Should I mention this to our sleep specialist

[Okie bipap]

My wife and I have an appointment with the sleep clinic tomorrow for a routine check of our usage. My wife has nights like this two or three times a month. Does this look like it is serious enough to mention to the sleep specialist when we see her tomorrow?

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[chunkyfrog]

Show it to the doc.

[Pugsy]

Didn't she have a little problem with centrals initially when she started therapy that required inching up on the pressures to get to where they took care of her OSA?

I am wondering why the machine couldn't decide between OA and central.......maybe the leaks are bad enough to allow the airway to collapse a bit.

[Okie bipap]

Yes she did have a problem with the centrals. Even now, she still has nights when the centrals are pretty high. Here is another night when there was a mix of OA and UA when the leaks were not very bad.

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[Pugsy]

I would say yes....the doctor needs to be aware that this is happening. Even if infrequently it's pretty ugly and significant.
I wouldn't let it pass at all if it were me.

[jnk...]

I don't think something has to be particularly significant to be mentioned to a sleep clinician. Little bits of seemingly random mundane information can, collectively, point to further possible areas of inquiry for heading off problems early. Most docs are happy to have a communicative patient.

Patients sometimes feel that the only things worth mentioning to a doc are the things the patient wants fixed. But any observations or changes that are even slightly concerning, or just possible future issues, are best mentioned and noted in records in case a pattern becomes apparent later.

And that is how one (me) spends the electrons to write two whole paragraphs in reply instead of just simply saying yes like a normal person would.

[esel]

I had those to, specially in the beginning under APAP. I had 20 to 50 min total time in apnea over 8 to 9 hour. They reduced when I started with VPAP. They still show up but less.

Your wife has 20 min total time in apnea over 4 h sleep. I would mention it.

If you figure out something I sure would like to know.

[lrob123]

Silly question, but since I don't think Dreamstation machines show UAs (unclassified apneas) and I'm not familiar with those, I wondered what types of things might cause those UAs? I understand they can't be classified, but do you have some ideas of what types of things it might be?

My AHI shoots up like that whenever I forget to wear my cervical collar to sleep.

[Pugsy]

Silly question, but since I don't think Dreamstation machines show UAs (unclassified apneas) and I'm not familiar with those, I wondered what types of things might cause those UAs? I understand they can't be classified, but do you have some ideas of what types of things it might be?

No...if the machine can't classify them how could we? Make a guess??? Not something I like to do. I don't do guesses.
In most situations the machine will know what to call something but in the face of a large leak it may not be able to decide what to call something. I figure if the machine can't decide...how can I. It's something though or it wouldn't be flagged.
You would have to understand ResMed machines I guess....When faced with a big leak the first thing to go is ability to name whatever is happening...and then if the leak gets worse then the second thing is ability to even flag it.

It's been a long time since I have used a Respironics machine and even longer since I have had a big leak with one but if you never see UAs then probably if you have a really big leak then the machine simply doesn't know something is happening and nothing gets flagged. Not because they didn't happen but because the machine simply didn't know. It's why we try to avoid prolonged large leaks beyond a certain level. We don't want to miss apnea events happening because of large leaks and be fooled into complacency by a low AHI. Because we don't know if the low AHI is because nothing happened or the machine was clueless in the face of a large leak.

At least the above holds true with the model machine the OP has here.
Now when we get into the ASV or some other high end machines....a whole new can of worms when it comes to UAs but with the AirCurve 10 Vauto or even the AirSense 10....UAs means usually a large leak is causing a problem identifying something.
Totally different discussion when talking about the machines that have back up rate capabilities which the above machine does not.

[Okie bipap]

I showed the chart to the nurse practitioner and she recommended my wife try a single pressure instead of variable pressure. This is her result for last night. This is one of the best charts she has had since she started treatment over three years ago. I don't know if I would have started her off at that high of a pressure, but it looks good.

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[zonker]

I showed the chart to the nurse practitioner and she recommended my wife try a single pressure instead of variable pressure. This is her result for last night. This is one of the best charts she has had since she started treatment over three years ago. I don't know if I would have started her off at that high of a pressure, but it looks good.


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bravo! but you KNOW we've got to ask it; how did she feel after a night of single pressure? slept well and so on and so forth?

[Okie bipap]

She said she slept fine. She slept 6 3/4 hours with the machine. She goes to bed early and wakes up early. Since I retired, we seem to have swapped sleep patterns. When I was working, I was always in bed by 9:00 and up 3:30 OR 4:00 while she would sleep until around 7:00. Now, she wakes up early and I sleep until around 7:00 or 7:30.

[zonker]

She said she slept fine. She slept 6 3/4 hours with the machine. She goes to bed early and wakes up early. Since I retired, we seem to have swapped sleep patterns. When I was working, I was always in bed by 9:00 and up 3:30 OR 4:00 while she would sleep until around 7:00. Now, she wakes up early and I sleep until around 7:00 or 7:30.

well, then. sounds like good news all around.

let's hope she continues to have nights of good sleep.