiratory, flow limitation.

Interesting, I'll have to do some research on that. Does it respond to PAP treatment?

Edit: I had a quick glace at this page on Palatal Prolapse - https://sites.google.com/view/palatal-prolapse

Sounds like you would need more EPAP to stabilize the palate so it doesn't flop around. Although there was also mention of increased IPAP causing worsening of prolapse so BIPAP might make it worse