rookie needs help [mixed apnea]

[Hojo]

I feel your pain, while waiting for my approval for ASV the only thing that helped me was setting my alarm every 2 hours to make sure I got up to get some good breathing in.

[Garym040]

I had another sleep study done a week ago.  I had a lot of trouble falling asleep so I don't know how accurate the results are.  The doctor called and said the insurance would not approve an asv machine for me because they found that at a constant pressure of 7.0 I had no events for a whole 20 minutes.  I disputed the results with him to no avail.  Here is a snapshot of my sleep last night and as you can see there are plenty of events.  The doctor thinks that I should continue with these settings for a few months then see him in June.  I told him I wake up every day with a headache but he thinks things will improve in time.  Before I go out and buy an asv machine on my own do you think you can recommend any better settings for me with this bilevel machine?

[Gideon]

Can you post that sleep study? The detailed study, not just the summary!

[Sleeprider]

The simple fact is, we know that with steady CPAP pressure there are many 20-minute (1/3 hour) periods with no events, but that eventually your breathing will destabilize and lead to centrals. Many of the people with complex apnea get the same advise from me: your results will remain consistently inconsistent, and there is nothing we can do about it. The optimum results will be with steady pressure without pressure support, EPR or Flex. With that, your event rate will remain near a clinically treated level and you will have many periods free of apnea, and then clusters of CA or hypopnea. Your doctor was not your advocate, and that is the problem here. The results were predictable as they were meaningless.

Contact Spy Car or look up his story. He got an ASV with no worse results than yours as long as we kept pressure okay, but was miserable and sleeping poorly. He complained and worked hard to get an approval that I rarely see.

[SarcasticDave94]

My path was very similar to get an ASV machine. Key point: complain your little head off constantly. Numbers may or may not be enough. Squeak squeak squeak goes the wheel that needs grease.

Best to ya they you'll get the ASV.

[Hojo]

Did the doctor say the insurance would not approve, or did not approve, there is a difference...the doctor may have never contacted the insurance.  If your not getting the results you need, then I would find another doctor or show him the Sleephead results.  When I took my laptop in and showed the doctor, he was impressed as to what was going on and jumped right on board with an ASV.

[Garym040]

The doctor told me that the latest sleep study showed that I was treated successfully with CPAP  Because of this he thinks I don’t need asv. I am going to request a copy of the sleep study and post it whenever I get it. In the meantime he is adamant I use CPAP for another 3 months as he believes the centrals will resolve in time.  I will also see if I can find another doctor to write the script. In the meantime I will use my machine in CPAP mode

[Garym040]

The doctor told me that the latest sleep study showed that I was treated successfully with CPAP  Because of this he thinks I don’t need asv. I am going to request a copy of the sleep study and post it whenever I get it. In the meantime he is adamant I use CPAP for another 3 months as he believes the centrals will resolve in time.  I will also see if I can find another doctor to write the script. In the meantime I will use my machine in CPAP mode

[Sleeprider]

Your central events are not unreasonably high, and we have seen members improve with time in therapy. ASV is not a fun and games technology, and can be disruptive to sleep and ineffective, be is a life-changer if you need it. It is fair to give CPAP up to three months to resolve issues like yours which are borderline. It would be good to have a contingency plan in the event that is not effective.