Plmnb's Never Ending OSA Journey (Data)

[Osiris357]

You still feel awful because even though you are 80% better you are still having one heck of a time inhaling. 

I still have flow limited breathing with low to no flow limitations also. On the flow rate chart the curve above the zero line is your inhale. It’s supposed to be a nice even curve. When there are flat spots and hooks that’s flow limited breathing and flow limitations.

When you receive your AirCurve after your bilevel titration those flat spots and hooks should turn into a gentle curve.

I would like to do the same but my AHI is way below 5 so I would have to convince my doc to write me a script and buy it online or if she won’t write it go through Craigslist or eBay for a used one. Either way I have to save some cash before doing anything because my insurance will never pay since my AHI is below 5. 

I hope that adds some clarity

[Plmnb]

You can't only look at percentages... you need to look at the raw numbers. Let's look at your last posted OSCAR chart which is the one above http://www.apneaboard.com/forums/attachm...?aid=18235

AHI 9.17, round to 9. 60/9 = 7 rounded.

You're suffering an event every seven minutes, obviously this is a significant improvement over without CPAP but still... being disturbed every seven minutes isn't exactly the path to good sleep.

Ok JoeyWallaby, thank you!  It is just so strange that I feel pretty much the same way with and without therapy.  I do know that it can take time for things to improve, and I know I can be very impatient, but I tried CPAP for over a year in the past as I have mentioned, I have had all kinds of surgery that was supposed to help, and I am still getting lousy sleep.  And now, my new husband is suffering from my situation.  Not a good way to start a marriage let me tell you.  Luckily, he is a wonderful man and he appears to be understanding of my situation...but he needs his sleep too!

Gotta go work on some charts per Sleeprider...bbs

[Plmnb]

You still feel awful because even though you are 80% better you are still having one heck of a time inhaling. 

I still have flow limited breathing with low to no flow limitations also. On the flow rate chart the curve above the zero line is your inhale. It’s supposed to be a nice even curve. When there are flat spots and hooks that’s flow limited breathing and flow limitations.

When you receive your AirCurve after your bilevel titration those flat spots and hooks should turn into a gentle curve.

I would like to do the same but my AHI is way below 5 so I would have to convince my doc to write me a script and buy it online or if she won’t write it go through Craigslist or eBay for a used one. Either way I have to save some cash before doing anything because my insurance will never pay since my AHI is below 5. 

I hope that adds some clarity

Thank you Osiris357 for providing clarity to my situation.

Over what period of time is the measurement of under or over 5 AHI calculated in order to be able to present request for Bipap to your insurance company?

Plmnb

[Plmnb]

Reviewing the past few pages, I'll start with the comment that regarding your sleep report. you have only 6 of 155 events that are central.  That is not central or complex apnea, so I think we can leave that concern behind.  Your untreated AHI is over 48 events per hour and your treated is less than 10, so you are 80% improved. You would be surprised how many doctors will try to persuade you that is "success".  Clearly there is plenty of room for improvement, but we have exhausted the options with CPAP and need to move forward with a more advanced therapy like BPAP, and better understand the source of obstruction from a medical or physical viewpoint.

In order to help your doctors better understand what is going on, let's gets some new images together.  In these images we are going to zoom into 2-minute segments of your sleep where the leak rate is low.  The objective is to contrast your flow-limited breathing (Flow Rate) vs times when flow limitation is much less. For example in your last posted chart, we can use the time from 5:30 to 5:32 as a period of low flow limitation. We can use 03:15 to 03:17 to illustrate your flow limitation.  Chart should include Events, Flow Rate, Pressure, Leak Rate, flow Limitation and Snore, in other words, just use the same chart organization.  Once you post this, I'll help you understand what we're looking at so you can discuss with your doctor.  We can then start looking for additional examples.  I'd like you to discuss these with your doctor ahead of the sleep test so can use these examples of what to look for in the respiratory flow trace during the test.

Is this what you wanted me to compile?:

[attachment=18242]

[Gideon]

I see comments above that say "My AHI is under 5 and therefore my insurance will never pay"
There are doctors that make the case for "Medical Necessity" which if successful will result in the insurance paying. THe issue here is finding a doctor that will understand the conditionand is willing to justify the treatment desired.

[Gideon]

PLMNB that chart is 20 minutes, 2 minutes will show the details of the breathing.

[Osiris357]

Over what period of time is the measurement of under or over 5 AHI calculated in order to be able to present request for Bipap to your insurance company?

Plmnb

I’m not sure if that’s a thing. But I do know that since it’s under 5, it’s actually 1.6 as of now, they will never pay for me being 100% comfortable. I am considered to be successfuly medically treated. Not that I’m not comfortable now. I would just like to see gentle waves throughout the night. 

I’m doing this because on my fathers side there has been a long history of heart problems and now that I know all this about sleep apnea I would bet my yearly salary that they all had sleep apnea because they all snored like lions. Both the men and women. 

Do I need to medically probably not at this point but I’d like to make sure since I have the ability to remove any and all flow limited breathing.

[Osiris357]

I see comments above that say "My AHI is under 5 and therefore my insurance will never pay"
There are doctors that make the case for "Medical Necessity" which if successful will result in the insurance paying.  THe issue here is finding a doctor that will understand the conditionand is willing to justify the treatment desired.

My last conversation with them was on November 5th and she was adamant that she sees no reason for bilevel. My next appointment is on the 3rd of January and I’m going to try to get her to understand why I feel I need to clear any and all flow limited breathing but I think she’s gonna be a tough nut to crack. If she does turn out to be difficult I could hunt for a doc who will but that may turn out to be more trouble than saving cash and buying a low hour used one. 

Thank you though Bonjour

[Sleeprider]

In order to help your doctors better understand what is going on, let's gets some new images together.  In these images we are going to zoom into 2-minute segments of your sleep where the leak rate is low.  The objective is to contrast your flow-limited breathing (Flow Rate) vs times when flow limitation is much less. For example in your last posted chart, we can use the time from 5:30 to 5:32 as a period of low flow limitation. We can use 03:15 to 03:17 to illustrate your flow limitation.  Chart should include Events, Flow Rate, Pressure, Leak Rate, flow Limitation and Snore, in other words, just use the same chart organization.  Once you post this, I'll help you understand what we're looking at so you can discuss with your doctor.  We can then start looking for additional examples.  I'd like you to discuss these with your doctor ahead of the sleep test so can use these examples of what to look for in the respiratory flow trace during the test.

Is this what you wanted me to compile?:

Close but not quite.  We want to zoom in to where we only see 2-minutes of therapy and we can clearly see each breath.  Here is an example:

[ApneaQuestions]

This may help you

1) Click on the events window at the start time you want to see
2) Hold left mouse button and slide the mouse to the right
3) The little yellow pop-up tells you how much time you are "grabbing"

In my attachment I grabbed 2 minutes and 4 seconds

You can do this on any graph (even if you've already zoomed in a bit)
So you can zoom in a little way and then zoom in some more.