Sierra

What type of mask are you using? I'm guessing it may be a ResMed AirFit P10 nasal pillow based on your reference to clips? If so I have used that mask for some time and I gave up on the clips, and finally cut the two straps, overlapped them about 1", and sewed them up again. It helped a lot.

I started to post to your "whats going on" thread, and this one came back from the dead. Without repeating too much, your results look very good. About the only thing I notice a bit out of line is the RERA number. It seems high, and is not counted in your AHI. What you might want to do is zoom in on some of those RERA events to see what the flow rate wave form looks like. You can do that with the Events tab and then click on the RERA events individually. Or what I do is just left click on the event of interest in the Events Flags area and repeatedly left click to get the level of detail I want. The up arrow also zooms in more, and the down arrow back out. Left and right move along the time scale. What you are looking for is some flattening out of the top side of the inhale cycle. A RERA event usually ends with some kind of flow disturbance indicating you are be aroused but not wakened by the event. This data indicates you may have been a good candidate for the ResMed AirSense 10 AutoSet For Her machine. It has been designed to respond quicker to flow limitations which tend to initiate the RERA events. But, I gather that ship has sailed.

There are some potential ways you may want to consider to minimize the RERA. I see most (but not all) of these events are occurring at lower pressures. You may want to ask about increasing the minimum pressure on your new machine to 8-9 cm. It may address some of these flow restrictions before they become RERA events and disturb your sleep. It appears you have Flex set at 2. I normally suggest that there can be benefits to turning that off to reduce maximum pressures and CA events. But your maximum pressure is not that high and your CA events are low, so it may not make sense in your case.

I believe you new machine is a DreamStation Auto? If so I believe it has a SmartRamp feature you may want to consider using. It holds the pressure at a selected ramp start pressure and only ramps pressure up to your minimum when it detects you are asleep. If you end up with a higher minimum I would suggest you also get the SmartRamp turned on with a start pressure of 7 cm. That should let you get to sleep comfortably.

Other than that, it looks to me that you had a very well set up machine that has been working well for you.

Those results look pretty good. It looks to me like you have all your history. For future posts, I would just do that first one -- the Daily Detail. The format looks pretty good except I would ditch the pie chart as it covers up more important detail on the left and is somewhat redundant. To hide the pie chart use File, Preferences, Appearance, and then uncheck the box that says something like "Show event breakdown pie chart".

The forum seems to have issues when a bunch of graphics are uploaded to a thread, and especially if the poster is a relatively new user. Don't know exactly what it is, but perhaps it is part of the forum spam protection... As a work around you when you post your new machine results, I would suggest just posting the daily detailed report screen.

In any case if I click on your user name, I can see your posts. Good to see that you got your computer issues sorted out. To me those SH charts look very good, assuming it is comfortable to you. About the only thing I noticed was that RERA seem a bit high.

I now noticed that your thread is back. So I will post further there....

The normal treatment for sleep apnea is a CPAP machine with a mask which delivers air pressure and is worn every night. The other most common method is using a custom dental appliance called a MAD. It has to be put in each night.

As I understand it, the current version of 1.1.0 is supposed to support all Windows versions from XP through to 10. That said I have never run it under 8.1. That version apparently has a nasty trick of trying to write to the SD card and messing it up, so you should make sure the card is locked before you put it in the card reader on the PC.

The other quirk with SleepyHead is that when it installs two .exe files are created under C:\Program Files (x86)\SleepyHead. One is the normal open GL version and the other the broken GL version. The open GL version is the preferred one and the one linked to the menu by default. The broken GL version is to get around some incompatibility in graphics cards, and has to be linked to a menu icon manually. I think if that is an issue you will not get it to run at all. Another computer is your best bet...

Sounds like you have it all figured out. I have not personally switched machines while maintaining a SleepyHead record, but I have seen others that do it. It should just put a new entry in the Machine Information section on the Statistics page, and a new line on the Changes to Prescription Setting area. Don't forget to make one more transfer of data from your old machine tomorrow. That should take much less time.

In general most insurance companies are supportive of going straight from diagnosis of obstructive sleep apnea to a trial APAP machine. That is because the machine is likely to cost less than the additional sleep study. If at all possible you want to do it as a trial, because you may or may not adapt well to using a PAP machine. The other option depending on your apnea severity may be the use of a dental appliance. They tend to be 2-3 times the cost, but also may be covered under your health care insurance rather than your dental insurance. Here is a link to an article that may be helpful in making a decision on what way to go. I think it is fair and well written based on my experience with PAP treatment. I have not tried the dental appliance (MAD) option.

Treating Sleep Apnea

Is he being treated for the sleep apnea? If he is then he should see his doctor and discuss what could be happening, and why the treatment is not working. If he is not being treated, then he should be making an appointment to see a sleep doctor.

I hear what you are saying, but I am not a big believer in conspiracy theories. Every once in a while you hear that big oil companies have a secret safe where they keep all of the 200 mile per gallon carburetors, and engines that run on water instead of gasoline. I think the reality is that we would not have for example the medications we have today if the drug industry did not fund the studies to prove they are safe and effective. It is government regulations that force them to do that, and they have to comply to get approval to market the drug. Yes, there have been studies which have exaggerated the benefits, and claims made that have proven to be false on closer examination. There is the example of the former British doctor Andrew Wakefield who published a study claiming MMR vaccine caused autism. It has since been withdrawn.

I think one could also make the argument that the UK National Health Services and their doctors are not totally unbiased. In the UK CPAP is a covered medical condition. They pay for the studies and the CPAP equipment. One could say that they are motivated to minimize the cost to the NHS. The UK not unlike Canada and Australia operate more of a "best buy" system of health care. Our costs are in the order of half what the US spends per capita on health care. And the ironic part is that being the highest per capita spender on health only puts the US in 45th position by country for life expectancy. I recall a while back that the UK restricted availability to heart bypass surgery, because they believed it it did not on average extend life. The UK are about 30th on the life expectancy list, while Canada and Australia are closer to 10th. Perhaps they are cutting a little too close to the bone in trying to save health care costs?

I think that a mild diagnosis of sleep apnea is not unlike pre-diabetes. Yes there are different ways of treating it and losing weight is a good idea for many reasons. Studies show the metformin which is a very inexpensive drug does a good job of reducing A1c, and often helps with weight loss. Is it needed for life? Sometimes yes, and other times no, and lifestyle changes addresses the issue. But to me withholding the metformin makes no sense. This is like apnea. If the individual has sleep issues, wants to try CPAP, and in many cases is willing to pay out of their pocket for it, then why not do it. The only risk I see is that if the discomfort factor of using one outweighs the apnea reduction benefit, then it may not be a good idea. Contrary to what that doctor claimed it is hard to imagine many cases of obstructive apnea at 15 that would not be improved with PAP treatment. The real question may be if there is an improvement in sleep quality, and is that improvement cost effective? The answer may be in the eye of the patient and the one that is paying for the treatment if it is not the patient.