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Still Having Centrals—even on APAP (Graphs Included)
#11
RE: Still Having Centrals—even on APAP (Graphs Included)
We still want to limit the pressure changes your CPAP delivers. You can stay in Autoset mode and limit pressure by changing the maximum pressure to 5.0 and turning off EPR. This will probably significantly reduce events, but you will need ASV to be treated. Do take the time to read about that therapy in the document I linked earlier.
Sleeprider
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#12
RE: Still Having Centrals—even on APAP (Graphs Included)
(11-09-2021, 09:14 PM)SarcasticDave94 Wrote: Central Apnea will be consistently inconsistent, expect it.

Have you gotten the actual diagnostic and/or full, detailed Titration copies yet?

It can be helpful to see the write-up, etc. This is not to dispute ASV necessity.

I would begin a sleep therapy diary, depicting the failed therapy on the CPAP, your ongoing fatigue, other symptoms and complaints regarding your Apnea therapy. This is ammo for obtaining an ASV.

I have not gotten actual detailed information (just a one page “here is what we found and here is what we recommend” type of thing)…it was an at-home sleep study, not an in-lab study, so I’m not 100% sure how much info they have from those machines.

I have started a sleep diary to make sure I have those important details written down to help with obtaining an ASV.

(11-09-2021, 09:57 PM)Sleeprider Wrote: We still want to limit the pressure changes your CPAP delivers. You can stay in Autoset mode and limit pressure by changing the maximum pressure to 5.0 and turning off EPR. This will probably significantly reduce events, but you will need ASV to be treated. Do take the time to read about that therapy in the document I linked earlier.

Thanks again, Sleeprider!  Just changed my setting to your recommendation and will give that a shot.

And I’ll definitely pursue the ASV avenue as quick as I can.
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#13
RE: Still Having Centrals—even on APAP (Graphs Included)
Things to remember.
CPAP, APAP, and BiLevel without a backup rate cannot treat Central Apnea.  They actually are designed to do nothing when a central apnea occurs.  We do perform actions to avoid centrals such as reducing EPR which has a side effect of possibly increasing obstructive events.  An ASV works by maintaing theinute vent rate by increasing flow on the very breath that decreases the minute vent do to a central event happening.

As Dave said centrals are consistently inconsistent. In other words the CAI can bounce all over the place for no obvious reason.
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#14
RE: Still Having Centrals—even on APAP (Graphs Included)
OK, well an at home study can report a reasonably accurate Central story if there was an effort belt present. Did you wear a wide Velcro belt over your chest for your at home diagnosic sleep test? Yes, then your info is accurate on the CA. No, then you will want to followup with getting a lab diagnosic.

I would call ASAP and request a full report. If they balk, remind them HIPAA law permits you to request and receive it. You may need to sign a release form and/or pay for the printing supplies.
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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#15
RE: Still Having Centrals—even on APAP (Graphs Included)
For insurance approval of ASV you will probably be required to undergo full polysomnography (PSG) diagnostic testing. This raises a really good question, how good is your is your insurance? You might find self-funding ASV to be faster, easier and cheaper if you have significant deductibles or copay.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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#16
RE: Still Having Centrals—even on APAP (Graphs Included)
Good point there on insurance. You might be much better at self funding if at all possible. I know first hand how insurance dictates withholding the correct therapy device by their rules and regulations.

I can only encourage you to self fund if you can. Attempting to play the insurance games can delay therapy.

Best to your success, and we'll try to assist however we can to inform and guide.
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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