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Oscar Data ?/ switch from APAP to Resmed Bipap or ASV?
#11
RE: Oscar Data ?/ switch from APAP to Resmed Bipap or ASV?
Could not find how to set the EPR to 3 on Dreamstation APAP.  If Should I order the manual? If its not a feature any other work arounds?
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#12
RE: Oscar Data ?/ switch from APAP to Resmed Bipap or ASV?
EPR is only found on Resmed CPAP machines. Philips has the Flex setting, which is as close as you will get to the EPR setting. However, it is not directly comparable to it.
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#13
RE: Oscar Data ?/ switch from APAP to Resmed Bipap or ASV?
Yep, Respironics will have Flex as mentioned. I've seen several not so pretty charts from others while trying Flex 3 so maybe keep it at a Flex 2 level.
Dave

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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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#14
RE: Oscar Data ?/ switch from APAP to Resmed Bipap or ASV?
I think Centrals may be treatment emergent since one Dr raised my pressurer ange on the Dreamstation when the data showed an average of 9.4 ish.
I reset the auto to 7-14 and my 90% pressure and average dropped down between 8-10cm.  My AHI is a bit lower, still not always 5 or less.
Can centrals reverse? I will download data after two weeks on the new settings...

The EPR concept is good to know before asking for a Bipap maybe the Resmed Air sense 10 for her with a EPR setting would be good to try...trying to kow what to ask for...

For now on the Dreamstation:
Should I try to set the AFlex to 2?
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#15
RE: Oscar Data ?/ switch from APAP to Resmed Bipap or ASV?
On Central Apnea (CA) there's 3 types, treatment emergent that's caused by a PAP increasing the removal of CO2 above what the brain has calculated to be normal for you in the past. This is actually below normal it seems due to Apnea. The brain has to take time to recalculate this, within 3 months of starting PAP therapy is acceptable and expected.

If your diagnostic sleep study showed 50% Apnea to consist of Centrals then I call the pre-existing or predominently CA. This typically needs an ASV as BPAP will almost certainly increase CA and in some a CPAP can avoid them, note that this is sometimes this way.

There's a third type, idiopathic CA meaning unknown medical cause. This can be treated via CPAP by avoidance of ASV to actually treat.

A key to define CA is were they in your diagnostic and how do they react to PAP pressures.
Dave

OSCAR
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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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#16
RE: Oscar Data ?/ switch from APAP to Resmed Bipap or ASV?
Of course the Phillips recall was the focus  at my Neurologist appointment....not getting a New resmed anything so I asked for the another Sleep study for Bi-level or ASV. Instead I got an overnight  "titration Study at 11cm....which was on a OLD RESPIRONIC. asked for it to be on mine declined, then I argued for a humidifier ( which I got.).... AHI below 5 remaining Apneas  are Centrals? see study...
I had stopped using my Dreamstation and Adderall....I then set my Dreamstation to 10cm and A FLEX and have had AHI under 5.
No imprvement with morning wakefulness ( Sleep Inertia)

I did get the MLST and got Hypersomnia diagnosis..... but since I am on Medicare none of the new drugs are covered on any Formulary. Samples of Sunosi are better than Adderall.

My Periodic Leg Movement in Sleep is "severe" 65.8..report says "above normal". I figured out my random toe wiggles are Restless Leg Syndrome and will discuss that as well. Meanwhile started gabapentin at night....thats another issue since the Horizant is the overnight but only the generic multi dose is vocered by insurance ( cash pay is less).

I will request the ASV or BI-Level and suggest Dr uses my 12/20  In home PSG. since the dreamstation is only 3 years old and was on my under 65 insurance....may be easier to get the BI-level this way...Of course3 the Dr makes more money ordering another sleep study...or Am I overly skeptical.....I have read my Insurane Clinical Policies and could argue I eet the criteria...its up to the Dr to write the report correctly.
I am having trouble attaching the scanned data pages....they scanned and are saved individually. after redacting my name...... 
I get so frustrated with Pilot error.....
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#17
RE: Oscar Data ?/ switch from APAP to Resmed Bipap or ASV?
Contiunation of earlier post .   Read Wiki.....on atachments, decided to try jpg. to reduce the size of the upload...
.Page 6/7 not legible so I have requested a B&W. 

Since my appointment is Monday I hope to get input on whats here.to know what to ask....

So it only let me attach three of 7 pages from the Sleep Study that I was advised to upload.....I guess I will find someone to put 7 pages in one attachment under 15 MB if there is such a thing....it would be easy if I new how to redact a PDF?

I appreciate this Forum and hope for the best.....between COVID and the  Phillips Recall getting a new Machine will require me to channel my inner Captain Kirk and try a KOBAYASHI MARU to get a new Repritory Device/Algorythm  to improve my  Cemtrals and in turn maybe my Sleep Inertia. 

Lots of variables to strategically address.....use of the  home PSG instead of the Titration to justify it.. Or use the current Titration with no longer compliant data to argue the Dreamstation was "ineffective". I now have to convince the Neurologist to give me a level 5  extended appointment... A Machine order,  a new Diagnosis of Hypersomnia for  RX for Stimulant, and evaluating the PLMS/RLS to be a diagnosis to support the stimulant coverage by insurance can't be worked out in 15 minutes.


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#18
RE: Oscar Data ?/ switch from APAP to Resmed Bipap or ASV?
What we'd really need to see is the Diagnostic sleep study that was done without CPAP of any sort. There, we would need info that states Central Apnea were x amount, Obstructive were X amount, and so on. Also possibly helpful would be the written area where the tech or doctor is discussing finding, areas that include mentioning Central Apnea specifically.

If you in fact suffer from predominant Central Apnea, testing that does not involve titration for ASV is wasting your time and money. Refuse anything that does not include this. This is my opinion until or unless we see diagnostic data that reverses my opinion.
Dave

OSCAR
Standard OSCAR Chart Order
Mask Primer
Dealing With A DME
Soft Cervical Collar Wiki
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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#19
RE: Oscar Data ?/ switch from APAP to Resmed Bipap or ASV?
Ask for a split titration that includes ASV. That means half the night on what the doctor wants, and half on ASV
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#20
RE: Oscar Data ?/ switch from APAP to Resmed Bipap or ASV?
if my quick scan of the titration study is correct, they titrated out oa leaving ca at 3.2/hr. on its own, that may not be enough to get you an asv, but 3.2/hr probably isnt that much of a problem.

otoh, imo, plm is a significant problem with something over 9 plm arousals per hour. that's likely exhausting & may be the cause of at least some of your ca. treat the plm & you may find your apnea therapy satisfactory.
  Shy   I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  
 
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