ASV and LVEF<45%

[Sleeprider]

If you go for it, then I am IN! Just stick around afterward, or there will be all kinds of rumors.

[zzzZorro]

After 3-weeks waiting with the S9 APAP parked on the shelf, tonight it is coming out anyway and it's going to run at straight 20cm/APR off, to see if I can get some rest!

That didn't go well!  Almost blew the full face mask up and felt like I was driving down the freeway on a motorcycle  

Reverted back to APAP 12/19 EPR-3 but after a couple hours the mask was really painful so I bagged it for the night. 

The Centrals were what I was trying to improve.

Why the disparity in two nights at the same setting??

AHI Disparity

[Sleeprider]

High pressure is going to be the worst for your events. You seem to tolerate the EPR, but again, I would limit the top pressure to perhaps 16 and see how that goes. Since my memory is not particularly good, can you review for me what we have tried so far?

[zzzZorro]

It's like a flea on a hot griddle.   I'll just post the Stats I have for you. 

BTW- Just called the SleepDocs and was told it will probably be another week before he gets the report from the SleepLab ("It takes 7-10 days AFTER we get the sleep report and the Doc won't be in 'till Friday- Maybe Monday") to be able to write a scrip.  And the Sleep Lab sez ("You got in faster than most people; It takes 7-10 days to get the report to the Doc") .  This is the most dyslectic operation between these two I have ever encountered. Wish to HE-doubleL I would have never gone there! 
BTW the ASV is not ruled out just on hold till an iota of thought issues forth.

Stats sheet

[SarcasticDave94]

Hey there hold your horses a bit. They don't call us patients for nothing. Hurry up to office and wait. Then you go to an exam room and wait. Rinse and repeat.

Seriously, I went through the same thing with that ASV. Waiting for something like this just will NEVER make sense to me.

Sincerely hope the process goes forward faster for you.

[zzzZorro]

High pressure is going to be the worst for your events.  You seem to tolerate the EPR, but again, I would limit the top pressure to perhaps 16 and see how that goes.   Since my memory is not particularly good, can you review for me what we have tried so far?

Also, here is the First Sleep test, the Second I don't have yet.  Maybe this will be of help?

First Test

[Walla Walla]

How do you get a total sleep time of 125 minutes and a REM latency of 212.5 minutes?

[zzzZorro]

How do you get a total sleep time of 125 minutes and a REM latency of 212.5 minutes?

Good question..

[Sleeprider]

Your sleep test has everything needed to authorize ASV except the titration. Interesting results on ST at 16/6 with 10 BPM. That is about what I would expect for you with ST and that is indeed the machine doing the breathing for you using PS 10. You can just imagine how confounding it is to me that any doctor would prefer that forced breathing to a ASV, and we've had some good discussion on discrediting SERVE-HF.

At least with that study in hand you won't start from scratch if you need to move your care to another doctor; however you will need to tell them you are aware of the issues and risks and will sign any needed waivers to get a script that will resolve your sleep disordered breathing.

[zzzZorro]

Your sleep test has everything needed to authorize ASV except the titration.  Interesting results on ST at 16/6 with 10 BPM.  That is about what I would expect for you with ST and that is indeed the machine doing the breathing for you using PS 10.  You can just imagine how confounding it is to me that any doctor would prefer that forced breathing to a ASV, and we've had some good discussion on discrediting SERVE-HF.  

At least with that study in hand you won't start from scratch if you need to move your care to another doctor; however you will need to tell them you are aware of the issues and risks and will sign any needed waivers to get a script that will resolve your sleep disordered breathing.

Perhaps you could explain in lay terms how the ST works vs the ASV.  From the titration I was aware the ST jambs air to you at a fixed rate in both time and volume.  Could I assume the ASV is just a ST with a brain that regulates the incoming air by patient demand (meaning variable time and pressure)?