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Permalink Reply by Mike on October 25, 2009 at 5:01pm

Jan, I think that any time you use the machine for a period of >4 hours, it counts as a "session" -- I'm not certain of this, but I believe that's how Respironics machines report these things. the 90% pressure feedback is telling you that 90% of the time, your pressure is at or below 10.7 cm/H20 --- what's your pressure set at currently? if it were set at, say, 10.7, i'd think seriously about getting your doctor to increase the pressure setting. on those facts, your machine would be struggling against its upper most pressure limit and you might benefit from greater pressure. the compliance check and the weird number is for the DME to get reimbursed/check up on you. Seems as if your compliance screen was locked up by your DME. i pointed you in the direction of an existing thread that explains how to change that setting. Once you see that data (you'll see even more of it with the software), you can track your AHI and leak better. Yes, leak would include time spent with mouth open as well as leakage around the pillows.

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Permalink Reply by Jan on October 25, 2009 at 5:16pm

Hi-- I am pretty sure that my settings are supposed to be auto titrating between 8 and 17. I have still been waking up in the middle of the night, either to go to the bathroom, or because I need to adjust the mask. Whenever I do, I check the machine to see what level it is at. I've seen it report in the 8's, 9's, 10's and once as high as 12 and a fraction but not higher than that. I used the ramp feature for the first couple of nights and it started ramping at 4. I found that feature a bit annoying especially since I couldn't adjust the ramp time so I just stopped using it.

So, if I am set to go on auto pilot between 8 and 17 and I am spending 90% of my time below 10.7-- then is that more or less saying that 10.7 would eliminate apneas 90% of the time?

Mike said:

Jan, I think that any time you use the machine for a period of >4 hours, it counts as a "session" -- I'm not certain of this, but I believe that's how Respironics machines report these things. the 90% pressure feedback is telling you that 90% of the time, your pressure is at or below 10.7 cm/H20 --- what's your pressure set at currently? if it were set at, say, 10.7, i'd think seriously about getting your doctor to increase the pressure setting. on those facts, your machine would be struggling against its upper most pressure limit and you might benefit from greater pressure. the compliance check and the weird number is for the DME to get reimbursed/check up on you. Seems as if your compliance screen was locked up by your DME. i pointed you in the direction of a thread that explains how to change that setting. Once you see that data (you'll see even more of it with the software), you can track your AHI and leak better. Yes, leak would include time spent with mouth open as well as leakage around the pillows.

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Permalink Reply by Jan on October 25, 2009 at 5:22pm

And, just a little rant here. I think it is pretty condescending and paternalistic for these manufacturers to hide this minimal amount of information from me/us. I see no reason that hiding it benefits me or my health or my ability to manage this condition. We've all had problems contacting doctors and DME's to assist us so it's not like they are hanging around waiting for us to call so that they can enthusiastically respond to our many questions. Sheesh!!! Had I known that the DME was going to lock this info from view, I would have had a showdown while picking it up.

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Permalink Reply by Mike on October 25, 2009 at 5:50pm

No. We do not yet know your AHI which is the measure of how many apneas/hypopneas you are having. The 10.8 number suggests that your machine need not have such a high uppermost setting. I'd get it knocked down to between 8 and 13.

By the way, you can adjust your ramp setting through sAme mechanism you use to unlock ahi and leak reporting.

Jan said:

Hi-- I am pretty sure that my settings are supposed to be auto titrating between 8 and 17. I have still been waking up in the middle of the night, either to go to the bathroom, or because I need to adjust the mask. Whenever I do, I check the machine to see what level it is at. I've seen it report in the 8's, 9's, 10's and once as high as 12 and a fraction but not higher than that. I used the ramp feature for the first couple of nights and it started ramping at 4. I found that feature a bit annoying especially since I couldn't adjust the ramp time so I just stopped using it. So, if I am set to go on auto pilot between 8 and 17 and I am spending 90% of my time below 10.7-- then is that more or less saying that 10.7 would eliminate apneas 90% of the time?

Mike said:

Jan, I think that any time you use the machine for a period of >4 hours, it counts as a "session" -- I'm not certain of this, but I believe that's how Respironics machines report these things. the 90% pressure feedback is telling you that 90% of the time, your pressure is at or below 10.7 cm/H20 --- what's your pressure set at currently? if it were set at, say, 10.7, i'd think seriously about getting your doctor to increase the pressure setting. on those facts, your machine would be struggling against its upper most pressure limit and you might benefit from greater pressure. the compliance check and the weird number is for the DME to get reimbursed/check up on you. Seems as if your compliance screen was locked up by your DME. i pointed you in the direction of a thread that explains how to change that setting. Once you see that data (you'll see even more of it with the software), you can track your AHI and leak better. Yes, leak would include time spent with mouth open as well as leakage around the pillows.

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Permalink Reply by Jan on October 25, 2009 at 5:52pm

OK-- YIPPIEIEIEIEIEIEIE!!!! I do LOVE feeling in control of my own self, thank you ;-) So, now I have the data and hope that someone can help interpret the two new-to-me fields. I have only been using this for 5 days so I will only provide 7 day average number:

Screen says: System Leak: L/Min = 30.2 (so what does that mean)

AHI= 3.1. I think that is a good number? The 3.1??? Should that be aiming for Zero?

OK-- just looked it up in the SG FAQ and <5 is supposed to be normal. Is this possible. My initial sleep test said that I had 220 events in 172 minutes of sleep. (20 central, 94 obstructive, 93 hypopneas, 1 mixed and 12 respiratory effort related arousals). So is it really possible that I could have gone from approximately 70 events an hour to just a tad over 3 per hour in just 5 days using this machine???

Am I misunderstanding???

And Mike, now that I am able to access all of the settings, I am set for a min setting of 8 and max of 17.

AND I EVEN RESET THE TIMER ON THAT PESKY RAMP ON MY OWN WITHOUT NEED OF DME hehe :-)

Who would have thought I would feel this good conquering this darn machine!

Jan

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Permalink Reply by Mike on October 25, 2009 at 6:23pm

ok, not to be a party pooper, but the 7-day and 30-day moving average isn't terribly meaningful data -- it obscures too much. what would be ideal is looking at detailed data for each night. that kind of information is only available with the software (that Respironics put out for its old machines but has not released for its new System One machines -- hint , hint, Respironics -- we WANT that software).

that said, an AHI of 3.1 is a good number. ideally, the number would be zero, yes, but anything <5 is considered good. the closer to zero the better. you said: " is it really possible that I could have gone from approximately 70 events an hour to just a tad over 3 per hour in just 5 days using this machine? " the answer is a resounding YES. it's as simple as that. Treating Sleep Apnea is good for you. Really, really good for you.

the leak of 30.2 L/min is also a fairly good number. every mask needs to leak a little and has a different range of acceptable leak numbers. your number is probably included in your mask's manual. but generally anything <40 L/min is pretty good. but again, you have no idea if there have been some pretty significant leakages over the course of time -- what are called "Large Leaks" -- you want the detailed data to identify those and try to piece together what might have caused it that particular night.

Bottom line: things look promising, but you're looking at very high level averages that can obscure too much.

Jan said:

OK-- YIPPIEIEIEIEIEIEIE!!!! I do LOVE feeling in control of my own self, thank you ;-) So, now I have the data and hope that someone can help interpret the two new-to-me fields. I have only been using this for 5 days so I will only provide 7 day average number:
Screen says: System Leak: L/Min = 30.2 (so what does that mean) AHI= 3.1. I think that is a good number? The 3.1??? Should that be aiming for Zero?

OK-- just looked it up in the SG FAQ and <5 is supposed to be normal. Is this possible. My initial sleep test said that I had 220 events in 172 minutes of sleep. (20 central, 94 obstructive, 93 hypopneas, 1 mixed and 12 respiratory effort related arousals). So is it really possible that I could have gone from approximately 70 events an hour to just a tad over 3 per hour in just 5 days using this machine???

Am I misunderstanding???

And Mike, now that I am able to access all of the settings, I am set for a min setting of 8 and max of 17.

AND I EVEN RESET THE TIMER ON THAT PESKY RAMP ON MY OWN WITHOUT NEED OF DME hehe :-)

Who would have thought I would feel this good conquering this darn machine!

Jan

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Permalink Reply by PD Laire on October 25, 2009 at 6:35pm

Jan, you wondered why DMEs would ever want to hide this information from you:

I see no reason that hiding it benefits me or my health or my ability to manage this condition.

But I think you have answered your own question:

I EVEN RESET THE TIMER ON THAT PESKY RAMP ON MY OWN WITHOUT NEED OF DME

Jan said:

AND I EVEN RESET THE TIMER ON THAT PESKY RAMP ON MY OWN WITHOUT NEED OF DME hehe :-)

Who would have thought I would feel this good conquering this darn machine!

Jan

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Permalink Reply by Jan on October 25, 2009 at 6:36pm

Thanks-- and I understand how obscuring averages can be. But, for now and until I get the more sophisticated capabilities...well, I call these numbers better 'n a poke in the eye :-) I will check the data daily. The software is on the way :-) And I am working on getting all the pieces together to run this on my Mac computers. Hopefully I will have this all tied together by the end of the week.

And thanks!

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Permalink Reply by RockRpsgt on October 26, 2009 at 8:18am

yes it is possible that you have gone from an AHI of 70 to one of 3. Good for you Jan. Do not get caught up in all of the DME hype. It will only piss you off and add negativity where it does not belong. In your therapy. You are and have been doing exactly what you should be doing.

Jan said:

OK-- YIPPIEIEIEIEIEIEIE!!!! I do LOVE feeling in control of my own self, thank you ;-) So, now I have the data and hope that someone can help interpret the two new-to-me fields. I have only been using this for 5 days so I will only provide 7 day average number:

Screen says: System Leak: L/Min = 30.2 (so what does that mean)

AHI= 3.1. I think that is a good number? The 3.1??? Should that be aiming for Zero?

OK-- just looked it up in the SG FAQ and <5 is supposed to be normal. Is this possible. My initial sleep test said that I had 220 events in 172 minutes of sleep. (20 central, 94 obstructive, 93 hypopneas, 1 mixed and 12 respiratory effort related arousals). So is it really possible that I could have gone from approximately 70 events an hour to just a tad over 3 per hour in just 5 days using this machine???

Am I misunderstanding???

And Mike, now that I am able to access all of the settings, I am set for a min setting of 8 and max of 17.

AND I EVEN RESET THE TIMER ON THAT PESKY RAMP ON MY OWN WITHOUT NEED OF DME hehe :-)

Who would have thought I would feel this good conquering this darn machine!

Jan

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