CPAPtalk.com

Ric wrote:

Ric wrote:Jerry, your 12/31 AHI vs PRESSURE graph shows a curious bump at 10 cm.

Jerry, on taking a second look at your graph, I realize I can't really tell if there is an OAI or HI data point obscured by the big red dot at 10 cm, or if the big red dot is just an artifact of the curve-smoothing equation (polynomial regression line, or something?). If so, then cancel my above remarks. I would say you have truly achieved CPAP nirvana, and there is nothing more except the endless vacuum of outer space, nothing is to be gained by going there. What a way to start the new year! HIGH FIVE! <slap>

Ric, I'm going to keep running it at 9cm for a while. Sort of boring, however. Two nights in a row with no hypopneas. Only one apnea, the previous night. Like playing golf well: "Nothing but fairways and greens. How boring." [Not my game. Just a saying when I do it two holes in a row.]

Thanks for commenting.

Jerry

Geez, Jerry! Like they said...you've hit CPAP Nirvana! Good for you!

Jan in Colo.

neversleeps wrote: <snip>
I personally don't view the acceptance of different results from manufacturer to manufacturer as obfuscating a problem, but rather demonstrating the point that they are, in fact, using different methods in obtaining those results.

Neversleeps,

Your para above would be fine if the results were similar or even close.

To more accurately state the situation I would reword it this way

<<
I personally don't view the acceptance of different results from manufacturer to manufacturer as obfuscating a problem, but rather demonstrating the point that they are, in fact, using different methods and can be obtaining markedly different results# from the same patient events.
<<

# Where results is taken to mean the AI & HI & AHI stats produced by the software.

I appreciate your abilty to simplify meanings but the above adjustment is closer to the reality I am talking about.

Cheers

DSM

Perry's post of Dec 24 at 11:30 p.m. poses an interesting question for me. How would the fact that I have asthma be reflected in the My Encore charts as compared to someone who did not have asthma?

Yoga wrote:Perry's post of Dec 24 at 11:30 p.m. poses an interesting question for me. How would the fact that I have asthma be reflected in the My Encore charts as compared to someone who did not have asthma?

Well I have asthma and what you normally see is a bunch of events, and a series of 3 pressure raises and no response. (respironics is programmed to try to resolve the event by raising the pressure, if there is no response after 3 times, the pressure stops rising, this is an effort to stop centrals) Asthma doesn't respond to pressure. If you look back, loonlvr had a number of posts looking for interpretations of his reports. His problem was gerd, which most likely irritated his airway and resulted in asthma like responses. This would only show if you were having issues with your asthma during APAP treatment. If your asthma is under control, your graph would look like everyone elses. (generally speaking)

Thanks, Mike.

Hi, folks,

Just wanted to put a wrap on my 'sleep study'. It has been interesting and fun.

My titrated pressure is 6.0 cm.

11/10/2005 - 11/22/2005 6 cm; Ave. AHI = 4.2
[Includes a bad, bad night of AHI = 8.0 (My 2nd night on CPAP) This data was downloaded by my sleep doctor on 11/22/2005.]

11/23/2005 - 11/27/2005; 6 cm; but data lost?

11/28/2005 - 12/6/2005; 6 cm; Ave AHI = 2.7 [8 nights, one night no CPAP]

12/7/2005 - 12/22/2005; 8 cm; Ave AHI = 1.9 [16 nights]

12/23/2005 - 12/24/2005; 4 cm; Ave AHI = 2.3 [2 nights]

12/25/2005 - 12/25/2005; 8 cm; AHI = 1.1 [One night]

12/26/2005 - 12/28/2005; 10 cm; Ave AHI = 0.4 [3 nights]

12/29/2005 - 1/4/2006; 9 cm; Ave AHI = 0.4 [7 nights; 0.0 on 12/31/2005!]

Summarizing by treatment pressure:

6 cm at start of therapy with some rough nights; Ave AHI = 4.2, later during an 8-night period dropped to 2.7

4 cm; Ave AHI = 2.3

8 cm; Ave AHI = less than 2.0, averaging 1.9 for 16 nights and 1.1 for one night after this period.

9 & 10 cm: Ave AHI = 0.4

What did I learn? That I can set the machine on anything from 4 to 10 cm and get adequate therapy, i.e., with AHI's less than 5.0. But, that settings of 9 or 10 cm will give the very best results with AHI's averaging 0.4 and some nights with only one disturbance and one night with none. So, I will continue to use the machine set at 9 cm. It is not difficult to exhale against 9 cm. I have a C-flex machine, and I have the C-flex set on 2.

I didn't mention the Snore Index. The SI drops like a brick when going from 4 to 8 cm.


And, I suppose my wife's complaints about my snoring, as much as anything, got me into the sleep study, although she did mention that she thought I stopped breathing sometimes. Now, she says she doesn't hear anything: no snoring and no machine or mask sounds. I'm using the Aura/Everest, but I think the Swift is just as quiet/noisy, with the Breeze being the quietest, by far. The Breeze is also the most cumbersome...by far, so don't jump to the conclusion that the Breeze is the best.

Here are the charts for the period of my data. Remember, the sleep doctor gave me a printout of the initial data and erased the card, so those results are not included, but I described them, above.





Thanks to all who participated in this topic, including the folks that educated me and a lot of others, I'm sure, on the nature of Auto PAP machines.

Jerry

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): breeze, C-FLEX, swift, CPAP, AHI, Aura, auto

Jerry

What a great thread this has been! It has convinced me the benefits of APAP while describing many of the intricacies and idiosyncrasies of this type of machine. Thanks for keeping the data flowing, and the time and effort it took to share it with all of us.

Griff

Griff: Jerry's machine is a Remstar Pro2 w/Cflex, a cpap machine. The Pro2 machine records data just like a autopap.

Jerry's demonstration clearly shows you can self-titrate yourself with the right machine and/or with one that records the right data. I bet once the sleep docs realize this they will do everything in their power to kill the idea just like many do with autopaps.

The advantage of Jerry's titration is he was able to titrate himself with the cflex feature enabled, something rarely done in the lab.


Thanks Jerry, all good info.

Snoredog wrote:Jerry's machine is a Remstar Pro2 w/Cflex, a cpap machine. The Pro2 machine records data just like a autopap.

Jerry's demonstration clearly shows you can self-titrate yourself with the right machine and/or with one that records the right data.

Good point, Snoredog. The fact that people can even titrate themselves well with just a basic cpap machine and no software at all is borne out by this study:

Can Patients with Obstructive Sleep Apnea Titrate Their
Own Continuous Positive Airway Pressure? A study by Michael F. Fitzpatrick, Christi E. D. Alloway, Tracy M. Wakeford, Alistair W. MacLean, Peter W. Munt, and Andrew G. Day -- Departments of Medicine and Psychology, Queen’s University, Kingston, Ontario, Canada

rested gal wrote:

Snoredog wrote:Jerry's machine is a Remstar Pro2 w/Cflex, a cpap machine. The Pro2 machine records data just like a autopap.

Jerry's demonstration clearly shows you can self-titrate yourself with the right machine and/or with one that records the right data.

Good point, Snoredog. The fact that people can even titrate themselves well with just a basic cpap machine and no software at all is borne out by this study:

Can Patients with Obstructive Sleep Apnea Titrate Their
Own Continuous Positive Airway Pressure? A study by Michael F. Fitzpatrick, Christi E. D. Alloway, Tracy M. Wakeford, Alistair W. MacLean, Peter W. Munt, and Andrew G. Day -- Departments of Medicine and Psychology, Queen’s University, Kingston, Ontario, Canada

RG, not sure what you meant by 'no software'. If I had not had 'Encore Pro' and 'My Encore', I would not have known what the AHI, SI, etc were? The machine does not provide a readout of AHI on the LCD panel.

What am I missing?

Jerry

Jerry69 wrote:RG, not sure what you meant by 'no software'. If I had not had 'Encore Pro' and 'My Encore', I would not have known what the AHI, SI, etc were? The machine does not provide a readout of AHI on the LCD panel.

What am I missing?

Jerry

Excellent question. Drill down on the article in the hypertext, the test subjects used subjective measures, self-scored, and adjusted the pressure accordingly. No AHI counts involved:

SAQLI: Sleep Apnea Quality of Life Index
FOSQ: Functional Outcomes of Sleep Questionnaire
ESS: Epworth Sleepiness Scale score
MWT: Maintenance of Wakefulness Test
Trails B: Trail-making test, part B

Seems pretty amazing they could use just that and come up with a pretty good titration.

Even better if they could have used objective data like you have demonstrated, using only a sophisticated machine and sophisticated software, and your analytic skills as an engineering professional! (Even better if you had an APAP). Once again I tip my hat in your general direction, you are carving new territory and making history. I await the flood of scientific publications. Maybe a new medical eponym bearing your name. It's only appropriate.

CHEERS!

Ric's right about it being easier to "self-titrate" using an autopap and software. I did it with a 420E and Silverlining software myself, two years ago. No insurance, no doctor, no sleep study. And with LOTS of help from the message boards.

For over three months, though, at the very beginning I was using a borrowed Healthdyne Tranquillity straight cpap. Had to use a tiny screwdriver to adjust the pressure at the back of the machine. I had no manometer, so was just "turning and guessing" when the air flow seemed ok for me.

To this day, I have no idea what pressure I was using during those three months. I felt sooo much more rested each morning, however -- I knew that was a treatment I would continue forever. Also knew I wanted a machine that could automatically find the right pressure as needed. And...I wanted software to show me what the machine was doing. I already knew how I was doing!

Of course, it's better to have a sleep study. I had one two years later. Confirmed that the pressure I was using was correct. Interestingly, it revealed that my sleep was occasionally disturbed by PLMs (periodic limb movements.) A sleep study can tell us more about "sleep" than just what the AHI is.

Ric wrote:

<snip>
Seems pretty amazing they could use just that and come up with a pretty good titration.
<snip>

I too think it was an excellent article myself. But some folk think it 'magical' that people can conduct their own self evaluations even when using multiple brands of machine & software & partner observations

This link here had me really smiling (what a trip ) but apart from the humour this person (a typical anon poster) should read the report and try to digest it assumin they have the capacity to do so

viewtopic.php?t=6355&start=30 (see post at the end dated Thu Jan 05, 2006 2:51 am - Starts "Since dsm's wife has magical powers")

Cheers

DSM

Ric wrote:

Jerry69 wrote:RG, not sure what you meant by 'no software'. If I had not had 'Encore Pro' and 'My Encore', I would not have known what the AHI, SI, etc were? The machine does not provide a readout of AHI on the LCD panel.

What am I missing?

Jerry

Excellent question. Drill down on the article in the hypertext, the test subjects used subjective measures, self-scored, and adjusted the pressure accordingly. No AHI counts involved:

SAQLI: Sleep Apnea Quality of Life Index
FOSQ: Functional Outcomes of Sleep Questionnaire
ESS: Epworth Sleepiness Scale score
MWT: Maintenance of Wakefulness Test
Trails B: Trail-making test, part B

Seems pretty amazing they could use just that and come up with a pretty good titration.

Even better if they could have used objective data like you have demonstrated, using only a sophisticated machine and sophisticated software, and your analytic skills as an engineering professional! (Even better if you had an APAP). Once again I tip my hat in your general direction, you are carving new territory and making history. I await the flood of scientific publications. Maybe a new medical eponym bearing your name. It's only appropriate.

CHEERS!