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The hospital swapped out my sleep cube for an Airsense 2 about a year ago.
Now the machine reports my sleep quality to them over the airwaves.
I've never been convinced that these reports are accurate because, even though the hospital staff are breezily confident about them, I still feel knackered.

I watched a you tubevideo just now about the flags that the machine uses to report an apnea. It seem like you can still have disturbed breathing, but the machine won't flag it as an apnea or hypoxia.

Early days on this, I've just started looking into it, but does this ring a bell?

Does anyone know how the reports from their machine compare with an independent device like an oxygen/heart rate monitor?

thanks

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The hospitals see far more than we see on the app in their clinical software, and do bear in mind that it's the opinion of a Youtuber you must have seen, as sleep professionals worldwide have used their software for many years, and Resmed's software, along with the clinical software from other manufacturers, are very well respected and important to the sleep clinicians.

If you're not feeling good and your AHI is 5 or below then it may help to check your oxygen levels and you'll need an overnight recording pulse oximeter, such as Nonin 3150 (expensive) or Viatom etc (don't rely on a smart watch). You do have to bear in mind though that oxygen desaturations can also be from other causes, as well as apnoeas. It would be a good place to start though.

Also, if all seems to be going well with your CPAP therapy, there's other things that can cause daytime tiredness - some often common in sleep apnoea, so blood tests for thyroid, diabetes, iron, B12 and Vit D are all worth doing. Plus checking the side effects of any regular medication you take as lots of meds cause tiredness and some also cause disruptions to sleep. Oh and also make sure you're getting a good 7-9 hours sleep every night with your CPAP.

Hi Kath, I did get myself an O2 Ring, but it hid behind some furniture somewhere and won't come out. When I find it I can check what's going on. I read that, like you say, smart watches aren't that good so I went for dedicated kit with a high sample rate. I got the OSCAR software which breaks out a load of info from resmed SD cards
I agree you have to be a bit streetwise with what blokes on youtube say. I don't quite know what to make of it. It was this


regards,
John

The o2 ring is good if you can retrieve it 😂

Yes I've seen Nick's videos and he has a lot of great content, but it doesn't mean everything is 100% correct (same for us all as we just try our best with the knowledge we have). Oscar is very good and reports very similar to Resmed. Nick uses his own software which I've never used so can't comment, but millions of sleep professionals use Resmed's software and I'm sure any issues would have been picked up over the many years it's been used if it was unreliable.

As I said in the last comment, there can be so many reasons why remaining tiredness continues, and because we have a sleep disorder we tend to be quick to blame that. To complicate things even further, sometimes there can be hidden problems though that don't always show up on the CPAP results as it's not possible. As an example, my CPAP therapy was 100% spot on, but what wasn't realised is that I was retaining co2, which is more common in obesity which I aren't, but can also happen with over conditions like COPD, neuromuscular problems etc (my reason isn't know as I'm always a mystery lol). The only way of confirming co2 retention (also called hypercapnia or hypoventilation) is to have arterial blood gases (ABG) done.

I'd suggest (assuming your AHI is 5 or below and you're getting 7-9 hours sleep) getting your oxygen checked and also those blood tests done I mentioned, then if all come up fine, it's time to speak with your clinic for further investigation.

John said:

Hi Kath, I did get myself an O2 Ring, but it hid behind some furniture somewhere and won't come out. When I find it I can check what's going on. I read that, like you say, smart watches aren't that good so I went for dedicated kit with a high sample rate. I got the OSCAR software which breaks out a load of info from resmed SD cards
I agree you have to be a bit streetwise with what blokes on youtube say. I don't quite know what to make of it. It was this


regards,
John

Hi Kath, thanks for your great answer. I think even if the CPAP was perfect it's the other rigmarole interferes with sleep, for me anyway - oh the pipe's gurgling, oh didn't shave and have to tighten everything, oh the temperature changed and now the condensation on the mask is whistling, oh I didn't refill the tank enough etc etc - all those constant tweaks.
I don't know if other people fiddle constantly with the kit, maybe they find it easier to settle on one set up.

One thing I've found is my nose can't be relied upon to stay clear so it's a nasal mask one day, then wake up with it stuffed so back to a full face, then a pillow because it feels clear again and so on.

I found I may have nasal valve collapse, if I do the Cottle procedure the air flow is like day to night it feels so much better. One of those things you don't realise is abnormal because you've always had it. I hope I can find a GP who knows about it and can tell me what's what.

So I use a silicone nostril expander, "Brez", which makes things feel much better and can go under a mask, but I worry that any mask pressing even lightly on the bridge of the nose will close already half closed nostrils. I think when you're asleep things can move around and without knowing it the nice nasal flow gets shut off.

Nose breathing, I'm given to understand, is the best way and mouth breathing can have negative consequences.

I did address the whistling vents on the mask by rubbing a little oil on the inside, a fine smear of veg oil that I hoped wouldn't hurt the plastic. I figured if I put something hydrophobic on then water won't collect so easily. It seemed to mitigate the whistling somewhat.

I'd have thought having a design with fewer, bigger holes would give the same vent flow but without being blocked so easily with water drops and turning into a whistle.

I never heard of co2 retention I'll have to look that up.

Hope some of that is helpful to others.

thanks,

John

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Profile IconAndrea Robbins, Dundeemeg, Jack Russell and 3 more joined Hope2SleepGuide
Jul 19
Chris B updated their profile
Jul 19
Kath Hope replied to John's discussion Oropharyngeal exercises
"I would always be guided by Dr Vik Veer, who is the UK's leading ENT surgeon specialising in snoring, sleep apnoea and UARS. He doesn't say the exercises will cure moderate to severe sleep apnoea, but can help by strengthening the airway…"
Jun 17
Kath Hope replied to John's discussion A tale of two nasal dilators
"Good info thanks. I personally prefer nasal strips though."
Jun 17
Tommas M is now a member of Hope2SleepGuide
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Irene Price is now a member of Hope2SleepGuide
Jun 11
John posted a discussion

A tale of two nasal dilators

Trying to get my nose to stay open, I've been experimenting with nasal dilators.So far I tried two types.- Generic tubes from ebay, 50p each- Fancy Airmax £10Both are moulded silicon rubber.I would say the packaging for the Airmax, which is really…See More
Jun 9
Jonathan replied to John's discussion Airsense 10 -humidifier runs dry
"Dab hand with a sewing machine :)  The "stethoscope" pipes were detachable with a bit of careful persuasion."
Jun 8
John replied to John's discussion Airsense 10 -humidifier runs dry
"How did you fasten it?I suppose you could do it with tape or elastic bands. Cut up an old fleece jacket, wrap it round the tube, strap it up, bit of velcro. That sort of thing. I hadn't really thought of that."
Jun 8
John replied to John's discussion Airsense 10 -humidifier runs dry
"Come to think of it you could likely double up a hose cozy, one over another.This is a piece of N95 face mask I used for high grade filtration. I just put it where the filter usually goes.This is around 6 months dirt I would say, thereabouts. I used…"
Jun 8
Jonathan replied to John's discussion Airsense 10 -humidifier runs dry
"Neat clip for your hose! I used to use the Respironics Comfort Curve one of the best masks ever, now discontinued of course.  With its stethoscope-style tubing, I had to make my own fleecy cover."
Jun 8
John replied to John's discussion Airsense 10 -humidifier runs dry
"Oh cool. Did you do any other DIY mods?I made a clamped strap to go on the headboard and lift the tube. Just a spare c-clamp with a bit of nylon strap and a clip but works well."
Jun 8
Jonathan replied to John's discussion Airsense 10 -humidifier runs dry
"Yes, I bought some fleecy material and made my own "snuggle hose" 10+ years ago. "
Jun 8
John replied to John's discussion Airsense 10 -humidifier runs dry
"Did you try a sleeve for the tube, Jonathan? For rain out? I got one off ebay for a few quid and I think it helps. It's a fleece sleeve  you zip over the main tube."
Jun 7
John posted a discussion

Oropharyngeal exercises

I asked medics at the Castle Hill CPAP clinic about tongue and throat exercises. They said no evidence, and it can't work anyway because the muscles fully relax during sleep.Yet I'm watching Vik Veer, head of ENT at a London hospital, offer evidence…See More
Jun 7
John replied to John's discussion Nasal valve collapse
"Well I found out what the norm was by asking my doctor to do the Cottle maneuver on herself, and she said there was no difference with and without.Whereas for me it's massively different.The Cottle maneuver is where you pull the skin by the…"
May 31
John replied to John's discussion Short apneas - official definition
"It's a suspiciously round number I wonder how they arrived at it?I asked the People at Castle Hill and they didn't really enlighten me on it, but I was told that it's normal for people to have apnoeas, which I didn't know.I…"
May 31
Kath Hope replied to John's discussion Short apneas - official definition
"An apnoea or hypopnoea of less than 10 seconds won't be reported as an event, in the same way they're not reported on a sleep study, as that's the cut-off point."
May 31
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