Hello Guest, Welcome to Apnea Board !
As a guest, you are limited to certain areas of the board and there are some features you can't use.
To post a message, you must create a free account using a valid email address.

or Create an Account


New Posts   Today's Posts

Bad Sleep study experience
#1
Bad Sleep study experience
Finally got a sleep study scheduled and completed to figure out what was going on with all my central apneas over the past 3 months.

Doc ordered a CPAP/BiPAP/ASV titration as he suspected I needed an ASV machine based on sleepyhead data I showed him.

Tech tells me upon arrival that no one gets an ASV unless they are seriously ill, and need super high pressures that a CPAP/BiPAP cant deliver. Tells me I don't want one and do I understand that is the same as the ventilator they use in the ICU?

Anyway, I suspect she only titrated CPAP and BiPAP as she was so against ASV. She told me the best way to resolve centrals was to use higher pressure with a BiPAP.

Can't wait to get my study results to see what really happened.

So frustrating.

Anyway, just needed to vent.
Post Reply Post Reply






Donate to Apnea Board  
#2
RE: Bad Sleep study experience
(03-31-2018, 02:27 PM)KCFLY Wrote: ..Tech tells me upon arrival that no one gets an ASV unless they are seriously ill, and need super high pressures that a CPAP/BiPAP cant deliver.  Tells me I don't want one and do I understand that is the same as the ventilator they use in the ICU?

Vent away.

..and did you tell her that your doctor, in all of his/her wisdom, thought you need to be titrated for ASV? Sheesh. Who is she to say how ill you are, or what you need in order to, um, you know, breathe, while you sleep?

So, yeah, vent away. Lest you wind up like me with a lot of unresolved issues with the whole sleep industry.
Post Reply Post Reply
#3
RE: Bad Sleep study experience
(03-31-2018, 02:27 PM)KCFLY Wrote: Finally got a sleep study scheduled and completed to figure out what was going on with all my central apneas over the past 3 months.  

Doc ordered a CPAP/BiPAP/ASV titration as he suspected I needed an ASV machine based on sleepyhead data I showed him.

Tech tells me upon arrival that no one gets an ASV unless they are seriously ill, and need super high pressures that a CPAP/BiPAP cant deliver.  Tells me I don't want one and do I understand that is the same as the ventilator they use in the ICU?

I went back and looked at some of your posted SleepyHead results from earlier this year. You have been through a lot, and certainly those higher CA driven AHI's are reason for concern. Your doc is on the right track, with an ASV. I don't think a CPAP is going to help as you have that now, and a BiPAP is not going to help either. I would suggest the tech is out to lunch and does not understand what causes CA's. Higher pressure alone is likely to make it worse, not better. 

In my look at your results I did not see an expanded flow rate graph of what one of your CA's looks like. Have you posted one? I have a bit of an issue with CA events too. Here is an example of what I mean by an expanded look at the flow rate. You just have to use the Events tab, and double click on the CA line, and then click on a particularly bad event -- it will have a higher number in brackets beside it. It helps to identify that the event really is a CA, and if there is anything else going on.
Post Reply Post Reply
#4
RE: Bad Sleep study experience
This is another IMO message by extremely opinionated and sometimes correct Dave:

The technician does not have place to modify the doctor prescribed sleep study except in such a manner that it stays within the prescribing doctor's specified test parameters.

Example is my CPAP to BPAP titration as prescribed: titration on CPAP until/unless pressure exceeds 15, then switch to BPAP.

On my ASV, admitted it was different than the OP's scenario, I knew I was titrating for an ASV machine. A special ASV tech was called in for this for me.

I call personal foul on this tech for scrapping the rulebook. Call the doc and/or the tech's superior and get them to make it right ASAP! Yesterday would suit me fine.

My $0.02
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply






Donate to Apnea Board  
#5
RE: Bad Sleep study experience
so this is what I have heard/read. no expert here at all

ASV verses CPAP/APAP/BIPAP. ASV "tries" to trigger you into breathing, it does this by a higher that BiPAP pressure. pretty sure it cannot inflate your lungs.

If you get hit in the face with a big wind, like sticking your head out a car window on the freeway, it can make you catch your breath. Higher air pressure in PAP can do the same and it is seen as a central. You can also jut have been turning over and kind of held your breath while you did it.
Post Reply Post Reply
#6
RE: Bad Sleep study experience
Quote:ASV "tries" to trigger you into breathing, it does this by a higher that BiPAP pressure.

I think you've read the wrong book, PoolQ. Wink What you've been told is not an entirely correct explanation of what happens. The following relates to the Resmed machines, but I don't think the Philips are too far different:

ASV machines maintain an expiration pressure (EPAP) which is either preset (ASV mode) or varies within preset limits (ASVAuto mode). This pressure maintains the patency of the airway thus preventing obstructive apneas or hypopneas. As you inhale the machine adds additional pressure (pressure support PS) to achieve the inhalation pressure (IPAP). EPAP + PS = IPAP. This is really not much different from a BiPAP type machine.

The machine monitors your breathing using a proprietary algorithm and increases EPAP as required to head off obstructive events. It also increases PS as required to keep your breathing regular against a baseline. On Resmed machines the baseline is your own minute ventilation and respiration rate. So PS will increase up to the preset limit if your minute ventilation drops too far.

The maximum pressure available on a Resmed machine is 25 cm H2O, which is the same as the Resmed Aircurve and Lumis machines. So the ASV can't give you a higher pressure than a BiPAP.
Post Reply Post Reply
#7
RE: Bad Sleep study experience
Personally, I would initiate a formal written complaint to your physician and the director of the facility to memorialize the conversation and to put them on notice that an unauthorized person might be practicing medicine without a license by countermanding your physician's orders and providing you with diagnostic advice.
"The object in life is not to be on the side of the majority, but to escape finding oneself in the ranks of the insane." -- Marcus Aurelius
Post Reply Post Reply






Donate to Apnea Board  
#8
RE: Bad Sleep study experience
Thanks everyone. Sorry for not responding sooner, it has been very hectic week with work.

I was just caught so off guard by this tech. My last sleep study was at the same lab and I was treated quite well I thought. Just goes to show even a good lab can be ruined by one bad tech.

I was just thinking this morning about writing a formal complaint about this tech and was trying to decide if I should wait until I get the results back before submitting the complaint.
Post Reply Post Reply
#9
RE: Bad Sleep study experience
(03-31-2018, 03:29 PM)Ron AKA Wrote:
(03-31-2018, 02:27 PM)KCFLY Wrote: Finally got a sleep study scheduled and completed to figure out what was going on with all my central apneas over the past 3 months.  


In my look at your results I did not see an expanded flow rate graph of what one of your CA's looks like. Have you posted one? 

Here's a shot from a couple nights ago...


Attached Files Thumbnail(s)
   
Post Reply Post Reply
#10
RE: Bad Sleep study experience
I'd would formalize the tech's bias with a letter regardless of your results. I doubt that you are the only patient that has experienced this tech's actions. In today's legal environment employers need to have as much documentation as possible before they will take any action.

Good luck!
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
Post Reply Post Reply






Donate to Apnea Board  


Possibly Related Threads...
Thread Author Replies Views Last Post
  [Diagnosis] Sleep Study Report - just looking for thoughts before consult XedSleep 0 146 05-12-2022, 03:33 PM
Last Post: XedSleep
  Sleep study dataq1 1 164 05-06-2022, 03:57 PM
Last Post: pholynyk
  Steep study w/ titration last night S.L. Ping Beauty 0 93 04-30-2022, 12:52 PM
Last Post: S.L. Ping Beauty
  Experience with Clear Dream, Silent Night or Taps oral devices? wvdthree 0 104 04-05-2022, 08:13 PM
Last Post: wvdthree
  What can i make of this sleep study while on apap AFAFAF 2 225 03-24-2022, 11:14 PM
Last Post: AFAFAF
  Where can I have a Type 2 Home Sleep Study in Bay Area? jawz 0 146 03-21-2022, 12:57 PM
Last Post: jawz
  F & P Simplus experience THANK YOU!!!! Dave W 1 153 03-13-2022, 06:50 PM
Last Post: Crimson Nape


New Posts   Today's Posts






About Apnea Board

Apnea Board is an educational web site designed to empower Sleep Apnea patients.