First night worrying, data even more so

[SarcasticDave94]

I think then with a 0 AHI, the apnea related numbers cannot get better. However you can adjust settings as you'd mentioned the symptoms of aerophagia. Maybe cap PS Max at 12 and see how data and your symptoms respond and/or if the therapy delivery feels better. We may move settings around a bit if you have symptoms to address such as this. Otherwise, congrats on successful treatment.

[orand]

Last week I sent a message to the sleep provider asking if they could do a single sleep titration that included BiPAP and ASV, per Sleeprider’s recommendation.  They had told me that it would take two more overnight sessions to get to ASV: session 1 - CPAP/BiPAP, and session 2 - ASV.

This evening I received the following response:

Hello Sir, I have forward your request to your sleep provider. Unfortunately it would not be appropriate to jump to ASV as I have previously discussed with you over the phone. Given that you trial the APAP for a brief time it is not appropriate to trial ASV machine. It is standard for a reason to complete a titration study for a CPAP then BiPAP first as it can often resolved therapy induced central apneas if they are occurring with APAP. And only then if is showing not appropriate response, then a ASV is considered. Unfortunately, we are not able accommodate your request of a ASV machine before CPAP, BIPAP titration first.

To be clear, I didn’t ask for an ASV machine like she claims, I asked for titration that included BiPAP and ASV.  I think she understands that, and this is just her indirect way of saying no.  However, I’ve gone around and around with their poor communication and lack of listening for several months now, and I don’t think it’s going to get any better.  So I’m seriously considering going to a different place to ask for a single titration that includes BiPAP and ASV.

I’m guessing that any new place is going to want a copy of my records from them to confirm my OSA diagnosis and APAP prescription.  I’m nervous that I’ll run into the same roadblocks with a new provider.  Any advice for how to gracefully switch providers midstream and jump straight to a BiPAP/ASV titration? Is this something I can do on my own, or will I need a new referral from my primary care provider? Perhaps my PCP can submit an order directly to a sleep lab for this titration??

[SarcasticDave94]

I'd not care much about the feelings of the one about to be fired. I had a titration about 2 weeks ago that was for ASV. The thing is though if we ask for CPAP, BPAP, or ASV titration, then they're all done on the same lab PAP machine. This doc or whoever is just saying round about NO we won't do it. There's no sense of it being 2 nights worth except it adds to their boat payments. Get your Nikes on and run elsewhere.

This response was from a doc's office? Maybe call the insurance customer service line and ask for in-network doctors nearby to replace whoever is about to be canned. Get about 4-6 contacts and call them up to schedule an initial consult, but ask about your test to include ASV. But I'd directly ask if they know how to treat Central Apnea. And ask HOW they treat CA. If they don't know what CA is or how to treat it, move on.

PS yes get a copy of any tests and maybe take a blank release form, or sign it then and there, so new doc can get all records. Be bold and stand up for yourself. They won't kill you, but they're also not helping anymore.