My ASV sleep study was not any different than the BPAP version in how it was conducted. They did have a specific ASV tech to do overnight sleep study/titration.
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Updates on Central Apneas
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05-07-2018, 10:27 PM
RE: Updates on Central Apneas
Yes, LVEF test (heart echo imaging and cardio doc write-up) needed. The ASV sleep study? I say likely needed/expected. May be an insurance co. requirement to approve ASV.
My ASV sleep study was not any different than the BPAP version in how it was conducted. They did have a specific ASV tech to do overnight sleep study/titration.
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.
05-07-2018, 11:27 PM
RE: Updates on Central Apneas
(05-07-2018, 10:12 PM)KCFLY Wrote: So, from the sound of things, I need to get LVEF tested. I was surprised that my sleep doc did not require an Echocardiogram. I did ask. He said I showed zero issues with my heart and if I had a disqualifying LVEF that I wouldn't be able to walk from the house to the car without knowing it. Plus the study that serves as the reason for disallowing ASV in those cases was very deeply flawed and contradicted all the clinical data and other small studies that had come prior. The average patient in the Serve-HF was non-compliant in their usage of the device (only about 3 hours a night) using non-optimized machines and an algorithm that is no longer used. A new study is underway. I did need to do an ASV sleep study. Bill
05-08-2018, 07:27 AM
(This post was last modified: 05-08-2018, 08:48 AM by Sleeprider.)
RE: Updates on Central Apneas
I am really pleased to see Spy Car and S-Dave join this conversation. The voice of experience from those two is invaluable. In fact, I recommend clicking on Spy Car's profile and looking back at his older threads prior to ASV to see how he progressed through the difficulty of CPAP and Bilevel and the nuances of how he dealt with his medical team as well as input from the forum. It can seem like a lot, but it is useful first-hand information and verification that "mild sleep apnea" that remains unresolved with conventional treatment, can be so disruptive to life that the medical system can be persuaded to treat it.
I'm going to drop off the full recommended Resmed titration protocol for ASV. Note that health screening is now part of that. Follow the flow chart and notice that in the absence of any other indicators of heart problems, an echocardiogram is not required as was the case with Spy Car. The big takeaway is that with AutoASV you do not need a strict single-pressure prescription. In fact you're far better off without it.
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.
05-08-2018, 08:36 AM
RE: Updates on Central Apneas
IMO the only positive of the ASV sleep study and/or titration was insurance approval. Insurance requirements seem to vary on if these are required or not.
And thanks SR for including the ResMed charts. I forget to add those in. And FWIW I kinda key in on thread of others about ASV and centrals to try to pass on info that maybe their running the gauntlet would be less painful than my own was.
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.
05-08-2018, 11:15 AM
RE: Updates on Central Apneas
I don't know that my in-lab ASV study really told us anything that couldn't have been better established by using a loaner.
I barely slept during the study (I thought not at all), but they said it was just enough to show ASV worked. So I got approved. If that was a hurdle I need to jump, OK. One of the benefits of ASV for me has been a near-elimination of insomnia. Insomnia had been a serious issue for me. I realize xPAP machines are not anti-insomnia devices; however, I think breaking a pattern of fractured sleep has put my body back on track towards more refreshing sleep. Some nights have been unbelievable. The ASV also seems to help me drift off--with the exception of the initial period mentioned earlier, when I'd be all set up to enter dreamland and the machine would over-blow. But, in the main, I find the ASV helps to put me out (and to stay out). I was definitely doing poorly on APAP as time progressed (early benefits faded). My AHIs even in the latter stages were never that bad, but did start averaging over 5. But it wasn't about the numbers (except as "evidence") so much as I felt terrible. I'm glad I had a doctor who would listen. I also know my sleep clinic would not have acted without me pushing for a different solution. I would not have been in a position to push for a solution without the knowledge Sleepyhead software (thank you JediMark!) and the help from my Master (thank you Sleeprider!). Bill
05-08-2018, 02:12 PM
RE: Updates on Central Apneas
I too failed the BiPAP horribly and had to return for the ASV titration (insurance justification), which went very well and I was completely treated during the study and have been ever since.
RE: Updates on Central Apneas
My 5 nights on Bi-level were pure torture. I naively believed I might see improvement on the Bi-level and felt very proud of myself in arranging to start my (ordinarily) 3-day trial on a Wednesday so I got 2 extra days over the weekend.
Big mistake. But as my doctor said, the good news was it demonstrated beyond doubt that a standard Bi-level wasn't the answer. Not that the offered an alternative. I had to keep asking if there was a technology aimed squarely at treating mixed apneas, because--if so--I wanted to try that device. And I made a paper trail. Bill
05-08-2018, 05:03 PM
RE: Updates on Central Apneas
Wow, thanks to everyone for their input, sharing their experiences and suggestions on next steps. Very helpful.
I have already been through Spy Car's threads on getting ASV and will look for others. It sounds like I have another sleep study in my future. So exciting. I'm more than willing if that is the hoop insurance requires I jump through, just frustrated to waste the time and money. I have an appointment next week with my doc to go over the data in sleepyhead and talk about next steps (ASV Rx and sleep study)
05-08-2018, 05:18 PM
RE: Updates on Central Apneas
(05-08-2018, 11:15 AM)Spy Car Wrote: I don't know that my in-lab ASV study really told us anything that couldn't have been better established by using a loaner. I remember the "master/grasshopper" conversation, but I think roles are reversed now. It is probably fair to say that there are more successful ASV users today as a result of my input on this forum, and I find that satisfying.
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.
05-08-2018, 05:19 PM
RE: Updates on Central Apneas
(05-08-2018, 05:03 PM)KCFLY Wrote: Wow, thanks to everyone for their input, sharing their experiences and suggestions on next steps. Very helpful. I share and understand the frustration. I was fortunate that insurance paid for my study, but I do think it was a waste of resources. As others have suggested, keep emphasizing the truth that you do not feel well. Ask/insist on trying a device that is specifically designed to treat central, complex, and mixed apneas. Many of us have found that polite, but firm, resolve is what it takes to clear the last hurdles. Stay strong. Best, Bill |
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