New Member - Hello! [how long before considering adjustments?]

[skiajl6297]

Full results and next steps coming tomorrow morning - and I will report back. But the data I have gleaned from my medical record (no copy yet of sleep study report, but will get it) showed the following from my night last week. We didn't get to ASV titration then, and I am anxious that I will be put on bipap only to continue to experience centrals as I was on apap. Fingers crossed tomorrow goes well.

"Study began with psg. After 3.5 hours cpap was started at 4.0cm. Switched to Bipap starting at 8/4 due to centrals. Titrated on bipap to 13/9."

[skiajl6297]

Saw the doctor this morning, and he is writing me a script for ASV titration study! According to the results (which I don't yet have) after being titrated to bipap, I continued to have centrals, and so he is writing the script showing persistent central sleep apnea after titration to bipap, now requiring ASV. Now the Care Centrix waiting game begins. As soon as I get a copy of the study I will share it.

[Dormeo]

Congratulations!! I’m so glad you don’t have to grind your way through the bipap detour.

[Sleeprider]

That is what we were hoping for. ASV is going to be a transformative therapy for you.

[SarcasticDave94]

Congrats on the victory. Keep us updated on how your circus progresses. I'm looking forward to assist in that ASV setup.

[skiajl6297]

Thanks all for the concern and support! I just (finally) got my ASV titration study authorized by insurance! I called every day to check on status, had my employer/s insurance rep call to check status, and had the doctor call to check. I cannot imagine how difficult this process would be for someone chronically ill, lacking caregiver support.

I am scheduled for the study early next week! My follow up with the physician to review the results is early (US) Thanksgiving week. I hope to have a machine well before the holidays!

I will report back with any updates, and will definitely follow up after the study and results.

[SarcasticDave94]

Congrats on some progress. Hope you get the test and ASV on the ASAP!

[Dormeo]

Oh, this is all such good news! Keep us posted.

[Sleeprider]

Good luck with the test. I'm pretty sure they won't have any problem finding central events. I think once you start the new machine, a new thread will be in order since we're at 15 pages here. What a long, strange trip it's been.

[skiajl6297]

Looking forward to starting a new thread!

I had the study, and have not yet received the results. However, subjectively, it was a rough night. I did not sleep very much unfortunately, even though I was very tired. It seems my body is resistant to pap right now after more than two months of being off any form of pap therapy. Initially I struggled with leaks. We had better results with the P10 and a chinstrap. When I did finally sleep, the technician (who was the same tech who did my prior study, and who was fully aware of my situation) indicated that while on ASV (the entire night) my breathing was very stable, respiration rate was great, and I had zero central apneas. She said my O2 sat was great throughout the night on ASV.

Subjectively, and interestingly, I felt a few different things being on ASV. First, I noticed when I was slipping towards falling asleep, because when my respiration rate slowed enough, the machine forbade it with a semi-forceful increase in pressure. The force softened as the night went along, but I felt it repeatedly as I was drifting off. I suspect this was a big part of why I had trouble sleeping, aside from all of the challenges of being all wired up in a lab. I tended to have centrals immediately at sleep onset during my sleep study - as soon as pap therapy started, centrals started. It seems when I am falling asleep, my respiration rate goes way down, and I suspect ASV will take some getting used to, particularly at sleep onset.

I also noticed how much more inflated my upper airway felt with the ASV. It felt like a baloon was being filled, and it was wonderful. It was almost like a baseline of inflation occurred, but it didn't have that same feeling of push back on the exhalation. It was the first time using any form of pap, where I felt that my breathing was driving the machine, as opposed to my breathing morphing to follow the machine. There were no struggles for breath, no challenges filling my lungs, no feeling air starved, all while feeling that my exhalations were supported, but not filled with effort. In short, inhales were easy and natural, and exhales were too. A major positive difference in my opinion.

Additionally, when I woke up after what felt like a pretty crummy number of hours asleep, I actually felt orders of magnitude better than I thought I should given the hours asleep. I felt physically more energetic, and awoke rather easily. I didn't have the brain fog I have come to be used to. I felt more physically alive than I have after any full 8 hour nights sleep I have had without PAP in the last two months. I probably had 3-4 total hours actually asleep.

I receive results at my appointment Tuesday morning. Is there any way this test wouldn't result in a RX for ASV? Does anyone do ASV titration and then not receive an ASV? I am hopeful this will go smoothly. I plan to use a new DME, assuming I get the RX after my experiences with my current. I'll report back with more once I have info, and will definitely start a new thread on the new machine if/when I get it!