CPAPtalk.com

mollete wrote:Did somebody on my Exclusion List say something!?

Of course and you know they did.

This place is like a comedy club.

SleepingUgly wrote:This place is like... comedy...

Well, periodically it does move into other genre, such as Fantasy:

mollete wrote:

Pugsy wrote:

kaiasgram wrote:Oh mollete, you've been given such an opportunity here...

Can I hide and watch? Please????

Why? What happened?

Did somebody on my Exclusion List say something!?

Ok, it's worth a chuckle but not up to your usual standards! Today is a rather long and boring day for me so I can use some really good laughs!

Dori, are you trying to get Dave to misbehave so you can stick in the corner?! Shame on you!

SleepingUgly wrote:Dori, are you trying to get Dave to misbehave so you can stick in the corner?! Shame on you!

I confess! But I know you'll skip this thread if it gets too "rowdy" because you're so sensitive!

DoriC wrote:

SleepingUgly wrote:Dori, are you trying to get Dave to misbehave so you can stick in the corner?! Shame on you!

I confess! But I know you'll skip this thread if it gets too "rowdy" because you're so sensitive!

I am VERY sensitive. And misunderstood. But a little stimulation never hurt a sleepy person.

DoriC wrote:Ok, it's worth a chuckle but not up to your usual standards!

Well, being that it's Lent certainly cuts down significantly on the available material, but you have to admit the Harry Potter-inspired banner is pretty clever!

i looked the hypop requiremtents and the desat is still associated with the event. I see an arousal can be, but our MD wants the desat as a better requirement. The RERA is associated with the arousals.

stage0 wrote:i looked the hypop requiremtents and the desat is still associated with the event.

I did not say "exclusively".

I said

mollete wrote:you don't need a desat to score a hypopnea.

because "Da Rules" are:

Da Rules wrote:There is a 3% oxygen desaturation from pre-event baseline or the event is
associated with an arousal.

stage0 wrote:I see an arousal can be, but our MD wants the desat as a better requirement. The RERA is associated with the arousals.

You are going to miss a ton of people if you use the AASM recommended and not the alternative criteria, as nicely shown in this article:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2635578/

SleepingUgly wrote:

stage0 wrote:I see an arousal can be, but our MD wants the desat as a better requirement. The RERA is associated with the arousals.

You are going to miss a ton of people if you use the AASM recommended and not the alternative criteria, as nicely shown in this article:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2635578/

Hmmm, just looked at my sleep study. It says, "Hypopnea Rule: 4A". Which uses the Recommended rule, and not the Alternative rule. I guess I could be OSA after all!

NotLazyJustTired wrote:

SleepingUgly wrote:

stage0 wrote:I see an arousal can be, but our MD wants the desat as a better requirement. The RERA is associated with the arousals.

You are going to miss a ton of people if you use the AASM recommended and not the alternative criteria, as nicely shown in this article:

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2635578/

Hmmm, just looked at my sleep study. It says, "Hypopnea Rule: 4A". Which uses the Recommended rule, and not the Alternative rule. I guess I could be OSA after all!

OTOH, this debate about "Da Rules" is a little myopic because is assumes (like everybody else on the planet) that the be-all, tell-all, know-all, key piece of information is "Da Number" (AHI), when it is not.

I mean, in re: desaturations, what is clinically relevant? 4% or 3%? What happens if you have a bunch of 2.9%'s?

It is more important to look at the whole picture ("Da Graphs")(and in some cases "Da Tables") which would allow successful interpretation of the data. Whether one uses AASM 2008 4A or 4B, or AASM 2012 is academic. No matter which rule one uses, arousals are recorded and documented. 4B and 2012 may end up associating them with hypopneas whereas 4A would not. If one chooses to score RERAs, then outlying respiratory events would then be accounted in the RDI.

In any case, if one chooses to use a hard line 4A and ignore everything else, one could still uncover underlying issues because one would see a big pile of "spontaneous" arousals sitting in the bucket which would need accounting for.

However, and not wishing to generalize, let's say we do have a person with a ton of "spontaneous" arousals (who may now end up with a dx of "primary snoring"). In these cases, the sleep disordered breathing events would not necessarily be technically severe (little or no desaturation and waveforms having a flow limited appearance). These people may be candidates for alternative therapy (weight loss, positional therapy, oral appliances, Provent, surgical intervention, etc.).

However2, if you're having ≥ "drop-dead" desaturations, might not ncessarily be a good idea to stray too far away from xPAP approach.

mollete wrote:

NotLazyJustTired wrote: Hmmm, just looked at my sleep study. It says, "Hypopnea Rule: 4A". Which uses the Recommended rule, and not the Alternative rule. I guess I could be OSA after all!

OTOH, this debate about "Da Rules" is a little myopic because is assumes (like everybody else on the planet) that the be-all, tell-all, know-all, key piece of information is "Da Number" (AHI), when it is not.

I mean, in re: desaturations, what is clinically relevant? 4% or 3%? What happens if you have a bunch of 2.9%'s?

It is more important to look at the whole picture ("Da Graphs")(and in some cases "Da Tables") which would allow successful interpretation of the data. Whether one uses AASM 2008 4A or 4B, or AASM 2012 is academic. No matter which rule one uses, arousals are recorded and documented. 4B and 2012 may end up associating them with hypopneas whereas 4A would not. If one chooses to score RERAs, then outlying respiratory events would then be accounted in the RDI.

In any case, if one chooses to use a hard line 4A and ignore everything else, one could still uncover underlying issues because one would see a big pile of "spontaneous" arousals sitting in the bucket which would need accounting for.

I agree to a point. My insurance isn't covering my treatment because my AHI is below 5. I have to pay for everything out of pocket. In that sense, that little number and the way that it is scored is significant, at least to me.