Replies to This Discussion

Permalink Reply by RockRpsgt on December 21, 2009 at 1:35am

Good Morning Claudette! Well I guess it is about my lunch time anyway. Unfortuanately I can not tell you anymore about the unit you have. jnk and Judy have way more knowledge on this particular machine than I do. I find myself reading their responses to you and just nodding in aggreement. I would be more than happy to help you interpret your report though. Post your questions here or PM me. I will follow the post.

Which Resmed mask do you have?

• ▶ Reply

Permalink Reply by claudette paluch on December 21, 2009 at 2:59am

Good Morning to you Rock Hinkle....By now you should be thru with your lunch...It has taken me hours to straighten out my email account ....strange tho, I had a sign in request for SG which I never received before...well anyway...its now 2:42 AM and I am still at the computer..so much for sleep hygiene...How do those hours affect your circadian rhythm?

Thank you very much for your offer to help me interpret my sleep study report...I dont know how to post it here....right now... I will attempt it at some future date.... I am just trying to be sure that i have everything that reflects what was done.....

But I will get back to you at some future date, if I may, when I feel more organized and have all the information.

I dont know how to PM here either....I tried once and I think it went over the airwaves so I have to learn that process as well. Jnk and Judy do know alot about this machine...and its great to have help from them....

When I have time to look at the sleep study again, I will post any questions...which, knowing me, will be quite a few...

Thanks for reminding me thru your comment to jnk that Christmas is upon us...I probably would have kept questioning thru that day and he may well need a break from all the questions that he responds to....nothing is so important that it cant wait....

and so I wish you too a Merry Christmas, Rock...and thanks again...........Claudette




Rock Hinkle said:

Good Morning Claudette! Well I guess it is about my lunch time anyway. Unfortuanately I can not tell you anymore about the unit you have. jnk and Judy have way more knowledge on this particular machine than I do. I find myself reading their responses to you and just nodding in aggreement. I would be more than happy to help you interpret your report though. Post your questions here or PM me. I will follow the post.

Which Resmed mask do you have?

• ▶ Reply

Permalink Reply by claudette paluch on December 21, 2009 at 3:04am

I forgot re the mask...I dont have a Res Med mask. I have a respironics profile lite....and have been wondering if I should get a res med mask or whether it makes any difference........thanks...claudette

Rock Hinkle said:

Good Morning Claudette! Well I guess it is about my lunch time anyway. Unfortuanately I can not tell you anymore about the unit you have. jnk and Judy have way more knowledge on this particular machine than I do. I find myself reading their responses to you and just nodding in aggreement. I would be more than happy to help you interpret your report though. Post your questions here or PM me. I will follow the post.

Which Resmed mask do you have?

• ▶ Reply

Permalink Reply by Judy on December 21, 2009 at 6:50am

First off, Claudette, if that Respironics ProfileLite is comfortable for you and you have a good Leak rate - stick w/it, do NOT change masks. Do you have the literature that came w/it? In that literature there will be a table type of chart. There will be table chart, probably on the back page that will have a caption like "Pressure vs Leak rate" most likely. Down the left side will be some numbers, probably 0 at the bottom on up to 60 at the top. On the bottom there will be numbers running from left to right, probably 10 to 20. And then a line running thru the chart lower on the left and higher towards the right. The numbers on the left are the "exhaust leak rate" or "allowed vent rate", the numbers along the bottom are various PAP pressures.

Pick your VPAP reported pressure (not set pressures, reported pressure) at the bottom and see at what number that line hits the exhaust leak rate.

For example, my Simplicity simple nasal cushion mask at 8 cms pressure hits the exhaust leak rate line at about 21 L/M.

Then look in your VPAP Auto 25's Users Guide. Somewhere in it there will be a list of Resmed Masks and their allowed vent rate (exhaust leak rate). Pick the Resmed mask w/the exhaust leak rate closest to your ProfileLite's exhaust leak rate at your pressure.

For example, the Resmed Swift nasal pillows mask has the exhaust leak rate closest to my Simplicity at 8 cms so I would set my Mask Selection to the Swift.

Most likely your DME provider has made this correct Mask Selection for you. and you don't have to bother w/this at all.

Claudette, do you have a set time that you have to get up each morning? I've found that I get my best sleep between 6 AM and 8:30 AM. Of course, few jobs allow you to sleep that late. But now that I am retired and can sleep any dibblety-darn hours I want I find I like going to bed about midnight to 1 AM and can often then sleep until 8 or 8:30 AM. Hubby is an early-to-bed, early-to-rise person. I find I really enjoy those few late night hours to myself. Why fight my natural sleep hours when I don't have to? I've always preferred a late bedtime as well as that 8:30 AM waking time as far back as I can remember.

AI = apnea index = the number of apneas you experienced PER HOUR that night - or averaged PER HOUR over the week, month, 6 months or year previous (once you've used your VPAP Auto 25 that long).

And, by the way, when I use my ProBasics Zzz-Mask full face mask, its allowed exhaust leak rate also happens to fall w/in the Resmed Swift nasal pillows allowed leak rate at my reported pressure so I use the Swift Mask Selection for the Zzz-Mask too - AND - I've gotten a 0.0 reported leak rate on several occasions so it is possible w/o a Resmed mask to get a 0.0 leak rate ON OCCASION. But, as jnk has said, as long as my leak rate is under 0.4 L/s I don't care, I'm happier than a pig in a pile of dung as leak IS a problem for me w/my Simplicity even w/a chin strap.

• ▶ Reply

Permalink Reply by Judy on December 21, 2009 at 8:43am

VT = tidal volume = the volume of air inspired or expired in one respiratory cycle (breath)
MV = minute ventilation = volume of air breathed in (or out) w/in any 60 second period
RR = respiratory rate = the frequency of breathing, expressed as the number of breaths per minute

None of them are of any importance to you, at least not at this point, and most likely won't ever be. The definitions are just to satisfy your curiosity.

Press = 95th percentile = the value exceeded during the selected range for 5% of the time - or to put it another way, the pressure AT OR BELOW which you spent 95% of the night.

jnk!!! We NEED YOU to explain, w/the IPAP at 20 and the EPAP at 7 and the PS at 4, WHAT is the IPAP range allowed, and the EPAP range allowed?? That gap between 20 and 7 is too big a range, isn't it? Isn't the accuracy lost if the PS is greater than 10? Or is it that the PS can't be set greater than 10?

I'll have to go check the Clinicians Manual again. I'm thinking that her provider has set her Resmed as he/she would a Respironics.

• ▶ Reply

Permalink Reply by Judy on December 21, 2009 at 9:00am

AND, an interesting phrase I never noticed before that is of particular significance to MY situation:
The pressure reported in the Efficacy Data submenu for a single session is the 95th centile pressure for mask-on time, excluding periods when the leak has exceeded 0.4 L/s (24 L/min).

• ▶ Reply

Permalink Reply by Judy on December 21, 2009 at 11:32am

Thank you, yet again, jnk!!! I swear I don't think I'm EVER going to be able to get the darn Resmed PS straight in my beady ole brain! I don't know WHY I have such a tuff time keeping it straight in my head but ...

AND ROCK HINKLE!!! This Leak rate bit certainly explains the "fun" we were having w/my Simplicity, Leak and Pressure, doesn't it???

Judy said:

AND, an interesting phrase I never noticed before that is of particular significance to MY situation:
The pressure reported in the Efficacy Data submenu for a single session is the 95th centile pressure for mask-on time, excluding periods when the leak has exceeded 0.4 L/s (24 L/min).

• ▶ Reply

Permalink Reply by RockRpsgt on December 21, 2009 at 1:23pm

Yeah Judy your mouth leaks were setting you back with the simplicity.

Claudette yours is a classic apnea case. As I learned with my 9 year old daughter treating the apnea is only half of the battle. Apnea can actually make your sleep habits worse. Prior to having her toncils and adnoids removed she was waking up 2-3 times a night. Despite the surgery fixing her apnea (for now) she continued the bad habits. It took me almost 6 months to turn he sleep around. Now Kylie is only 9. Her bad sleep habits were very few years in the making. I do not know how old you are, but I would be willing to wager that your bad sleep habits are at least 10 years in the making. It might take you sometime to unlearn the bad sleep habits that your life has taught you.

Bad sleep hygeine and anxiety can be a very interesting combination. I consider myself OCD with an ADD rising. Meaning I do not think anything was aligned when I was born. Stars, planets nothing! I have found that the closer it gets to bed time the more anxious I get about things I have not finished. To solve this problem I make a list of everything I have to do for that day. I give myself a certain time frame to finish this list. Typically for me if I have not finished my list by dinner it gets moved to tomorrows list. This leaves after dinner time for relaxation, kids, and my wife. God forbid she does not get her time LOL! The hardest part for me was accepting that sometimes I will not get everything done.

I have found that I am a clock watcher. This was a huge discovery for me as far as my anxiety goes. If there is a clock in the room I will check it every five minutes. To alleviate this problem my wife and I have made it sort of an effort to find out what time it is. We only have one wall clock in the house. Every other clock has a button or some other act that has to be done to see it. Call it laziness if you want, but I do not clock watch near as much. This simple act has made my days and NIGHTS go a little smoother.

• ▶ Reply

Permalink Reply by claudette paluch on December 21, 2009 at 7:34pm

Judy, thank you so very much for all that information....!

I need to search to find the literature for that mask..I should have it in a file..If not, I am sure that I should be able to get it. I have printed out all that you wrote so that I can read it more carefully.

I do need to take a good look at the hours of sleep I am (or not) getting...another day of sleeping irregularly...and make a decision as to what hours will work best for me....Overall I am comfortable breathing with the machine....but I have been waking after about 4 hours no matter what time I go to sleep...and then I have to return to bed at some point later in the day because I am tired, so I am staying up too late...I will google Sleep Hygiene as jeff suggested..no question that i have to spend some time on that....your information re the mask is really helpful...

Thanks again Judy..I appreciate it.........Claudette

Judy said:

VT = tidal volume = the volume of air inspired or expired in one respiratory cycle (breath)
MV = minute ventilation = volume of air breathed in (or out) w/in any 60 second period
RR = respiratory rate = the frequency of breathing, expressed as the number of breaths per minute

None of them are of any importance to you, at least not at this point, and most likely won't ever be. The definitions are just to satisfy your curiosity.

Press = 95th percentile = the value exceeded during the selected range for 5% of the time - or to put it another way, the pressure AT OR BELOW which you spent 95% of the night.

jnk!!! We NEED YOU to explain, w/the IPAP at 20 and the EPAP at 7 and the PS at 4, WHAT is the IPAP range allowed, and the EPAP range allowed?? That gap between 20 and 7 is too big a range, isn't it? Isn't the accuracy lost if the PS is greater than 10? Or is it that the PS can't be set greater than 10?

I'll have to go check the Clinicians Manual again. I'm thinking that her provider has set her Resmed as he/she would a Respironics.

• ▶ Reply

Permalink Reply by claudette paluch on December 21, 2009 at 8:02pm

For the hours that I am sleeping now ie approx 4 at a time, I do sleep well..dreaming more than I can ever remember and I am remembering the dreams, which I am not always happy about...With the respironics I dont remember dreaming much....At that time, I was sleeping about 6 hours at nite which was the only time available for me to sleep....but I was waking intermittently alot.

I find that as an hour near bedtime is approaching...its not anxiety that keeps me from going to sleep...I seem to get increased energy and want to accomplish alot of things....and I do like being awake at night...but maybe it is as you describe...maybe it is anxiety that is interfering...thanks...interesting things for me to think about and analyze....

I think that because I have had life changing events occur shortly before I acquired the auto 25 I am being impacted with residual emotional overload and perhaps anxiety that I am not yet in touch with....I will have to give all the sleep hygiene issues alot more reflection to see what may be impacting me.

I am thinking that maybe I dont even like to go to sleep...a little self analysis is in the making.

.Thanks for your thoughts Rock.................They are helping me to realize that i need more reflection....claudette



Rock Hinkle said:

Yeah Judy your mouth leaks were setting you back with the simplicity.

Claudette yours is a classic apnea case. As I learned with my 9 year old daughter treating the apnea is only half of the battle. Apnea can actually make your sleep habits worse. Prior to having her toncils and adnoids removed she was waking up 2-3 times a night. Despite the surgery fixing her apnea (for now) she continued the bad habits. It took me almost 6 months to turn he sleep around. Now Kylie is only 9. Her bad sleep habits were very few years in the making. I do not know how old you are, but I would be willing to wager that your bad sleep habits are at least 10 years in the making. It might take you sometime to unlearn the bad sleep habits that your life has taught you.

Bad sleep hygeine and anxiety can be a very interesting combination. I consider myself OCD with an ADD rising. Meaning I do not think anything was aligned when I was born. Stars, planets nothing! I have found that the closer it gets to bed time the more anxious I get about things I have not finished. To solve this problem I make a list of everything I have to do for that day. I give myself a certain time frame to finish this list. Typically for me if I have not finished my list by dinner it gets moved to tomorrows list. This leaves after dinner time for relaxation, kids, and my wife. God forbid she does not get her time LOL! The hardest part for me was accepting that sometimes I will not get everything done.

I have found that I am a clock watcher. This was a huge discovery for me as far as my anxiety goes. If there is a clock in the room I will check it every five minutes. To alleviate this problem my wife and I have made it sort of an effort to find out what time it is. We only have one wall clock in the house. Every other clock has a button or some other act that has to be done to see it. Call it laziness if you want, but I do not clock watch near as much. This simple act has made my days and NIGHTS go a little smoother.

• ▶ Reply

Permalink Reply by claudette paluch on December 21, 2009 at 8:18pm

the PS of 4 does seem better...when i received the loaner it was set at 3 for some reason and after reading some of the information here and wherever, I asked them to change it to 4 to see if I would breathe more comfortably..and I do....I could tell the difference between the 3 setting and the 4. I dont understand how that impacts the pressures yet or how it really relates to it..

I will print your reply as I did Judys ....which also has alot of helpful information....then I can take my time ingesting it all....and determine what further clarification i may need...

thank you................

j n k said:

@ Judy,

With those numbers, the 20 is the highest IPAP can go, the 7 is the lowest EPAP can go, and the delivered pressures will always be 4 cm apart at any given moment. Good standard setup, in my opinion, if that keeps AI below 1.0 most nights.

The IPAP range with that setup is 11 to 20 and the EPAP range is 7 to 16. The upper limit doesn't matter much unless the pressures are running away. Starting the night at 7/11 makes sense. The delivered IPAP and delivered EPAP is always PS-distance apart. Whoever set that machine up knew what they were doing, in my opinion.

I don't like PS set higher than 6 on that machine, myself. And hers is at 4, the most common setting. That is good. One day months down the road, she and her team might find that another number for PS might lower her HI. But, like I said, that really doesn't matter right now.

@ Claudette,

Judy is giving you VERY good answers. She has a gift for putting things in a very understandable way.

@ Rock,

You crack me up, man.

Take good care o' that family!

jeff

• ▶ Reply

Permalink Reply by claudette paluch on December 21, 2009 at 8:46pm

Jeff,

I cannot formulate a proper reply to you right now for your wonderful words and suggestions....except to tell you that I appreciate them so much.........Thank You!........Claudette

j n k said:

Claudette,

You have to train you brain and body to sleep by being consistent in what you expect. You start dimming the lights in the evening and giving clues to your body and brain that it is time to start winding down as the evening goes on. Then, by the time you get to bed, your brain is ready to sleep.

It is natural for your nervous system to dread sleep if it spent years learning that it had to gear up to startle you awake every few minutes just to keep you alive at night. It doesn't have to do that anymore. So you have to help it calm down as it unlearns that. Give it time. You can help it learn that by developing a set time for sleep and a set time for being awake.

If you have gone through life changes and have emotions to work through, one of the best things you can do is to get enough in-bed time, where the rule is you aren't allowed to think about those things there to give yourself a break from it and heal. If need be, you set aside time early in the evening to sit in a chair away from your bed to think about things calmly. Then when you go to your bed, if those thoughts start to creep back, you laugh at your brain for doing that and lovingly remind it that it isn't allowed to think about it when you are horizontal, that you already thought about that stuff in the chair earlier. It is kind of like lovingly house-breaking a pet. You have to be strict with your brain or it will keep doing the same things. But you have to be gentle with it, too, so you don't discourage it or get it upset. It is an organ. It belongs to you. It is your job to train it. It pays off, because you don't have to go around cleaning up after it. :-)

Well, enough of my pop-psych babble. I hope you sleep well tonight, Claudette.

jeff

• ▶ Reply

▶ Reply to Discussion

• ‹ Previous
• 1
• 2
• 3
• Next ›
• Page