(08-06-2014, 08:30 PM)surferdude2 Wrote: I have to pay full price for my equipment since I couldn't pass a sleep test, scored AHI of 1.9 according to my doc. Maybe I should have studied harder. Funny thing though, I get 17.3 reading with my ResMed S9 and the ResScan software.
(08-06-2014, 10:07 PM)surferdude2 Wrote:
(08-06-2014, 09:45 PM)Gabby Wrote: I don't understand what you mean about your sleep study AHI being 1.9, surely that means you don't have sleep apnea?
What it means is that I didn't meet the criteria that Medicare has established for authorizing payment for the equipment. I have to pony up the dough from my life savings.
I suspect the test was flawed but I'm in no position to challenge that yet ....
What is breakdown of the 17.3 AHI, how many Obstructive Apneas, Central Apneas and Hypopnes?
To see whether the hypopneas are obstructive or central, in ResScan move the graphs of Snore and Flow Limitation (FL, which indicates a type of obstructive partial restriction of your airflow) and Tidal Volume (Vt, the volume of air inhaled or exhaled in each breath) or Minute Ventilaion (MV, which is the total amount of air breathed in one minute) or Flow (which is the rate of airflow entering and exiting your airway and lungs) and Events next to each other. (In ResScan you can do a left mouse button press/hold in the box with the graph label and the cursor will change shape and let you drag the graph up or down to reorder the graphs.) When you zoom in closely on the graphs near Hypopnea events (until just one or two minutes fills the screen) are your Hypopnea events accompanied by Snore or Flow Limitation? If yes, I think that would indicate the hypopneas are likely obstructive in origen rather than central. On the other hand, if the hypopneas look more like Periodic Breathing, which is when the tidal Volume (Vt) or Minute Ventilation (MV) or the amplitude of the Flow graph slowly increases and decreases cyclicly (cycle periods typically take about 30 seconds or a minute or two), I think this would indicate the hypopneas are likely central hypopneas in origen.
Higher pressure will help avoid obstructive events, but higher pressure will not help avoid central events and often makes central events occur more often. Higher pressure is also associated with aerophagia (air swallowing). More rarely, higher pressure is associated with vision or hearing or balance or heart or lung problems.
You should get a copy of your full sleep report(s), including all data (graphs or plots). Don't let anyone tell you that you don't have a right to the full report including data. You have a right to this for your own records.
I think a diagnostic study would be invalid if there was not a certain amount of REM stage sleep while sleeping in the supine position (flat on back). I suggest you investigate this possibility.
In any case, print out ResScan full reports showing your sleep data, and persistently ask that your doctor look at the diagnostic study in detail, with an eye toward invalidating the results of the diagnostic study, to get a new one authorized by Medicare.
Surely there is an appeal process to go through. I think you can appeal even without your doctor's help, but but if your present doctor won't advocate on your behalf, I suggest getting a sleep specialist involved, or a new one.
Also, I suggest you start a new thread to focus on this, in case any forum members may know what are the criteria for the minimum amount of sleep needed during diagnostic sleep study.