"please keep me updated about oximeters "
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In laymans terms someone explain how the machine knows I have had an apnea.
The green in this post shows I am still having lots of them. How does my machine know that?
http://www.sleepguide.com/forum/topics/hello-newbie-is-all-confused
http://www.sleepguide.com/forum/topics/hello-newbie-is-all-confused
Views: 88
Replies to This Discussion
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Permalink Reply by Mike Fritz on
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So are you saying that I am breathing more with my mouth and that is causing the problem. I was told that the full face mask took care of that. But I don't know...I guess I could try the taping thing for one night and see what happens.
As far as a leak on the mask I have 4 of them that are all alike. At first it was a problem but now I have that part beat for the most part. I am going to post the Doctors report on the other thread please take a look at it. thanks
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Permalink Reply by Daniel on
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Jeff, I'm not sure you really answered Mike's question. The pressure sensor built into your CPAP is very sensitive, and can detect the increase in pressure from the the back-pressure of your exhalation. For example, if your CPAP is putting out a pressure of 17cmH2O in one direction, and you exhale with a pressure of 3cmH2O, the sensor will detect the temporary increase to 20cmH2O. The CPAP recognizes you have exhaled, and since you have CFlex, it does a dip in the pressure so that your exhalation is more comfortable.
If you have an apnea event (the dreaded green stripes), by definition, you are not breathing for 10 seconds or more. The device keeps track of how much time since it last detected an exhalation. If more than ten seconds go by, it scores an apnea event and time stamps when it happened.
I hope this explanation makes it clearer.
Daniel
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Wow - talk about a technical answer! I may have oversimplified, but the idea is that the device monitors your breathing patterns and derives the apnea and hypopnea information based on a set of pre-programmed rules for interpreting those patterns. It's interesting to note that every brand has it's own rules, so it merely works out to be an estimation of what would be found in a sleep lab.
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Permalink Reply by RockRpsgt on
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That is crazy jnk. The 3 different companies with three different rules all representing the 3 AASM scoring and alternative scoring rules for these events. I wish I had my scoring manual on my computer to show you. It's not exact yet still very close. Great post! I did not know the differences.
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I wonder if there is any correlation between these rules, how a lab scores events, and which machines will be eligible from an insurance company based on the 2. I hope that made sense.
Rock Hinkle said:That is crazy jnk. The 3 different companies with three different rules all representing the 3 AASM scoring and alternative scoring rules for these events. I wish I had my scoring manual on my computer to show you. It's not exact yet still very close. Great post! I did not know the differences.
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Yeah sometimes I feel like i am way out of my league on these sites. Makes it fun.
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The resmed machines do not know the difference between someone holding their breath or an event. A machine is not going to score the same way a human is with the info that a psg gives. in a psg you get to look at the events from so many more angles. And to be honest a hypopnea is a form of flow limitation.
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Mollete I honestly do not think it matters. I currently work at a lab That follows a strict interpretation of the AASM rules. We use the Chicago rule for scoring hypopneas. However I not to long ago left a lab that used the alternative rules of scoring. I do not believe that either miss diagnosed due to a misinterpretation of the rules. Every lab I have worked for or visited have had strict guidelines in which several people look over studies before a Dx is given. I think this in itself evens out the rules no matter which is used. Also if the rules of a given lab are followed then there should not be to much of a discrepency regarding scoring an event. this may change from lab to lab, but in a single lab everyone should be on the same page with the medical director.
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Permalink Reply by Duane McDade on
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Now that you're confused here's what you asked for....You wear a mask attached to a machine by a hose, about the size of a garden hose. There's a small tube that is mounted on the machine, (seperate from the garden hose) and it is mounted on the mask too. The computer in the machine sences pressure changes that might be created by someone having a apnea (not breathing) and stores it in its memory. It's not very effective but it's the only option that some people have. It is much better to go to a sleep lab and let a human analize your sleep. they have ten times the data to make a correct assesment of sleep issues.
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JNK if you are having CENTRAL Apneas you better have a Doctor. Because your problems are much more serious than simple Obstructive Sleep Apnea. Little hose, big hose. It makes no difference! it is still a very bad way to judge or correct sleep Apnea. Before I was asked to be a Sleep Technician I was in R&D for several Aerospace Agencys.No matter how you tried a system as bad as auto/CPAP machines would never fly. They don't want to loose passengers or pilots. Now lets address the cost well let's see spend money feel good ? or don't spend money feel like crap. I rest my Case.
j n k said:Mollete,
A central event may not be flow-limited in the sense of being an obstruction, but it must involve a reduction (or limit) in flow to be considered a hypopnea, as I understand it. Terminology often has technical use and layman use. And since most home machines do not even attempt to differentiate the obstructive event from the central, then in the context of home machines and their scoring, the concept that a hypopnea is a kind of flow limitation may be the most salient point. But that's only my opinion, and I respect yours.
Duane,
Most machines don't have the second hose you mention.
I agree home machines aren't the best way to diagnose sleep issues. A lab is. But a lab is way too expensive of a way to assess treatment efficacy night-to-night over time because of how expensive that would be. That would be like a diabetic who needs insulin having to travel to a hospital every time he or she wanted to assess blood-sugar levels. Thus the benefit of home machine data.
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Sorry Mollete that should have read "we don't". I was sleep deprived at the time.
Mollete said:Rock Hinkel said:
"We use the Chicago rule for scoring hypopneas."
Do you use the Chicago criteria for scoring Medicare patients?
Rock Hinkel said:
"I currently work at a lab That follows a strict interpretation of the AASM rules."
I would respectfully submit that if you are using Chicago criteria, you are definitely not following a strict interpretation of AASM 2008.
jnk said:
"And I also think you got to the heart of the matter much better than I did when you said "a hypopnea is a form of flow limitation." That really says it all."
At most that says only half, since central hypopneas are not flow-limited.
mollete
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