Where do i start? appt today with results & pics!

He gave me a graph 2 papers one pre-titration and one post-titration. Can someone help me understand these numbers?

What i can say is i have mild sleep apnea for the first 3 phases averaging at a 7. During my REM stage my "most important" for functioning stage i am a 28 moderate/severe.
Recommendation cpap of course. He wants me to play with the pressures anywhere from min of 6 to 10. He said during titration i was around a 6 and doing great but during rem they had to ramp it up to 7 because of my horrible OSA during REM sleep. I did request mask of my choice but i told him i wanted Resmed Quattro FX for her and he specified that on the rx. I also told him i wanted the resmed s9 autopap h5i and he agreed so that i may play with my pressures and can track my progress on the software and he told me about the memory card for it i will have to send in. He seemed very surprised how informed i was with everything and the BS DME's can pull lol i made sure i mentioned like 10x resmed S9 AUTOSET h5i not escape or anything else haha. I'm sure he probably thought i was nuts. I asked a ton of questions too and he was happy i did he said the more i ask the better involved and successful my treatment will be. Here is pics of my first night study 7/24 and 2nd night with titration 7/31. I also am posting a copy of the rx i did ask for my copy as well OVERALL HE SAID MY 2ND NIGHT WAS MUCH BETTER WITH THE MASK BUT I DON'T UNDERSTAND THESE GRAPHS YET LOL HELPPPPP

btw he is amazing he prescribed me ambien to get through the first few months without me even asking since he said it will take some adjustment i have 5 refills!

Did he do this right so i ONLY GET THE MACHINE I WAS ASKING FOR?

July 24th 1st sleep study


Continued on bottom first sleep study


July 31st TITRATION


CONTINUED JULY 31ST


AND THE RX

Well Dr should have written one more word past ResMed S9 "AutoSet" then there would be no questions ... As they do make a S9 Escape Auto which is a "brick" depends on how DME interprets ... You may have to get Dr to be more specific ...

Take a look here to see if Robysue's blog will help you understand what you are seeing on the reports.
http://adventures-in-hosehead-land.blog ... -test.html

It seems to me that the one who scribbled on those pages was interested mainly seeing more REM sleep (the heavy dark lines marked with R), and total arousals which were 65 before CPAP and dropped to 47 after.

About the 10/6 you are NOT correct that you should play with these numbers but that the DME should set on the AutoCPAP [Resmed S9] a 10 cm as maximum pressure and a 6 cm as minimum pressure.

avi123 wrote:It seems to me that the one who scribbled on those pages was interested mainly seeing more REM sleep (the heavy dark lines marked with R), and arousals which were 67.

About the 10/6 you are NOT correct that you should play with these numbers but that the DME should set on the AutoCPAP [Resmed S9] a 10 cm as maximum pressure and a 6 cm as minium pressure.

Oh i didn't know the DME does that i guess i don't know everything lol now it makes sense why he added that on the rx duh.. i am learning new things everyday! Gonna call the DME tomorrow to so that i can make sure they got the rx.

I guess that is why the machine says auto right? So how does it know when to automatically change pressures? Obviously i need a higher pressure during REM sleep when i have the most OA's

Pugsy wrote:Take a look here to see if Robysue's blog will help you understand what you are seeing on the reports.
http://adventures-in-hosehead-land.blog ... -test.html

Ty i will take the time to read through this... i am slowly learning little by little.

123.Shawn T.W. wrote:Well Dr should have written one more word past ResMed S9 "AutoSet" then there would be no questions ... As they do make a S9 Escape Auto which is a "brick" depends on how DME interprets ... You may have to get Dr to be more specific ...

Yes! That was what i was afraid of when i saw this rx but i figured it was okay because it was circled as auto cpap. I tried to get the HME in my doctors building to read the rx for me and of course because i wasn't going through them the RT wasn't available to help me. Glad i didn't go through them i never felt so ignored before uhg i do know it's not their job but considering i told them if techmed doesn't work out i may change to them they didn't seem all to willing or helpful.

The machine will know when to increase your pressure according to how you are breathing (it uses an algorithm) when you're asleep - not while you're awake though.

Julie wrote:The machine will know when to increase your pressure according to how you are breathing (it uses an algorithm) when you're asleep - not while you're awake though.

Well that is good to know. I only went to a max pressure of 7 i may need more i don't yet we shall see. I hope to have my equipment drama free in the next few days.

Trust the machine to know what to do. They do their jobs pretty darn good. Your starting pressure is 6 and the machine will stay there (unless you use EPR and then there is a drop during exhale) and it will auto adjust the pressure up to 10 as it senses the need.

I also have a much larger number of events during REM sleep than I do in non REM sleep. It is very common. Not rare at all. Some people have more events when they sleep on their backs. Sometimes these events need more pressure and sometimes they don't. The machines do a good job figuring out what to do when the minimum is set effectively. Your pressure needs are relatively low and a minimum of 6 and maximum of 10 should do a good job for you.

I happened to post a couple of my old reports today that show how sometimes the APAP will increase the pressure and sometimes it doesn't need to. viewtopic.php?f=1&t=80754&start=15
Just skim over some of the technical stuff that was discussed. The ResMed machines don't show the same graphs.
These reports are from my Respironics machine and a different software so your reports won't look like this but I think you can easily see the pressure changes when they happened and the rather boring night when they didn't.

If you look in my signature line I have some SleepyHead software links. Sleepyhead will work with your new machine. You might look at the User Guide as it explains some things and also the Glossary link. It will help you with the terminology that you are going to be seeing.

mzlaura1884 wrote:Well that is good to know. I only went to a max pressure of 7 i may need more i don't yet we shall see. I hope to have my equipment drama free in the next few days.

Hi,

You asked where to start? Well, I think you are off and running, and way past "start". This is your treatment, so I am glad to see you get so involved, and glad to see that you have a doctor who is so progressive.

For the first two weeks or so, I'd worry less about numbers and data, and just try to focus on getting comfortable, and getting through this one night at a time. It took you a long time to get to this state (with your OSA), so it is going to take a while for your body and brain to adapt, and for you to get caught back up on sleep. In fact, some folks essentially have to re-learn how to sleep all over again.

After about 2 weeks, it will be time for you to start doing your own downloads, assuming of course, that you are a little computer savvy. You already know how to post photos, so the data download will be no big trick for you.

For now, I think you want to let the auto machine do its magic by adjusting the pressure on its own. One thing that sometimes happens is after you get onto CPAP, you start sleeping more deeply, so you body gets more relaxed. That makes your airway tissue relax more, and it can actually make the OSA a little worse. The auto machine will be able to compensate. That is why you don't want to focus too much on the numbers right away. The one number to look at first is your mask leak number, followed by the AHI. After you get more time on the hose, then you can start considering optimizing the pressures. For now, optimizing your bedroom and sleep environment is a good item to work on.

Good luck, and please post back on how it goes.

-john-

jweeks gave you some good advice.
Don't try to absorb all this right now, this very instant. Take your time. Do your reading...reading and more reading.
For now, concentrate on just making things as comfortable as you can and getting good sound sleep.
Keep reading...you may have to read some stuff multiple times for it to sink in.

Only thing to caution you on...make sure that you get a machine that says S9 Autoset on it.
The script says S9 auto cpap with a prescribed range...there is a S9 Escape Auto that would meet the RX requirements but it doesn't offer you the data that the AutoSet offers. The Escape Auto only has AHI (no breakdown into categories), average pressure and hours of use. So yes it offers data but not the other data that the AutoSet offers. It doesn't offer leaks, or event category, or anything else beyond the 3 data points I mentioned.
Some DMEs might try to sneak the Escape Auto in because it technically meets the RX requirements. It doesn't cost them as much so they make more money off of supplying it to you than they will if they dispense the AutoSet.

Pugsy wrote:jweeks gave you some good advice.
Don't try to absorb all this right now, this very instant. Take your time. Do your reading...reading and more reading.
For now, concentrate on just making things as comfortable as you can and getting good sound sleep.
Keep reading...you may have to read some stuff multiple times for it to sink in.

Only thing to caution you on...make sure that you get a machine that says S9 Autoset on it.
The script says S9 auto cpap with a prescribed range...there is a S9 Escape Auto that would meet the RX requirements but it doesn't offer you the data that the AutoSet offers. The Escape Auto only has AHI (no breakdown into categories), average pressure and hours of use. So yes it offers data but not the other data that the AutoSet offers. It doesn't offer leaks, or event category, or anything else beyond the 3 data points I mentioned.
Some DMEs might try to sneak the Escape Auto in because it technically meets the RX requirements. It doesn't cost them as much so they make more money off of supplying it to you than they will if they dispense the AutoSet.

My doctor faxed over that script today. Now legally if they fill it and try to give me a "brick" can i turn away, if they won't give me the autoset? I did get a copy of my rx as well obviously since i posted it. I just didn't know if they fill the prescription and give me a crap machine i don't want if i am stuck with it?

They might just go ahead with the AutoSet. Lots of DMEs will do that. I just wanted to alert you to that little in between brick..the Escape. The doctor didn't say "AutoSet"...he wrote ResMed S9 Auto cpap...technically the S9 Escape meets that requirement. It does offer limited data so it isn't a total brick...if someone wants to get real nit picky but it isn't what you want so don't accept it.

Should they try to give you the Escape just tell them you don't want that because the doctor wants the detailed data that the AutoSet offers like the leaks and more than a single AHI number.
So just don't accept it. Tell them you will get with the doctor to make sure he writes a more detailed RX.

It may not come to that, they may just hand over the AutoSet.
There are some good DMEs that just go ahead and dispense them on a regular basis.

mzlaura1884 wrote:btw he is amazing he prescribed me ambien to get through the first few months without me even asking since he said it will take some adjustment i have 5 refills!

Ever wonder if some of these docs own stocks in the company the write scripts for?