First night with new Bipap after sleep study and 37 AHI mostly CA

[PandaZA]

Hi,

AHI was a little higher last night.

   

[SarcasticDave94]

I think it's time for the EPAP edit. Maybe bump Min from 5 up to 6 and Max from 8 up to 12

New EPAP 6-12
View results, evaluate, edit again if needed.

If that seems too much of a change, EPAP Min 6 still, EPAP Max 10

[PandaZA]

This is what things looked like last night with an AHI of 1.89.

   

[SarcasticDave94]

Not bad for an overnight noticable change.

Do you better for the change?

Unless there's a negative aspect with this setup, I'd keep it at this to see what trend develops.

[PandaZA]

It's difficult to say if I feel better after just the one night. I will give it a couple nights and see how it goes.

Thanks again for all the advice.

[PandaZA]

They are saying they want to try me on a ST first before doing an ASV titration. What would the benefit of an ST machine be over ASV or vice versa. It's just going to end up being and extra cost to try and ST first as I would have to pay rental on it and if it doesn't work would have to pay again for ASV.

[SarcasticDave94]

The ST? Zero benefit for you. It was the old answer to attempt Central Apnea treatment. Mostly it helped some a bit due to the backup rate. Period. I myself would say the ASV is the only answer. The ST will waste your time and money.

If you're going through a Titration, maybe request or ask if they'll try ST and ASV to find out. But the ASV will be better in treating CA. And realistically, typically a Titration is not necessary, giving not much better than guessing on pressure settings. One night snapshot is only good for that night in my opinion.

[Sleeprider]

ST is a fixed pressure bilevel with a timed backup and square-wave pressure transitions. Old tech. Absolutely obsolete compared to ASV which gives an adaptive backup rate and pressure support as well as variable EPAP and Easybreathe pressure transitions. I have never seen a member do better with ST which is intended for pulmonary disease and obesity hypoventilation. Read about ASV and ST in the Resmed Clinical Titration Guide. https://www.resmed.com/us/dam/documents/...er_eng.pdf

Who is "they"?

[PandaZA]

This is the message I got from the respiratory therapist. It’s coming from the doctor at the sleep lab.

Hello, just wanted to give you an update on your unit. I just spoke to Lindsay at sleep lab and the pulmonologist is fixing the sleep report and will send over so I can forward to our intake to work on getting you the Bipap ST. She stated he will not just go straight to an ASV unit, so if there are any problems with the ST then they would have you go back to the lab for an ASV titration.

[Sleeprider]

Read the chart on page 5 of the reference I gave you...

ST: Augments any breaths initiated
by the patient, but also supplies
additional breaths if the breath rate
falls below the clinician’s set “backup”
respiratory rate

Treats: COPD, NMD, OHS and other
respiratory conditions

ASV: Targets the patient’s minute ventilation,
continually learning the patient’s
breathing pattern and instantly
responding to any changes

Central or mixed apneas, complex
sleep apnea, Periodic Breathing (PB)

What was your diagnosis? What is the objective of this therapy. Do you have any of the conditions described under ST or ASV? Which one?