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BIPAP making my CSA worse
#11
RE: BIPAP making my CSA worse
Tell your therapist to get the ASV on order. Alternatively, we have seen members source ASV from an online vendor when the DME provider claimed a long delay, and get insurance coverage. Get the prescription first, then get your DME provider working to fulfill, while letting insurance know that they are unable to timely provide the machine. They will likely allow reimbursement as an out-of-network provider with a higher deductible or copay; however you will get the therapy you clearly need.

Leaks are not a problem in your last graph. We can see the artifacts of central apnea throughout the flow chart, even where events are not scored from 02:30 until end of session. Lots of periodic breathing. You need ASV. Get the script because this is all just time wasted on the wrong therapy. The Aircurve 10 Vauto cannot trigger pressure support to mitigate central apnea or periodic breathing. Your doctor has a responsibility to you to make an accurate diagnosis and prescribe the right device.
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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#12
RE: BIPAP making my CSA worse
I'll keep pushing them. Do you have a normal oscar chart? and/or one with asv correction I can see for comparison?
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#13
RE: BIPAP making my CSA worse
There are many people on this forum using ASV with great results.
Start with our wiki: http://www.apneaboard.com/wiki/index.php...tion_(ASV)
Read this recent thread about "Zeoce;s Therapy Thread" where a new user with central apnea was improperly prescribed CPAP, but purchased ASV and achieved success. http://www.apneaboard.com/forums/Thread-...apy-Thread

This could be you! Same diagnosis, same improper treatment and your future with ASV.
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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#14
RE: BIPAP making my CSA worse
Well I hope it'll work. talking with my doc tomorrow, anything I should ask specifically? I stumbled my other meeting and didnt get much info.

Looking at one of my apneas, 37 seconds, seems quite concerning

https://i.imgur.com/v5IOThR.png
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#15
RE: BIPAP making my CSA worse
All I can think of to do is to push for ASV titration or a prescription to trial ASV. There really is no point to titration because ASV is so automated, but insurance generally requires it. Review your diagnosis and ensure it reflect your sleep disordered breathing is central not obstructive, and be sure the record repeats the recommendation to move to ASV. with a time-line for obtaining the needed titration study or any other background workup.
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: BIPAP making my CSA worse
It seems my doctor wont progress me because I cant 'comply' with 4+ hours of sleep on regular bipap, I still havent made it an hour. I tried it in the afternoon the other day to get re-acclimated again, for over an hour and then again later another hour and now have had sharp chest pain for a few days, it's about 50% better every day, but wow it was initially quite painful, why did this happen? I asked the doctor to which the nurse responded 'you need to be transported to the ER' which seems like a ridiculous response
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#17
RE: BIPAP making my CSA worse
We have asked you for data which would give us a chance to help you. The image below is all we have to work from.  this is a 1:45 duration session, where we can see fixed pressure from nearly 2-months ago.  Your therapy was not effective, however it is your responsibility to "try", and that means using the machine at least 4-hours per night for 21 days in a month.  You clearly need to try harder.  I know I recommended that you push for ASV, and that has not changed, but we should have emphasized that if you don't use the machine and do your part, insurance will shut you down as simply "noncompliant:.  There has to be enough machine use to demonstrate that in spite of your best efforts,  you cannot achieve efficacy.  We suggested setting trigger sensitivity to high or very-high.  Did you do that? What were the results?   

There are a lot of things we can suggest to get the therapy you need, but if you want insurance to pick up the cost, you must use the machine and give them a reason to conclude the machine and therapy is a problem, not your attitude and lack of effort.  I know that's harsh, and I suspect the machine is not comfortable for you or at least not rewarding, but you have to fail bilevel for medical reasons, not just refuse to use it.

[Image: wsZXSYK.png]
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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#18
RE: BIPAP making my CSA worse
no matter what I do I just cant sleep while on it. tried taping my mouth shut, still ends up open. with mask, I end up not sleeping at all, or out of breath, waking up. Do I have to start popping ambien?
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#19
RE: BIPAP making my CSA worse
Have you considered requesting a full-face mask? The leaks were no a problem in the only graph we saw, but if you can't stop mouth leaks, the answer is not to quit but to let your DME or doctor know that nasal therapy does not seem to be an option. I know it's not a home-run like ASV, but you have to walk before you can run. Ambian is for armatures. I was experincing a severe cough and even experienced a cough syncope a couple nights ago. The prescribed codeine cough medicine was amazing for sleep.
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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#20
RE: BIPAP making my CSA worse
I got the mask from my sleep study, but its too claustrophobic for me, dont have access to the mask right now, only nasal as I'm way out of town.
I did try setting it to high, didnt notice a difference. After that chest pain, just from using it while awake, I've been apprehensive to try again.

daytime attempts
https://i.imgur.com/xF43cNR.jpg
https://i.imgur.com/psey87x.jpg


probably one of the multiple times my mouth goes open and it blows directly out my mouth
https://i.imgur.com/asBguvi.jpg


another
https://i.imgur.com/URqrVq8.jpg

2hours, dont know if I was sleeping much though
https://i.imgur.com/JZM3YEr.jpg

https://i.imgur.com/Aj294IB.jpg
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