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+--- Thread: Just diagnosed but headed back for 2nd study. Advice? (/Thread-Just-diagnosed-but-headed-back-for-2nd-study-Advice)
RE: Just diagnosed but headed back for 2nd study. Advice? - Sleeprider - 12-30-2016
With insurance I would expect that you will be issued a bilevel, which at DME prices will consume most of the deductible. You need to develop a strategy with your doctor that ensures any additional studies and potential move to ASV can occur within the same calendar year to avoid another deductible event in 2018 for an even more expensive machine. DME prices on the Resmed Aircurve 10 ASV will be in the $5-6K range. I know of a unit sold last week for $600 used.
RE: Just diagnosed but headed back for 2nd study. Advice? - Piggles - 12-31-2016
While on my quest for knowledge I have been reading about bilevel machines that offer a "backup rate" or bpm settings. I see that Resmed offers one.
Assuming that my insurance is going to make me go with a bipap machine first, would getting a machine that offers a back up rate be of benefit to me since I'm showing central apneas?
Happy New Year everyone.
RE: Just diagnosed but headed back for 2nd study. Advice? - Sleeprider - 01-01-2017
If you can find a deal on either a Resmed S9 VPAP Adapt or Airsense 10 ASV, that would be a final device for resolving central and mixed apnea and hypopnea.
RE: Just diagnosed but headed back for 2nd study. Advice? - Piggles - 01-05-2017
I have gotten the results from my full night titration and my prescription.
Here is the 2nd sleep study: https://www.dropbox.com/s/xjcw8nkwdbto2oj/sleepstudy2.pdf
My prescription is for 24/20. I'm pretty disappointed with the study. They only had me at that pressure for 20 minutes. During my split, it looked like 17/13 was a good pressure but I was only there for 15 minutes (link to that sleep study is on the previous page).
The ASV is a no-go from the DR until bi-pap fails. My Dreamstation Bipap Auto should arrive today and I will be keeping my eye open for a decent deal on an ASV as I go.
Any thoughts on where I should start with my machine? I'm not very convinced by the study.
RE: Just diagnosed but headed back for 2nd study. Advice? - Sleeprider - 01-05-2017
I certainly think you start with the prescription. That is very high pressure indeed.
RE: Just diagnosed but headed back for 2nd study. Advice? - Piggles - 01-05-2017
Alright I'll start with the prescription. I am setting up the machine myself since I bought it outside of the DME world. I've read through the provider guide and here is what I'm thinking... please let me know if I've made a misstep or left something out:
Therapy Settings:
- Mode: Bi-Level
- IPAP: 24
- EPAP: 20
Comfort:
- Humidification: Adaptive (adjust as necessary as I go)
(Question: With adaptive set, do I need to set a tube/humidifer setting or will it take care of that for me?)
- Smart Ramp: On
- Ramp Time: 15 mins
There are a few simple things I'll have to work out like Rise Time and mask type but based on what I'm reading and my prescription I think that is about it. Does this all sounds about right?
Thanks in advance Sleeprider, you've been a big help to me.
RE: Just diagnosed but headed back for 2nd study. Advice? - Piggles - 01-05-2017
I'm setting things up as described above and playing around with the settings. I really am having trouble exhaling against the 20. I don't know what to do about that.
RE: Just diagnosed but headed back for 2nd study. Advice? - Mosquitobait - 01-05-2017
Won't let me delete...
RE: Just diagnosed but headed back for 2nd study. Advice? - Sleeprider - 01-05-2017
You have a Dreamstation auto, so maybe use the auto function to your advantage to keep pressures a bit lower. I would prefer that you use the prescription settings, but that does not take into account the fact your machine can automatically adjusts, and we don't know what the clinician was looking at in the final titration. On a BiPAP auto, your prescriptions is basically S-mode with fixed IPAP/EPAP 24/20.
If titration says a minimum PS of 4 is good, then let's roll with that. If you set the mode to BAuto and PSmin to 4, and PSmax to 6, then a EPAPmin of 18 and IPAPmax of 24 should be about right in auto mode. Unfortunately, OA control is all about the EPAPmin setting. One thing I found useful on the PRS1 BiPAP auto was increasing TiMax to 2.2.
RE: Just diagnosed but headed back for 2nd study. Advice? - Piggles - 01-07-2017
I'm really having a hard time with these high pressures. I've yet to get any reliable data because I have to take my mask off because my lungs just feel warn out. My lung function is normal and healthy otherwise.
Is there any harm in doing an "auto titration" on my own and can you offer any settings on how to start? If it turns out I have to deal with this high of pressure, it is what it is.
I guess I'm jus hoping things like sleep position (I'm a side and stomach sleeper) will change my pressure needs. Since OA isn't really my issue, id think that a lower pressure would be better for my CA. Then it is just hypopneas I'm dealing with.