14 DAYS!! Question for EXPERTS' Advice on Stats

[Grand-PAP]

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[Pugsy]

If you need a different machine and your doctor provides necessary information Medicare will do their part on the cost. You are in the "rental" period anyway. With Medicare you will likely have to "fail" at the standard treatment before they will consider allowing a charge for the pricier machine. So perhaps you need to clarify with your doctor what the actual plan is with regards for what he expects to do with the centrals.

95% leak number means that for 95% of the night you were either AT or BELOW that number. Since ResMed says they can handle anything up to 24 L/min a leak of 12 L/Min is acceptable..Especially for just starting out and having to deal with leaks and such. It's not unusual to see large max leak numbers at first since you are getting use to the mask and likely fiddle with it a lot. I imagine with time that 95% will come down.

How to post images of the detailed graph reports? I use screen shots.
Here is how I do it.

Open the image to full size so it is easily read.
I use Vista snipping tool to create a screen shot and crop the image at the same time.
Prt/scr key will also take a screen shot if using XP. If laptop is used sometimes the Fn key has to be pushed at the same time as the prt/scr key
I think windows 7 Home Premium has the snipping tool, Basic may not.
Once the screen shot is created save it in jpg format.
Upload the image to a host site. I use Photobucket it is free, there are others.
Once the image is uploaded then copy the ENTIRE IMG address. Be sure to include the opening and closing IMG in brackets. Paste that copied address into a post here.
Use the preview button. If you can't see the image try again because if you can't see it we can't.

[Java Time]

Survived two weeks! It was rough!

I guess compared to 2 weeks, I'm a veteran; I'm at about 10 weeks. I'll let someone else respond to your events and leaks questions, but I'll address how you "feel" at 14 days. If your AHI per hour at your sleep study was high (mine was 70), it may take awhile for your AHI to drop down with your new machine. I averaged around 6AHI for most of the first 6 weeks, but it jumped around quite a bit from night to night. My leaks were higher at first, but not nearly as high as you are seeing.

I didn't really start feeling better until close to the two month mark. A lot of the "feeling better" for me was from sleeping better after figuring out several peripheral things like how to arrange your hose, humidity levels, pillow, body position with a hose sticking off your face, etc. These are all unique for each person, but with trial and error you'll figure out how to get more comfortable which will help with your feeling rested. As everyone on here says, it does get better!

THE CONCERN I HAVE IS THAT I THINK THE DOC PRESCRIBED THE WRONG MACHINE -- CPAP vs APAP or VPAP.

3. MEDICARE. If there any Medicare Veterans -- if it did turn out that the DOC wanted to prescribe VPAP, or whatever, would Medicare change the rental to that machine, or would that have to come out of my pocket?

Here is what helped with my doctor/insurance, it may help with your doctor/medicare as well. For me it was a mask problem, but I'd think it would be applicable with a machine problem as well. I told my insurance that I understood that "due to my severe sleep apnea it is Medically necessary for me to use a CPAP machine". I also told them that with my current mask (for you it would be your current machine) "I feel like I cannot breathe and I cannot sleep. I do not believe I can do the therapy with the current mask (for you it would be machine) and I would like to try another one to see if that will allow me to be successful with the treatment."

Also, several people have pointed out that getting insurance/medicare to pay for something is much easier if you can get your doctor to be SPECIFIC on the prescription! My doctor specifically said an APAP machine with heated humidifier on the Rx, which forced the insurance to give that to me.

Good luck!

[Pugsy]

1. EVENTS. The major EVENTS seem to be Central and my understanding is that CPAP will do nothing for them. Is my understanding correct?

This is correct. Centrals are open airway cessation of breathing and since the airway is already open there is nothing for the pressure to hold open.

Did you have centrals in your initial sleep study or titration study?

[Perrybucsdad]

Grand, I would not call myself an expert as I have only been at this since for a few months, but I did start out on a FFM and then switched over to the nasal pillows. I see you have them on order. You will love them. Not sure if the same will happen for you, but when I switched to the pillows, my AHI dropped like a rock and I am feeling much better. With so many Central's though, I don't know if that will happen for you. Your pressure isn't really that high (at least I don't think so) but I wonder if they are pressure induced.

John

[Pugsy]

Your pressure isn't really that high (at least I don't think so) but I wonder if they are pressure induced.

This is why I asked if there was a history of centrals either during the initial sleep study or titration study.
If they were present during initial sleep study..then obviously not pressure induced.
If they only showed up during the titration study then they might be pressure induced. Also might be a combination.

If I was wanting to bet...I imagine that the centrals were present on the initial sleep study.

[Grand-PAP]

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[Pugsy]

I don't know what the numbers inside the squares above the Central and Obstructive Events mean. Do they, by chance, mean the NUMBER OF SECONDS of duration?

Yes, duration of event in seconds.

It's WAY too soon for me to try and draw relationships or conclusions, but looking at ResScan and SleepyHead charts, "often" the events (particularly when they are bunched together) correspond to higher leak events. I HOPE that that may be good! It seems if I am rolling over, "wrestling" around in bed, fighting with the mask and hose, that I might both cause leaks AND change my breathing pattern that might result in "false" Centrals.

You are quite correct. Way too soon to be going into panic mode. It is entirely possible that those "Centrals" aren't real Centrals or at least some of them anyway. Your obstructive component (Obstructive apneas and Hyponeas) are well treated. If the clusters of centrals appear near sleep onset or awakening they may even be normal centrals because it is common to have them at those times. The machine can only use one criteria for its identification of "centrals" and lacks the ability to see if you are really asleep (need EEG) or the thoracic effort that sleep techs look for.

And yes, if leaks are spiking, it can disrupt sleep, which will in turn mess with sleep cycle and possibly create a new sleep onset group of centrals. So just watch things for a while and see if you can spot a pattern.