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victormiller wrote:I do have a question: it looks like the clock inside the machine is set at GMT (5 hours ahead of EST). At least the times of day given on the waveform report are 5 hours ahead of my local time. Does anyone know how to set the clock on the System One Auto Bipap? I couldn't find anything like this on setup.

EncorePro 2 is a bit different from EncoreViewer. I haven't seen anything to tell me definitively but it seems the PR1 internal clock is at Zulu time (GMT) and the reports generated all use the offset to translate to local time. For whatever reason, EncoreViewer is smart enough to use your computer's offset from GMT to set local time for the report EncorePro 2 does not.

To change it, click on the "Company Setting" tab then click on "Offices". You'll see about halfway down on the left the TZ and DST observed settings. Click on "Edit" and change to your local TZ and whether you are observing DST at the moment.

All your reports will magically be corrected as it seems to calculate local times during report generation.

trike-mike wrote:

victormiller wrote:I do have a question: it looks like the clock inside the machine is set at GMT (5 hours ahead of EST). At least the times of day given on the waveform report are 5 hours ahead of my local time. Does anyone know how to set the clock on the System One Auto Bipap? I couldn't find anything like this on setup.

EncorePro 2 is a bit different from EncoreViewer. I haven't seen anything to tell me definitively but it seems the PR1 internal clock is at Zulu time (GMT) and the reports generated all use the offset to translate to local time. For whatever reason, EncoreViewer is smart enough to use your computer's offset from GMT to set local time for the report EncorePro 2 does not.

To change it, click on the "Company Setting" tab then click on "Offices". You'll see about halfway down on the left the TZ and DST observed settings. Click on "Edit" and change to your local TZ and whether you are observing DST at the moment.

All your reports will magically be corrected as it seems to calculate local times during report generation.

Mike, Thanks. I noticed that after I posted the query. I think that this is a deficiency in the software or the machine itself. For instance, I'm planning to take a trip to Japan next month (and bringing my machine). The time zone there is MUCH different than my home time zone (EST). When I changed the time zone on the encore pro 2.2 software it warned me that it could take up to 24 hours to recalculate things for all patients (of course it's only me). After 20 minutes it still said that its progress was 0%. Whoever wrote their program needs some better algorithms!

victormiller wrote:Mike, Thanks. I noticed that after I posted the query. I think that this is a deficiency in the software or the machine itself. For instance, I'm planning to take a trip to Japan next month (and bringing my machine). The time zone there is MUCH different than my home time zone (EST). When I changed the time zone on the encore pro 2.2 software it warned me that it could take up to 24 hours to recalculate things for all patients (of course it's only me). After 20 minutes it still said that its progress was 0%. Whoever wrote their program needs some better algorithms!

Victor... I have the same issue but with many TZs in the mix. While it may be simple (and to a certain degree elegant) for the machine to not care what TZ it is in with the reporting software sorting it, it presumes that the machine will never move. That's a tiny bit simplistic thinking to my mind in this day and age.

I can't get the overall report to look right but, while a pain, will shift the TZ for the waveform reports to get them to be the actual sleeping time.

victormiller wrote:... The sleep doc called me back. ...

Wow! That was fast!

victormiller wrote:... He also was positive about the fact that I was able to change the settings on my machine. He said that I should send him reports periodically and we could work on getting the settings of the machine fine tuned. ...

A definite keeper. He understands the concept of the patient being involved in the process. This is no different than a diabetic patient working with a doctor to find the treatment that works for the patient.

victormiller wrote:... I also noted that a large chunk of CA was reported in the morning as I was waking up (I woke up spontaneously -- no alarm), and that I really was almost awake during that time. He did say that a lot of the apneas that I had during the study were during a sleep/wake transition. Overall, the fact that my OA index was only 0.8 (practically 0) was good.

Okay, time to share a set of pages. First, please be aware that when we transition from wakefulness to sleep (or back) our bodies transition the method used to drive our breathing. This results in what would normally be seen as a "central apnea". However, since you are transitioning it is NEVER counted as a central apnea - because it is perfectly normal.

Here's an indepth article that describes this instability in breathing during the transition between wakefulness and sleep (and back again).

Ventilation is unstable during drowsiness before sleep onset
http://jap.physiology.org/cgi/reprint/99/5/2036

If those apneas cluster around that boundary, it's not a big deal, unless it seriously disturbs your ability to fall asleep. Abnd for most people it is not a big deal. Of course with my severe central apneas, I find this transition unbearable without my ASV unit. When I just had a BiLevel I would stop breathing so long the auto-off feature (that took effect after 60 seconds) would kick in. My machine would turn off while I was wearing it because I had stopped breathing for more than a mintue. When someone has that much of a problem, it definitely should be addressed.

Anyway, it's GREAT to hear you have such a responsive and progressive doctor. Best wishes!

John, Thanks for the info and the encouragment, and the article. That's really interesting. I can see that the most significant CA were when I was falling asleep and then waking up. There were two more during the night. When I looked at the waveforms it looked my breathing was changing mode even a minute before the CA happened. I'll keep on this.

Victor

I've been getting more used to things. Last night I slept 7 1/2 hours with the machine. However, this morning I feel really dragged out. I checked my stats with the Encore reader. I had OA of 0.1 (virtually nothing), but CA to 5.1 and HI of 4.1, PB of 5%. No large leaks - average leak of about 20%. So the stats look good (even though I'm concerned about any CA). But when I woke up this morning I felt dizzy and really zonked. So the stats aren't everything (my blood pressure is good). I wonder what's going on.

It is possible that you are fighting something known as REM Rebound. That is, due to all the apnea events in the past, your body never got the chance to get the rest it needed. It is now able to do so, but you will awaken feeling groggy and out of sorts. This can often last several weeks.

But do keep an eye on the data. While the numbers are not bad, you definitely want to see the apnea events decrease over time. If they do not, or you continue to feel poorly, you will want to go back to talk with your sleep doctor about the situation. Provide the data and symptoms. Don't provide the "diagnosis" of what you think is wrong.

If they do not clear over time, then with the central apneas, you may need to look at a different type of machine and/or the use of supplemental oxygen. And it might take another sleep study to track down the issue.

Best wishes, and keep us posted.

The last few days have been good and bad. The night before last I was very tired, so decided to get to sleep early (for me). I was asleep by 11:15pm. I then woke up around 5:30am because the hose had pulled out (I'm using a Mirage Swift nasal pillow -- this was the small attachment to the main hose). I took a brief trip to the bathroom, and then reconnected. It took me a while to fall asleep, but I was rather surprised that I didn't wake up until 8:45am (fortunately I have very flexible hours in my job) and I felt really awful. I uploaded my data to Encore Pro and saw that I had an AHI of 11.1, but the vast majority of it was during the second part of the night which was filled with PB and CA. Last night was better -- I slept from midnight until 7:30am and had an AHI of 4.4. In all cases since I corrected the settings on the machine my OA was always below 0.5 -- almost nothing. Last night my CA was 2.2. I did have a phone conversation with my sleep doc yesterday after I had emailed him my detailed report (plus a few waveforms) from last week. He thought that the numbers were great, and agreed that I might be working off sleep debt. I'm still going to keep at it, but subjectively I feel more sleepy than when I wasn't using CPAP. This is the same situation that I had three years ago -- after using CPAP for 3 months with the Mirage Swift I was feeling worse. I went back to my sleep doc (a different one) and suggested that I might be a mouth breather, so he switched me to a full face mask, which wasn't as comfortable (I've been through five different ones). However, it's clear both from my last PSG (only a few weeks ago) and from the data from the System One that I'm not a mouth breather. In the two weeks I've been using it, there was only one period of "large leak" which lasted about a minute a few nights ago. Other than that the leak percentage is never above 30%.

Any comments?

Victor

This morning I felt about as awful as I have since using CPAP. It's not plain tired -- it''s feeling hungover. My blood pressure is great: 114/64. And the numbers from the report on Ecnore Pro look great: CA of 1.9, OA of 0.6 and H of 2.0 with PB at 2.6%. It seems the better the numbers I'm getting the worse I'm feeling. Any explanations?

My stats are slowly improving but I still feel like crap. This morning my AHI was 3.7, with CA 1.7, OA 0.1, and H 0.9. I briefly woke up after about 6 hours, looked at my watch (seeing that it was 6am) I went back to sleep until a little after 8. My first reaction to waking up was to say "oh crap" which described the way that I felt. On the optimistic side perhaps I'm restructuring my sleep architecture, so I'll keep plugging away. By a coincidence, on the local radio station there's an extended interview with Patricia Morissroe about her book "Wide Awake" about her sleep problems and sleep in general. It's actually pretty fascinating. You can hear it on http://www.whyy.org/podcast/081710_110630.mp3

Hi, I use a CPAP and have asthma and it helps but I still feel tired and not rested on waking up.
Sometimes I feel faint and have chest pains after using the maching with full face mask on 8.0
Does the Bipap work much better? Do you feel normal and rested after waking up? I think too
low of a setting is bad and can lead to dizziness, fainting. Thanks!