New Member Intro. Hi!

[Sabina]

Yep OSA is 1 Obstructive Apnea and 21 Central Apnea plus 24 obstructive hypopneas. Mixed or complex apnea at best.

Hypothetically speaking, if it is not treatment emergent, and after 2-3 months it doesn’t improve, will the Machine I am getting work for that, or would I be looking at a different type of machine?

[DeepBreathing]

It is possible - with a great deal of experimentation and fine tuning - to get central apnea more or less under control with an ordinary CPAP or APAP like your Autoset. However the results are very inconsistent and you could have a few good nights followed by a shocker. You could also try a bilevel machine with a similar outcome.

Really the gold standard for treating central and mixed apnea is adaptive servo-ventilation (ASV). It looks just like your Autoset but has a totally different algorithm which adjusts pressure on a breath-by-breath basis. Almost guaranteed to give outstanding results. However they are expensive and your insurance company will make you jump through hoops to get one. This usually involves multiple sleep studies and a trial on a bilevel - many thousands of dollars wasted to see if you qualify for a machine worth a couple of thousand.

[Sabina]

Nothing worth it is ever easy eh?

I’m just confused. Why would they consider the Apnea successfully treated if they only got my AHI 8.3 vs <5, and why aren’t centrals or complex included in my diagnosis. Is this normal?

I’m totally new to this.

Are there specific questions I can address with my primary now, or should I wait to see if the machine they are giving me tomorrow helps before I address it?

[Gideon]

That is why we like to see the whole, complete sleep study.

It seems that if there is ANY OSA a diagnosis of OSA is applied.  That leaves no doubt that you will be initially assigned a CPAP/APAP which have the same insurance billing code.  A diagnosis that indicates centrals would indicate that the doctors need to pay attention.  I swear that most doctors do not look beyond the diagnosis provided by the sleep lab which rarely mentions any central apnea.  

Some countries will not treat apnea unless the AHI greater than 10 or 15, at AB we like to see it well under 5.

[Sabina]

That is why we like to see the whole, complete sleep study.

It seems that if there is ANY OSA a diagnosis of OSA is applied.  That leaves no doubt that you will be initially assigned a CPAP/APAP which have the same insurance billing code.  A diagnosis that indicates centrals would indicate that the doctors need to pay attention.  I swear that most doctors do not look beyond the diagnosis provided by the sleep lab which rarely mentions any central apnea.  

Some countries will not treat apnea unless the AHI greater than 10 or 15, at AB we like to see it well under 5.

I like optimization. That’s why I’m here. I need my life back. 

It looks like she did exactly what you said. Fortunately she is very good at letting me drive my own care, so there’s that. I can just form my case and ask, she’s always agreeable.

I get a copy of the actual RX tomorrow, though my patient portal says:

CPAP 12cm/h20 nasal at bedtime 365 days.  

I’m surprised so many people out there just accept what they’re given without question, so it’s enlightening to find a place where so many people are active in their own care.


It’s gonna be a rough couple of months. Thanks so much for the feedback and advice.

[Gideon]

Managing your DME.

DME's have been known to provide the cheapest machine available that they can load the settings in, even when the Rx says otherwise.  To protect yourself.

1. Only accept the ResMed AirSense 10 AutoSet or AutoSet for Her.  If not this machine walk away no matter what they say.
   
2. Validate the Total Run Hours on the machine they give you.  This means plug it in and look (in the clinical menu under About) There are many here that have accepted the new to you machines only to discover thousands of run hours already on it.  New means 0 hours.
   

[Sabina]

Great, I’ll do that. 

I think they said they only offer two machines. One is the ResMed Airsense 10 Autoset and I’ve asked for the “for her” version. 

The other is a Dreamstation Auto...don’t want to get anywhere near that., especially with this potential central/complex issue that may or may not be looming in my future lol. 
 
I have no qualms walking away though! 

Thanks. More to follow.

[Sabina]

Went to DME. Despite my request last week, they didn’t have the “for her” version available, but it is a ResMed AutoSense 10 Autoset so it’s a good start and I don’t feel like waiting another month to  start getting my life back because I’m pretty much too tired to do anything.... So I made him go into the clinical settings and show me the hours which were zero. I got the SD card for the machine.

My entire out of pocket cost was $53 so I was pretty happy with that. I went thru Apria, and besides an extreme lack of choices on hand (they will FedEx anything you need though), they were great. 

So, should I just plug it in and go as it is set and See how the next couple of nights go and then post some Oscar screenshots? I’ll be able to do that on Saturday.

[Gideon]

We only need 1 night to get started. So yes. Plug it in and go. Be sure to organize the screenshots.(see the link in my signature.)

[Sabina]

Great just read through and will post on Saturday, unless I have a crisis or something. ?