events per night

[Sleeprider]

Medicare requires you to try and fail CPAP, Bilevel, and sometimes bilevel ST before getting the ASV you need. Understanding how this works, can help you expedite the process. It also may help to have a good talk with the doctor to be sure he is on track. If he is, he may assume you wouldn't understand, and has not discussed it. if he is not thinking ahead to ASV, he needs a punch in the arm. Here are some references. Pay attention to Central and complex apnea in these decision matrices for a bilevel sevice with backup rate (ASV) HCPCS Code E0471.
https://www.resmed.com/us/dam/documents/...F_RADs.pdf
https://www.resmed.com/us/dam/documents/...elines.pdf
https://www.resmed.com/us/en/blog/sleep-...erapy.html
https://www.cms.gov/Research-Statistics-...2-R10b.pdf

[Sleeprider]

I saw your comment regarding your health issues and pain meds after posting the above.  This certainly explains why you suffer from predominantly central apnea, and raises the urgency to move you to appropriate treatment.  With ASV Your pressures will be much lower, and pressure support will eliminate the central apnea and hypopnea.  If your doctor could just prescrine ASV Auto uning the default settings of EPAP min 4.0, EPAP max 15.0. and PS 3.0 to 15.0, you would probably have an AHI near zero.  I will post the titration protocol below.

This is how to change settings on the Vauto https://www.apneaboard.com/resmed-airsen...setup-info

[Kacie]

Sleepyrider,  So I took your advice last evening and changed the IPAP from 19 to 14. I was shocked this morning when I got up. My events per hour were only 5!! wow that's a big drop!  any other suggestions.  Wondering what will happen when the doctor and Medcare people see that I've been "playing" haha

[Gideon]

Post your nightly charts from SleepyHead as it will help us help you to tweak it in.

[Sleeprider]

Kacie, I can get your AHI lower, but I'd rather get you on the right machine for your condition and completely solve the problem. Before we solve this problem for your doctor, let's get you on the Resmed Aircurve 10 ASV. I am not a Sleepyrider, I am the Sleeprider; or you can call me Tom.

Fred wants a Sleepyhead chart, and that is a good idea, but you need a super secret new version. If you want to use Sleepyhead, follow this link.http://www.apneaboard.com/forums/Thread-Sleepyhead-Version-1-1-0-TESTING-Beta

[Kacie]

    [attachment=9150][attachment=9150]Tom,

I have a call into my doctor and I'm waiting to hear back.  Here are last nights charts. If you need others please let me know.  Thank you again!!

[Kacie]

i, Just a update..  still waiting to hear from Doctor after I sent a demanding letter about the ASV machine.  here are the last few night screen shots. Thanks!!

[Sleeprider]

No changes, you still need ASV. If you want to further cut centrals in the meantime try pressure at 11/9.0 rather than 14/11.

[Kacie]

Thank you Tom, I'll make those changes tonight!

[SarcasticDave94]

IMO do what Sleeprider said. Get with the Doc and find out when you're starting the ASV path. It needs to be ASAP. And, yes, if you continue use of a BPAP, you can actually make yourself worse for usage. That situation applied to me a bit over a year ago. Get up, make the call and appointment, and let's get this device trade going.

Best to success, and keep us updated.