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+--- Thread: Cannot get answers!! (/Thread-Cannot-get-answers)
RE: Cannot get answers!! - Lambsydoats - 11-01-2014
(11-01-2014, 06:48 AM)DeepBreathing Wrote: Hi 3porpoise. Yes, the AHI is the average number of events (obstructive, central and hypopnea) per hour. What's not clear from the Rx the time over which those events occurred.
Let's see. For my third test (with pressure), the TRT is 8h 19m, and the TST is 6h 52m. Does that tell you what you're looking for?
So yes...with 18+11, why isn't my AHI 29? The results showed 0 mixed apneas, so it can't be that 11 of those 18 were CSA....
I'm SOOOOO new to this, and VERY eager to learn!! Thank you all for continuing this conversation.
Lamb
RE: Cannot get answers!! - PhyllisBalboa - 11-01-2014
(11-01-2014, 10:11 AM)Lambsydoats Wrote: Thank you all for continuing this conversation.
Lamb
Lamb, we love conversations here. And this is an interesting one.
RE: Cannot get answers!! - retired_guy - 11-01-2014
Once again, it appears the docs feel they induced the CA's with pressure, and therefor consider them insignificant to the OP. So the prescription quotes an AHI of 18, all obstructive.
Once on the machine for a few days Lambie will find out where she's really at.
By the way Lambie, you very well may have great quality sleep from the very first day. But you also might need a few days to "sink in" to the new therapy. So if the results on "day 1" turn out to be less than what you desire, don't worry, you will get there! In fact, we insist on it!
RE: Cannot get answers!! - PaulaO2 - 11-01-2014
Lambsy, here's my example. From my sleep report, at a pressure of 5, my AHI was reduced to 13, all obstructive (OA), O2 was 97%. They increased it to 7. My AHI jumped to 36, O2 dropped to 90%. My OA dropped to 5. The rest were central events. My doctor gave me a script for a machine set to 8. In 3 months, it was increased to 10. But I had a brick (non-data capable) so I had no clue if anything was working. I just accepted everything as fact and went with the flow.
I bet that even now, if I switched my APAP to CPAP, set it to one pressure, I would have more CA than OA until my body got used to that pressure. It's just the way I am. It's the way a lot of us are. Our brains are just confused. It's not bad, it's not something to freak over, it just happens.
But you can be more prepared than I was because you have this forum. I think an APAP would work better for you because the changing pressure would help keep the CA events lower.
As for the code, yes, most insurance have the same code for all regular CPAP machines. Meaning the Escape, Escape Auto, Elite, and Autoset. They pay the same amount for all four. So don't let the supplier tell you otherwise.
Have them show you the ResMed Autoset and the Phillips Respironics equivilent. I can't remember the number of it. They are both very good machines. The Autoset though you have to download the detailed data every 7 days or you will lose it. The PR will keep it for longer. But the Autoset has a better screen.
RE: Cannot get answers!! - Lambsydoats - 11-01-2014
PaulaO2, thank you for the examples and advice. Examples always help me, and I'll take all the advice I can get!
What seems odd to me is that both my 2nd (no pressure) and third (pressure) studies showed the same values: 18 OSA, 11 CSA.
RE: Cannot get answers!! - DeepBreathing - 11-01-2014
(11-01-2014, 01:51 PM)Lambsydoats Wrote: What seems odd to me is that both my 2nd (no pressure) and third (pressure) studies showed the same values: 18 OSA, 11 CSA.
Lambsy I think you should get hold of the sleep test reports to get the full amount of information available. The prescription for has partial information at best (eg no mention of hypopneas), and we are guessing as to what it actually means. Anyhow, go with an Autoset but ensure you have a low (or no) cost upgrade available to an ASV if required.
As I said before, if you are getting nearly 30% of your apneas as centrals without cpap pressure then quite obviously they are NOT being caused by pressure. I think there is an unfortunate tendency on this board to treat central apnea as being unimportant. While it's true in many cases that they are caused by pressure and will go away in time, the converse is also true for a lot of people (including myself). A central apnea is still an apnea - your breathing stops and you body is starved of oxygen.
RE: Cannot get answers!! - Lambsydoats - 11-01-2014
Here are the results of my first two tests. I thought I had the results from my third, but I don't--I just have the prescription.
https://dl.dropboxusercontent.com/u/8932686/Sleep%20tests%201%20and%202.pdf
RE: Cannot get answers!! - DeepBreathing - 11-01-2014
OK, the first one is pretty clear. You had 154 apneas and 268 hypopneas in a period of just over 8 hours (8.16 to be precise). This gives you an apnea index of 154 / 8.16 = 18.8, call it 19. Your hypopnea index is 268 / 8.16 = 32.8, call it 33. Add these together: 19 + 33 = 52, which is your AHI, and is classed as severe. Unfortunately this test hasn't broken down the apneas by type so we don't know how many were obstructive, central or mixed. One thing that does strike me is your extremely low breathing rate of only 2.5 breaths / minute. I'm not sure what that tells us, but you sure were breathing slowly.
For the second test the time was 6h 52m = 6.86 hours. Your breathing rate was 16.25 which is much more normal. Your apnea index was (18 + 11) / 6.86 = 4.23, call it 5. The hypopnea index was 86 / 6.86 = 12.54 (call it 13). Adding them together gives you AHI = 13 + 5 = 18. This time a breakdown is given which shows that your 11 centrals give a central apnea index of 2 out of your total AHI of 18. In fact the biggest contributor by a long way are the hypopneas. (This is the information that was missing from the prescription).
Taking all this on board, I'm going to back-track a little on what I said earlier - I think the Autoset is probably the way for you to go. If that can keep your hypopneas and obstructive apnea under control, then the relatively small number of centrals shouldn't be enough to warrant a more expensive ASV machine.
RE: Cannot get answers!! - Lambsydoats - 11-01-2014
(11-01-2014, 09:53 PM)DeepBreathing Wrote: Taking all this on board, I'm going to back-track a little on what I said earlier - I think the Autoset is probably the way for you to go. If that can keep your hypopneas and obstructive apnea under control, then the relatively small number of centrals shouldn't be enough to warrant a more expensive ASV machine.
Oh my gosh--THANK YOU, Paul! It's so helpful to hear how all of this breaks down (or adds up, as the case may be)!
Lamb
GETTING ANSWERS! - Lambsydoats - 11-17-2014
I called again today, and FINALLY got an appointment to go in to see the PA! My appointment is scheduled for Wednesday at noon.
Now here's the kicker: We're under a winter storm WARNING, and you would not believe how many slide-offs, crashes, jackknifes and upside-down vehicles there have been in my area ALREADY! So we'll see....
Lamb