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[Diagnosis] CameronK- BiPAP ST Help
#1
Question 
CameronK- BiPAP ST Help
Hello, I am right in the middle of my long sleep study journey with various results and treatments, and I was wondering if anyone would be willing to look over my info and give me their guidance or opinion.

In July 2020, I completed a sleep study and was diagnosed with mild to moderate obstructive sleep apnea and was prescribed a ProSomnus MAD device. Here are the results from that study:

Code:
https://docs.google.com/document/d/1e2_rYebh-rFtxZpo6S8j8ZgcMgBSZrjozc8jVWNNlt8


The MAD has helped me sleep a great deal with the side effect of negatively affecting my jaw positioning. I decided I wanted to either stop using the ProSomnus or use it as a back up method, so I asked my neurologist about the possibility of treating my sleep apnea with a CPAP. We did a home sleep study in late 2023 with these results: 

Code:
https://docs.google.com/document/d/18uCFMjFOTUB6bZc0OLnTMQ09md0vFj5ZETavGkQKGWs


After that study, I was prescribed an AirCurve 11 CPAP and was hoping my journey was over! But from the very beginning I could tell this may not be the right therapy for me. The CPAP pressure always seemed too strong to breath against as I exhaled and would cause me to swallow air. 

The discussion then switched to BIPAP therapy and we did another sleep study. Unfortunately I had a hard time sleeping during this study, but they were able to test CPAP therapy on me and determined that all of my apneas were Central in nature. Here is a link to that study:

Code:
https://docs.google.com/document/d/1z3wCjYAT7WP7SxfICT9pU-Mi8pPkM0EdNEE8vfyjg8c


This was surprising to me because neither the 2020 or 2023 study showed signs of Central apnea and lead me to question if the central apenas were caused by the CPAP therapy itself. This may be related, but I do have an issue where I cannot breath in if there is a pressure of air in my face. For example, if I were to stick my head out of a car window from a moving car, I can’t easily breath in and will inadvertently swallow instead of breathing.

To follow up on that study and to test out BIPAP therapy, we did another sleep study with these results:

Code:
https://docs.google.com/document/d/1rwPtn3hm_OZ-hxHM5ranRpcwBOERskB2DpVjE5qJrAg


During this study, I remember tolerating the therapy well, except for the Timed portion where I was awakened by it and basically waited for it to end so I could fall asleep again. I don't feel like I would tolerate that well if I had to deal with it every night.


Based on all of this, does it seem like a BIPAP ST machine is right for me?

I am concerned that I will attempt treatment with this machine, only to have to return it and move to ASV or similar and would I would like to get this right as much as possible. I am supposed to take home an AirCurve 10 ST on Monday and wanted to talk this through before I do so. Thank you big time for anyone that would like to look this over   Thanks
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#2
RE: Is BIPAP ST right for me? (Studies included)
It seems to me you lucked out with a good PSG tech. They did a thorough analysis and made what seem to be sound recommendations. I do not see anything that would suggest questioning their judgement. 

Whether it will work or not you will not know until you try it. According to the study it worked well, so I would expect it to do the same when you have it at home. It is worth a go.

Try it as they configure it and post some OSCAR charts. Folks here can help from there if needed.
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#3
RE: Is BIPAP ST right for me? (Studies included)
If all you're trying to treat is Central Apnea, then ST is not correct. This is the old school treatment for CA, which had been replaced by ASV. So now ASV is the best answer for CA treatment.

ST always has been for patients with lung disease, but some with CA might be treated acceptably but not great.

So to answer the question, the better Central Apnea treatment is ResMed AirCurve 10 ASV not ST. Same medical codes apply for both machines, maybe it'll just need a discussion with the doctor to edit the script to ASV.
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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#4
Question 
Looking for advice on ST therapy, OSCAR included
I'm a little over 2 weeks into using a Bi-level machine, and I am looking for some advice. While I was initially diagnosed with moderate obstructive sleep apnea in 2020, subsequent sleep studies have shown central apneas. I have one other post in this forum with all of my sleep studies attached there if that helps.

I was prescribed an AirCurve ST. After reading some threads here, I am unsure if this is the appropriate machine for me as I have no pulmonary conditions. The sleep technician simply used ST therapy on me, it worked, and therefore is the machine insurance will cover. 

But before I invest in this or another machine, I really want to make sure it is the best one to treat me. An extra gripe I have is my DME gave me a machine with 1,300 hours after I was told it was new.

I am contemplating just paying out of pocket if that is what it takes to get an appropriate therapy without having to do another tritiation study, which would likely take months. 

Thanks for any advice and help. I attached screenshots of OSCAR data from the last few nights.

I also attached one screenshot where I tried S mode one of the nights. 

Please let me know if I need to expand on any of the data and I will reply with it here.


               
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#5
RE: CameronK- BiPAP ST Help
CameronK - Your 2 threads were related to your therapy. For this reason, I have merged them. This provides the reader a history of your past settings and results. Having the ability to see past attempts and their results will help to form better recommendations. Please use this thread for all your therapy related posts. I have changed the thread title to, "CameronK- BiPAP ST Help" to be more inclusive.
- Red
Crimson Nape
Apnea Board Moderator
www.ApneaBoard.com
___________________________________
Useful Links -or- When All Else Fails:
The Guide to Understanding OSCAR
OSCAR Chart Organization
Attaching Images and Files on Apnea Board
Apnea Helpful Tips

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: CameronK- BiPAP ST Help
While the numbers look OK, ST is still not the correct choice as a Central Apnea treatment machine. You're already not happy about being given a machine with 1,300 hours on it, you should also be upset the medical team that's supposed to be supporting you want to treat Central Apnea with an old, dumb technology when better and newer is available for the same script codes.

The 2 reasons I know why ST can even seem to give therapy for CA, 1) backup rates, 2) timing. ASV will do similar but you can't program most things manually, however ASV has a backup rate

Tell your doctor you don't want a device that treats pulmonary disease you don't have. Demand the ResMed AirCurve 10 ASV. ResMed states this ASV is the Central Apnea treatment device, period full stop.

Tell this doctor to get with the 21st century and get the ASV.

This quote is from ResMed

"AirCurve 10 ASV
Leveraging adaptive servo-ventilation (ASV) to target a patient’s recent minute ventilation, the AirCurve™ 10 ASV offers truly personalized therapy for obstructive sleep apnea (OSA), central and/or mixed apneas and periodic breathing. Auto-adjusting pressure support is designed to treat central breathing disorders, while auto-adjusting EPAP is suitable for upper airway obstruction."
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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