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Here are my first night results
#21
RE: Here are my first night results
(07-22-2019, 09:15 AM)Croweater Wrote: Could somebody please help me with this?

I think an ASV would be the answer for me but I just wanted someone to verify this once and for all.

I'm also questioning why me CAs go down when I'm taking a sleeping pill. Is that normal?

It is TOO early to say once and for all whether an ASV isappropriate.
The majority of cases of treatment emergent Complex Sleep Apnea resolve themselves within the first 3 months.
I had Complex Apnea that resolved within the first month.
Exercise also helps.
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#22
RE: Here are my first night results
I don't have Treatment Emergent Central Apnea. My sleep study proves that. The CAs haven't gotten worse since I started treatment, but they certainly aren't going away either.
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#23
RE: Here are my first night results
I just saw my ENT Doctor. He is just not knowledgeable enough to help me. When I told him I thought my main problem was central apneas, not obstructive ones, it was clear to me he didn't even know what central apneas were. He ordered me another sleep study (with titration this time) and then he said he would refer me to another sleep doctor (this is a good thing).

He also mentioned something called Inspire and suggested that that may be my best option going forward. Of course I already know that operation is to treat Obstructive disorders, for people who don't tolerate the a cpap machine well. I have no trouble tolerating my machine. It just doesn't resolve central apnea. Inspire won't treat central apnea either.
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#24
RE: Here are my first night results
Please validate that the Titration study is to include ASV Titration (which usually is just setting the default values and validating that it resolved the Centrals).
Please let him know that that may require measurement of LVEF (Left Ventricle Ejection Factor) which is currently a requirement to use an ASV.  (we expect that to be cleared as a requirement in the next few years)
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#25
RE: Here are my first night results
(07-23-2019, 06:12 PM)bonjour Wrote: Please validate that the Titration study is to include ASV Titration (which usually is just setting the default values and validating that it resolved the Centrals).
Please let him know that that may require measurement of LVEF (Left Ventricle Ejection Factor) which is currently a requirement to use an ASV.  (we expect that to be cleared as a requirement in the next few years)

I don't have any idea how to do this. My doctor ordered the titration study, but he had no idea what ASV was so I'm certain he would not have written instructions to use ASV Titration.

I suppose I could talk to the sleep clinician right before he performs the study and ask him if he will do an ASV Titration. I suspect that he will not have the requisite knowledge to do so, but it is worth a shot.
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#26
RE: Here are my first night results
Simply ask, via a nurse (easier to get a hold of), and ask if they could make sure that the titration study included a ASV Titration since you know this is the best machine to treat Central Apneas (In addition to Obstructive Apneas) and prove if the ASV would actually treat my Central Apnea or not.

It could be that this is already scheduled.

I feel that this is the opportunity for you to speed the process of getting an ASV.  There is no, or minimal, cost to adding or just doing an ASV Titration, and when they see it works it makes for a strong argument to get an ASV.
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#27
RE: Here are my first night results
There are different types of sleep studies. Diagnostic and Titration are the main ones. Titration studies generally target a specific technology; CPAP, Bilevel and Bilevel ASV or ST. You want to be sure your study is designed to determine your needs with ASV. We already know CPAP and Bilevel without backup is not effective. Do not simply go to another CPAP or Bilevel titration, it is a waste of time an money. Be sure the test is designed for your needs.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
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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.
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#28
RE: Here are my first night results
(07-24-2019, 07:57 AM)Sleeprider Wrote: There are different types of sleep studies. Diagnostic and Titration are the main ones. Titration studies generally target a specific technology; CPAP, Bilevel and Bilevel ASV or ST.  You want to be sure your study is designed to determine your needs with ASV. We already know CPAP and Bilevel without backup is not effective.  Do not simply go to another CPAP or Bilevel titration, it is a waste of time an money. Be sure the test is designed for your needs.

All I ever had was a Diagnostic study. I pressed my Doctor to prescribe an ASV but he said he wanted to do a Titration Study first because he said Medicare would not proceed without it. I didn't realize there were different types of Titration studies and I'm 99% sure my Doctor just ordered the standard one (CPAP). I would hope that the sleep technician will do an ASV Titration if I ask him to but I don't really believe he will because these guys take their orders from the Doctor, not the patient.

The Doctor doesn't want to see me again until the CPAP Titration has been completed. Should I just cancel it and demand to see the doctor again, without the study results?
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#29
RE: Here are my first night results
We all know CPAP is ineffective for central apnea, and that your use of CPAP continues to show central apnea. I think you should consider finding a doctor that understands central apnea and will support the proper treatment of it. It is absolutely insane to have you do a CPAP titration. It is doomed to failure. Demand the ASV titration. Your doctor is wrong in anticipating that insurance will deny ASV without CPAP titration. The fact is you have trialed and failed CPAP therapy. The next step is bilevel, and preferably a dual titration with bieevel and ASV when bielevel without backup fails!

You should decline this test and request the BiPAP and ASV test. Ask your doctor for a referral to a physician competent in primary central apnea (central apnea found prior to CPAP therapy).

A single titration study can evaluate CPAP, Bilevel and ASV all in one night. You will fail CPAP and Bilevel, then the value of the ASV trial will be apparent. I just can't imagine that a doctor does not know this. The same test machine is capable of producing all of these tests without interruption or changing equipment.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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.
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#30
RE: Here are my first night results
I agree with Sleeprider, I was just thinking about how much pain you could be looking at going through with this doctor. If they don't even know what a central apnea is it just seems almost futile to keep working with them.

Aside from getting a referral from the ENT doctor, could you go back to your GP and ask for a referral to a sleep specialist from them? It might help get you things straight sooner if you work both angles. Also it wouldn't hurt to research doctors in your area on your own and take a list in with you for the official referral.
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