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How to identify central or complex apneas using software
#31
RE: How to identify central or complex apneas using software
The foam does seal better (easier) and with insurance replacements, money may work out ok. They don't last as long, but you get 3 at a time. I use foam on my dad and I use silicone.

PS9 is pressure support of cm and is the difference between your epap and ipap
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#32
RE: How to identify central or complex apneas using software
Got it - on the pressure support.    Thanks.

Been browsing and gathering information I can on masks and fitting.   Takes time - every bit helps plus I need a periodic refresher.  Downloaded info from ResMed.

DME vendor is good about resupply if you can get full 30 days out of a foam mask pad.  

I'll see what tonight brings - last night was in the horrible category after about 0230 hours.

Goodnight, c!
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#33
RE: How to identify central or complex apneas using software
16 May 2019.   Last night was equally BAD.   Dense clusters of apnea events on each end of the night with some reasonable breathing in the middle.  Overall, very unsatisfactory.  No point in posting screenshots or anything else.

As of this morning I have a ResMed AirTouch F20 on order and it should be available by mid-week next week.   I intend to test the AirTouch and should it become necessary try the AirFit F20 as well.

I will post further results as available next week.   Thanks for help.  c! / clif
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#34
RE: How to identify central or complex apneas using software
Page 4? I was expecting a "it's all fixed" post Smile
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#35
RE: How to identify central or complex apneas using software
Based on the info we have so far the Resmed ST is no longer doing it for you so you need an ASV to treat your Central Apnoea hopefully your medical team will eventually get there
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#36
RE: How to identify central or complex apneas using software
Agreed!   My intent if possible is to resolve leaks prior to visit with respiratory specialist on 10 Jun 2019.   He is the one with the ability to write a 'script for any change in machine.   I am aware that ResMed recommends an ASV machine for tx of central apneas.  But then I have Medicare to deal with; and it took ~~18 months in 2016-2017 for them to approve the ST machine I have now.  I understand that the Medicare coding for ST and ASV  machines is the same (but I can't verify that at this moment).

I plan to have enough graphic evidence at hand to demonstrate a clear picture of what is happening prior to the physician visit.   c! / clif Thanks
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#37
RE: How to identify central or complex apneas using software
I wouldn't say that. I think we are still at step one
I doubt that in the US, that an insurance company would have the boxes ticked.

step one, mask fit ..fail, repeat step one.

we don't really have a history how we got to ST. It could be OHS or restrictive or obstructive or some CA or just that someone thought it was a good idea.

I think the path to ASV runs similar to this.
step 2 with cpap, resolve OA/H to under 5 and see what CA are left.
step 3 If unacceptable CA and OA/H move to bpap and titrate to S or ST, if needed.
step 4 They hope to have dragged it out long enough, for the pressure induced CA to have resolved. if not, titrate with ASV
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
For auto-cpap, from machine data or software. You can set the min pressure 1 or 2cm below 95%. Or clinicians commonly use the maximum or 95% pressure for fixed pressure CPAP, this can also be used for min pressure.
https://aasm.org/resources/practiceparam...rating.pdf
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#38
RE: How to identify central or complex apneas using software
This Wiki article highlights Medicares requirements for getting ASV

Justifying Advanced PAP Machines
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#39
RE: How to identify central or complex apneas using software
We originally got to S/T 24 years ago ( 12/1994 ) at about 2:30AM one morning in a sleep lab when CPAP totally failed.

More currently sleep lab 2/2017 resulted in ResMed Air Curve 10 VAuto with results:
   OA 10.4, CA 12.5, Unk 10.1, AHI 37.3
Sleep lab May 2017 resulted in ResMed Air Curve 10 ST with results from (take note) 6/5/17 - 7/10/18:
   AI 4.2, HI 7.9, AHI 12.1
....then with Air Curve 10 ST following surgery results jumped for 7/15/18 - 5/15/19 to:
   AI 9.6,HI 11.4, AHI 21.1
-----------------------------------------------------------------------
Well - it will be up to respiratory specialist what he does at the time of my visit to him.  What will be will be then.

Bonjour just sent a response about WIKi and requirements for ASV.   I had read that before but will re-read it.  One thing I recall is within three years there has to have been a change.   I consider the change in July 2018 as a significant change.   Another factor entering into it is approval to tritrate again which may not be too difficult with (1) changes, and (2) two years have passed.   I'll cross that bridge at the time.

Step one - resolve leaks...   I'll see what follows.
Thanks   c! / clif
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#40
RE: How to identify central or complex apneas using software
....I would add that CPAP failed in 1986 - and as reported to me at that time BiPap was not available.  FWIW
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