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Re: Why I always insist on a data-capable machine and software
Posted: Mon Feb 28, 2011 8:33 am
by lucynethel1998
SleepingUgly wrote:You can't tell from software whether you're in REM or not. Someone who has REM-dependent OSA may guess that clusters of events are occurring in REM because that's when their events occurred on their sleep study, but there's no way to know definitively when you're in REM without an EEG.
Thanks. Was trying to figure out why some keep telling me my "problems" are occurring when I was in REM sleep!
Re: Why I always insist on a data-capable machine and software
Posted: Mon Feb 28, 2011 8:36 am
by SleepingUgly
Many more events in REM is very common, especially in women.
Re: Why I always insist on a data-capable machine and software
Posted: Mon Feb 28, 2011 9:12 am
by Pugsy
I call it REM because it followed a normal REM staged sleep pattern. When I went over my studies with sleep doctor PA and my own report we both concluded that given my history with greater than 50 AHI in REM and very mild in Non REM that the clusters were most likely popping up when I was in REM.
So while it is true that the reports do not actually give sleep stages, sometimes we can approximate REM if the history and reports seem to coincide. The reports are really to give us a trend or idea anyway. Doesn't really matter when the clusters occur though. They still need to be broken up because if a person has an excessive number of events in a grouping (for whatever reason) the stress on the body is pretty significant because the body doesn't have much time to recoup from one event before another hits. I was having 45 sec events and desats to 73%. Put several of those together in a short time period and I would feel awful even though my overall AHI wasn't that remarkable because the bulk of my time asleep would be pretty much uneventful. With an AHI of 5 under treatment I would still feel crappy and usually have the massive morning headache. With an AHI under 2, felt some better and the morning headaches were much less frequent and more easily managed.
This is why I think that it is a good idea for people with "okay" AHI numbers but still feel awful, that they look at their reports to see if it is possible to spot something like clusters that might explain feeling bad.
If I had not had the reports to look at, I would have been one of those people either using the titrated pressure of 8 and getting so so numbers yet feeling awful and very likely would have put the machine in the closet.
Re: Why I always insist on a data-capable machine and software
Posted: Mon Feb 28, 2011 10:44 am
by LoQ
SleepingUgly wrote:You can't tell from software whether you're in REM or not. Someone who has REM-dependent OSA may guess that clusters of events are occurring in REM because that's when their events occurred on their sleep study, but there's no way to know definitively when you're in REM without an EEG.
I don't have a lot of events any more, but I can still tell where the REM is and how long from the other charts on the detailed data. Things are "different" during REM.
Re: Why I always insist on a data-capable machine and software
Posted: Fri Mar 18, 2011 8:48 am
by roster
From:
viewtopic/t61708/Sleep-study-pressure-r ... ement.html
jonnybee wrote:
Sleep study pressure results vs real world rquirement
FWIW.
Initially, I was issued a ResMed S8 CPAP set at 5cm as determined by sleep study. After joining this forum, I realized I had been issued a unit with no data capability so I pushed for an S9 series machine and was issued an S9 Elite CPAP, again set at 5cm. My AHI was erratic over the next three months while using the Elite with a high AHI of 12.2 with several in the range of 6.5 to 7.0. During the last month of using the Elite set at 5cm, my average AHI was 3.4.
Having read many posts here concerning the advantages of the the APAP, I decided that if I was ever going to get the AHI down, I would need an APAP since the Elite set at 5cm did not seem to be doing the job. DME told me I would have to pay $300 out of pocket to get a new S9 Autoset which I didn't feel was that unreasonable since they had upgraded me from the S8 to the S9 at no cost. I paid the $300 and was issued the S9 Autoset. Initial setting was 5.0-11.0. I have since bumped the min pressure up to 6.0 since the 95th pct was running near 8.0. My AHI average since starting to use the Autoset (2 weeks) has been 1.5. For the last two nights (since bumping the min up from 5.0 to 6.0cm) my AHI average has been 0.6 (0.4 last night; my lowest ever). Other stats for the last two nights pressure were Median 6.4, 95th pct 7.6, Max 8.8.
This tells me that the sleep study results were off base which does not surprise me at all given the artificial conditions under which the study is conducted.
Moral of this story. You have take charge of your therapy. I have received ZERO assistance from the DME because the nurse just does not have the knowledge/training required to be of assistance. I actually had to show her how to download my info into ResScan. My family physician, who ordered the sleep study at my request, was of no help; totally clueless regarding sleep matters. She has since left town. There are no REAL sleep doctors near me; only a few whose sub specialty is sleep medicine. So, if I had not taken it upon myself to join this forum and learn as much as I could, I would still be sucking on the S8, totally clueless as to whether the therapy was working or not. Thanks to all who post here.