This is my big chance. Which machine?

Thought I did, we do send all pt's home with data capable machines and do extensive follow-up....what more are you looking for?

rooster wrote: Understand? A simple question, which, if answered, can give you some credibility that you are currently lacking.

Wouldn'd/Couldn't answer my questions either?!

Here they are again:
Have you reviewed any of the studies? Are there aspects of the research methodologies that you think invalidate the findings? Wondering, too, if you can provide us with any peer reviewed medical research reports that support your beliefs regarding the inaccuracy of APAP titration? I know we'd all like to take a look, if indeed it exists.

Not that I wouldn't or couldn't, am happy to comply with the request once I get back to my work computer that already has everything nice and organized...why redo the work @ home when it is already been done @ the job is my motto regarding this matter

PolyMar wrote:Thought I did, we do send all pt's home with data capable machines and do extensive follow-up....what more are you looking for?

So the data capable machines confirm the lab always found the optimal pressure and you "rarely" have to change a setting?

Yes in most cases, unless a pt gains/loses weight, medical conditions change or meds, etc. We do see your typical OSA pt but we also deal with many pt's who have many additional comorbidities the go beyond the realm of simple high blood pressure, diabetes, etc. Again, we do require the physician to make the ultimate decision as it is his/her pt.

RipVW wrote:

rooster wrote: Understand? A simple question, which, if answered, can give you some credibility that you are currently lacking.

Wouldn'd/Couldn't answer my questions either?!

Here they are again:
Have you reviewed any of the studies? Are there aspects of the research methodologies that you think invalidate the findings? Wondering, too, if you can provide us with any peer reviewed medical research reports that support your beliefs regarding the inaccuracy of APAP titration? I know we'd all like to take a look, if indeed it exists.

Ok, so at this point my spouse is about to kill me, but here is a link to an article describing the pros of CPAP vs APAP, and a blog discussing the results. More to come when I get back to work.

Article - http://www.ncbi.nlm.nih.gov/sites/entre ... t=Abstract

Blog - http://www.apneasupport.org/about10570.html

PolyMar wrote:Yes in most cases, unless a pt gains/loses weight, medical conditions change or meds, etc. We do see your typical OSA pt but we also deal with many pt's who have many additional comorbidities the go beyond the realm of simple high blood pressure, diabetes, etc. Again, we do require the physician to make the ultimate decision as it is his/her pt.

I have no remaining argument with the things you have said.

However, as far as what people write anonymously on the internet, it is wise to "believe only those things which you can verify or which are consistent with what you already know to be true".

For the time being, I will remain skeptical that your lab consistently finds the optimum pressure in a one-night titration study.

PolyMar wrote:

RipVW wrote:

rooster wrote: Understand? A simple question, which, if answered, can give you some credibility that you are currently lacking.

Wouldn'd/Couldn't answer my questions either?!

Here they are again:
Have you reviewed any of the studies? Are there aspects of the research methodologies that you think invalidate the findings? Wondering, too, if you can provide us with any peer reviewed medical research reports that support your beliefs regarding the inaccuracy of APAP titration? I know we'd all like to take a look, if indeed it exists.

Ok, so at this point my spouse is about to kill me, but here is a link to an article describing the pros of CPAP vs APAP, and a blog discussing the results. More to come when I get back to work.

Article - http://www.ncbi.nlm.nih.gov/sites/entre ... t=Abstract

Blog - http://www.apneasupport.org/about10570.html

The first source you cite is "Fixed and autoadjusting continuous positive airway pressure treatments are not similar in reducing cardiovascular risk factors in patients with obstructive sleep apnea." It has nothing to do with your statement regarding the inaccuracies "you experience" with APAP titration.

Same for the second citation, the "blog," which, by the way adds "I wouldn't put too much faith in this study. I have read the study and it has problems. The results actually strengthen the argument for using APAPs, especially in cases of excessive oxygenation indicated by CPAP therapy-induced central apnea from too much pressure, excessive swallowing of air and mask leaks, all of which impact compliance, but the APAP MUST be set correctly for the patient to benefit." Continues to say, "The fact is this study is being used as the basis for denying APAPs to people who could use their features, some of whom will die as a result. A doctor should not publish a document that is unverified and that causes harm. As far as I'm concerned this a violation of the doctor's hypocratic oath. "

Neither of these (the article or the blog) say anything regarding the "inaccuracy of APAP titration."

And, you've still not answered my questions:
Have you reviewed any of the studies? Are there aspects of the research methodologies that you think invalidate the findings?

Wondering, too, if you can provide us with any peer reviewed medical research reports that support your beliefs regarding the inaccuracy of APAP titration?

Okay, I think we'll just stay with your suggestion that we "agree to disagree." Onward! And best wishes to you and your organization.