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Just diagnosed but headed back for 2nd study. Advice?
#1
Greetings,
I had my first study done about 2 weeks ago. It was a split study but apparently they were unable to get the correct pressure narrowed in so I'm supposed to go back this week for round two. They said my AHI was 63 so my apnea was considered severe.

I have a dreamstation auto en route that I paid for out of pocket since my deductible had not been met. My real question is: are there any questions I should be asking this second time around? My goal is to start therapy ASAP. I plan to ask what pressure I ended on so hopefully I can start my therapy ASAP instead of waiting 2 more weeks for the results to be given to me.

Any advice? Is this a bad idea? I'm just sick and tired of being sick and tired and now that I know what is wrong with me I'm eager to get started. Thanks in advance.
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#2
I was in a similar position to you in 2003.

If you don't have the pressure don't worry about it.
Set your machine for auto mode with low at 4cmH20 and high at 20 cmH2O.

The machine is smart enough to figure out what pressure you need. Over time post your sleepyhead data and get adjustment advice. Many will boost the low pressure up to where you are getting many of your events and will feel better doing that.

Fred
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#3
If you have an auto machine, there is not much need for a titration study unless they suspect something is wrong with your therapy. That does not sound like the case.

I will disagree with the starting pressure of 4. That is down in the paediatric range of these machines. Most people will feel air starved when inhaling. A starting pressure of at least 6 or 7 is better for most people. You can use the Ramp feature if you need help getting used to the small pressure. You will probably want the C-Flex feature too.

You can get the clinicians manuals from the link at the top of this page. That will show you how to setup the machine. And also get SleepyHead, link also at top of page, so that you can download the data from your machine. This will allow you to monitor and fine-tune your therapy. We are always happy to help with this.

Welcome!
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#4
I'd ask the purpose of the 2nd night study.

It's possible they are considering a different machine such as a bilevel.
You run a slight risk by having bought a machine in advance.

OTOH: If they are just trying to find a better single pressure, then your auto machine will be fine; and you can bracket the pressure they determine with your min and max pressure settings.

BTW: Be sure to get copies of both sleep studies and a copy of your prescription.
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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#5
Ok Chill, I can agree with the higher starting pressure. I was hinting at upping it rather quickly anyway.
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#6
Thanks everyone for your responses.

(12-27-2016, 04:29 PM)justMongo Wrote: I'd ask the purpose of the 2nd night study.

It's possible they are considering a different machine such as a bilevel.
You run a slight risk by having bought a machine in advance.

OTOH: If they are just trying to find a better single pressure, then your auto machine will be fine; and you can bracket the pressure they determine with your min and max pressure settings.

BTW: Be sure to get copies of both sleep studies and a copy of your prescription.

I don't understand the reason for the 2nd study. I'll call again tomorrow and ask them if it is necessary with an Auto Machine. The medical industry loves billable visits Confusedigh:. They told me that they didn't have enough time with the mask on to find the correct pressure for me. Unfortunately the biggest reason for me to go through with the study is just to satisfy them so I can get a proper prescription from them.
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#7
The real question would be BiPAP or CPAP.
BiPAP can go to 25 cmH2O, CPAP to 20 cmH2O
BiPAP can set a separate inhale and exhale pressure

There are other differences but these are the main ones.
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#8
(12-27-2016, 05:31 PM)bonjour Wrote: The real question would be BiPAP or CPAP.
BiPAP can go to 25 cmH2O, CPAP to 20 cmH2O
BiPAP can set a separate inhale and exhale pressure

There are other differences but these are the main ones.

My understanding was that bipap was more for people unable to exhale against the constant pressure. The sleep study was done with a bipap (I believe anyways) and I really disliked the pressure changes on exhale/inhale. The machine didn't do a good job with my breathing pattern and would wake me up when it kicked in the pressure.
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#9
Piggles, I had the same experience, I felt the BiPAP was sending a square wave signal and the exp dropped instantly. My AirCurve 10 has a relief which slightly ramps that Inh to Exp and makes it acceptable to me. Without that it was triggering a new full breath and I was hyperventilating as a result
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#10
Hi Piggles,
WELCOME! to the forum.!
I wish you good luck with your CPAP therapy.
trish6hundred
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