"please keep me updated about oximeters "
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How much weight should one put on indices?
General Background: I switched machines about a month ago, from Resmed to Respironics. My sleep doc had said that the Resmed Autopap allows for more fine tuning but that I might find the Respironics more breather friendly -- I had complained about the Resmed sometimes feeling as if I were forced to inhale or exhale slightly ahead of what I wanted to do.
Soecific Background: The Respironics data set is somewhat less detailed than the Resmed. However it provides a distinction that Resmed did not; rather than AI and AHI, it purports to distinguish between Central Apnea (Clear Airway Apnea) and Obstructive Appnea.
The Good News: AHI, which, once I adjusted to Resmed and tweaked mask fit -- a matter of months -- had plateaued at about 1.1, has been a steady 0.9 on this machine, right off the bat. The breathing seems more comfrtable and the average EPAP and IPAP each slightly lower than had been the case.
Bad News? Any Reason to be Concerned?:
The average Periodic Bretahing is 0.5%, the CA Index is 0.4 Obstructive Airway Apnea 0.3 and Hypopnea 0.2.
Should I be worried that the CA is higher than either of the other two measures, or should I be delighted that the other two measures are so low and think of the CA as background noise? I don't think I am borderline neurotic/hypochondriac in wondering about this. I am not likely to see my sleep doc again until June or I would have run this by him first -- the DME provider always ducks medical issues (as well they probably should).
Thanks in advance and apologize if this is too much background /detail -- I am a BiPAP veteran, have had too much surgery and now have much skepticism about that, and find this forum useful and informative -- hope that some or all of the detail is relevant and/or helpful to others.
Views: 161
Replies to This Discussion
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Permalink Reply by Mary Z on
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I personally would not be concerned about the central apneas. Many machines do not even measure them. I'm glad you are finding the new machine to be more comfortable.
Mary Z.
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Permalink Reply by Clueless in Redwood Shores on
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Interesting but academic -- there is no S9 Bipap yet.
Jo said:
FYI, the ResMed S9 Elite shows central apneas in the detailed data.
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Update which I hope is of interest -- eleven months later! Alarmed by both a recurrence of the defect in the Respironics machine as well as a prolonged spike in symptoms measured by no sleep machine but which, in my own medical history had been associated with untreated apnea, I switched back to Resmed shortly after the release of S9 BiPap -- with a lot of creative begging on my part resulting in much financial help from my DME provider and a small out-of-pocket expense. I slept more soundly but noted that, as suspected, the Central Apnea number made up almost the entirety of a low AHI.
On a follow-up visit to my sleep Doc, the good doctor noticed that my (90th percentile?) pressure hovered near the bottom of the prescribed range. He opined, based on that observation, that the CA number probably reflected my body and brain fighting the machine and resisting the pressure, which he tweaked downwards. Since that tweak, my AHI on a good night is 0.x and on a bad night is anywhere in the range of 2.0 to 4.X. The S9 is also much quieter than the Respironics ever was, let alone a Respironics in pre-failure mode.
Bottom line, if your Central Apnea is consistently higher than either Apneas or Hypopneas, you might benefit from a similar conversation about pressure with your own doc.
Happy whatever-you-choose-to-celebrate-at-this-time-of -year and best wishes for a Healthy, Happy, Prosperous and Productive New Year to all,
Clueless
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Clueless, thanks for the update. It's always good to remember that if our numbers seem a little high that sometimes we need to tweak down instead of up. How's it going now.
And FWIW, Jo, the S8's do not record CAs. Many of us have older machines since they should last five years.
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Mary:
My pleasure! Interestingly enough I have had only one night with an AHI over 5 (it was low sixes); that happened to be a night when I either had bad food poisoning or stomach flue. Fasting and lots of lemon water and peppermint tea seemed to have restored what passes for normalcy...
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Permalink Reply by ZolliStar on
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I'm very grateful that you returned to post this update, Clueless. Thank you very much.
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I am glad that you read it! It sounds as if your adventures with pressure have some similarity to my own. Do you have any options when it comes to DMEs? From your thread it seemed as if the doctor or the DME or both were not nearly as responsive / responsible as they ought to be. We have a DME locally that is doing quite well by being much more flexible, informative and supportive than Apria or the other national providers.
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There is a DME that is highly recommended -- and isn't in my insurance network. I'm thinking of heading out to buy things from this organization (they handle sleep equipment and nothing else) just to get their insight and advice. The owner, btw, is an apneac.
My DME is reasonably good, but not great.
My doctor and his RT are quite responsive, however. That said, I'm wondering if I shouldn't get a machine that reports numbers, etc. (mine only reports compliance so that my insurance company will pay the freight). I'm not a techie and would be perfectly happy to have everything work fine, no questions asked from or by me. This hope may be an unreasonable one, however.
Again, thank you for "reporting in".
Clueless in Redwood Shores said:I am glad that you read it! It sounds as if your adventures with pressure have some similarity to my own. Do you have any options when it comes to DMEs? From your thread it seemed as if the doctor or the DME or both were not nearly as responsive / responsible as they ought to be. We have a DME locally that is doing quite well by being much more flexible, informative and supportive than Apria or the other national providers.
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Zollistar- if you want to be able to check your numbers, and we recommend it, see if your doc and dme will help you switch machines if you are in rental. However, if your CPAP without data is meeting your needs you might just continue with that one if switching would be expensive.
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Permalink Reply by Lynn on
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I'm not an expert but it seems to be a very low number so probably shouldn't be worrisome. If it was happening a lot, you would probably need a bipap.
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I'm on Bipap! That is driven by the pressure which is still 19 something or 20 something over 15 or 16 something.
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