Getting a machine advice

[raylock1]

When I went for the in lab sleep study the order stated BPAP/AVS titration.  In the morning, before I left, the tech showed me the comparative graphs which clearly showed that the AVS worked and the BPAP did not.  That was the end of the issue in my case.  Your situation is probably entirely different, but the in lab titration is what cemented the decision in my case.

[slowriter]

When I went for the in lab sleep study the order stated BPAP/AVS titration.  In the morning, before I left, the tech showed me the comparative graphs which clearly showed that the AVS worked and the BPAP did not.  That was the end of the issue in my case.  Your situation is probably entirely different, but the in lab titration is what cemented the decision in my case.

The potential difference for dolppl is whether insurance will accept the medical necessity of treating the RERAs.

[dolppl]

Just had my appointment (over Zoom) with my sleep doctor, went awesome.

He agrees that he thinks I will benefit greatly from ASV, but he is nervous about the insurance company getting on board. 

He is scheduling me for an in-lab ASV titration, but first he has to show the insurance company that I will benefit from ASV, so for the first couple of hours he is going to instruct the technician to let me have a bunch of centrals then switch to ASV titrating.

He says it is a shame that they have to do this, but the insurance companies are a pain to work with.

I am glad he is on my side.

Thank you all for your help.

[SarcasticDave94]

Well, congrats on a bit of hope and progress. Keep us updated.

[Sleeprider]

Sounds like your doc is a winner! He certainly showed he has a logical path to ASV and knows the ropes. That puts you way ahead of the game. I think his plan wll work, but even if insurance does not get behind it, your doctor can prescribe ASV and that will facilitate a purchase onlne at a discounted price.

[dolppl]

Wondering if I can get some details on what Tidal Volume is and what it means?

My Average Tidal Volume since I started CPAP is:
Med   95%   Max
400    570    750

When I look at other peoples charts that they post they seem to always be higher, usually much, than mine.  Does this have to do with the low pressures I am at?
I am 5'8" Average build.

Thanks,

[Sleeprider]

A brief discussion is in the Beginners Guide to Sleepyhead wiki http://www.apneaboard.com/wiki/index.php...SleepyHead

Tidal Volume Tidal Volume (ml)
Tidal volume(symbol VT or TV) is the lung volume representing the normal volume of air displaced between normal inhalation and exhalation when extra effort is not applied. In a healthy, young human adult, tidal volume is approximately 500 mL per inspiration or 7 mL/kg of body mass.

Tidal volume is how much air you breath in during one inhalation. It's measured in mL and there are 1000 mL in one L. That's why these numbers are so much "bigger" looking than the minute ventilation numbers, which are measured in L/min.
The Tidal volume and the Minute Ventilation are related to each other:
Minute Ventilation in L/min = (Tidal volume in mL/1000) * (Respiratory rate in breaths per minute)

Tidal volume is of great importance for people who are using an ASV machine since Tidal Volumes are used by the machine to figure out when to trigger inhalations. But for the rest of us? Tidal volume doesn't really have much significance if we don't have a daytime breathing problem.
Like Minute Ventilation and RR, the Tidal volume varies from person to person. And when we're asleep, our tidal volume typically is less than when we're awake. For now you can pretty much ignore the Tidal volume numbers.

There is a great deal of variation in tidal volume for individuals and we really don't stress over this parameter by itself. People tend to get the air, or minute vent rate, they need. We some people with large Vt and low respiration rates end up with the same MV as someone with smaller Vt and higher BPM.  CPAP is not used to manipulate tidal volume, so we really don't target this parameter unless using advanced bilevel ventilation.  FWIW, your Vt is not particularly remarkable or alarming.

[dolppl]

I was just checking my numbers from last night and I noticed that the pressure on my machine went back to its original setting.  The ramp turned back on and everything.  I have an appointment with the DME Monday for my 1 month follow up.  Did they check my machine through the modem and can they change the settings remotely?

[SarcasticDave94]

Reset the settings to your choice. Yes, changing settings wirelessly is possible at the DME. I would contact the DME right away and tell them from this time forward they do not have your permission to edit the settings. Leave a message if you must. Follow-up tomorrow and tell a person you do not permit remote setting edits. The settings you choose do not need to be shown on the script. At least this is true in the US. I'd still tell them not to change anything.

[dolppl]

Is there a way to tell (using OSCAR) whether you are breathing through your mouth at all during the night?  I see the leak chart but I don't know if there is a way to differentiate whether the mask itself is leaking or if i am mouth breathing during the night.