I put an SD card into the airsense 11 machine. Every day I take it out and transfer it to the Windows program OSCAR and the website SleepHQ. My pictures are from SleepHQ.
Nice! I was using the MyAir site and also occasionally requesting a data download from the cloud to analyze myself. I'll have to try your approach.
On the topic of the post, my sleep services doctor (PA technically) has been very responsive to my requests, fortunately. I do understand the hesitancy to ask, though. Contrast that to my wife, an RN, who goes to a provider and tells them what she wants done. She's also known (by her peers) as the worst patient ever. Lol.
I go to a local clinic and have a PA prescribing for me. He is awesome. He said to try whatever settings I want to so that I can feel better.
I just got a call from the CPAP supplier and she told me I shouldn't have to go to my PA all the time for prescriptions, she said, "Just call and we can make changes here, so you don't have a copay for visiting your PA." I told her that when I tried to make changes, I was reprimanded by one of her coworkers (about my pressure changes). She apologized I was treated that way.
Sometimes it really depends on who you get on the phone with you that day and whether they're having a good or bad day. This lady from today said I should be able to make adjustments to my pressure without involving the PA.
Of course if people want to feel like a victim, they will not advocate for themselves and will just let one set back (like that little reprimand I had a few weeks ago) be everything.
There are two related things going on here that have converged to result in you having to do this runaround with the DME provider and your insurance company.
One is the fact that the person calling you has no authority to make decisions and is just running a script. The script says you're not allowed to muck about with your CPAP settings, so they're going to give you crap about that. This is basically the same phenomena you see everywhere there are bureaucratic systems, i.e., systems designed to produce desirable outcomes by rote, such that any literate person capable of following basic instructions can achieve said outcomes. Frustration occurs in edge cases, where the facts don't entirely fit the script and some divergence is needed. Because the person running the script has no authority to make such divergences, you get stupid, obviously idiotic outcomes with depressing frequency.
The second is the reason the script is written to prohibit patients from messing about with their own CPAP settings. The concern isn't really liability, though that's probably in the mix somewhere. It's that insurance companies don't like paying for expensive medical equipment that patients either don't use, or don't use correctly. CPAPs in particular take some getting used to. I know; I've used one for over a decade now. And there are a lot of people who don't stick with it long enough to really get the benefits the devices can and do provide. Something about the settings wakes them up, or the style of mask they start with is uncomfortable, or the mask leaks, or whatever, and they just quit using it. CPAPs aren't cheap, and insurers don't like paying for them if patients aren't benefiting from them.
Thing is, when people mess with their CPAP settings, it's even odds that they'll mess with them in a way that provides clinical benefits. They'll definitely change the settings to a point where they think they're sleeping well, or at least not waking up all the time, but the whole problem with sleep apnea is that you don't realize you're not sleeping. So what happens is that people adjust the settings so as to ensure they don't regain consciousness, but in doing so they eliminate the benefit of using the CPAP in the first place. The default script is thus to prohibit patients from doing this.
Now, an intelligent system would permit the person presented with an instance of a patient changing their own settings to evaluate the usage data/stats to see whether the new settings were working properly. But that would 1) require low-end bureaucratic drones to be authorized to make real decisions, and 2) require low-end bureaucratic drones to properly interpret and understand CPAP data. Neither of those are consistent with the ideal of a bureaucratic script: bone-headed to the point that it does not require any actual judgment on the part of the person running it.
All of which to say that yeah, you're clearly dealing with a sub-optimal situation. It seems like you're using your CPAP correctly. But changing the system to allow for an optimal outcome in your situation is just not going to happen. Which is bad, but nobody has any viable better ideas.
I can see how it might be about them not wanting to pay for a device that's not being used properly or at all. I have mild hypopnea and got a nasal pillow (rather than full mask) and I was remarkably pretty comfortable with falling asleep with it it from the get-go. It's the waking up from too much pressure and annoying rain outs that make it frustrating to use. But even with that, I'm using it every night, and for a large portion of my sleep. If it wasn't for the pressure issues, I would probably be able to sleep with it on 98% of all of the sleeping I do. All of my scores in the app are fantastic.
You would think that they could give some leeway if a patient had great app scores (showing they're using it enough, not having many leaks or AHI events).
Yes, I can see how people might turn the pressure down low enough so that they don't wake up from pressure, but increase AHI. I'm just saying if the AHI was under 5 (which the app info should tell you) it shouldn't be an issue. This doesn't seem like a difficult thing to do. They just have no incentive to do that.
Excellent article as there really are a wide range of views on pharmaceuticals.
My view: "Evil, evil, evil" (with some minor rare exceptions)
I have too many decades of experience and research finding healthy natural alternatives that are safer and perform better than pharmaceuticals. So yes, I'm extremely biased against them.
There are some cases where a prescription item (unfortunately some natural substances they have "locked up" by requiring prescriptions) using in a proper dosage *short term* can work wonders.
If I were to throw out a "rule of thumb": never take any prescription drug for more than three months. And completely avoid the most popular and commonly prescribed drugs.
I have no problem of weighing the pros and cons and figuring out if a prescription is worth it in a cost/benefit analysis. I agree, in most cases it's not worth it, unless we're talking extremely low doses.
But, for some people health issues arise where there is a need where the pharma suits it much better than natural remedies.
And we talk about using pharma as a "crutch," like it's a bad thing. It's only a bad situation to use a crutch if you never learn to walk again. Using a crutch to get you to the point that you can walk again is smart. So sometimes people need it in the heat of the moment to get to a better situation when they can get off them again.
A different topic, but still Drama related, is that healthcare workers (as rescuers/saviors) do things that keep people on prescriptions forever (to have eternal "victims" and not have their jobs disappear). And some people like to play "victim" and complain forever so they don't want to do the things needed to get better and get off drugs. Those situations can be true at the same time as others using drugs responsibly to get better and no longer need them.
I found this quote about APAP vs CPAP: "Looking for an example of an APAP machine? Resmed’s AutoSet™ technology — available in the AirSense™ 10 AutoSet™, AirSense™ 10 AutoSet™ for Her and AirMini™ AutoSet, for example — was engineered to dynamically adjust pressure to provide maximum comfort for sleep apnea patients."
I actually tried out the AirSense 11 AutoSet for Women because I thought it might work better. I only tried it for a few days but it didn't seem to help. I had high hopes for it though.
Weirdly, my device seems to be set on APAP mode now that I'm looking at the data. You can see that in the pictures in the article. Though I think you mean an APAP machine. This setting seems to just try to mimic that.
That seems like much more detail than is available from the ResMed site. How do you get that detail?
I put an SD card into the airsense 11 machine. Every day I take it out and transfer it to the Windows program OSCAR and the website SleepHQ. My pictures are from SleepHQ.
Nice! I was using the MyAir site and also occasionally requesting a data download from the cloud to analyze myself. I'll have to try your approach.
On the topic of the post, my sleep services doctor (PA technically) has been very responsive to my requests, fortunately. I do understand the hesitancy to ask, though. Contrast that to my wife, an RN, who goes to a provider and tells them what she wants done. She's also known (by her peers) as the worst patient ever. Lol.
I go to a local clinic and have a PA prescribing for me. He is awesome. He said to try whatever settings I want to so that I can feel better.
I just got a call from the CPAP supplier and she told me I shouldn't have to go to my PA all the time for prescriptions, she said, "Just call and we can make changes here, so you don't have a copay for visiting your PA." I told her that when I tried to make changes, I was reprimanded by one of her coworkers (about my pressure changes). She apologized I was treated that way.
Sometimes it really depends on who you get on the phone with you that day and whether they're having a good or bad day. This lady from today said I should be able to make adjustments to my pressure without involving the PA.
Of course if people want to feel like a victim, they will not advocate for themselves and will just let one set back (like that little reprimand I had a few weeks ago) be everything.
There are two related things going on here that have converged to result in you having to do this runaround with the DME provider and your insurance company.
One is the fact that the person calling you has no authority to make decisions and is just running a script. The script says you're not allowed to muck about with your CPAP settings, so they're going to give you crap about that. This is basically the same phenomena you see everywhere there are bureaucratic systems, i.e., systems designed to produce desirable outcomes by rote, such that any literate person capable of following basic instructions can achieve said outcomes. Frustration occurs in edge cases, where the facts don't entirely fit the script and some divergence is needed. Because the person running the script has no authority to make such divergences, you get stupid, obviously idiotic outcomes with depressing frequency.
The second is the reason the script is written to prohibit patients from messing about with their own CPAP settings. The concern isn't really liability, though that's probably in the mix somewhere. It's that insurance companies don't like paying for expensive medical equipment that patients either don't use, or don't use correctly. CPAPs in particular take some getting used to. I know; I've used one for over a decade now. And there are a lot of people who don't stick with it long enough to really get the benefits the devices can and do provide. Something about the settings wakes them up, or the style of mask they start with is uncomfortable, or the mask leaks, or whatever, and they just quit using it. CPAPs aren't cheap, and insurers don't like paying for them if patients aren't benefiting from them.
Thing is, when people mess with their CPAP settings, it's even odds that they'll mess with them in a way that provides clinical benefits. They'll definitely change the settings to a point where they think they're sleeping well, or at least not waking up all the time, but the whole problem with sleep apnea is that you don't realize you're not sleeping. So what happens is that people adjust the settings so as to ensure they don't regain consciousness, but in doing so they eliminate the benefit of using the CPAP in the first place. The default script is thus to prohibit patients from doing this.
Now, an intelligent system would permit the person presented with an instance of a patient changing their own settings to evaluate the usage data/stats to see whether the new settings were working properly. But that would 1) require low-end bureaucratic drones to be authorized to make real decisions, and 2) require low-end bureaucratic drones to properly interpret and understand CPAP data. Neither of those are consistent with the ideal of a bureaucratic script: bone-headed to the point that it does not require any actual judgment on the part of the person running it.
All of which to say that yeah, you're clearly dealing with a sub-optimal situation. It seems like you're using your CPAP correctly. But changing the system to allow for an optimal outcome in your situation is just not going to happen. Which is bad, but nobody has any viable better ideas.
I can see how it might be about them not wanting to pay for a device that's not being used properly or at all. I have mild hypopnea and got a nasal pillow (rather than full mask) and I was remarkably pretty comfortable with falling asleep with it it from the get-go. It's the waking up from too much pressure and annoying rain outs that make it frustrating to use. But even with that, I'm using it every night, and for a large portion of my sleep. If it wasn't for the pressure issues, I would probably be able to sleep with it on 98% of all of the sleeping I do. All of my scores in the app are fantastic.
You would think that they could give some leeway if a patient had great app scores (showing they're using it enough, not having many leaks or AHI events).
Yes, I can see how people might turn the pressure down low enough so that they don't wake up from pressure, but increase AHI. I'm just saying if the AHI was under 5 (which the app info should tell you) it shouldn't be an issue. This doesn't seem like a difficult thing to do. They just have no incentive to do that.
Excellent article as there really are a wide range of views on pharmaceuticals.
My view: "Evil, evil, evil" (with some minor rare exceptions)
I have too many decades of experience and research finding healthy natural alternatives that are safer and perform better than pharmaceuticals. So yes, I'm extremely biased against them.
There are some cases where a prescription item (unfortunately some natural substances they have "locked up" by requiring prescriptions) using in a proper dosage *short term* can work wonders.
If I were to throw out a "rule of thumb": never take any prescription drug for more than three months. And completely avoid the most popular and commonly prescribed drugs.
I have no problem of weighing the pros and cons and figuring out if a prescription is worth it in a cost/benefit analysis. I agree, in most cases it's not worth it, unless we're talking extremely low doses.
But, for some people health issues arise where there is a need where the pharma suits it much better than natural remedies.
And we talk about using pharma as a "crutch," like it's a bad thing. It's only a bad situation to use a crutch if you never learn to walk again. Using a crutch to get you to the point that you can walk again is smart. So sometimes people need it in the heat of the moment to get to a better situation when they can get off them again.
A different topic, but still Drama related, is that healthcare workers (as rescuers/saviors) do things that keep people on prescriptions forever (to have eternal "victims" and not have their jobs disappear). And some people like to play "victim" and complain forever so they don't want to do the things needed to get better and get off drugs. Those situations can be true at the same time as others using drugs responsibly to get better and no longer need them.
Yes, a temporary "crutch" is very reasonable. I'd love to see that become common healthcare! That would be a massive improvement.
I totally agree with your last paragraph.
An APAP may be more effective for you, but they can be more difficult to get.
I found this quote about APAP vs CPAP: "Looking for an example of an APAP machine? Resmed’s AutoSet™ technology — available in the AirSense™ 10 AutoSet™, AirSense™ 10 AutoSet™ for Her and AirMini™ AutoSet, for example — was engineered to dynamically adjust pressure to provide maximum comfort for sleep apnea patients."
I actually tried out the AirSense 11 AutoSet for Women because I thought it might work better. I only tried it for a few days but it didn't seem to help. I had high hopes for it though.
Weirdly, my device seems to be set on APAP mode now that I'm looking at the data. You can see that in the pictures in the article. Though I think you mean an APAP machine. This setting seems to just try to mimic that.