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I am pushing buttons trying to determine where to go to get the information i need to assess how I am doing....what is considered the patient menu? I saw advanced settings come up at one point and dont know if that is the entry to the clinician area and I am afraid that I might inadvertently alter my pressure settings if i try to access that area to see what is there....any suggestions for direction would be appreciated...........thanks Claudette

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wow...thanks jeff...spent time earlier today holding my breath while i pushed different combinations....when I hold the right arrow button and left arrow button simultaneously for a few seconds. "review" arrives in the screen.....

j n k said:
Does pushing the right-arrow button and the left-arrow button simultaneously for 5 seconds or so allow you to see the words "Efficacy Data" on your screen. If so, that is the patient menu that allows a patient to look but not change.
I dont know if it matters but when i hold the left and right buttons simultaneously...I am at the "settle" screen..does it make a difference from which screen I am pushing those 2 buttons?? thanks...

j n k said:
Does pushing the right-arrow button and the left-arrow button simultaneously for 5 seconds or so allow you to see the words "Efficacy Data" on your screen. If so, that is the patient menu that allows a patient to look but not change.
Jeff,

I dont know why I am laughing....nor should I perhaps admit that I am so confused...but why not? I am. So many posts are discussing important issues and I am trying to maneuver thru something that seems to me should be simplistic....I tried...I need a map I think..or greater mental clarity....

I spent part of the afternoon giving myself the "pats" you suggested....because I thought I was doing pretty well without direction.....then I became confused even tho I wrote a rough flow chart while I pushed the buttons looking for a logical sequence of actions.....then i couldnt read my writing... and gave up...i remember part of it tho.

My machine is now sleeping elsewhere......I dont have an extra electrical outlet near the computer....but I do recall that when I push the 2 buttons it does say review... not results....from the settle screen....Now then... how do I get from review to results? to the efficacy data? and from the efficacy data to the specifics of it?

If I push the left and right arrows I get review then if I push the left arrow i get ..settings....left arrow..mode....down arrow IPAP setting, down arrow Epap setting, down arrow pressure support....Those appear to be the settings that were set for me....and not the ones from the nite.....but it was after 12:PM so i dont know if that affected anything.

IPAP is 20, EPAP is 7 and pressure support is 4.....then I am lost.....I was doing this at about 1PM.

The Velbor post you sent me a while back says that the machine has an internal clock and therefore the results have to be taken prior to noon....for that particular day......is that correct?

Well, I should be awake by then, .hopefully, .I like the peacefulness of night tho....sleep hygiene is also on my to do list.

I have a flow chart that came with the machine that says Clinician Menu on it...I thought that perhaps they forgot to take it away....but that's where I see the advanced setting term and I wondered if I see that term again on the machine and push more buttons indiscriminately I might alter my pressures....does that seem possible?

So Sorry to present so convoluted a question....I hope that I am not giving you a headache following my confused comments.....Thank You so very much.!!.........Claudette









j n k said:
At the settle screen is fine.

It should, I believe, say "results."

I should correct my terminology above. Technically that is not the "Patient Menu," but is the part of the Clinical Menu that can be accessed by patients by pushing those two buttons. It is a way for patients to see the Results section of the Clinical Menu without giving access to making changes.

Now that I've corrected my wording, where was I? Oh yeah . . .

In the morning when you wake up, push those two buttons to get to the "Results" so you can scroll down to see your leak number and your AI number and your AHI number to see how you did with your breathing and your mask leak.
You get somewhat different screens w/the VPAP Auto 25 than you do w/the VPAP Auto I've found out. I have the VPAP Auto, not the 25. *sigh*

Let me go check the VPAP Auto 25 Clinicians Manual to see the exact sequence thru to the info you want w/o being able to accidentally or intentionally changing your settings. BRB.
Okay. Left/Right to Clinical, down to Settings, down to Advanced Settings, down to Results, left to Enter, down thru each of the reported results. right to Exit, right to Exit, etc. until you are out of the Clinical Menu again.
Thank you very much Judy for checking and sending the "formula"...I have printed it out. I will check all that later.....claudette



Judy said:
Okay. Left/Right to Clinical, down to Settings, down to Advanced Settings, down to Results, left to Enter, down thru each of the reported results. right to Exit, right to Exit, etc. until you are out of the Clinical Menu again.
Mission Accomplished again...thanks...i redid my flow charts so that i could read them and traveled around the machine....am still not clear as to the differences between the clinical menu and the patient menu.. and what comprises them....but i am able to find the efficacy data , usage data etc....but am still not sure when i might come into contact with something whereby i might alter the settings....claudette

claudette paluch said:
Thank you very much Judy for checking and sending the "formula"...I have printed it out. I will check all that later.....claudette



Judy said:
Okay. Left/Right to Clinical, down to Settings, down to Advanced Settings, down to Results, left to Enter, down thru each of the reported results. right to Exit, right to Exit, etc. until you are out of the Clinical Menu again.
Jeff,

Yes, it does, except that I would like to see a big sign that says STOP here to feel secure because i find myself experimenting with the buttons to see what comes up in the screen....but i know that the only 2 buttons that I hold simultaneously lead to the review screen which then takes me eventually to the efficacy data screen....

and I do recall being shown 2 other buttons that have to be pushed simultaneously to enter the clinical data area...so your explanation is sinking in even more now....in fact, that was a very good explanation!....my head is clearing....I will avoid pushing 2 simultaneously except for bringing up Review....thanks for that....

As i see it then, the relevant information that comes up for me in the efficacy data group are: leak, VT, RR, MV, Press, AHI,AI...

Is there anything else that I should be looking at re: the machine that would help me to evaluate my treatment other than the set pressures and pressure support?

What does Press: refer to? in the efficacy data.... And should I give more emphasis to the AI rather than the 15.1 AHI which seems to be high....I know you have cautioned about emphasizing the numbers too much....but...I would feel better to see that lower.....and if I am in auto mode I would assume that the numbers bounce around during the nite....then is the 15.1 representative of an average for the time slept? or what?

One arguement given to me about this machine and others like this is that company information is proprietary and therefore clinical studies have not been able to be done to evaluate the data and therefore the validity of the machine data is questionable...do you agree? I guess if that is a correct statement one could question the validity.

Do I need to be concerned about VT and MV?

I was also wondering if I should enable "smart/stop" which would shut off the airflow when I take the mask off and start when I put it on....and then i dont have to worry about rushing to shut the machine down when i dont want to. i believe that it would automatically shut off the leak alert..... but its off anyway. maybe that would help reduce my leak rate which i think was pretty good today.

but it still seems to me that if my leak rate is at .22L/s that the AHI should be lower than 15.1..doesnt it?

So sorry to inundate you with so many questions....my strict superego is kicking in....but I have to say that I am finding this exciting and challenging..and FUN....It's nice not to be wandering the maze quite so much anymore....even a little silver lining is better than none at all........

thank you Claudette

j n k said:
Technically speaking, the "patient menu" for that machine is the part of the menu anybody can get to without holding any combination of buttons down simultaneously in order to get there.

As for the clinical menu: As long as the way you look at the clinical menu is by holding the left and right buttons down simultaneously, you will not have to worry about changing your prescribed pressures inadvertantly, since that method of looking at the clinical menu is designed specifically to let you see your clinical information without your accidentally changing your prescribed pressures. That way of looking at the information in the clinical menu locks you out of the ability to change pressures. That is the method I use to look at pressures and my leak and my efficacy data, since I don't want to accidentally change my pressures.

I hope that helps.

jeff
Once again I would like to point out just how sexy jnk is when he talks sleep. His post have been amazing. GAME ON! I can't help but to follow him around the boards like a lost pup. It makes you wonder what happened in Jamaica. Hmmmmmmmmm. I am going to have to sneek up on him and play devil's advocate soon. It is Xmas jnk
Thanks Jeff... a wealth of information here....excellent....

My sleep hygiene is a major issue ...I have slept about 4 hrs the past few nites then I wake up and cant sleep...get up and then go back to sleep for a few hours in the afternoon because I am falling asleep again at the computer or wherever and then start to wake up later in the evening....I am hoping that is only related to sleep hygine issues. I will google sleep hygiene....thanks for the suggestion. I just hope its not something wrong with the pressures...somehow...it is in auto mode.

I just goofed up my email account and lost it somewhere and now that its nighty night time I have to work on that...not a good time but i will worry about it so i am going to try and attack whatever the problem is.....computer challenged as I am...so sleep hygiene will unfortunately have to wait a day or two....

I will give more thought to events that may influence what occurs at night....I would have thought a glass of wine would be a good thing....I never would have thought that the items yu mentioned that may occur near bedtime would have an affect on the readings....I will watch for individual variations.. thats also interesting....

Thank you for the reassurance especially re the numbers...I tend to be somewhat obsessive ( I like to say detailist..it makes me feel better) so its good that you presented that caution....I did press on the start/stop button last nite for 5 seconds which is supposed to give me a reading as to how well the mask fit is...and i got 5 stars or excellent....I was surprised....I must leak when I turn..I will be of course giving more thought to all of this and monitoring what i get from the machine....all very interesting...

My mask is not a Res Med mask...how is that relevant? I received a new respironics mask which is what i have been using but perhaps I can return that next month when I have my next visit...and get a Res Med...any suggestions as to which one or is it trial and error?

And I am still curious as to what the AI is based on...the last reading for the night? because its an index..that doesnt seem to make sense so I am assuming that maybe its an average or some other mathematical calculation of the values representing a correlation of apneic events during the night....I would just like to know what it is....

well back to my email mess..it may be gone forever....and Thank You again....this was a great explanation of important things for me to know!! A very big help....Le Professeur.................Claudette

j n k said:
In my opinion, right now all that matter to you are the number for leak and the number for AI.

It may be possible to get your leak number down to 0.0 one day, if you are using a ResMed mask. But since anything below 0.40 is within limits, there is no need to be overly concerned about 0.22, since it is reasonable, if not perfect.

AI is what really matters on a ResMed, and you should be very proud of yourslef for that number being below 1.0. That is GREAT! I would ignore AHI and HI completely right now. If you have leak within reason every night and have AI below 1.0 most nights, you are getting good therapy.

No home machine gives you numbers that are as good as the numbers obtained during a professional sleep study. The numbers from our home machines are estimates given mostly for the purpose of seeing if they are getting better, getting worse, or staying the same, over long lengths of time. In that sense, the data may be considered "questionable," in that it is not as good as PSG data. But it is still very USEFUL information. It is as important to understand the limitations of the data as it is to understand the usefulness of the data, if we are to be balanced about it as patients. Why?

For example, a patient could get so obsessed about the numbers that the patient gets emotionally involved with the night-to-night variations to the point of thinking the variations night-to-night are significant and could get discouraged or overly satisfied with how treatment is going. Now that you know leak is decent, but might need some improvement, that is useful info. Now that you know your AI is below 1.0, that is useful info. But it is more important to practice good sleep hygiene (important info to be googled) and enjoy sleep than it is to try to get AI lower or to be overly discouraged by occasional leak troubles. Right?

So practice good sleep hygiene, find satisfaction in your AI being below 1.0, keep an eye on leak and gradually experiment to see if you can get leak lower, just for fun, and then watch how your numbers do over the next few months. Once you have data in your weekly and monthly sections, you get an eye for trends in your AI and AHI where you notice things like: "Hmm, when I eat late in the evening my numbers get worse," or "a glass of wine sure messes with my numbers," or "when I let myself get emotionally upset just before bed, my numbers deteriorate," or whatever you discover. That allows you to make practical life decisions for getting better sleep based on your specific life-style and experience with your life and body.

jeff
Hi Rock Hinkle....Here I was expecting pearls of wisdom from you and I find comments re jnk....but I completely agree with you....His posts are great! They have been a BIG help for me....and I read others of them when I can also....I dont know anything about Jamaica, but if it helped him to be happier and help us more.....that is also great!

My question to you the other day about the PSG really had to do with the fact that I was trying to determine whether I had everything that I should have for each sleep study for my file.....part of the obsessiveness i referred to in my jnk reply...I am not ready to try and interpret my results...or have them interpreted...and having just lost my email address and all my mail you can see how badly computer challenged I am....I mean, how many people can do that!

I havent had time to read this yet, but I found good info on what is included in the PSG or should be in
wikepedia and I will be able to figure out perhaps from there...for starters...

I was not clear in my question to you, and I thank you for responding............claudette




Rock Hinkle said:
Once again I would like to point out just how sexy jnk is when he talks sleep. His post have been amazing. GAME ON! I can't help but to follow him around the boards like a lost pup. It makes you wonder what happened in Jamaica. Hmmmmmmmmm. I am going to have to sneek up on him and play devil's advocate soon. It is Xmas jnk
Jeff,

I had added a couple of questions in my reply to you tonite...nothing of any urgency...Rock Hinkle pointed out to you here that this is Christmas.... which I forgot about...He is right!.....so just to let you know that my questions and any others I may have can wait until there is a more convenient time for you to reply... if you wish.. after the holiday....

and so ,instead, I wish you a very Merry Christmas! .....Claudette

claudette paluch said:
Thanks Jeff... a wealth of information here....excellent....

My sleep hygiene is a major issue ...I have slept about 4 hrs the past few nites then I wake up and cant sleep...get up and then go back to sleep for a few hours in the afternoon because I am falling asleep again at the computer or wherever and then start to wake up later in the evening....I am hoping that is only related to sleep hygine issues. I will google sleep hygiene....thanks for the suggestion. I just hope its not something wrong with the pressures...somehow...it is in auto mode.

I just goofed up my email account and lost it somewhere and now that its nighty night time I have to work on that...not a good time but i will worry about it so i am going to try and attack whatever the problem is.....computer challenged as I am...so sleep hygiene will unfortunately have to wait a day or two....

I will give more thought to events that may influence what occurs at night....I would have thought a glass of wine would be a good thing....I never would have thought that the items yu mentioned that may occur near bedtime would have an affect on the readings....I will watch for individual variations.. thats also interesting....

Thank you for the reassurance especially re the numbers...I tend to be somewhat obsessive ( I like to say detailist..it makes me feel better) so its good that you presented that caution....I did press on the start/stop button last nite for 5 seconds which is supposed to give me a reading as to how well the mask fit is...and i got 5 stars or excellent....I was surprised....I must leak when I turn..I will be of course giving more thought to all of this and monitoring what i get from the machine....all very interesting...

My mask is not a Res Med mask...how is that relevant? I received a new respironics mask which is what i have been using but perhaps I can return that next month when I have my next visit...and get a Res Med...any suggestions as to which one or is it trial and error?

And I am still curious as to what the AI is based on...the last reading for the night? because its an index..that doesnt seem to make sense so I am assuming that maybe its an average or some other mathematical calculation of the values representing a correlation of apneic events during the night....I would just like to know what it is....

well back to my email mess..it may be gone forever....and Thank You again....this was a great explanation of important things for me to know!! A very big help....Le Professeur.................Claudette

j n k said:
In my opinion, right now all that matter to you are the number for leak and the number for AI.

It may be possible to get your leak number down to 0.0 one day, if you are using a ResMed mask. But since anything below 0.40 is within limits, there is no need to be overly concerned about 0.22, since it is reasonable, if not perfect.

AI is what really matters on a ResMed, and you should be very proud of yourslef for that number being below 1.0. That is GREAT! I would ignore AHI and HI completely right now. If you have leak within reason every night and have AI below 1.0 most nights, you are getting good therapy.

No home machine gives you numbers that are as good as the numbers obtained during a professional sleep study. The numbers from our home machines are estimates given mostly for the purpose of seeing if they are getting better, getting worse, or staying the same, over long lengths of time. In that sense, the data may be considered "questionable," in that it is not as good as PSG data. But it is still very USEFUL information. It is as important to understand the limitations of the data as it is to understand the usefulness of the data, if we are to be balanced about it as patients. Why?

For example, a patient could get so obsessed about the numbers that the patient gets emotionally involved with the night-to-night variations to the point of thinking the variations night-to-night are significant and could get discouraged or overly satisfied with how treatment is going. Now that you know leak is decent, but might need some improvement, that is useful info. Now that you know your AI is below 1.0, that is useful info. But it is more important to practice good sleep hygiene (important info to be googled) and enjoy sleep than it is to try to get AI lower or to be overly discouraged by occasional leak troubles. Right?

So practice good sleep hygiene, find satisfaction in your AI being below 1.0, keep an eye on leak and gradually experiment to see if you can get leak lower, just for fun, and then watch how your numbers do over the next few months. Once you have data in your weekly and monthly sections, you get an eye for trends in your AI and AHI where you notice things like: "Hmm, when I eat late in the evening my numbers get worse," or "a glass of wine sure messes with my numbers," or "when I let myself get emotionally upset just before bed, my numbers deteriorate," or whatever you discover. That allows you to make practical life decisions for getting better sleep based on your specific life-style and experience with your life and body.

jeff

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