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12-16-2019, 02:47 PM (This post was last modified: 12-16-2019, 02:53 PM by Aussie Lee.)
Questioning CPAP when experiencing proportion CA events
Hi
Only recently diagnosed and about to have first appointment with sleep technician after my at home sleep study.
I am in Australia.
Sleep physician has diagnosed severe apnea
AHI 61
Average apnea/hypopnea length 32.9 sec (full reort attached)
But when looking at the respiratory events graph there is a significant proportion of CA events with a majority of OA events.
I'm questioning the recommendation for a CPAP trial rather than BIPAP due to the CA Events.
Machine: Respironics Sys One Auto Mask Type: Nasal mask Mask Make & Model: swift fx Humidifier: respironics CPAP Pressure: 14 CPAP Software: OSCAR
EncoreViewer
RE: ??? CPAP when experiencing proportion CA events
although vauto has a couple settings apap doesn't have that seem to help with ca, it's my understanding that only asv is designed to treat ca & mixed apnea. if you had significant ca in your sleep study then you might need asv. if you are experiencing pressure induced treatment emergent ca, which is quite common, it'll dissipate in time.
RE: ??? CPAP when experiencing proportion CA events
Thanks SorryIAmNormal for the reply but as i live in Australia and I presume don't have the USA insurance issues of having to trial CPAP first before bpap.
I am confused that the doctor recommend CPAP when i believe he is free to recommend whatever therapy is required.
Or are we also subject in Australia to this graduated approach to machine selection and therapy escalation?
Machine: Needing iVAPS but QUACKS refusing to help but they love testing Mask Type: Not using mask Mask Make & Model: F&P Vitera on shelf Humidifier: None/nada CPAP Pressure: 0-0 pressure set CPAP Software: Not using software
Other Comments: SCS PVC K9D** Untreated CA Asthma Dr. Donothings
12-16-2019, 03:54 PM (This post was last modified: 12-16-2019, 03:58 PM by SarcasticDave94.
Edit Reason: Clarify
)
RE: ??? CPAP when experiencing proportion CA events
I didn't see the event counts breakdown for OA vs CA, and as I'm US, my take may not count for you in Aussie, but for me to get ASV I had to have 50% or more CA events. My example is my numbers were 124 CA to 24 OA.
Again based in US, most insurances want to see CPAP BPAP and maybe ST machine fails before ASV.
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.
RE: ??? CPAP when experiencing proportion CA events
I hadn't seen your study before postiing. the first one you posted (page 2?) is out of focus so it's hard to read but appears to show a fair number of central apnea,. fewer than obstructive apnea, though, if I'm reading it correctly. it's fair to ask your doctor what they expect to do about the centrals. typically, at least in the US, if after 1 - 3 months they don't subside with cpap/apap, you can make a case for a different modality that will help. if you're lucky (and need a different machine, an open question at this point), your doctor will listen to your appeal for better treatment, but right or wrong, it's very common for almost everyone to start on cpap or apap.
RE: ??? CPAP when experiencing proportion CA events
(12-16-2019, 03:54 PM)SarcasticDave94 Wrote: I didn't see the event counts breakdown for OA vs CA, and as I'm US, my take may not count for you in Aussie, but for me to get ASV I had to have 50% or more CA events. My example is my numbers were 124 CA to 24 OA.
Again based in US, most insurances want to see CPAP BPAP and maybe ST machine
From my guesstimation looking at the sleep study graphs I'm experiencing 70% OA and 30% CA
Other Aussies might be able to enlighten me further but it is my understanding that we don't have to go through the escalation of trials that our friends in the US do.
Insurance only provides a small portion of the cost in Australia unless we are on a pension or benefits where the machines are provided free of charge.
Unfortunately I don't fall into that category and so will be paying for it myself.
RE: ??? CPAP when experiencing proportion CA events
(12-16-2019, 04:02 PM)sheepless Wrote: I hadn't seen your study before postiing. the first one you posted (page 2?) is out of focus so it's hard to read but appears to show a fair number of central apnea,. fewer than obstructive apnea, though, if I'm reading it correctly. it's fair to ask your doctor what they expect to do about the centrals. typically, at least in the US, if after 1 - 3 months they don't subside with cpap/apap, you can make a case for a different modality that will help. if you're lucky (and need a different machine, an open question at this point), your doctor will listen to your appeal for better treatment, but right or wrong, it's very common for almost everyone to start on cpap or apap.
Thanks again Sleepless,
I appreciate your insight
.
While I've read the wiki on machine selection I'm confused as to which asv machine to choose should i be offed one. The wiki doesn't seem to be clear on this.
As I'm purchasing the machine myself... with very little subsidy from health insurance...i want to get this right at that get go.
Do you have a recommendation!?
