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I cannot fall asleep with my bipap/home ventilator. Hypoglossal nerve stimulator?
#11
RE: I cannot fall asleep with my bipap/home ventilator. Hypoglossal nerve stimulator?
Jay51, if the Astral does not work out, what are the odds you can trial ASV? I'm really certain that you are just pounding nails with a sledge-hammer. Complex apnea (mix of obstructive and central) is the in the wheelhouse of ASV. ST and ST-A have been used by other member here with dismal results, and I don't thing the Astral 100 is the answer. Be sure to give Dave a referral to whoever your generous benefactor is, because you are getting some really expensive machine, when the less expensive ASV would do. I'll link to the Resmed Clinical Titration Protocol below. It has a good description of the ASV and ST-A and their intended use. Check out pges 28 and I think 35 and compare how these machines work and what they are trying to treat. I just think you are being over-treated with the ST-A and Astral.
https://document.resmed.com/en-us/docume...er_eng.pdf
Sleeprider
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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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#12
RE: I cannot fall asleep with my bipap/home ventilator. Hypoglossal nerve stimulator?
OK copy. Parts of what you're going through are typical. That is, little information on why the doctor decides to go a certain direction. If it helps on your request to get any of the diagnostic test results, be certain to request all of the full, detailed reports. Then if they don't comply, mention HIPAA law that permits you to request and receive.

Two fold need for you to have these reports, you need them in your own file so you don't need to start testing over especially if you actually do need this high of a machine level, and posting it here redacted.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#13
RE: I cannot fall asleep with my bipap/home ventilator. Hypoglossal nerve stimulator?
Thank you Sleeprider for the links to the threads and posts about the Inspire hypoglossal nerve stimulator.  I read through just about all of them.  This has really helped me in the direction I would like to go with my sleep apnea treatment.  For me, the diagnosis of sleep apnea has brought with it the responsibility to manage my own sleep apnea treatment(s) for the rest of my life.  

Thank you Dave about the very simple fix that could quickly solve my Astral 100 problem (adjusting to stop the "air trapping).  

I did have an overnight clinical polysomnography done in early June at the local hospital here by an RT.  Electrodes and wires from head to toe with the RT in the other room with all the monitors decifering all the data.  My guess is that she found similar results to the home sleep study I will attach later.   She did mention, Cheyne Stokes respirations also.
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#14
RE: I cannot fall asleep with my bipap/home ventilator. Hypoglossal nerve stimulator?
OK, my understanding on the CSR (Cheyne-Stokes respiration), it would have a link to a heart condition if it's the actual thing. I'm thinking you'd not have to think if you have something there, because you'd know something's up with heart health. Being that it's showing in-lab increases the possibility of it being true and not false flagged CSR. THIS would be a pretty good reason for the high level machines path in my opinion. Are you working with a cardiac specialist regarding this or any heart health issues?
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#15
RE: I cannot fall asleep with my bipap/home ventilator. Hypoglossal nerve stimulator?
Thank you again Dave.  Great point.  When I saw the ENT (sleep apnea specialist) a few weeks ago, I told him about the "buzzing" sensation I have felt in my head, neck, chest and left arm when I wake up in the night from sleep.  It goes away in a few minutes and I go back to sleep.  Happens about 5 time a night though.  Have never noticed it during the daytime. 

As I am talking to the ENT when he puts the scope down my nose and checks out everything physcially, he says to me, "The buzzing may be a- fib.  What does your Cardiologist think?"  I said I have never seen or had to see a Cardiologist in my life.  I have never had any heart problems.  Always good BP.  Low resting pulse rate (50's) from being in good shape.  

Maybe 4 or 5 times in my life I have felt pain in my chest.  It happened mostly at night.  When I woke up felt like I had a huge weight pushing down on my chest and I could not breathe.  Only lasted one second though and dissapeared.  All 4 happened when I was very stressed out.  Since they only lasted one second or so and went away and I felt fine afterwards, I never had them checked out.  Very infrequently also.  Maybe 6 months to a year or more between each.  Should I ask PCP for a Cardiologist consult.  Dave, the RT did the clinical polysomnography in June this year on me.  All the electrodes and monitors around my heart.  Wouldn't she have found something abnormal with my heart during this test?  I have a colonoscopy in Feb.  again electrodes and heart monitor on.  I saw it.  Would not the nurses have found something then.  Especially when I went under anesthsia to have the proceedure?   The 2 other home sleep studies don't mention any heart abnormalities.  But again, father had heart attack at age 65.  Mother's father died of heart attack at age 50.  Other 2 brothers of my father had heart attacks, too.  Don't heart attack symptoms last longer than a second or so?   I can perform physical labor wighout getting too winded.  Thanks Dave. I am only 52 years old.
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#16
RE: I cannot fall asleep with my bipap/home ventilator. Hypoglossal nerve stimulator?
I'm 52 also, and not trying at all to be negative. I'd get on the phone with your primary Monday and schedule getting referred to a cardiologist soon. A-fib I believe is one item linked to CSR.

I myself have the heart condition called PVC, preliminary ventricular contraction. It took tests via the cardiac doc to find it. This was my answer to why oxygen drops sometimes and why I've got these random heart palpitations.

OK enough on me, get yourself checked. Better to know what is happening. I myself would be asking docs what is going on and why haven't we acted on this sooner. And of course why didn't you tell me...

Keep us updated.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#17
RE: I cannot fall asleep with my bipap/home ventilator. Hypoglossal nerve stimulator?
Thank you Dave for the info again.  Thank you Sleeprider.  I am sorry I missed your post about the Resmed ASV earlier.  Why did they give me the ST - A bipap machine instead of the ASV with all the info from the 2 home sleep apnea tests and overnight polysomography they had?  

I have a plan on trying to get on the ASV.  My PCP is great and will basically give me any consult I feel I need.  The ENT is great in that he specializes in sleep apnea treatment also.  PCP is around 65 in age.  ENT about 50.  The RT at the DME is around 50 with lots of experience also.  How in the world could she have given me the ST-A instead of the ASV?  She didn't answer my phone calls to her at 1st, but now with the ENT sleep apnea specialist on board, she is moving much quicker.  We texted daily this week.  

Only about 2 weeks now using the Astral, my gut feeling is like yours sleeprider:  the astral will not work for me either.  I think the Astral was 100% the ENT's idea.  

I will try to post the rest of my 1st home sleep study.  Warning:  the results were very abysmal.
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#18
RE: I cannot fall asleep with my bipap/home ventilator. Hypoglossal nerve stimulator?
    [attachme     nt=37880]


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#19
RE: I cannot fall asleep with my bipap/home ventilator. Hypoglossal nerve stimulator?
[attachment=37883][attachment=37883]

[attachment=37885]    


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Advisory Members serve as an "Advisory Committee" to help shape Apnea Board's rules & policies. 

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#20
RE: I cannot fall asleep with my bipap/home ventilator. Hypoglossal nerve stimulator?
Welcome, now let's see how it goes in the attempt to get on an ASV. Going down from Astral you'd think would be easy.

Keep us updated and keep asking questions as they crop up. The ASV is pretty easy to dial in compared to ST-A and Astral vents.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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