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[Diagnosis] Sleep Study questions
#1
Sleep Study questions
Hi, I don't understand why data from two different sleep studies different centers are poor quality compared to Oscar data from my system one. Both sleep studies were done on Cadwell systems and viewed using Cadwell Easy Reader software. The blowers were different Respironics and Resmed. My observation of the diagnostic and titrations (ST vs ASV) was that flow measurements were virtually noise and not relatable to the chest and ab sensor bands. During the Diagnostic with 85 Ahi they did not report any CSR events, but the ST titration noted in summary reduced CSR at X pressure and nothing reported at the different pressure points. Next study will likely be auto Bipap or just Bipap which likely will not suppress CSR events. Does the Dr. have to specify any additional scoring items beyond a default set for diagnostic and Titration studies in order to detect mixed / complex apneas?
Does this require different equipment? settings? setups? software?
TIA
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#2
RE: Sleep Study questions
Have they confirmed this is actual Cheyne-Stokes Respiration? It'd be most likely caused by congestive heart failure, that you'd not need guess.

My understanding is that on your differing titration results might be due to trying differing mode and pressure settings.
Dave

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#3
RE: Sleep Study questions
Hi Dave, and others?
I have been on Pap therapy for 14+ years. Initial sleep study identified CSR, have seen plenty of cardiologists, couple of holter devices, and Mri's with no CHF found. My issue is that I am an engineer and what I observe in the recent testing seems a bit under instrumented and poorly prescribed in the first place. It may be the software to view the sleep tests, the resolution provided to me by Cadwell export or the actual instrumentation. Any opinions?
I am currently using a 7 year old Respironics System one BiPap Auto that I have been attempting to replace for 2 years many reasons for delays.  The system has been flagging Periodic breathing for 7 years.  First recent doctor after I identified PB and original CSR decided to do a Diagnostic after 14 years and a ASV Titration. Rejected by Medicare... How do you prove PB or CSR with a ASV titration when it is being actively suppressed by the machine? No data was collected from the Respironics blower that I can identify, No data was presented from Cadwell regarding the ASV active controller response. Asked if I felt better rested -> script for ASV rejected!  Second doctor similar but sent off for a ST titration ( I hadn't researched ST) but same exact scene rejected by Medicare. 
I am now desperate Respironics is blowing black foam at me filtered by a Antibacterial filter that Respironics now says not to do. Reporting high AHI, PB caused by filter.
I am attempting to avoid steps 1 and 2 above based upon current observations from recent sleep testing. 

I have seen no mention of PB or CSR events in any recent testing does it need to be specially requested as part of the scoring protocol? Are there any optional scoring events that should be requested? Special instrumentation? Special setups for PB or CSR on a BiPap machine in Auto or Non Auto Mode?

How to prove I need an auto mode machine similar to what I have filling me with foam. 

I requested copies of the recent sleep testing raw data and was disappointed in how noisy the data was especially the flow rate waveform was there but unusable. Strap data was there with some noise but as I understand recording effort not flow. Is this the instrumentation or the exported data?
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