I was just wondering how you read the data on this.. I had 2 titrations and insurance does not want to pay for bi pap so they loaned me the remstar auto cpap.. they said it will give me a 90 percent number to see where i am supposed to be..
My bi pap titration levels were determined to be 20/8 Now, they set the remstar auto to start at 8 and i would like to find out what it is getting up to.. I still feel so tired. I just wondered what all i had to have to find out the info stored..
They did tell me that a big part of mine was episodes while on my back during testing and i do not sleep on my back, however during the test i had 137 events per hours on my back, and 4.9 on my side.. lowest oxygen level 68 percent, this is what scares me. I just don't know if i truly need a level of 20, the tech did saw at 18, while on my back, my oxygen was still dropping into the 70's.. so it becomes a question of who to trust the techs or the auto machine, my money is on the paid professionals, but i am curious to hear everyones input on this issue.. thanks, this has been a long process for me and i am still not where i need to be at all.
question about reading data on Remstar auto, titration vs au
3 posts
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if your pressure ends up being around 15 cm or higher you start complaining about getting that Bipap.
Most (not all) insurance companies state that you must:
-First attempt therapy on a CPAP machine before they will pay for a Bipap. That "attempt" may only be a week or a few days and you have met that requirement.
You need to go to your insurance website, log in, and search for "CPAP" policy. It should state the hoops you need to jump through before they will pay for a Bipap which offers you the most relief if you require higher pressures. The next best thing in my opinion is the A-Flex machine.
If you are like most the machine they give you for the first 30-days or so is a trial, then it turns into a rental/purchase. Once you get past that first month you are pretty much stuck with the machine, after 3 months an uphill battle.
The exceptions to the above in getting a Bipap is if you have a compromising disorder like Asthma, COPD, past history of heart attack or stroke, then your doctor can specify just about any machine they feel you need.
Note:
You had 2 titrations. They found your pressure to be 20/8. That is IPAP=20 and EPAP=8. IPAP=Inhale pressure, EPAP=Exhale pressure. That is a 12 cm spread between IPAP and EPAP.
I ALSO would question that if I was a doctor or DME and would want a trial on an auto. I would also stop going to that lab that is coming up with pressure like that.
Because if they would have brought the EPAP pressure up from 8cm, you would most likely NOT need 20cm pressure. You would have to look at the titration table to determine HOW they obtained those pressures but rarely does a person have a 12 cm spread. Even the Bipap Auto machines only allow a 8 cm spread maximum. If you are on Bilevel, those would most likely only be a 4 cm spread. 8cm I could see but 12cm? I'd question that finding also.
Each pressure handles different events, IPAP may handle Flow limitations and Hypopnea, EPAP apnea and snore. The EPAP pressure should always be high enough to hold your airway patent even when you switch from inhale to exhale.
I can almost guarantee you that the autopap trial won't make its way up to 20cm pressure. Because it operates like a CPAP machine, it may have CFlex or AFlex for exhale relief (not as much as a Bipap offers).
So based upon that 20/8 finding it puts your whole titration in question unless the tech that titrated you can explain that finding.
Obtain a copy of that PSG from your doctor/lab. Look for any CA or MA or other non-OSA sleep disorders such as PLMD and even spontaneous arousals. But again that pressure finding puts the results you obtained from that lab in question.
If your sleep doc owns a piece of that sleep lab (ask), then ask what's up with this pressure finding of 20/8. If that was botched, was the rest of the sleep study also botched? If they couldn't explain it, I'd be getting another PSG done elsewhere and that first lab would be paying for it.
Most (not all) insurance companies state that you must:
-First attempt therapy on a CPAP machine before they will pay for a Bipap. That "attempt" may only be a week or a few days and you have met that requirement.
You need to go to your insurance website, log in, and search for "CPAP" policy. It should state the hoops you need to jump through before they will pay for a Bipap which offers you the most relief if you require higher pressures. The next best thing in my opinion is the A-Flex machine.
If you are like most the machine they give you for the first 30-days or so is a trial, then it turns into a rental/purchase. Once you get past that first month you are pretty much stuck with the machine, after 3 months an uphill battle.
The exceptions to the above in getting a Bipap is if you have a compromising disorder like Asthma, COPD, past history of heart attack or stroke, then your doctor can specify just about any machine they feel you need.
Note:
You had 2 titrations. They found your pressure to be 20/8. That is IPAP=20 and EPAP=8. IPAP=Inhale pressure, EPAP=Exhale pressure. That is a 12 cm spread between IPAP and EPAP.
I ALSO would question that if I was a doctor or DME and would want a trial on an auto. I would also stop going to that lab that is coming up with pressure like that.
Because if they would have brought the EPAP pressure up from 8cm, you would most likely NOT need 20cm pressure. You would have to look at the titration table to determine HOW they obtained those pressures but rarely does a person have a 12 cm spread. Even the Bipap Auto machines only allow a 8 cm spread maximum. If you are on Bilevel, those would most likely only be a 4 cm spread. 8cm I could see but 12cm? I'd question that finding also.
Each pressure handles different events, IPAP may handle Flow limitations and Hypopnea, EPAP apnea and snore. The EPAP pressure should always be high enough to hold your airway patent even when you switch from inhale to exhale.
I can almost guarantee you that the autopap trial won't make its way up to 20cm pressure. Because it operates like a CPAP machine, it may have CFlex or AFlex for exhale relief (not as much as a Bipap offers).
So based upon that 20/8 finding it puts your whole titration in question unless the tech that titrated you can explain that finding.
Obtain a copy of that PSG from your doctor/lab. Look for any CA or MA or other non-OSA sleep disorders such as PLMD and even spontaneous arousals. But again that pressure finding puts the results you obtained from that lab in question.
If your sleep doc owns a piece of that sleep lab (ask), then ask what's up with this pressure finding of 20/8. If that was botched, was the rest of the sleep study also botched? If they couldn't explain it, I'd be getting another PSG done elsewhere and that first lab would be paying for it.
someday science will catch up to what I'm saying...
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Guest
this is all so confusing, i dont know what a CA or MA is. The first titration was for cpap an it was a level of 16 which i couldnt exhale against so the doc ordered the bi pap titration, why would it change from 16 to 20 on bi level ipap? My doc has nothing to do with the sleep lab, i know that. It is very confusing because what if you end up with incorrect numbers? I know one thing, whatever machine i end up has to be one i can buy the software for and know what is happening... where is the cheapest place to get the right software and reader?
3 posts
• Page 1 of 1