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Okie bipap wrote: ↑

Tue Mar 30, 2021 7:56 pm

Their recommendation of a second study to titration makes sense. The only way they can prove the central events are true events is to do an in lab study. Also, most insurance companies will not approve the purchase of bilevel or ASV type machine without a titration study.

Gotcha, that makes sense to me. My provider did not tell me this initially though. Their reasoning was the titration study could help determine the optimum pressure that would minimize my OA/Hyp which made no sense to me. After more discussion, they gave me the same reason you posted. If this is a hoop I need to jump through, so be it.

Thank you for your post.

I had to do two sleep studies before I got my machine, and my wife ended up having three because they thought she may need to have an ASV type machine. She ended up on an auto bi-level machine like I use.

Well, I went ahead and scheduled a titration. I have it later this week actually. I think this is probably the first time I'm actively wishing for a bad night with a bunch of CAs. If I happen to have a good night (<5 ahi), I don't know where that will leave me. I can't see them approving any changes to my treatment if they think it's working. We will see what happens...

Janknitz wrote: ↑

Tue Mar 30, 2021 8:40 pm

Okie bipap wrote: ↑

Tue Mar 30, 2021 7:56 pm

Their recommendation of a second study to titration makes sense. The only way they can prove the central events are true events is to do an in lab study. Also, most insurance companies will not approve the purchase of bilevel or ASV type machine without a titration study.

Yes, this!

But only if they trial you on an ASV. If they just try to tune up your settings on your current machine, or on a bilevel machine, you won't be any further forward.

Generally when titrations are ordered they start a person out on cpap and then proceed depending on what happens and responses to what happens.
They may or may not make it to ASV the first titration....you may or may not make criteria for moving to ASV.

Here's sort of a guide or cheat sheet that techs in sleep labs use
http://www.isetonline.org/yahoo_site_ad ... 190318.pdf

The first thing they will look at is if your central apneas are real asleep apneas or not.
Easily seen in a sleep lab...not so easy for use to figure out at home.

You have to start somewhere though and this is the first starting point.

Update:

I had my titration study earlier this week. Unfortunately, it did not go very well at all. I was unable to fall asleep for many hours which was extremely frustrating. I doubt they got the data they needed to determine an optimum pressure (if there is one) or to determine if I belong on a different machine. I'm still waiting on the results but I'm not expecting much from them.

I'll update once I have the results.

Thanks for reading!

Sometimes they can get what they need with a relatively limited amount of sleep. Fingers crossed for you.

Update:

I had my sleep study about two weeks ago and got the results last week. During the titration, they were unable to find a pressure that resolved my obstructive events that did not cause excessive centrals. They want me to come back in for a titration with an ASV machine. I guess that is progress.

I'm hoping this means I'm going to end up with an ASV. I'm gonna be more than a little upset if I go down there for the titration and for some reason I don't get a prescription for an ASV.

I'm anxiously awaiting my appointment. I'm hoping this is the last one I have to do and that maybe this journey will be coming to an end soon.

That IS progress! When is the titration?

Miss Emerita wrote: ↑

Sun Apr 25, 2021 7:59 pm

That IS progress! When is the titration?

Unfortunately I have to wait until the end of May. I wish it was closer it is what it is.

GRRR.

Update:

Finally had my 3rd sleep study last night with the ASV. Unfortunately, it did not go well at all. Everytime I was about to drift off to sleep, the machine would send a puff of air which would wake me up. It also seemed to be increasing the pressure when I inhaled which I did not find enjoyable. I think I slept for 3 hours total. I'm hoping that is enough data for them to write the prescription for the machine. I really do not want to go back for another study. It's not an enjoyable experience and it's expensive!

Doublearon wrote: ↑

Thu May 27, 2021 1:56 pm

Update:

Finally had my 3rd sleep study last night with the ASV. Unfortunately, it did not go well at all. Everytime I was about to drift off to sleep, the machine would send a puff of air which would wake me up. It also seemed to be increasing the pressure when I inhaled which I did not find enjoyable. I think I slept for 3 hours total. I'm hoping that is enough data for them to write the prescription for the machine. I really do not want to go back for another study. It's not an enjoyable experience and it's expensive!

be of good cheer. you prolly slept more than you realized and they will have enough info.