Vauto?? (duh) ASV...Ins.Co.'s AGAIN !)

[optimalsleep]

I have to post the cover sheet.....and graphs again. I'll try later tonight.

Dr's office mentioned I have to qualify for ASV...3rd study

Not enough Centrals to warrant ASV

Gotta give ResMed aircurve 10 S  bilevel 3 to 4 weeks... 

Res Med web site...sleep lab titration...

TiControl lets you set minimum and maximum time limits on either side of the patient’s ideal spontaneous flow cycling, creating a window of opportunity for the patient to spontaneously cycle the breath and timely intervention during challenging conditions. Adjustable trigger and cycle sensitivity settings can be used to optimize synchrony between the device and the patient’s own respiratory efforts.

What are the benefits of bilevel?** Bilevel works to: • Prevent nocturnal hypoventilation and hypoxia, which reduces cardiovascular consequences. • Improve ventilation (gas exchange), which includes - Reducing nocturnal CO2 levels - Increasing nocturnal O2 levels - Improving daytime blood gases • Stabilize upper airway • Rest respiratory muscles • Decrease daytime sleepiness by correcting sleep architecture - Reduces arousals due to SDB and associated sleep fragmentation

[optimalsleep]

Ok... here's the Dr's technician write up.

[Sleeprider]

Well, there you go. You only had a CAI of 1.25 with obstructive index at 10 and a lot of arousals. SpO2 averaged 96% and the minimum was 92%. There is nothing there to justify medical necessity for ASV. As I suspected, the central event index does not point to ASV at this time, and you will need to try bilevel therapy. It may work fine, but only time will tell. Bilevel has the potential to work well for you, so let's give it a fair chance. The Resmed Aircurve 10 Vauto gives you the best chance at minimizing centrals due to the trigger sensitivity controls.

I'll delete your attachment with personal information and you can re-post it if you want. Just crop out the personal info.

[SarcasticDave94]

ASV would be a definite no-go with 1.25 CA to 10 OA. I agree that the VAuto could work some great things for you in giving very good therapy. Best wishes this continues quick to get this in your hands and get on with setup.

[optimalsleep]

It's a no go with Vauto.... S mode.. the sleep center used ResMed S bilevel saw it right off.. recongnized it. And that's what my Dr's office told me, not enough CA's to warrant a ASV. How many do I need to get a ASV? And what's the likelihood of the S titrating?

I am really impressed with ResMed Aircurve 10 S. They really layout everything it does ! It's ordered. Spoke with sleep center.. the get machine... I talked to gal I got my PR APAP...

I asked how long to see the change... 3 to 4 weeks. And I was impressed with the trigger controls.....!! PR doesn't go over nothing on thier machine on thier website. Hey could you change my thread title?

My first initial question...

Those CA's should have been taken care of before the duration of time.. to be flagged?

[SarcasticDave94]

The CA to OA ratio that I know of is equal or higher on CA to OA. You'd have had to shown 10 CA and 10 OA as a minimum. Since my PSG showed 124 CA to 24 OA, you should know that plain BPAP was going to be great...not.

[Sleeprider]

A Vauto is capable of S mode. The only difference in features is an auto-adjusting pressure in Vauto mode, all other controls are present. We like the Vauto because it offers auto-titrating pressure when needed, which can keep overall pressure lower than S-mode. Sometimes S mode is a better option, especially for individuals that experience disruption, with varying pressure. It's like the argument for fixed CPAP vs auto CPAP. Even if the doctor wants to prescribe the fixed pressure mode, it may be useful to have auto-pressure. Better to have it and not need it, than to need it and not have it.

Forget ASV. With the results of your test, it's not happening. I'm sure you have heard us say that central apnea is consistently inconsistent, therefore, a single test may not be a good indicator that you don't need control of CA. The problem, if present, could be better or worse at any given hour on any given night. If it becomes a chronic problem, your doctor may revisit the issue.

[SarcasticDave94]

That is a good point that I'd even forgotten to calculate in the mix. Consistent inconsistency. I'd push for the VAuto, get it set up, and prepare for good sleep at night. Best to ya in getting it done ASAP.

[optimalsleep]

I asked about the Vauto, and they said they are ordering the same machine as was done with the study, and set where I had the best management. I am not that well versed in Vauto titration, but it makes sense to have the auto for changes that need to be addressed instead of manually changing it. As I said the S already ordered...

The S algorithms seem to be well designed to Ti control, trigger and cycle sensitivity, vsync.

From what I see the Vauto just takes care of manual adjustment. And considering I had to clear OA's with my Auto Cpap... I guess I can adjust the S myself. Was inquiring an oximeter with OSCAR.

[Gideon]

I guarantee you they are not literally ordering the same machine that was used in the sleep study. That machine supports all modes on a a specific machine, costs over $10000, and is not available to users like us.
They need to be more specific. .