[Treatment] Still Tired, Trying to treat Symptoms

[novanoe]

If I were to pursue an ASV it would have to be through insurance because as a college student I see no way of self funding my treatment. That being said I also don't just want to bandage the problem and hope for the best because I've been doing that up until now and have continuously felt tired and have fallen asleep in class which is not great. A long term solution would be great cause I don't want to continue feeling tired and feeling like I need to sleep during the day. Having read through the wiki page, if the H's are central then most nights where my AHI is above 5 it is solely because of CA and H, and those are above the 50% of total events. What Would I need to do in order to start the process? Cause I'm honestly feeling like every day I need to sleep more and more and it's not making me feel better.

[SarcasticDave94]

Potentially a similar path to mine in 2017 then I'd think where you'll need to get a doc to see CA and listen to you that these are a serious hindrance to being well rested. It's going to sound a lot like a homework assignment, but notation on the symptoms and complaints, of PAP therapy failure, and failure to recognize and treat Central Apnea. That report is important as well. It shows CA as a problem, but they're not treatable via CPAP. There's a PDF where ResMed states ASV treats CA. If I find it, I'll post it. You'll need to complain until the doc is tired of hearing it. If this doc won't listen, either consult with another of your docs or fire the one you've been working with on Apnea and get a new one that sees and treats CA.

See page 28 ASV.

https://www.google.com/url?sa=t&source=w...wM0GgxbJIN

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[novanoe]

Should I reset my pressure settings to what they originally placed them at, 6-9? Cause I'll tell you now I moved that up after a week back to 7 cause I kept waking up in the middle of the night feeling out of breath. Writing down symptoms isn't going to be that hard, I wake up some days with a massive headache, can't focus on school and sometimes fall asleep in class. There's more than those but those are the bigger issues right now. Thank you so much for the help!

[SarcasticDave94]

Quite welcome.

If the settings that you've changed are helping, I'd leave them. Note what and why you changed for doc. FWIW changes you did are legal in case someone tries to say otherwise.

Take a look at my post above #22 I've added a PDF.

http://www.apneaboard.com/forums/Thread-...#pid384986

[novanoe]

Just out of curiosity, and since you are better at reading the charts than I am, I was looking at the few OA's I had last night and the CA's and I noticed that one OA looks a lot like the CA that happened a bit before it, I attached them, do you know why the look so similar but are marked differently? Or is it just poor interpretation from my dreamstation, on those events?

[SarcasticDave94]

I'll let it to the better OSCAR readers, I've not mastered that to be honest. There can be patterns that will help differentiate between Central and Obstructive.

Even so, do whatever you need in order to try to rest as best as possible. Us AB members will help give you as much ammo to fight to get the best Apnea treatment and the correct machine that's needed.

[Dormeo]

Now that Sleeprider has identified that H as central, I'm on board with pursuit of an ASV.

Meanwhile, to follow up on Sleeprider's suggestions, try setting your min = max = something comfortable, and turn off flex. I would suggest trying 7, so you won't feel difficulties exhaling without the flex. But 7.5 would be fine too; whatever is comfortable for you.

Any chance you could swap out your PR machine for a ResMed Airsense 10 Autoset? (Or same, in the "For Her" version?) The quest for an ASV may take a while, and Sleeprider thinks you may do somewhat better with the ResMed machine.

When you have the time, you might post zoomed in shots of a couple more Hs. Before you do that, could you make a few changes to the flow rate graph? (You make them by right-clicking on the graph label.) First, add a dotted line at the 0 rate. Then change the y-axis to +/- 65. You'll cut off the very highest and lowest bits, but that's OK and it'll be easier to see what's going on.

[novanoe]

Here's some more H's from that same night since I haven't gotten a chance to upload last night's data. I don't think it would be possible for me to swap my machine out, I've only had it for about a year, I'm on the low income state insurance plan, so I'm not too sure they would want to cover it. Anyhow, last night I went down to 6.5 kept 9 but forgot to turn off flex, from looking at dreammapper, it gave better numbers, 12 CA, 1 OA, 9 H, 2.9 AHI, but I felt exhausted, I fell asleep in the car while getting driven to and from errands, something that usually doesn't happen on 15-20 min car trips.

[Sleeprider]

What is your flex setting? I see a rebound out of exhale that suggests it is set to a high value like 3.

[SarcasticDave94]

Just as info, in '17 I was still appealing a social security disability case, was on welfare insurance United Healthcare, a Medicaid based health insurance. Spring '17 they were covering DreamStation BPAP, sleep study, titration then I made doc recognize CA, returned the BPAP, and then an ASV based sleep study and coverage of ASV fall of '17. Point is if doc changes diagnosis and scripts a different machine, yes it should be covered via insurance. Maybe call insurance customer service and ask.

We'll help whatever you decide but I felt I should give you the insurance info.