Muse's APAP Data Collection-Trial

Sleep doc's loaned me a ResMed AutoSet Vantage..no easy-breathe or EPR *sigh*. It's set 4-20 cm with Smartmask start on. They'll have data for the coming 5 nights; gotta return it next Tuesday. I'll hafta wait for Doc to analyze results & call. I'm assuming he'd rather I come so we can chat at some length about the data and what device/settings/mask changes, if any, are needed. I'm a bit concerned about the 4 as my current ramp pressure is 8 (sustained pressure=11) but the tech said that the machine will identify and adjust as needed and that's part of the data collection process. When ramp was 4 in my Escape, I felt it was nowhere near enough air and had them re-set ramp to 8. PA said the APAP might eliminate the occasional puffs of exhaled air I'm aware of, then again maybe I'm having lots of mouth leaks while I'm asleep.

They also loaned me a Respironics pulse oximeter (model 920 MPlus) with the Nonin technology (???). They'll have 4 nights of data as I hafta return it next Monday...why not turn it in with the APAP o Tuesday you ask as did I. Well, normally they just loan it out for a single night; but, as it's the holiday weekend, I'll have it until Monday. The PA will call me with the sats/desats next week after she downloads the data.

I need help getting data from the APAP's LED -- I'm not supposed to change the settings...well, duh this is to collect data and see if my breathing is easier with an APAP, I'd be an idiot to mess with the setttings and undo the value of data collection. Sure be nice to know what my API, HIs, AIs are and leak data for each night. While the CPAP tech cannot give me the figures from my sleep study *grrrrr*, she did tell me I had no centrals in the study then she remembered she's not supposed to tell me numbers *sigh*. If I remember correctly (questionable given the state of my muddled thinking back then ), I had no aps just many, many, many hypops with destaturations.

Please help me figure out how to get data from the LED or as much as possible so I can post it for interpretation/comments each morning -- thanx thanx thanx!

muse-inc@live.com for CPAPtalkers

I have the S8 AutoSet II, and I don't know if the procedure is the same for your Vantage.

If you PM me with your email address, I can send you instructions for my machine.

I would make time this afternoon to lay down with it. I suspect the 4 might be too low for you to feel like you can get air. Mine was at 5.5 before I could "breath". If you check it now, you can either call them to walk you through upping it or get someone here to give you a manual on how to change it.

BeanMeScot wrote:I would make time this afternoon to lay down with it. I suspect the 4 might be too low for you to feel like you can get air...If you check it now, you can either call them to walk you through upping it or get someone here to give you a manual on how to change it.

cool beans scott ( sorry, could not resist) . I'm off to try that now.

Gee, tried to take a nap and guess what? at 4 cfm, I can't get enough air...duh, I told 'em that when I picked up the APAP..."No problem, the machine'll adjust." Well, it's not or at least not fast enough and I'm sucking air like a fiend trying to get enough air...so much for a nap which I really needed anyway . I have a call in as the tech's meeting with a patient, I told 'em I'm calling back every 10 mins to get them to increase the beginning pressure. So much for this tech listening to me , the other one listened which is how my ramp was re-set to 8. The pressure on the LED kept increasing when I finally gave up figuring being all sweaty from trying to breathe wasn't worth it, the APAP was up to 4.5 at the end of my 20 mins attempt to take a nap...big deal, still couldn't get enough air.

UPDATE: They just called me back & cannot change the settings without the doc's OK and he's left for the holiday and, furthermore, esp not over the phone (heck, I might learn how to change the pressure for MY therapy, do these people think I want less pressure so I can kill myself?). The upshot is they'll get back to me Monday. More time wasted, while I still don't know if I'm really having events and desats; I'm really tired of being tired again and having my under-eye circles get darker and larger...grump grump grump. Anyway, they did say that if I end up going back to my Escape until Monday, not to worry about my return dates for the APAP or oximeter as they don't need them immediately.

Why do they not listen to what we say, do they have so little respect for our knowledge of our body's behavior that they ignore wat we say and slavishly push the standard 'party' therapy regardless of our saying that 'x' doesn't work for us? I bet my doc had forgotten why my ramp pressure is 8 when he talked to the tech about setup....sucks...I mean it literally sucking air thru the exhaust events is exhausting...b#tch b#tch b#tch.

I know y'all can tell me how to up the min pressure, but I think this little waiting exercise while personally inconvenient and frustrating, is worth it because I'm gonna be aggressive/difficult to deal with the next time someone messes with my initial pressure setting and I will never trust what this tech tells me (the one I liked meeting with is no longer there *sigh*).

Muse... follow jnk's link... looks like the directions are in RG's links that he's pointed to.

Thanks to Rested Gal, I have the numbers for my aborted nap this afternoon:

About 20 mins in length

AHI = 4.1, all hypops

Leak = 0.28 L/s

My OptiLife mask's leak rate is about 14 LPM for pressure at slightly above 4. So do I (14 / 60) to get 0.23 LPS? I am so clueless

Then, I compare the APAP's reported # (0.28 L/s) to the mask's leak rate (0.23 LPS if I did that calc right) ? If so, then that means the machine detected a leak rate expected with my mask -- right? If so, I got one thing straight .

Now with 4 hypops in 20 mins, I was having them about every 5 mins, so the device increased pressure by 0.1 for every hypop (and I was awake!!!) as it ended up at 4.5 from initial 4. Have I got this?

EDIT: I guess it'll just take, let's see, at 0.1cfm/5 mins, then 1.0 cfm/50 mins at that rate. So, to get to 8 (my current beginning) would take 4x50 mins or 200 mins 3 HOURS ...aaaaiiiieeeee...I'll never last that long to get to 8.

Did I interpret these numbers properly (see preceding post) -- thanks.

I'm not sure about the Vantage but my AutoSet II uses the Mask setting in the Clinical Menu to allow it to calculate the expected mask leak rate and subtract it from the total leak. Only the "excess" leak is displayed. The settings available are only for ResMed masks, of course. I've read that for non-ResMed masks one should set the mask to Standard, but I'm not sure what that does. Alternatively one could compare the leak/pressure graph from a non-ResMed mask to the various ResMed graphs to see if one is close. Then that ResMed mask setting could be used for fairly accurate results.

jdm2857 wrote:I've read that for non-ResMed masks one should set the mask to Standard, but I'm not sure what that does.

I believe setting to standard mask gives a 24 L/min (0.4 L/sec) deduction to allow for intentional flow/vent rate when the machine factors in the flow rate before giving the reading on the machine as to leak report.
They needed some figure to allow for non ResMed masks.

Finally fell asleep @ 4cfm. Trick for me at that pressure was to physically slow down, slow my breathing rate by taking long deep breaths, make a concerted effort to relax thinking & body BEFORE getting into bed -- much different than when I tried to nap in the afternoon.

Trouble falling asleep & staying asleep: flashing LED on oximeter but being able to read made me feel more secure @ 4, APAP sound is different than my Escape, very aware of the finger sensor. Felt like I coasted in & out of sleep for some time before finally dropping into sleep. I woke up multiple times.

Oximeter:
O2: started at 98 and immediately dropped to mid 90s. As my pulse rate dropped, the O2 dropped into low 90s. During many of my wakeups (like the events I've been having), it was mid-90s and pulse rate was up to 70s-80s (bedtime is low 60s pulse rate). Wakeup = 98% SaO2.

Pressure: woke up after 2 hrs & it was at 6 cfm, an hr before getting up woke up pulse in the 90s...yikes with pressure just into 7 (maybe 7.2 hard to read). Interesting, my current ramp is set to 8 and sustained at 11 -- wish I could see what the APAP pressure was all night long...maybe I need less pressure since I lost 50#s...impatient wanna know now .
APAP mask setting is standard. OptiLife leak rates are:
@ 2.5 = 11.2
@ 5 = 16.1
@ 10 = 23.1

Thanks for helping me understand these numbers!

EDIT: what does the 0.1 AI mean? 1 apneic event? More than I??? I am so clueless (sound so much better than ignorant *sigh*)

AI, HI, and AHI are all in events/hour.

Your numbers look good, except for the leak, but I have no idea how much the machine is subtracting for the mask setting. Can you check that setting in the clinical menu?

If you are having significant leak, the other numbers may not be accurate.

jdm2857 wrote:AI, HI, and AHI are all in events/hour

Thanks! I assume this means that during my 9-hr sleep I had 1 apnea event (1/10 of an event per hour). Right?

jdm2857 wrote:Your numbers look good, except for the leak, but I have no idea how much the machine is subtracting for the mask setting. Can you check that setting in the clinical menu?

This is all I found:
Leak is derived by analyzing inspiratory and expiratory airflows (via the flow sensor located in the device). Theoretically, inspiratory and expiratory volumes should be equal. A net airflow greater than the expected mask vent flow is equal to the leak. Generally, a leak rate of more than 0.4 L/s (24 L/min) is associated with patient discomfort, disturbed sleep, and reduced efficacy of treatment...If the leak exceeded 0.4 L/s (24 L/min) for more than 30% of the previous session, the following message will appear on the LCD: High leak in last session. It refers you to the PC software for more details *sigh*.

I must admit that the shallow breathing I've been complaining about did NOT occur today. Plus, I lost 2.5 #s overnight.