Upcoming Sleep Study (ASV related) Opinions Wanted

[Sleeprider]

Bill, be sure to read up on the ASV titration protocols.  The results you get[video=dailymotion]https://www.youtube.com/watch?v=JmCJjDOjYQQ[/video] will depend on how the machine is setup.  You need to ensure the EPAP min is sufficient to control most OA events, it does not have to control H or FL.  Go back through your APAP use and decide what that needs to be.  The EPAP max should control nearly all OA events.  Pressure support in the titration protocol generally ranges from 3-15.  You can vary that based on your results.  If you are normally comfortable at 3 and it doesn't make CA worse, then that should be fine.  Keep a relatively high PS max so there is support there for hypopnea and flow limitation.  You already know of my strong preference for the Aircurve 10 ASV in ASVauto mode. Don't get tested on something not set to auto mode.

Titration protocols? 

Most of my time on APAP I've been around 7 min/11 max with an EPR of 3. At the least, these setting have been very comfortable for me. I've had some good therapy around this range, and some not so good.

I will ask for AutoASV. Any more thoughts? I feel a little bit out of my league here, and concerned about having one night (or 4 hours) to "do or die."

Bill

For you, Mode ASVauto, EPAP min 5, EPAP max 8, PS min 3, PS max 15. 

Go to page 41 VPAP Adapt (ASV). 

https://www.resmed.com/us/dam/documents/...lo_eng.pdf

Page 15 here Philips BiPAP Auto SV Advanced:
https://www.sleepapnea.com/downloads/100...fGuide.pdf

Stuff:
http://www.masm.wildapricot.org/resource...Morgan.pdf

wild card (this is okay,but takes a lot of patience):

[Spy Car]

For you, Mode ASVauto, EPAP min 5, EPAP max 8, PS min 3, PS max 15. 

Go to page 41 VPAP Adapt (ASV). 

https://www.resmed.com/us/dam/documents/...lo_eng.pdf

Page 15 here Philips BiPAP Auto SV Advanced:
https://www.sleepapnea.com/downloads/100...fGuide.pdf

Stuff:
http://www.masm.wildapricot.org/resource...Morgan.pdf

wild card (this is okay,but takes a lot of patience):

Thank you so much for both the "short answer" and the educational materials. I've begun reading and watching.

Bill

[ckingzzzs]

Bill,


I went through the same process.  A Second in-house sleep study with switching to asv to address centrals.  The study results are documented for insurance purposes to get the asv machine as its higher in costs.  One thing I learned with this sleep apnea stuff is the insurance game.  asv did the trick for me hope it works for you as well.

[kiwii]

Just a thought... do you have difficulty getting back to sleep, or staying asleep, during the second half of the night?

If so, is it possible to request or insist on starting the night with the ASV? It would be a shame if they didn't have enough data because you couldn't get back to sleep, or stay asleep.

[Spy Car]

Just a thought... do you have difficulty getting back to sleep, or staying asleep, during the second half of the night?

If so, is it possible to request or insist on starting the night with the ASV? It would be a shame if they didn't have enough data because you couldn't get back to sleep, or stay asleep.

Interesting question. I think I generally sleep better in the second half of the night...but often that means my AHIs go up relative to the first half of the night when I don't typically sleep as well.

Bill

[Spy Car]

Bill,


I went through the same process.  A Second in-house sleep study with switching to asv to address centrals.  The study results are documented for insurance purposes to get the asv machine as its higher in costs.  One thing I learned with this sleep apnea stuff is the insurance game.  asv did the trick for me hope it works for you as well.

Yes, I get the strong impression that cost-containment is a factor in all this. Kaiser (which I like generally) is an interesting model where insurance and providing care are mixed into one entity. And I do get the feeling that doctors are encouraged to keep costs down.

I hope the ASV is a solution for me. Congratulations on your success and thank you both for sharing and the encouraging words.

Bill

[Spy Car]

A quick update. I'm going in for my sleep study Monday night.

On Wednesday I emailed my sleep doctor to ask why we were doing a split-study when we had over a year of efficacy data with APAP and considering things have gone south with APAP?

He said if I'd rather do ASV all night that it was "no problem" and he changed the orders. He also said that if I tolerated ASV he'd be happy to write a prescription for a new machine.

So I've either seriously misjudged the amount of "push-back" on ASV that I was sensing or he's decided I'm the sort of patient that's too informed and is easier not to resist. I'd like to believe it's the former, but who knows?

I am so hoping ASV works for me.

Bill

[Sleeprider]

Good luck with study. Hope you sleep well.

[trish6hundred]

Hi Spy Car,
I hope your sleep study for ASV goes well.

[JesseLee]

Bill,

I don't know about you, but sometimes when I have a lot going on and I've got a lot to take in to the medical office, I make notes to take in. I don't know how many times I've left the docs office and didn't ask some things that I thought were important going in. Nervous, forgetful, got caught in a conversation with the nurse/doc taking blood pressure. Anyhow, just a suggestion.

Wishing the best for ya,
Jesse