RE: New User Seeks Guidance
Thanks Sarcastic Dave. Great to be an award-winner. 
I will certainly follow your suggestion now, to obtain the entire sleep study data set, and will maintain the sleep journal, keeping a close watch on Centrals. If they continue, and with the excellent advice of this board, I will go after Dr. Doolitle, who, to date, has minimized the Centrals. I mentioned BIPAP already, and he said "too soon to consider." How much data do you believe that I need to be compelling enough to request a machine change? Furthermore, is it likely that this machine change to ResMed AirCurve 10 ASV would correct the Central problems (should they continue or become worse)?
Thank you again.
RE: New User Seeks Guidance
One more thought on this. Is this all about the cost of equipment? In other words, IF I was able to obtain an ASV today, is this something that I should want to pursue, or am I better off waiting for a month or so of data? I just don't want insurance to dictate the best course of treatment for me. If the odds aren't good that I will be well-rested and find my AHI at optimal levels, perhaps I should be more proactive right now. Appreciate your further thoughts on this.
RE: New User Seeks Guidance
I would wait just a bit, see if AutoSet can handle your therapy successful with well rested and high comfort. If it goes badly in any way then time to move on.
Mask Primer
Positional Apnea
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
06-24-2021, 09:42 AM
(This post was last modified: 06-24-2021, 09:44 AM by Sleeper396.)
RE: New User Seeks Guidance
Got it, thanks. Any suggestions on settings at this point? Also, can someone explain the difference in the MyAir ResMed app and Oscar AHI.
RE: New User Seeks Guidance
The difference is just to do with slight differences in how OSCAR calculates the AHI from MyAir. They use the same flags that the machine sets, but MyAir rounds a lot more so there's a little inconsistency. That's why MyAir shows your AHI to one decimal point whereas Oscar shows it to two. OSCAR is technically more accurate and MyAir is only good for collecting the gold and silver star emails and to prove that you've met your daily usage to be marked compliant. I actually scored 100% one day and regularly get 95-97. despite having severe central sleep apnea that absolutely is NOT controlled by APAP. I, too, am waiting on a doctor to go the ASV route.
I'd follow SarcasticDave's advice - he's the one I plan to turn to as soon as I (hopefully) get an ASV! I would probably stick where you are for now but definitely keep that journal (you can do it in OSCAR obviously). If, most of the time, your centrals are low and you're doing okay, then great. If it proves to be more troublesome, then go chase down the doctors with your data in hand. I hate that so many doctors decide that centrals are harmless. This is why I've been stuck on APAP for five months now despite having been first diagnosed with CSA nearly a decade ago (and dismissed without treatment because of no obstructive apnea).
RE: New User Seeks Guidance
The reason I've said what I did was 2 fold. The worse case is inevitable sometime in your future. So you need to implement this building a case now for ASV. But you also need to exhaust all that you current APAP can do. This adds to your ASV case too.
If the AutoSet does the job, great you're treated. But if/when it fails you due to Centrals, then you know what you need to prove and have been doing so.
Mask Primer
Positional Apnea
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: New User Seeks Guidance
Yup. It is clear that we must be our own advocates on health decisions, armed with whatever knowledge is available; and this one is particularly complex, unless you fit the textbook OSA case. I have a good plan now, greatly improved by you guys on this site; so thanks for that, as well as your quick replies. Will double back again when I have more concrete information and data to evaluate my progress.
. . . to be continued.
RE: New User Seeks Guidance
OK best to ya. Just keep an eye on the Centrals and keep your SD in the PAP to document that. If you need to edit settings feel free to do so, ongoing as long as you use this AutoSet. Sticking to a certain pressure set isn't needed to prove ASV necessity, the Central count, the test result, your statements of failing, these are needed only.
Mask Primer
Positional Apnea
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: New User Seeks Guidance
Thanks, Dave. Your comment, "The worse case is inevitable sometime in your future" triggers a last question. Does that mean, in your opinion there is 100% likelihood that Centrals will win out?
RE: New User Seeks Guidance
I mean, nothing is 100%... but if you had mixed apnea on your sleep study, then it's a high probability that the centrals won't go away. I have had SOME reduction in my centrals on APAP - but from 80+/hr to an average of 30-35 and a max of nearly 60 while treated. So yeah, you might be okay... but if not, you've already proven that APAP isn't working and can put the evidence in front of them.
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