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[split] Data analysis - Breath55
#11
RE: [split] Data analysis - Breath55
looks like the mods split out your own thread here so nothing more for you to do there. I deleted the suggestion in my earlier post since it's no longer relevant. don't let my relatively uninformed assumptions deter you from learning more about the cpap alternative, especially if it really is intended to address central apnea. if it works, I might check it out too. meanwhile, if you have a significant central component that's not treatment emergent / pressure induced (which tends to dissipate in time), asv is the machine for that and it's depressingly commonplace that even folks that clearly need it have to fight for it.
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#12
RE: [split] Data analysis - Breath55
This thread is a fine thread for you to continue in.
Change your EPR to 1
EPR = 1 Then post your nightly charts again. If you have CSR again post a 10 minute zoomed view so we can verify what is going on.

This will tell us a lot.
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#13
RE: [split] Data analysis - Breath55
Thanks for the input and an currently working on getting a new machine and there has been another titrations' study ordered just waiting for the rest of the paperwork to make its rounds. They turned the cpap into an apap and now not sure where to go. So ordered more tests. 

I hope I have removed the right stuff. I wasn't thinking last time, thanks for taking it down.




.pdf   sleepreport xout.pdf (Size: 587.29 KB / Downloads: 21)
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#14
RE: [split] Data analysis - Breath55
Breath, your diagnostic sleep study shows a clear diagnosis of severe central sleep apnea. You need an ASV machine, and I would specifically like to see you have a Resmed Aircurve 10 ASV. You need to call your doctor's office and find out what your path to ASV is. You will need a titration for ASV to demonstrate efficacy and probably will need to do cardiology screening for ejection fraction.

With this diagnosis, CPAP is inappropriate and will not work. Please call the doctor's office to get on the right machine. If you have an affordability issue or poor insurance, let us know and we can help you find less expensive options to buy. Your sleep or primary doctor or frankly any doctor can write a prescription for ASV from the diagnostic study you posted. While I know what Bonjour is trying to do with cutting EPR and keeping CPAP pressure steady, I think CPAP is a waste of your time. You will likely reduce your AHI from your study AHI of 46 per hour, it won't be good enough to be considered efficacy. Anything other than ASV is simply a stop-gap measure for you, and you need to call the doc and get this rolling.
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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#15
RE: [split] Data analysis - Breath55
FWIW Sleepriders description is what I expect to be able to conclude after overnight results. Now that I have read your sleep study, there is one and only one conclusion to make. That is an ASV and preferably the ResMed ASV. NO other machine is designed to treat this, only an ASV.

I would call RIGHT NOW.
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#16
RE: [split] Data analysis - Breath55
Yeah, it seemed kind of strange to me too, but I was also new to having insurance I thought that was the way things went till something got worked out so I just flowed along mostly just grateful that I now had insurance. Saw seven different doctors my first year there and each one I had to try and tell all over what was going on with the sleep apnea at which time I had no report of my sleep study and had no idea how bad it was and I can remember the doctors just glaceing over the information and basically it remaining in limbo. Though after awhile I was issued a cpap machine. Later I was told I had the wrong machine and that's why my neaps where getting worse, so I was given an apap. Now after problems with it a tit-ration study has been ordered I guess to find out just what kind of machine may help me. At the time that I had the wrong machine but no one seemed assured about any of it and there were other health issues being dealt with, none as major as that at the time though no one seemed to notice. So that just got put off to the side, When i did see the doctor its usually for two to five moments and I generally leave more confused than when I come in. I'm just now starting to understand that this is going to be an issues that I have to be more proactive about, and these online forms seem very helpful. The older I get the more problems the SleepApnea is causing me, more headaches in the morning more fatigue, troubles focusing on most anything for long periods and just waking up feeling like I've been running a marathon all night, waking in a dense fog. Thanks for the help!
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#17
RE: [split] Data analysis - Breath55
Talk to the doctor and decline any study that does not incorporate ASV evaluation! Do not accept any study for CPAP or BiPAP titration. You must insist the order include ASV. Just learn to say NO. There is a clear and obvious answer, and you can find someone that practices medicine without quacking like a duck. Keep calling and find a specialist that will accept a central apnea patient, and don't accept anything less. ASV will solve your problems immediately.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
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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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#18
RE: [split] Data analysis - Breath55
In your discussion with your doctor, it pays to have a couple of points in the back of your mind:
  1. Most doctors have been trained to believe that central sleep apnea is very rare (it's not) so they don't really know what to do.
  2. It is rare to have such a clear-cut case of CSA as you have - usually there is obstructive and central apnea mixed up together. Yours is 100% central, which should make the course of action very clear.
  3. Most doctors don't seem comfortable prescribing the higher-end machines as there are too many variables. The Resmed Aircurve 10 ASV has the simplest setup of all the high-end machines with most of the fine tuning done by the machine itself on the fly.
  4. Most people will agree the Resmed machine is far superior to the equivalent Philips Respironics.
  5. There was a large study done which indicated that patients on ASV machines had a higher death rate than those not on the machine. This study Serv-F (if I remember rightly) has been pretty much discredited. However your doc may require you to have a heart health check before going to an ASV - this is a sensible precaution.
  6. American insurance companies would rather pay out multiple thousands of dollars for sleep studies and intermediate-level machines rather than going straight to ASV. Yes, ASV machines are expensive, but not as so expensive as to justify the waste on sleep studies. However you will probably need to have an ASV titration study.
  7. If you do have a titration study, insist that it is performed with an ASV setting. Often we see studies where they have messed about with various bilevel machines and never got to try the ASV. Waste of time and money.
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#19
RE: [split] Data analysis - Breath55
Good advise from Deepbreathing, but the old study was SERVE-HF, and the updated pending study that suggest these risks are negligible is the ADVENT-HF. You can search those studies if you're interested.
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: [split] Data analysis - Breath55
said they were going to try cpap, apap and bipap titration at my next test, but AVS was never mentioned.   Do you suggest I bring it up? Outright ask for it?
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