Would you be happy with a compliance only machine?

jedimark wrote:I just noticed you have an Intellipap.. I've been working on hacking the flow waveform out for your machine

That would be very interesting to see Can you do it from the SD card or does it require a PC attached to the serial port?
I have the serial cable, if there is something I can help with or confirm, please let me know.

Btw. I have been trying to get my Zeo data into Sleepyhead (0.9.2-1). The program reports that the data was successfully imported, but no graphs show up. Is there a trick to this?

Burkebang wrote:

jedimark wrote:I just noticed you have an Intellipap.. I've been working on hacking the flow waveform out for your machine

That would be very interesting to see Can you do it from the SD card or does it require a PC attached to the serial port?
I have the serial cable, if there is something I can help with or confirm, please let me know.

Btw. I have been trying to get my Zeo data into Sleepyhead (0.9.2-1). The program reports that the data was successfully imported, but no graphs show up. Is there a trick to this?

A serial cable and PC is unfortunately the only way to get at it.. (for now, unless DeVilbiss decides to be awesome and release a firmware update that records flow rate data..)
I haven't played as much as I would like yet..

Hmm... Please PM me about the Zeo stuff and I'll see what I can do about it..

Which Zeo firmware? The one I'm using (the one that gives serial access) with the off-line CSV generator place incorrect timestamps in the data, and if I want to import, I end up going into the file to fix the day and hour listed.

jedimark wrote:A serial cable and PC is unfortunately the only way to get at it.. (for now, unless DeVilbiss decides to be awesome and release a firmware update that records flow rate data..)
I haven't played as much as I would like yet..

Is the data module needed to use the serial cable?

Jedimark,
I understand where you and others are coming from and am replying from that understanding.

Consider that the vast majority of cpap users do not access data, and trust their Doctors, and still do well on cpaP therapy.

And also consider that cpap machine data is actually vary marginal data. Many doctors disregard it as insignificant. It's nowhere near as valid as PSG data.

And also consider that the average cpap user can also detect when the therapy is doing well. By that, I mean daytime sleepiness, throat sensations in the morning (as a symptom of snoring) and other factors.

In other words, scrutinizing cpap data as if it's the holy grail is not the means to health. In some ways I feel it's actually a distraction.

I've been a cpap use for over 6 months and because of computer issues and cpap machine issues...I have not been able to access my cpap data. So I've judged my success by how i feel. If I snore, I wake up with a sore throat. If I have severe apneas I wake up with wet T shirt from night sweats. And generally I feel much better if my therapy is going well.

I don't need numbers to monitor success

I have a data-less machine because it was a $100 Craigslist machine. I was tired of paying a ridiculous co-pay for an inappropriate machine.

So my final answer is...yes, I'm happy as a clam with a data-less cpap machine.
Jamis

What does it cost to make a machine that will store the data? The extra hardware costs on the ResMed S9 seems to be right at about $0.00 but that is because they use the SD card to configure it so it has to read it anyway. The cost difference seems to be related only to the different software and it would be cheaper to just maintain one life of software vs two.

How do I change MY answer from "no" to "HELL NO!"?

Compliance only is all that my SleepDoc will allow.
Toronto, Canada.

--So how often do they allow follow-up PSG's?
You probably don't want to miss any.
As we age, our needs change.
Do what you are permitted to enable your continued health.
This may be all you need.

No, definitely no. I recently had to renew my licence, I had to answer a series of questions, mostly on health issues, one of them was "Have you ever been diagnosed with sleep apnea?" I ticked yes. A week later I received paperwork in the post that I had to have my Dr fill out, to say that I was receiving treatment and could keep driving. In the 4 months of using PAP and reading this forum I've learnt a lot, my Dr happily concedes that I know more on the topic than he does. At the appointment I took my laptop along, showed him my data, compliance, AHI plots etc. everything sleepyhead has to offer. He was happy that my treatment is yielding good results and signed the forms that allow me to continue driving. Without the detailed data I would have a hard time proving the efficacy of my treatment, with the possible outcome of having my drivers licence restricted or cancelled.
I've also recently sourced an S9 autoset for a friend that had been using an S8 brick for 3 years, no one had reviewed his data or settings in those 3 years. He was very impressed with sleephead and being able to review his own data, he feels better with the new machine and has the data to show why.
When it comes down to it, we are the ones with the vested interest in making sure the machines are doing what the manufacturers claim they will do. As for people happily using compliance only machines, my friend was blissfully happy with his ignorance until shown that better options are available.

jamiswolf wrote:And also consider that cpap machine data is actually vary marginal data. It's nowhere near as valid as PSG data.

A fully data capable CPAP machine shows airflow waveforms for every breath. You may debate whether it's a "real" apnea in terms of an O2 desaturation or EEG arousal. If you look at the waveform, you may see clear, objective data that indicates, for instance, that the patient stopped breathing completely for 60 seconds. You don't need SPO2 or EEG to know it's a problem. You can often make a very good guess whether it's obstructive or central from the shape of the waveform.

There may be some borderline events where the CPAP derived data is inconclusive. Very often, the data is unmistakeable to a doctor willing to actually look at it, especially if he looks at the waveforms.

Even if you can't prove that the patient DID have an apnea, you CAN prove he DIDN'T have an apnea. The machine can reliably detect that the patient never stopped breathing through the night. If the machine reports an AHI of, for instance, 3, you can feel pretty confident it's not more than 3.

Would any doctor seriously claim that it's not valuable to know that the CPAP treatment IS working, even if you don't believe the machine when it says CPAP isn't working? A "free" test with few false negatives is of value for screening, even if you think it provides a significant number of false positives.

Would any doctor ignore it if a patient's wife said he snored loudly at night stops breathing for a minute or so, and then started breathing again with a loud snort and then breathed heavily for a while? Would he just say that wives aren't as accurate as a PSG, and ignore it?

jamiswolf wrote:Many doctors disregard it as insignificant.

Many doctors are idiots.

What I don't understand is why a doctor would be happy with a compliance-only machine? How would they ever really know how their patient was doing or where the problems were if the patient was not feeling that much better after being on cpap for a while? I assume that the doc is actually interested in how their patient is doing....

For my own part, I do have a compliance-only machine as a back up/travel machine; but my home machine (used 90+% of the time) is fully data capable. I find the info valuable to me, and it let's my doc know what's going on with my sleep. The gaps in the data from travel or the odd power outage when I use the backup machine are not serious, but a total lack of data would be. Adding data capability cannot cost that much, over the 'dumb' version of the same machine. Mechanically, they are the same, it's just the extra electronics... electronics that I suspect, are already on board the p/c board, just enabled or disabled as needed. Enable, and add a card reader mechanism, et voila! Data capable. (I'm guessing on that, but I bet it's right.)

Bookbear wrote: Mechanically, they are the same, it's just the extra electronics... electronics that I suspect, are already on board the p/c board, just enabled or disabled as needed.

Data capable machines also require an airflow sensor in addition to the hardware a non-data capable machine requires.

jamiswolf wrote: Consider that the vast majority of cpap users do not access data, and trust their Doctors, and still do well on cpaP therapy. (emphasis added)

I won't argue that the vast majority of cpap users don't access data---but in part that's because the vast majority of CPAP users have been sold machines that gather no data (other than compliance data) in the first. You cannot access what you do not have.

I'll even grant that just maybe the vast majority trust their doctors.

But I do NOT believe that the vast majority do well on CPAP: If the vast majority did well on CPAP, there would NOT be a 40-50% drop out rate in the first year.

As long as compliance rates remain in the 50-60% range, there's a very significant problem in getting people to use the damn machines. And my personal opinion is that is the key to increasing compliance rates is much higher quality patient education, much better follow-up care, and much more available patient support groups. And a huge part of that patient education effort should be in teaching folks how to monitor their therapy and what the meaning of the numbers is---both in the sense of teaching patients the lingo we're all familiar with here because we've educated ourselves and in terms of just what the untreated numbers mean to our bodies. But trying to simply scare the newly diagnosed into using CPAP correctly by listing all the nasty things that can happen to you if you don't treat the OSA just doesn't work for very significant numbers of folks.

And also consider that the average cpap user can also detect when the therapy is doing well. By that, I mean daytime sleepiness, throat sensations in the morning (as a symptom of snoring) and other factors.

As someone whose daytime functioning took a nose dive during the first four months on CPAP in spite of fantastic AHI numbers and leak numbers, I beg to differ. The ONLY way I knew that the machine was doing its job during those dark first few months of therapy was through the data. Had I been forced to buy a brick, I would not have made it: My guess is that I would have concluded that CPAP therapy was clearly NOT working by around the end of the first month and I would have simply not gone back to the doc who had smuggly assured me that I would feel better in two weeks.

""But trying to simply scare the newly diagnosed into using CPAP correctly by listing all the nasty things that can happen to you if you don't treat the OSA just doesn't work for very significant numbers of folks.""

As one whose sleep has severely worsened since starting cpap treatment, I couldn't agree more. When I can barely function, all the nasty things that could happen doesn't have great significance to me since I am already feeling horrible.

What does have significance even though I don't yet have the software for my Intellipap Machine is running the data codes and seeing the AHI statistics. Yup, says me, I do need to make this work even though I am going through h-ll right now.

And when I get my software and can either troubleshoot by myself or with the help of this group and eventually my doctor, it will because of having a data capable machine that will help me get back on track. I may need light therapy to deal with other insomnia issues but that is another post.

By the way, unlike alot of people on this board, I do feel I have a good doctor. She told me specifically to get a data capable machine. Due to not having health insurance, I have held off as long as possible in scheduling a visit but I think I am at the point where I can't wait much longer.