Here are my first night results

[alshayed]

I just had another thought - you might print out page 7 from the ResMed Sleep Lab Titration guide and take it with you. It's the page that shows different modes of ventilation and what it does/treats.

[Croweater]

I just spoke at length with the sleep study people. They explained to me that they MUST go through their protocol or the insurance will simply refuse to proceed. Their titration protocol involves having me try CPAP (fail), then BiPAP (fail), then ASV. I need to fail each level before they will test the next technology in the protocol. When I told her I had already been prescribed an Auto CPAP and had failed she said the study would still need to witness the CPAP failure to pass protocol.

I then asked if the entire protocol could be performed in one night, or if I would have to come back again for ASV should I fail CPAP and BiPAP. She said they would attempt to do all 3 in one night, but that it was entirely possible it could take a second visit.

In regards to my doctor, fortunately my ENT realized he was in over his head and he scheduled me to work with another doctor AFTER the Titration results are documented.

[KallyA]

Croweater...
You've gotten very good advice and support here, but I am not surprised at the response from your medical personnel. Their hands are tied in terms of getting the tests done in a way that insurance will cover. You need to continue to be your own advocate to get on the machine that works for you. Squeaky wheels really do get the grease, and doctors do not like having dissatisfied patients particularly if they are assertive and don't just let things slide.  I had a night around your level of AHI (24+), almost all central apneas and many for 11 to 1-1/2 min in length. I felt so sick the next day, I camped out in the doctor's office without an appointment until he would see me and adjust my ASV settings. You're well being really depends on getting the best treatment possible as soon as possible. This level of AHI puts a terrible strain on your heart and adrenals. You're doing it right. Test scheduled, specialist in your future. Keep us informed! Best of luck!