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treatment emergent CSA
#1
I was diagnosed with treatment emergent CSA (TE CSA) during my split-night study. Although my physician would like to do another sleep study to see whether the central apneas can be controlled with BPAP or whether I will need ASV, my health insurance (BC/BS) requires that I try BPAP for a month before going back for another sleep study. They are doing this to save money because: 1) ASV machines are more expensive the BPAP machines; 2) there are some studies that suggest that TE CSA resolves over time with BPAP. However, there have now been two good randomized trials demonstrating that ASV is a better treatment for TE CSA than ordinary PAP.

I'm curious whether anyone else has faced this issue with their insurance company, and, if so, how they dealt with it. Did you succeed in getting your insurance company to pay for ASV after diagnosis of TE CSA (and demonstration of ASV effectiveness) or did they require that you "fail" BPAP before authorizing payment for ASV?

Thanks in advance
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#2
Hi welcome js62,

It seems the system requires one to fail at one before trying the next but as far as insurance and ASV ,lots just don't cover it, period. As in my case.
Best of luck.
3
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#3
(08-12-2015, 08:40 PM)js62 Wrote: I was diagnosed with treatment emergent CSA (TE CSA) during my split-night study. Although my physician would like to do another sleep study to see whether the central apneas can be controlled with BPAP or whether I will need ASV, my health insurance (BC/BS) requires that I try BPAP for a month before going back for another sleep study. They are doing this to save money because: 1) ASV machines are more expensive the BPAP machines; 2) there are some studies that suggest that TE CSA resolves over time with BPAP. However, there have now been two good randomized trials demonstrating that ASV is a better treatment for TE CSA than ordinary PAP.

I'm curious whether anyone else has faced this issue with their insurance company, and, if so, how they dealt with it. Did you succeed in getting your insurance company to pay for ASV after diagnosis of TE CSA (and demonstration of ASV effectiveness) or did they require that you "fail" BPAP before authorizing payment for ASV?

Thanks in advance

Hi js62. I developed CSA too to the point where I was getting many more Central apnea than Obstructives. I have good insurance. My new doc (a new one is often helpful, very helpful) required me to take another sleep test to prove that I had CSA. Then I had to take an ASV Titration sleepover to determine what pressure setting(s) I would need the ASV to be set at. The best ASV imho is made by ResMed. I got mine last year. It was the model S9 VPAP Adapt. It IMMEDIATELY brought my AHI down from an average 14 to about 1.0 ! And many others I've read about have had the same or similar great experiences. So I would go after an ASV, preferably ResMed's. I hear that Respironics has one just as good. Any further questions? All the best, --Papit
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#4
There seem to be so many things that can immerge using these machines, CA's, insomnia, fragmented sleep. Trying to find any help in the medical field is very difficult.

For myself I have been through two sessions of CPAP, bought myself a ResMed S9 VPAP Adapt, AHI down from 20 to 0-1 most nights. Played with a BiPap for 5 nights just last week, it was horrible, back on ASV now.

This sleep stuff can get difficult. I had a sleep study and titration, showed few CA's. But something clearly happens when on the machine. Only the ASV cleans up my breathing while asleep.

At least you have a sleep doc and study that shows the CA's...I would try the BiPAP, they will see within a few nights if the BiPAP will work for you. These are the medical hoops that are out there...personally I just have gone my own way as the medical system cannot help with my sleep issues.

As Papit wrote, the effect of ASV was immediate, as it was/is with me.. It is worth going through the hoops to get official help.

Good luck....

Storywizard
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#5
Dear Storywizard,
Thanks for sharing your success with ASV. I'm sorry that you have had difficulty with the medical system. I am finding the medical system to be helpful but insurance to be a nightmare. Your experience with ASV matches what the research literature says--that ASV is the best treatment for treatment emergent CSA. I'm now scheduled for a repeat sleep study to assess BiPAP with backup and ASV (and then I will need to do battle with my insurance company to get them to cover the cost of the 2nd sleep study).

Jeffrey
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