BPAP Titration Sleep Study

[ajack]

If I was HalfAsleep I would set the autoset using min12 epr3 max15 The results could be used to show the doctor, if they aren't good. HalfAsleep want's to press the issue, if the sleepyhead charts are still poor. Perhaps if he orders a resmed o2 sensor for a week, to get detailed data?

Ajack..... although my settings are 8/15 with EPR of 3, most of the night, per SleepyHead, I'm settled in to same as your recommended 12/15 epr3. That's just the way it works out. I float around between 13 and 15 ipap quite steadily most of the night.

I can't exhale at 9 when I first go to sleep. And ramp climbs relentlessly; I need the auto.

Will it make a difference if I go 12/15 epr 3 instead of easing up to it the way I do now?

sorry I missed this post before..Ok, use resscan to do a report, showing you are around the 12/3 and failing because of apnea. they can ignore the lower initial pressure (they won't accept sleepyhead) 

That and the AHI:17 for the 4:45 hours from the sleep test should mean something.

I was using 15-20 on apap, you do get use to it. increase the pressure 0.5cm every day.

resscan needs setting up to reduce the Y-axis, so you can see the chart data. sing out if you have trouble.

[HalfAsleep]

Right, Ajack. There were no evidentiary grounds for recommending 12/8; potentially it could increase the AHI rather than decrease it. In fact, I had already rejected 12/8 because I can’t exhale at 8 when I first go to bed.

I do have more bits to the study. I’m beginning to make my way around them as you and SleepRider request more detail. I think maybe tomorrow morning I’ll re-shoot it all in sensible sections and then put the whole thing via Imgur into one post.

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How in the world could I have got 3x my SleepyHead AHI during that study?

How in the world does this result let me “pass BPAP”? I can’t wrap my head around it.

[jaswilliams]

Not sur half asleep can use resscan as she is a Mac user unless she has access to a pc to run it on maybe someone will need to get her data and produce the graphs for her ?

Jason

[kiwii]

In the doc's summary report, she says: "The technologist did not raise the BIPAP pressure too much because it sounded like you were having some problems tolerating it."

I think you should be retested, clearly they've dropped the ball.

Also, escalate looking for another doctor/facility.

[Sleeprider]

I really don't see how continuing with this sleep center serves any purpose. They are clearly incapable of conducting a structured sleep test, let alone comprehend the results and translate that into a prescription. Why would you pay them for more of the same?

[HalfAsleep]

While I’m pondering whether I really want to spend time Imgur-ing up my whole sleep study (the crucial pieces are likely here already)....


Whadda y’all think about me making no objections to the incompetence of the sleep lab and simply accepting a BPAP? The doc is willing to prescribe one (although for no evidentiary reason)....

[SarcasticDave94]

If that's a choice open to you, I'd consider doing it to salvage a bad situation. Probably better this than no progress. Just to balance the answer, don't do it just to do something, but if you believe it's the right answer/action, then go for it.

Dave

[Sleeprider]

A BPAP will help you to resolve some things CPAP cannot, particularly flow limits and obstructive hypopnea, and should make it possible to exhale, even when higher IPAP pressure is used. It will not do anything for centrals or to break those long apnea events. How much of this is out of your pocket? I know you're on Medicare, but don't know how this impacts you. The bottom line has been you will need to change doctors because this one refuses to diagnose a condition that would qualify you to use BPAP with a backup rate. As long as you have so many central apnea, and your doctor is in denial mode, you have no other avenue.

[HalfAsleep]

SleepRider....Are you thinking (as I'm beginning to) that all those hypopneas are central in origin and that's why they aren't disappearing with OSA treatment?

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Also, I would have $0 out-of-pocket cost for a BPAP since this doc has (staggeringly) prescribed treatment with cause.


What I would not be able to do is to buy and supply any machine out-of-pocket, so just buying an ASV is not an option.

[Sleeprider]

No way to know from where I sit, but if pressure support from BPAP doesn't improve them, or if they convert to CA we may find out.

Your doctor acknowledges you had central events, and dismissed them as "transitional apnea which are normal". He calls them pauses in breathing, but your results show the mean time of these "transitions" is 30 seconds. His conclusions also don't consider that if you are having so many transitions between wake and sleep, your sleep efficiency is crap. We call these transitional central apnea "Sleep Wake Junk" and your results don't look like SWJ that I have ever seen. I just get the feeling your doctor had his mind made up before he ever saw the study, then interpreted the study to reinforce his predispositions.