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+--- Thread: Having Centrals but not Diagnosed with Centrals, also having CSR's (/Thread-Having-Centrals-but-not-Diagnosed-with-Centrals-also-having-CSR-s)
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Primalyogi - 08-16-2020
The way I see it is;
The tonsil stone was impacting my throat which screwed up all my readings from the CPAP machine; it just coincided with the upgrade of the machine; no doctor thought to look at my sore throat until I took myself to an ENT; who removed the stones and all of a sudden I’m more stable..
ALSO capping the pressure to EPAP of 13 seems the reduce the abdominal gas problems I was having.
So what’s going to be interesting is to see if the Centrals come back (was it the tonsil or coincidence)
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Primalyogi - 08-17-2020
I’ll post OSCAR when my girl wakes up but; my theory is wrong so I’m back to positional
[attachment=25736]
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Primalyogi - 08-18-2020
if you were me, would you go do a titration study at a hospital that has a COVID=19 ward/clinic across the street even though your are having inconsistent and most often feel lacking sleep however the numbers are (now thanks to this board) below 10 a night which is a 60% improvement?
Last night :
- AHI 2.8 = CI(2.5) + 0.7(OSA+HA) with a median pressure of 8.5 (8-16 EPR 2)
[attachment=25782]
The night before :
- AHI 8.9 = CI(4.4) + 3.94(OSA+HA) with a median pressure of 11.9 (8-16 EPR 3)
[attachment=25783]
both nights my partner said I was on my back for 40-60% of the night... same pillow... but completely different results... i'm guessing there's a positional element (based on the flow rate graphs)...
... but would I benefit from a new titration study?
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Gideon - 08-18-2020
IMHO a titration study is useful in proving efficacy on a new model of machine.
OSCAR provides detailed info that is typically more than sufficient to base your therapy on. If you are looking to get an ASV then a Titration study WITH and ASV may be appropriate.
The question is why are you getting a Titration study?
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - SarcasticDave94 - 08-18-2020
To me a titration study is used for some supposed professional to monitor your sleep and PAP use overnight, adjusting settings to see what happens when they change X Y Z to see if they can find a magic combo of those settings that results in the lowest event counts. The problem is this represents only one night of sleep and almost every night is a little different.
Me? Another titration would be a waste in my viewpoint, excepting like bonjour mentions. If it means proving need of a different class of PAP, then you likely need it, otherwise no. Are you able to adjust your own PAP machine? I ask because some areas of the world have different rules than here in the US. I can adjust my settings to whatever and the insurance doesn't care beyond meeting the compliance.
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Primalyogi - 08-18-2020
Thank you.
I can (and do) adjust my settings, the DME supplier actually showed me for the Resmed after I figured it out with the Philips... actually my Sleep Doctor showed me how to change the settings on the Philips. I was told I have free control - compliance seems to be only on duration per night and it effects me differently, if I don’t average 4 hours a night they’ll take away my drivers licence - but it doesn’t change the situation with the machine as I bought both the Resmed and Philips outright.
The only question mark is whether the Centrals would be better managed by an ASV which would mean doing the study & then the public health system in Australia allocates you a machine from a pool - you have no control over what it is or how old it is or anything so I would probably choose to buy one if that was the case and it worked.
Oh and to answer the question - the sleep doctor hasn’t confirm exactly why I’m doing it and if an ASV is involved. I’ve tried asking multiple times and in multiple ways..
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - SarcasticDave94 - 08-18-2020
I'd think it would be your right to know what the procedure is and what it's for. Demand an answer to what and why. If ASV is not involved, then you're wasting time, effort, and money. Tell the doc you can't afford to waste any of these.
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Primalyogi - 08-18-2020
Thanks for saying what I was thinking.
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Gideon - 08-18-2020
Dave has had to "work the system" to get what he needed, listen to him.
RE: Having Centrals but not Diagnosed with Centrals, also having CSR's - Primalyogi - 08-19-2020
I asked for clarification on if the titration study was on a CPAP or ASV and the response was that I have to make a appointment to go see the doctor because she’s not answering any question via email.
I asked what I though was a simple yes/no question... “What’s the purpose of the proposed “titration” study - Is it using a standard CPAP/APAP, adjusting pressures under observation to determine a treatment protocol; or is it using different ventilation options, like an ASV as my CPAP reports are primarily central Apneas?”
And got told I either have to go in for a face to face or have a phone consult and pay to have that question answered.
I’m honestly stumped. I was expecting a call to book in a study this week and it hasn’t happened.. and now I can’t even verify what it’s for...
EDIT: I have an appointment in 2 weeks to speak to the doctor, having to pay to get this clarified is not right & I’m filled with frustration & fear that I’m going to have to find a new sleep doctor somewhere in Sydney.