(12-23-2012 04:08 PM)Ugly Wrote:
(12-23-2012 02:01 AM)vsheline Wrote: By the way, to qualify for a machine which treats Cheyne-Stokes Respiration and Complex apnea, I think insurance companies require our CAI (Central Apnea Index) all by itself to be above 5.0 while we are being treated with a more standard (more economical) xPAP machine.
I may have to go the dangerous route to find out.
Set the machine for as low as it will go to find out what my AHI is with minimal assistance. That certainly wasn't done during my sleep study. My successful AHI numbers, USUALLY under 5 are while the CPAP was in use so I don't have a real number as to where I'm at.
Then again I don't know if I'm comfortable with finding out since I'd rather use the machine at a functioning level. Regardless, I was never diagnosed with Cheyne-Stokes (the "CS" in the AutoSet CS).
Quote:If a CAI of less than 5 is considered normal and would prevent insurance coverage for something like the S9 VPAP Adapt model, your trial with the S8 AutoSet would not have given your DME or anyone else enough data to determine that you actually need the more expensive model, even if your AHI while being treated with the S8 AutoSet was higher than 5.
The woman at VitalAire didn't even have a clue I was dealing with mixed apnea. It never registered during the sleep study. But then again, neither was anything else so I wasn't surprised.
Until the time comes when I duke it out with the powers that be, at least I can work with the prescribed pressure of 11.0 (up from what I had previously, 8.0 although I had it on 8.2 for the past few days.
Actually I think it's starting to help although it's not instant.
Simply using the regular S9 AutoSet with an appropriate (normal) minimum pressure and maximum pressure and looking at the SD card data will show clearly whether you have any Complex Sleep Apnea and how much (if any) of your AHI is attributable to clear airway events. Same thing if using it in CPAP mode at normal CPAP pressure, the data in the SD card will be able to show you what you need to know.
It will be totally unneccessary to lower the pressure or anything like that. The S9 AutoSet reports a breakdown showing Obstructive Apneas separately from Central Apneas separately from Unknown type Apneas, so it is immediately obvious how many of your apneas are clear airway apnea events. And the waveforms show when during the night each event occured, and its type (OA, CA, or Unknown), and what the pressure was during each event, and pretty much everything else you would want to know except Pulse rate and Oxygen Saturation levels (have to use separate Pulse-Ox for those).
I think I may be missing something, because you seem to strongly suspect you have Complex Sleep Apnea, yet I do not yet see in the data you have shared any basis for your concerns.
Can you explain for me what makes you suspect you have anything more than common Obstructive Sleep Apnea?
You certainly have at least Obstructive SA because the S8 AutoSet raises the pressure only in response to obstructive events.
Although the S8 AutoSet does not *report* a breakdown showing the number of obstructive events versus Unknown or Cental events, the S8 AutoSet and S9 AutoSet only raise the pressure when they classify an event as being obstructive in nature. I know this because I have Complex Sleep Apnea and for years I used an S8 AutoSet II with the special card reader and ResScan software sold me by my doctor, and the machine would often decline to raise the pressure in response to clusters of apnea events. With my S9 machine, I now can see that when this occurs these are clusters of what the S9 reports as being Central Apnea events. Looking at the high rate Flow waveforms in ResScan or SleepyHead, I can now see that I often have long periods of Periodic Breathing or Cheyne-Stokes Respiration. I have been working for 3 months on getting this diagnosed, getting an ASV Titration done and getting a new machine ordered, and I expect to receive an S9 VPAP Adapt machine soon.
By the way, I cannot imagine that if data from your new S9 AutoSet were to establish that you need the more expensive machine, that you would somehow get "stuck" with having to use the standard S9 AutoSet until the end of its expected 5-yr life. Undoubtedly, the standard S9 AutoSet could be returned for credit toward the more expensive unit.