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Vauto?? (duh) ASV...Ins.Co.'s AGAIN !)
#1
Vauto?? (duh) ASV...Ins.Co.'s AGAIN !)
Here I go again...... 2nd sleep study.. Bilevel titration 

Ins.Co. want to use the Vauto.. First, then see if I need ASV.  Oh-jeez


Here's my Sleep study results.....I have to admit not being home in my bed...caused alot of awake/arousals.

But even so... you'll see the BPAP didn't take care of the CA's after 2:30 am


https://imgur.com/vICagDi
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#2
RE: Vauto?? (duh) ASV...Ins.Co.'s AGAIN !)
https://imgur.com/5xZCycd

about 2:55 am the first central comes in. Second one 3:05 am... 3:15 the third one. 3:40 the fourth one. 3:55 the fifth one. 5:10 the 6th one. And 6:00 the 7th one.... all 10 seconds or more and on bilevel.

Those CA's should have been taken care of before the duration of time.. to be flagged?
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#3
RE: Vauto?? (duh) ASV...Ins.Co.'s AGAIN !)
The link failed, or I would help you repost it . CA events are consistently inconsistent, and the problem with titration studies is that when they try to get CA events, it is hit and miss. You may titrate great for over an hour at a particular pressure, yet it will make no sense in the overall sequence. The most useful information is the table that shows pressure, events, AHI, etc. This table should show the progression of the titration study and results. The graphs are not always our best information unless they also show the test condition. So the question is, what pressure (IPAP/EPAP) was recommende, and are the results linear with the pressure trials before and after? The ideal attachment would be a pdf file, not a photo or screenshot.
Sleeprider
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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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#4
RE: Vauto?? (duh) ASV...Ins.Co.'s AGAIN !)
it is a pdf file but I don't know how to load a PDF

https://dochub.com/milboltnut/6mO8oy7Kp7...-color-pdf


try that..... it opened for me
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#5
RE: Vauto?? (duh) ASV...Ins.Co.'s AGAIN !)
It's the same as any image. Use Reply, and select the file.  The only reason a PDF won't load is if it exceeds 1.0 MB.  You can separate pages or if you contact me by PM I can probably help you break it up.  PDF files are allowed as attachments. http://www.apneaboard.com/forums/Thread-...ttachments
Sleeprider
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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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#6
RE: Vauto?? (duh) ASV...Ins.Co.'s AGAIN !)
I'd prefer to see the full PDF file, but it looks like they took you through CPAP starting at 6.0 cm and at 10 CM started bilevel of 14/10 and moved to 15/11. You had a brief episode of CA events after being awake for quite a while. I would not be surprised if they call 14/10 good and set it there. You have pretty high arousal rate throughout the night, but did get some deeper sleep and low event rates near the end of the study at 15/11, and had a pretty good REM period at that pressure as well.
Sleeprider
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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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#7
RE: Vauto?? (duh) ASV...Ins.Co.'s AGAIN !)
so you saw the polysomnograph.... that's all I posted. You saw a colored polysomnograph correct?
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#8
RE: Vauto?? (duh) ASV...Ins.Co.'s AGAIN !)
(06-23-2020, 10:00 PM)Sleeprider Wrote: I'd prefer to see the full PDF file, but it looks like they took you through CPAP starting at 6.0 cm and at 10 CM started bilevel of 14/10 and moved to 15/11. You had a brief episode of CA events after being awake for quite a while. I would not be surprised if they call 14/10 good and set it there.  You have pretty high arousal rate throughout the night, but did get some deeper sleep and low event rates near the end of the study at 15/11, and had a pretty good REM period at that pressure as well.

I was telling my wife... I really didn't sleep well at the sleep center.. I felt really good afterwards considering. So I believe I will do well with the machine they ordered. I asked if they ordered the same machine they used in the sleep center. From what you saw.. do you think an ASV is necessary?
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#9
RE: Vauto?? (duh) ASV...Ins.Co.'s AGAIN !)
From what I saw, the AHI and RDI was not scored, and there is no time-scale, so it's a matter of interpretation.  The event rate during sleep looks high and sleep is very disrupted.  Since ASV was not tried, that question is not resolved in this test, but the event and arousal rate seems to be lower with bilevel. Note we discard parts of the est noted as waked (W).

[Image: p.jpeg?fv_content=true&size_mode=5]
Sleeprider
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____________________________________________
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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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#10
RE: Vauto?? (duh) ASV...Ins.Co.'s AGAIN !)
For myself, I could see in post 1 an Imgur showing a graph, but there's no doctor or technician write up, no charts or tables stating the results. I didn't see things like CA events were X, Hypopnea were X, etc. Most of the data that one should see from a detailed sleep study is missing. The PDF attempt later requires a password for access.

This is how I got to post my sleep studies to allow others to review and offer feedback: I scanned the pages on the printer we have connected to our home network, I began typing a post on my thread and gave a description, stating usage, settings, complaints, etc. Then at the bottom of the text window, I did the New Attachment feature by clicking Choose File. Choose file means I had to locate where the scanned document was saved on the PC. I pointed to that location. Then I can Add Attachment and Insert into the text box. I repeated that for however many pages my study contained.

OK, having all that out of the way, let's go on with an ASV, as it seems you want that to be considered. I am saying what follows without the data, as I've already mentioned that I can't see but little data so far. However, I will base what I say on my own experiences. Be aware that to get any insurance to pay for an ASV, you will have had to use a CPAP/APAP and then a BPAP, and fail both due to insufficient treatment of events or inability to gain restful sleep due to events, symptoms and documented complaints in your patient file. Likely both machines will accompany a sleep study, split with titration or as separate study appointments. Titrations may or may not be required. After that, and also successfully getting your doctor to consider testing for ASV, you would then do a sleep study with ASV. Right here is the only place I am aware any shortcut can be gained. Most paths to ASV will include an ST machine before ASV, but if you address this with the doctor that lots of CA exist, especially if these CA are pre-existing/predominant, you may successfully avoid the ST. If these are treatment emergent, I don't think an ASV will be considered by doc or insurance.

Just to put into perspective what I had to go through to get the ASV, here's the thumbnail sketch. I took sleep study 1 and titration 1. I was issued a REMStar CPAP and failed compliance as it was on 18 for pressure. Directions were "use it and you'll get better". My complaint was I had trouble exhaling with the mask on against the pressure. I failed compliance and quit PAP for a year while getting Bariatric Surgery to possibly avoid PAP. Weight loss was successful, but I still needed PAP. Sleep study and titration 2 with Respironics ScreamStation BPAP Auto in early 2017. Failed that in about a month total. As soon as I masked up, I felt sick. I had problems with it from first use. Later it was proven to be lots of CA. I had an urgent need visit with the pulmonary nurse to discuss feeling terrible due to the BPAP and also to discuss lots of pre-existing CA on the sleep study. She agreed ASV was needed and that started my path for it in spring 2017. Things were so bad, doc finally told me to quit using the BPAP. ASV sleep study and titration 3. I didn't get the ASV until about August '17. Now I've had a new ASV sleep study earlier this year as ASV and my COPD don't play well.

PS none of the above info is indicating you need an ASV, just how to get one if it's proven needed
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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