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[Pressure] Help for a newbie: titration failed
#11
RE: Help for a newbie: titration failed
Even if it's a bilevel only test, it'll show stats that are identifiable regarding the CA tendencies or lack of it. Remember that CA are consistently inconsistent; they will be high one night and low the next. So the stats also depends on which night the test is done so to speak on what the CA will show. Even so, there should be tendencies seen and may be exploited.

Homework ought to be contact with insurance customer service to not only get a list of DMEs to window shop but also doctors too if you're shopping for someone better. BTW even a dentist or primary doc can script a CPAP, BPAP, ASV. It does not need to be a pulmonary or sleep doc.

Start new with one of each. Part of the criteria I use for the DME is do they have the brand of machines I want. It also must be an in-network business/office, this actually needs to apply both to a DME and doc. In-network enhances likelihood of better rates and that the insurance will pay a greater portion according to your insurance policy. Sometimes this can make or break coverage period. Consider any/all insurances that cover medical equipment and doc visits.

Keep the questions coming. We'll have something for an answer.
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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#12
RE: Help for a newbie: titration failed
I had to go through 4 sleep studies, 4 face to face doctor meetings, before the fourth machine was an ASV. Then the DME issued me an outdated machine. But darned if I knew. Insurance paid for it all, but it sure took time, and tried my patience. And the DME took one look at me and knew they could take advantage of my lack of knowledge and gave me a Phillips System One, not even a Dreamstation -- that was 2.5 years ago. I just dumped them for a different DME and got a ResMed. I am in love with this website. The Phillips AHI average was 3.5 -- so far, one week in, the ResMed AHI is 0.8. The quality difference is noticeable. With the old DME, my Doctor said she would contact them and have them lower the pressure on my machine. I never heard from them. I found out later that the machine was too outdated for them to remotely make changes to the settings. No one bothered to call me and tell me how I could manually do it. It's a zoo out there.
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#13
RE: Help for a newbie: titration failed
I'll jump on the bandwagon.  You are heading in the right direction.

IMHO whatever machine you get, make sure it is a ResMed

Will you fail BiLevel Titration?  Most likely.  They will probably set PS at a fixed 4 cmw and leave it there and from there just periodically increase the pressure just like they did with CPAP.  ASV will likely be in auto mode and will likely succeed with a very low AHI.
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#14
RE: Help for a newbie: titration failed
Good luck your making progress as frustrating as it seems
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#15
RE: Help for a newbie: titration failed
What's the difference between hypopnea and flow limitation?
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#16
RE: Help for a newbie: titration failed
Flow Limitation is milder and is not timed.
Gideon - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter

Download OSCAR
New to Apnea? Helpful tips to ensure success
Soft Cervical Collar
Mask Primer
Dealing with a DME
Organize Charts
Optimizing Therapy
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#17
RE: Help for a newbie: titration failed
I wasn't the least bit nervous for my first sleep study, but now that I know what's coming (bilevel titration in 3 days), I'm a wreck. The mask was SO painful. They put a medium on me, but I printed a measuring template from the Fisher and Paykel website today, and it turns out a small would have been a better choice. They probably don't have smalls. I didn't mind the wires so much, but trying to sleep with the pulse ox squeezing my finger was awful. And knowing that the pressure that woke me up was just the tip of the iceberg...oof! I don't have a question, I just wanted to vent to someone who will understand.
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#18
RE: Help for a newbie: titration failed
This test is for bilevel PAP. Based on your original test results, and assuming this one will not move to ASV, you have nothing to worry about. You will fail to show efficacy, and this will be a repeat of the first test. Ask your doctor for a sleep aid to help make it tolerable.
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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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#19
RE: Help for a newbie: titration failed
Which F&P mask have you tried out? I have both the full face Vitera and the slightly older Simplus. If you've not done so, consider the Vitera.

On sleep aids, I was given Ambien on the last study a month or so ago.
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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#20
RE: Help for a newbie: titration failed
It's a Simplus. They gave me zero choice of mask last time (well, they offered nasal pillows, which I couldn't stand.)

Given that I'm still waiting for my PCP to put in the order she told me she would two days ago, I think getting a script for Ambien by tomorrow is a no-go.
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