Can't believe this

[Wulfman]

Just one question, Did the BiPAP (ST) exist in 1996? Sounds fishy to me. Jim

There were SOME bi-level machines around that time......I have manuals for the Tranquility Bi-Level and Synchrony that (if I deciphered the printing dates correctly) were around that time (give or take a couple of years). Those are Respironics machines, but I'm not familiar with what ResMed or some of their predecessors had in those earlier years.

Den

[Wulfman]

Thanks, I'll look for that. I checked out the last 6 months a while ago and the duration tends to be from about 8 to 12 seconds with most being in the average 10 second range.

JeffH

That's about the duration of mine, too.....when I have any.

Ya know......there might be another possibility......that they just screwed up your sleep study and the person scoring the events didn't know the difference between a central from an obstructive.
Or, that all the "clean living" you've done in the last 10 years, along with being on CPAP therapy has "healed" you.

Den

[JeffH]

Thanks, I'll look for that. I checked out the last 6 months a while ago and the duration tends to be from about 8 to 12 seconds with most being in the average 10 second range.

JeffH

That's about the duration of mine, too.....when I have any.

Ya know......there might be another possibility......that they just screwed up your sleep study and the person scoring the events didn't know the difference between a central from an obstructive.
Or, that all the "clean living" you've done in the last 10 years, along with being on CPAP therapy has "healed" you.

Den

No this is a ten year old sleep study....the only one I ever had.

JeffH

[Wulfman]

I meant that they may have screwed up your sleep study back then (couldn't tell CA from OA) and that your typical apneas "now" are only of the obstructive type......and typical length is 10 - 12 sec.

Den

[JeffH]

I meant that they may have screwed up your sleep study back then (couldn't tell CA from OA) and that your typical apneas "now" are only of the obstructive type......and typical length is 10 - 12 sec.

Den

I see what you mean now.

It was a pretty screwy sleep study, only .5 hours on cpap recorded all night, with 0 obstructions (down for 25 a's and 50 h's with out cpap) 0 hypopneas, and 24 central's! in a half hour.

JeffH

[marshaeb]

Just one question, Did the BiPAP (ST) exist in 1996? Sounds fishy to me. Jim

Yes, it did. Well, let me qualify that. It did IF what I found is the same machine. Please understand -- what I know about bipap could be put in a thimble with some room left over. All I did was run some Google searches, and I didn't go any farther when I found this: Respironics released a video in 1992 about "the use and care of the BiPAP S/T ventilatory support system." I found it here: http://naaekij.shelton.cc.al.us:84/ipac ... TITL#focus

Marsha

[gasp]

It's my policy to never let an inept medical organization have the opportunity to mess up twice. I give my business elsewhere after adequate research.

[2girlsmom]

Wow. Just wow. I wish you the best wishes in sorting out this mess and hope you get some answers and proper treatment soon.

[Goofproof]

Just one question, Did the BiPAP (ST) exist in 1996? Sounds fishy to me. Jim

Yes, it did. Well, let me qualify that. It did IF what I found is the same machine. Please understand -- what I know about bipap could be put in a thimble with some room left over. All I did was run some Google searches, and I didn't go any farther when I found this: Respironics released a video in 1992 about "the use and care of the BiPAP S/T ventilatory support system." I found it here: http://naaekij.shelton.cc.al.us:84/ipac ... TITL#focus

Marsha

Good find, I thought the ST was a more recent design, I wonder what they cost in 1992, I bet it would hurt. Jim

[echo]

I meant that they may have screwed up your sleep study back then (couldn't tell CA from OA) and that your typical apneas "now" are only of the obstructive type......and typical length is 10 - 12 sec.

Den

I see what you mean now.

It was a pretty screwy sleep study, only .5 hours on cpap recorded all night, with 0 obstructions (down for 25 a's and 50 h's with out cpap) 0 hypopneas, and 24 central's! in a half hour.

JeffH

I wonder how much of people's initial centrals are due to the fact that the titration is the very first time we've been exposed to pressurized air while sleeping, and the brain reacts funny. I wonder because I too have had a screwey experience with this (and thanks for posting this Jeff, it's a great reminder for ME to get my titration report too...)

During my titration, they saw that at 10 cm I had too many centrals, so they started me out at 7, even though it wasn't high enough to stop all the obstructions. I even remember the first 2 hours of the titration I kept jolting away, which i now recognize as central apneas. However, I now run fine on 10.5cm , and according to the P&B 420E I only have a handful of central's per night. The few nights I tried 11cm, they increased significantly. Note that it took me one year to find the right pressure just because of this incorrect? ceiling of 10cm that the doctor set (arbitrarily??).

So anyway my point is that perhaps during the titration we experience more centrals than we do once we get used to the therapy, just because the brain isn't used to dealing with pressurized air.

Just food for though... Not that I mean you shouldn't investigate this further!!!!! I do hope you get to the bottom of this, and that you weren't deprived of 10 years of proper therapy!!

[JeffH]

I meant that they may have screwed up your sleep study back then (couldn't tell CA from OA) and that your typical apneas "now" are only of the obstructive type......and typical length is 10 - 12 sec.

Den

I see what you mean now.

It was a pretty screwy sleep study, only .5 hours on cpap recorded all night, with 0 obstructions (down for 25 a's and 50 h's with out cpap) 0 hypopneas, and 24 central's! in a half hour.

JeffH

I wonder how much of people's initial centrals are due to the fact that the titration is the very first time we've been exposed to pressurized air while sleeping, and the brain reacts funny. I wonder because I too have had a screwey experience with this (and thanks for posting this Jeff, it's a great reminder for ME to get my titration report too...)

During my titration, they saw that at 10 cm I had too many centrals, so they started me out at 7, even though it wasn't high enough to stop all the obstructions. I even remember the first 2 hours of the titration I kept jolting away, which i now recognize as central apneas. However, I now run fine on 10.5cm , and according to the P&B 420E I only have a handful of central's per night. The few nights I tried 11cm, they increased significantly. Note that it took me one year to find the right pressure just because of this incorrect? ceiling of 10cm that the doctor set (arbitrarily??).

So anyway my point is that perhaps during the titration we experience more centrals than we do once we get used to the therapy, just because the brain isn't used to dealing with pressurized air.

Just food for though... Not that I mean you shouldn't investigate this further!!!!! I do hope you get to the bottom of this, and that you weren't deprived of 10 years of proper therapy!!

Thanks Echo, I thought the same thing. Believe me, I'm going to get to the bottom of this and probably going to piss a few medical professionals off in the process.

[Craig-Tx]

JeffH - please advise your doctor before you self-titrate. Thank you.

OK, I know TheDean posted this way back in the thread... but I can't let it go. No Where in this thread does ANYONE mention self-titrating, changing pressure, or anything of the like. So to TheDean, we all already know what you want to say ALL THE TIME. There's no point in you repeating yourself, especially in a topic that has nothing to do with this.

-craig

[JeffH]

JeffH - please advise your doctor before you self-titrate. Thank you.

OK, I know TheDean posted this way back in the thread... but I can't let it go. No Where in this thread does ANYONE mention self-titrating, changing pressure, or anything of the like. So to TheDean, we all already know what you want to say ALL THE TIME. There's no point in you repeating yourself, especially in a topic that has nothing to do with this.

-craig

Well said, craig, but he doesn't listen.

[MMCGOWAN]

Just one question, Did the BiPAP (ST) exist in 1996? Sounds fishy to me. Jim

Been on BIPAP since 1994 yes it did

[ozij]

It was a pretty screwy sleep study, only .5 hours on cpap recorded all night, with 0 obstructions (down for 25 a's and 50 h's with out cpap) 0 hypopneas, and 24 central's! in a half hour.

JeffH

I'm going to quote the part called, "interpretation"

"During the diagnostic portion of the evaluation, a severe degree of obstructive sleep apnea (780.53-0) was documented. Apneas were not position related. The patient did not obtain and stage REM sleep during this portion of the study, therefore, a possible REM effect could not be determined.

At the cpap pressure of 12 cm h20, all obstructive apneas were abolished, however, the patient began experiencing central apneas at 7 cm h20, numbers of which increased with increased cpap pressure. While a significant number of apneaic events remained at the cpap number of 12, no clinically significant oxygen desaturations were noted at this pressure. No clinically significant amount of central apnea was documented at the cpap pressure of 12. A retitration is recommended with Bi-level positive airway pressure (Bipap ST) to better manage both the central as well as the obstructive component of the patient's apneic events.

I was never told of the need for another sleep study with Bipap. Can you believe this?

When I had my study I went to the state teaching hospital so the "Doctor" I saw was a resident doing his 6 week ENT rotation. I can't believe that the docs that were supervising him didn't intervene and tell me I needed this.


JeffH

Jeff,
The things I colored just don't jell - I wonder if it was actually a proper supervisory intervention that kept you from getting this baseless interpretation. From 7 to 12 in half an hour? I mean, how absurd can they get? That ENT resident must have been a true idiot, assuming he could interpret anything based on 30 minutes of sleep with cpap (were those 30 consecutive minutes?). Do you know who signed your Rx, as opposed to who signed the interpretation? A repeat sleep study may have been necessary - but its also possible that someone decided you couldn't sleep in the lab, and they'd give you a cpap to see how it helps you.

O.




You've had 10 years of experience on CPAP to teach you about your