Resmed VPAP Adapt SV - for Central Sleep Apnea

dsm · Post by **dsm** » Sun Mar 02, 2008 3:35 pm

SAG,

As afr as I can tell, Pprox isn't used in the new Vpap Auto either.

The value in debating its purpose is in my mind, is understanding what it can achieve and why. Is it a device for better air control ? does xpap construction cost containment dictate it gets dropped to lower production costs.

I made the point in a past post that the high-end top-of-the-line healthcare machines mostly seem to use one.

I guess the absolute input on this matter would be to have one of the designers explain why they put it in and why some other designers take it out. I currently lean to removal for cost containment purposes but am always open to a well put case.

DSM

Liam1965 · Post by **Liam1965** » Sun Mar 02, 2008 6:11 pm

rested gal wrote:artwood, if your insurance will pay for an out-of-state sleep study, I know exactly where I'd go. Please check your Private Messages. Button at top right of this page.

RG, where would that be, exactly? I'm still trying to get my PCP to refer me for a new study, with complex SA in mind, and I'm trying to find someone around who is up to date on the latest stuff and might be open to a diagnosis of compSA.

If I can't find a local sleep clinic that seems to have a clue, I'm curious where you'd go, if you could go anywhere...

Thanks,

Liam, who will go just about anywhere for a cheap laugh, so why not for a sleep study?

rested gal · Post by **rested gal** » Sun Mar 02, 2008 6:47 pm

Liam, I'd go to this one, at Greenwich Hospital in Connecticut:

http://www.sleepcenters.org/CentersInfo ... _ID=175820

Birdseed · Post by **Birdseed** » Sun Mar 02, 2008 6:48 pm

Liam,

IMHO, I would call your closest University-based hospital/Medical Center if you have one in your area. It seems they would be more likely to be equipped to diagnose and treat CSDB, like CSA or Mixed SA.

Birdseed

Liam1965 · Post by **Liam1965** » Sun Mar 02, 2008 7:09 pm

Birdseed wrote:IMHO, I would call your closest University-based hospital/Medical Center if you have one in your area. It seems they would be more likely to be equipped to diagnose and treat CSDB, like CSA or Mixed SA.

That sounds like good advice, but I had my first round of sleep studies at Dartmouth Hitchcock Medical Center sleep lab, the hospital that is associated with Dartmouth College's medical school, and I was underwhelmed at the care I received.

It wasn't horrible, but I learned a lot more about sleep apnea from a few hours on CPAPTalk the first night I had my diagnosis than I ever learned from them, and there were a few times they were downright hostile to my attempts to have some say in my own treatment (like suggesting I might do better with an APAP than a CPAP when I started having some of the centrals).

So I have to say that they may be better on average, college-based sleep labs aren't necessarily always better.

Liam, who still finds it eerie when they start playing that "Hitchcock Presents" theme as he walks in the door.

-SWS · Post by **-SWS** » Sun Mar 02, 2008 8:36 pm

Liam, one of the world's leading CSDB research centers just so happens to be in your general neck of the woods:

http://www.bidmc.harvard.edu/display.asp?leaf_id=488

If I were in your shoes I'd fill the car up with gas and point it in that direction. Then I'd call for the appointment. Good luck!

Liam1965 · Post by **Liam1965** » Sun Mar 02, 2008 8:42 pm

-SWS! You're still around! I was wondering, I've been running around for a few weeks and I hadn't seen you...

You think Harvard beats out the one RG suggested? It would definitely be closer for me, but might be more expensive.

But then again, it's worth the extra expense if I can end up working with someone who can actually successfully TREAT my problem.

Anyway, good to see you again!

Liam, hoping he doesn't seem TOO eager to see -SWS back again.

-SWS · Post by **-SWS** » Sun Mar 02, 2008 9:25 pm

Liam, the sleep center Rested Gal suggested is SAG's. Laura went out there for her study and received an absolutely top-notch sleep study from SAG's team of sleep technologists. I don't blame her one bit for recommending the place where she received great treatment.

Alternately, Beth Israel specializes in both CSDB state-of-the-art treatment and CSDB research (general sleep medicine as well). BI is thus internationally very well respected as a world-leading CSDB research and treatment center. You may go there for state-of-the-art treatment, or you may request a research program (if one happens to be available).

SAG's sleep center treats CSDB as well. I also happen to think SAG is one sharp cookie. However, I have no clue how many CSDB patients SAG's sleep lab sees. SAG may be able to give you more details either via PM or perhaps in this thread. I'd be very comfortable going to SAG's sleep lab as well.

We knew you'd come back, Shane... er, uh... Liam!! Welcome back!

rested gal · Post by **rested gal** » Sun Mar 02, 2008 10:45 pm

My recommendation is definitely colored by this:

I'd rather go to a top notch accredited sleep lab run by someone knowledgable about CSBD who would take a personal interest in figuring out "what'sa'matter with Liam?" than go to an impersonal center no matter how much CSDB research they're doing and take a number - hoping for luck of the draw.

After all, the person who can discover what makes Liam's sleep (or lack thereof) tick will be a hero here! It's a challenge I think SAG could handle. Not so sure that the BI guys could -- or perhaps I should say, not so sure they would take the time to do that as thoroughly as SAG would.

Either place, though...go for it, Liam. It's time for you to start sleeping well so you can get back to posting regularly here!!

-SWS · Post by **-SWS** » Sun Mar 02, 2008 11:16 pm

rested gal wrote:...than go to an impersonal center no matter how much CSDB research they're doing and take a number - hoping for luck of the draw.

Fortunately that's not Beth Israel's approach either. I saw their email correspondences first hand and felt they had a very personal touch.

I've seen SAG's correspondence here first hand as well. He most definitely offers a personal touch. Plus SAG is Laura's buddy!

.

rested gal · Post by **rested gal** » Mon Mar 03, 2008 12:20 am

You are too...my buddy!

-SWS · Post by **-SWS** » Mon Mar 03, 2008 12:32 am

So as you can see, Liam, we use the buddy-buddy system here. SAG's also one very smart guy, and I'm sure he runs a smart sleep lab.

Do not talk to him immediately prior to your sleep study, though. His jokes will make you laugh. Evening laughing will, in turn, totally ruin your sleep efficiency score...

Liam1965 · Post by **Liam1965** » Mon Mar 03, 2008 1:28 am

Darn it! I hate it when my computer loses a post.

I just wrote a nice long one as well..

Sigh.

The upshot of it was that I liked RG's argument, after my last experience it would be nice to have someone who was working WITH me, instead of treating me like a mechanic does a car.

But then I wondered "what if I'm the patient from hell and don't even know it", do I really need that to become common knowledge on this board, would it be better to remain in (relatively) high esteem on the board and relative obscurity in the sleep lab.

Finally I noted that this may all be moot of the darn primary care physician doesn't get back to me with a referral for a new sleep study (or declines to provide it).

Still waiting...

Liam, like the energizer bunny, but more inert.

Liam1965 · Post by **Liam1965** » Mon Mar 03, 2008 1:30 am

-SWS wrote:Do not talk to him immediately prior to your sleep study, though. His jokes will make you laugh. Evening laughing will, in turn, totally ruin your sleep efficiency score...

Oh, and I forgot this part of the lost post: Yeah, this is good advice, given that I'm such a serious guy and all. We'd hate for me to be infected by laughter.

(OK, somehow it was funnier-phrased last time. What do you want at 2:30 in the morning?)

Liam, whose subconscious answers "Um, sleep. Duh!"

rested gal · Post by **rested gal** » Mon Mar 03, 2008 1:44 am

Liam1965 wrote:The upshot of it was that I liked RG's argument, after my last experience it would be nice to have someone who was working WITH me, instead of treating me like a mechanic does a car.

Wait! Wait!!! Now I'm all a'skeered!!! I don't wanna be responsible for SAG making you get up and run 10 miles in the pre-dawn not-so-bright early morning light!!!

Also, I've been speaking a lot about what SAG'd do for you, without even asking him. LOL!!! He might just say, "Yeah, yeah... here, dude, take a number, sit down, and wait. RG who?"

Laura, who chickens out sooooo fast.

P.S. You look pretty ert to me, Liam.

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Additional Comments: Also have the RemStar BiPAP Pro2 with Humidifier and Encore Pro

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