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Hi Dave,

i will start by saying i am not an RT, nor am i some sort of clinician, but I do know the medical device industry and how it works in terms of reimbursement and DME's etc. so If i make a mistake in what I am about to say a) i apologize b) I am sure i will be corrected............I find the whole oximetry angle interesting/peculiar. If you suffer from Central Apnea's your airway is open thus I do not see how adding oxygen will help your situation out? Are you even desating? Never knew oxygen to help CA's and studies show it O2 has a minimal impact in showing improvement in CA patients. Now If you are a chronic hypoventilator then the Adapt SV is NOT for you (it is a contraindication) and you need a BiPAP ST with a large delta P (Difference between IPAP and EPAP) to provide ventilation. But based on what i have heard from you, I do not think this is the case.

niko wrote:I find the whole oximetry angle interesting/peculiar.

As did I, which is why I questioned the suggestion.

niko wrote: If you suffer from Central Apnea's your airway is open . . .

My sleep study showed mostly centrals and obstructive hypopneas

niko wrote:If you are a chronic hypoventilator then the Adapt SV is NOT for you (it is a contraindication) and you need a BiPAP ST with a large delta P (Difference between IPAP and EPAP) to provide ventilation. But based on what i have heard from you, I do not think this is the case.

I am currently on a BiPAP ST with a delta P of 6 (16 IPAP, 10 EPAP). Nightly AHIs have been in the 7-10 range according to the machine.

I am not a medical person either but it seems like adding oxygen before the AHI is above the "normal" range would be treating the symptom, not the problem. It would be like turning the car stereo up to drown out the squeal coming from the engine. Gets rid of the symptom but the problem is still there. If there is a machine out there that can get the apneas under control, then it seems to me like the O2 levels will be fixed as well.

Anyway, new plan . . .the DME my doctor wanted to switch me to does not carry BiPAP STs -- only straight BiPAP. I was told this was because "they were very expensive and the insurance does not pay much for them". They did "wish me luck on my journey" though. How thoughtful.

So now will do another oximetry study to determine if the other one was a fluke and I will bugging the doc for another PSG with the Adapt SV. I am not trying to get the "latest, greatest machine" because I think it is cool, I just want to get a decent night's sleep.

RT picked up oximeter yesterday. Have not heard results yet. Still waiting for call from sleep center regarding PSG. RT admitted that she was getting pressure from area manager because of cost of Adapt SV. Said she is not even supposed to tell patients about it. She seemed very frustrated that her area manager does not want her to recommend the best treatment for her patients. I am glad she gave me a way to work around it though . . .to penetrate the bureaucracy.