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Going onto CPAP without definitive results
#11
RE: Going onto CPAP without definitive results
I thought I had responded earlier, sorry

Your Watchpat study screams UARS because of the High RDI/Low AHI,the others not so much.
The RDI of 12/AHI of 12, realize that RDI=AHI + RERAs so nothing there. The question is did they even measure RERAs Was that the 4/19 study
4/19 study AHI 12.3 Arousals 36, no mention of RERAs. "3. Respiratory monitoring revealed AHI at 12.3 /h (sleep). Rising to 34.3 /h in REM. Typically
hypopneas with associated arousals" RERAS are a series of flow limits (I'll accept hypopneas) followed by Arousal

There is not enough data on the other to indicate anything but to say you are good.

UARS is something that VERY few doctors follow because insurance often says it is Apnea and Apnea is measured with AHI and you don't have it.

The machine you need is the ResMed AirCurve 10 VAuto. This machine because of the higher PS it is capable of providing.
Initial tuning is easy, ongoing tuning will involve manual interpretation of the Flow Rate Chart. Basically, you are looking for the small events, flow limits a reduction in flow 25% or less ( 10-50% reduction ) so these events are don't as obvious as Obstructine Apneas (80-100% reduction in flow for 10 seconds).

Initial settings
Used Machine - Factory Reset to make sure ALL settings are in their default setting
Mode VAuto
Min EPAP: 6
Max IPAP: 20 (doesn't matter unless you are having issues) or 25, the machines Max
PS=4 Common starting PS
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#12
RE: Going onto CPAP without definitive results
@ Gideon - please correct me if I am wrong. In the US, patients don't just go into the doctor and say I need a VAuto. Because they are pretty expensive, there is a protocol that must be followed before a VAuto will be prescribed and before Insurance will pay. As I understand it, the patient must first "fail" with a CPAP machine before going to a bipap. And then "fail" with the bipap machine before going to VAuto. The complicating factor in this case is that the OP will not "fail" with CPAP because AHI is too low to call a failure. Once again, this is AS I UNDERSTAND IT. I may be wrong. Please advise.
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#13
RE: Going onto CPAP without definitive results
You are correct.
You can ask the doctor for a prescription and you may get one. Tell the doc you are going to get one on your own. That usually ends up as cheap or cheaper than going through insurance anyway with deductibles. I doubt very much you will get an Rx and insurance to pay for it..
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#14
RE: Going onto CPAP without definitive results
My RDI was 15 overall, however 24 for REM sleep. AHI was only 3, but 7 in REM. I haven't tired a mouth guard yet, although it's something I may look into. As for the Bipap, this is just from my research on here and Reddit. Essentially it just allows you to have a higher pressure range, so your EPAP can be much lower, allowing you to breathe easier, and open up your airway. It's by no means a well researched topic, but there's a few doctors that recommend it to deal with UARS, and a number of success stories. It may not work, but I'd rather give that a shot first, before jumping into even more expensive dental devices or surgery.
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#15
RE: Going onto CPAP without definitive results
I'd agree with Gideon here. It's going to probably be better to buy it out of pocket anyway. Unless you have an amazing health insurance, or live in Arizona which I believe by in large will supply Bipaps for UARS apart from a couple insurance companies, you're kind of on your own and they overcharge to a ridiculous amount. My buddy who just got his CPAP was overcharged by about $500 for his machine. 

It's unfortunately not just insurance companies, providers can suck as well. I was lucky in that my pulmonologist PA was extremely helpful and willing to listen to me. She's only ever hesitated in prescribing something as she didn't want to cost me money, as she knew I was going to have to pay for this stuff out of pocket. But if my APAP doesn't work out, we have already talked about going with a BIPAP down the road. She's unfortunately a rarity, as it took me 3 years to find someone like her to listen to me.
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#16
RE: Going onto CPAP without definitive results
I am sorry gaydolphinorgy I cannot access any of the links you provided to the PDF files.  I don't know why some can read them.

QAL
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#17
RE: Going onto CPAP without definitive results
(10-17-2021, 07:39 PM)quiescence at last Wrote: I am sorry gaydolphinorgy I cannot access any of the links you provided to the PDF files.  I don't know why some can read them.

QAL

Does this work?

https://docdro.id/OsnbnZQ

https://docdro.id/FpsN59P

https://docdro.id/AbDkgsE

https://docdro.id/kmRkiKv

https://docdro.id/i2LqtrK
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#18
RE: Going onto CPAP without definitive results
(10-12-2021, 04:56 PM)Gideon Wrote: I thought I had responded earlier, sorry

Your Watchpat study screams UARS because of the High RDI/Low AHI,the others not so much.
The RDI of 12/AHI of 12,  realize that RDI=AHI + RERAs so nothing there.  The question is did they even measure RERAs  Was that the 4/19 study
4/19 study AHI 12.3 Arousals 36, no mention of RERAs. "3. Respiratory monitoring revealed AHI at 12.3 /h (sleep). Rising to 34.3 /h in REM. Typically
hypopneas with associated arousals"   RERAS are a series of flow limits (I'll accept hypopneas) followed by Arousal

There is not enough data on the other to indicate anything but to say you are good.

UARS is something that VERY few doctors follow because insurance often says it is Apnea and Apnea is measured with AHI and you don't have it.

The machine you need is the ResMed AirCurve 10 VAuto.  This machine because of the higher PS it is capable of providing.
Initial tuning is easy, ongoing tuning will involve manual interpretation of the Flow Rate Chart. Basically, you are looking for the small events, flow limits a reduction in flow 25% or less ( 10-50% reduction ) so these events are don't as obvious as Obstructine Apneas (80-100% reduction in flow for 10 seconds).  

Initial settings
Used Machine - Factory Reset to make sure ALL settings are in their default setting
Mode VAuto
Min EPAP: 6
Max IPAP: 20 (doesn't matter unless you are having issues) or 25, the machines Max
PS=4  Common starting PS

I confirmed that they did score RERAs. 

I spoke to another doctor who knows about UARS but said that I should have an in-lab study as 2 hours is insufficient. The doc also said for high RDI and low AHI they wouldn't actually prescribe a machine but rather a mouth guard. 

Yes, I was thinking AHI was 0 in the 4/19 study because otherwise how can AHI = RDI?
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#19
RE: Going onto CPAP without definitive results
my trouble seeing some of your pictures was solved by Admin, so I am good.  I will look through them tonight.

QAL


btw. have we seen any charts using the machine you have?  some data from the display may give us hints even if you do not have OSCAR or other software.
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