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New Guy! High AHI
#31
RE: New Guy! High AHI
Thank you. What's odd is that my bi-level titration study eliminated CA's at 10/6. I'm curious why the VAuto machine produced so many centrals. Wouldn't treatment induced CAs show up in both cases?
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#32
RE: New Guy! High AHI
(11-21-2019, 12:30 PM)dahornor Wrote: Thank you.  What's odd is that my bi-level titration study eliminated CA's at 10/6.  I'm curious why the VAuto machine produced so many centrals.  Wouldn't treatment induced CAs show up in both cases?

theoretically yes.  But Centrals are consistently inconsistent and during titration settings are only trialed for brief periods of time.  It could have been easily missed.
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#33
RE: New Guy! High AHI
O.k. Thanks. That makes sense. As I recall, I didn't sleep that much on the night of my BiPAP titration. Probably not enough data to "catch" the CAs.
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#34
RE: New Guy! High AHI
We have seen many cases of individuals being titrated to bielvel therapy with "efficacy" demonstrated at a particular pressure(s). When we examine the lab results we can see that there are usually lots of apnea on both sides of that titration pressure. Invariably the person fails when they are dispensed the machine.

There is a Resmed Aircurve 10 ASV in the Phoenix Craigslist for $525. You will fail ST, or at the very least find it is uncomfortable. As Bonjour said earlier, it is specifically intended to treat pulmonary disease (COPD, Asthema) Neruomuscular respiratory failure and hypoventilation, none of which describe your complex apnea, which the ASV is inteded to treat. Please ask your doctor why not ASV?
Sleeprider
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#35
RE: New Guy! High AHI
I tried the Vauto at 10/6 with PS=2 last night.  Somewhat predictably, plenty of CAs.  The ST is supposed to arrive today.  I'm going to use it as the doc prescribed tonight (10/6 Backup=9 seconds).   Then I'll follow Fred's suggestion of 5 / 5 with PS=0 and see what happens.  All in preparation for a followup with doc to get an ASV machine...


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#36
RE: New Guy! High AHI
Well, I'm kind of discouraged today.  The DME just phoned me and said the data from my 3 sleep studies does not warrant an ASV machine for insurance purposes.  They say my OSA to CA ratio is too high to justify an ASV machine.  She says the VAuto machine they delivered is the "best" they can give me. 

Questions:  

1. Is the CA data from the SD card via OSCAR accurate?   

2. My understanding is that the sleep lab measurement of CA is based on the chest and belly band numbers, rather than the data from the xPAP machine.  Are these two ways of evaluating CAs generally close in their results?  

3. Why isn't the sleep lab seeing nearly as many CAs as I see via OSCAR?  And I see them 100% of the nights I run OSCAR on them. 


I still feel pretty crappy--tired and sleepy.  Maybe I need to "go commando" and buy an ASV machine on the open market.

Thanks in advance!

Dave
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#37
RE: New Guy! High AHI
This is a medical requirement for ASV for medicare, most insurance companies go by this.
http://www.apneaboard.com/wiki/index.php...P_Machines

Per this Eliminate the obstructive apnea, start with a PS =4, you know what that means, and it's OK.  Beat the obstructive to death.  And yes, your Centrals will be bad, that's good.

Ammo to clearly demonstrate failure on the VAuto.
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#38
RE: New Guy! High AHI
P.S. No ST will be arriving. They're saying the VAuto is what I need.
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#39
RE: New Guy! High AHI
I never thought an ST would be a good machine for you. Funny though is that I just suggested an ST as a strong possibility for a woman on Facebook with "I have major muscle weakness already (possible myasthenia gravis, or MS or FSA".  
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#40
RE: New Guy! High AHI
So... is 10/6 with PS=4 where I should start with the VAuto to start to completely eliminate OSA and support the case for an ASV?
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