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bipap ST was the treatment for a lot of stuff before ASVs were really out. It has worked for people. Just gotta see how it goes.

If it doesn't... there's always ASV to try

Xney wrote:... I have a hard time imagining an ST doing a better job than an ASV for central/mixed/complex sleep apnea. But I guess for some people that could be true. ...

Xney, you need to do some research. Rested Gal put together a post with a list of links to Central Sleep Apnea resources:

viewtopic.php?t=3025

Of particular interest and toward you comment, please review the following study:

http://journal.publications.chestnet.or ... &issueno=6

In the study the researchers found that ASV is FAR more effective than all other therapy modes to address central sleep apneas.

Sure, I think ASV is better too, but it's not like the bipap ST never worked. I'd get an ASV if it's possible, but it may not be at first due to insurance.

I really think this is a ridiculous insurance requirement - the price difference isn't that much, and ASV is better, so.....

Xney, trust me you have my sincere empathy. As others are want to say (and as I've seen you recommend), we need to advocate for our own needs. I know it literally took me years to get my central sleep apnea addressed. And unfortunately, having doctors and insurance fight the process led to permanent damage to my kidneys. "Gee, thanks Doc! Can I now send you the bills?"

So, here's hoping you (as well as the original poster) are able to get a therapy that makes a difference for you and addresses your sleep issues.

My ASV has worked great, for me - but not feeling rested despite AHI 0. Trying a new type of machine next month (see my thread on it) - hoping it works.

But I wouldn't have gotten this far, and gotten the results I've had (even if they're not great) without really fighting for it.

I had read about the "Winx" therapy. Glad to see they were able to bring it this far. And here's hoping it helps you sleep better! Trust me, I understand how very, very frustrating it can be when you are unable to attain good sleep. So, I really do wish you the best possible outcome!

JohnBFisher wrote:I had read about the "Winx" therapy. Glad to see they were able to bring it this far. And here's hoping it helps you sleep better! Trust me, I understand how very, very frustrating it can be when you are unable to attain good sleep. So, I really do wish you the best possible outcome!

Heh you would! I'm crossing my fingers but I'm wayyyyy past false hope at this point. Just have to see how it works.

Annoyingly, I have to wait til jan 2 to get the machine.

To the OP, I'd definitely push for an ASV, but if your doctor can't override your ST test due to insurance, you must just have to see how it works. It can work, and if it doesn't, you have another option left. The problem is you don't want the ST mostly working and then have a tough fight to try an ASV, but it may not be something you can avoid.

Edit: The post immediately above this appeared while I was writing this one. In particular, yes, I will push for the ASV or at least for a clear explanation about why I cannot or should not.


An update:
Review: After 30 days of CPAP I still had aneas, mostly central. I was sent to the sleep lab expecting to be put on ASV, but instead was put on ST witht he thought that I could go on ST only if ST did not woek. I was told later this was because of insurance regs, but I have not found these regs anywhere. I am pretty uneducated about this stuff but I am learning, in mo small part thanks to this site.


Anyway, I now have my report from the lab about the the overnight on the ST. It's three pages but it has a paragraph called Impressions which I quote:

Severe Obstructive Sleep Apnea 327.23 with significant improvement in the patient's sleep disordered breathing while using BiPap ST therapy at a pressure of 19/15 cm of H2)with an overall RDI of 2and a nadir saturation of 92%.
Central Sleep Apnea Syndrome 780.51.

Ok, I don't know the meaning of the numbers 327 and 780, but I have come to understand the RDI of 2 and the nadir saturation of 92% are good, or at least not bad.

I think my immediate concern is the pressure of 19/15. With an ST I will have that pressure throughout the night, or so I understand. At the lab, there was a tech adjusting the pressure during the night. Apparently I handled it but it seems fairly high. Just for amusement I looked up one atmosphere of pressure and that's something like 10 meters H2O so ok, 19 centimeters is not really huge, but still it will be all night every night. An ASV has variable pressure through the night, perhaps rising to 19/15, perhaps higher, but it would not just sit there at that pressure unless I needed it.

Is this something that should concern me?

Elsewhere in the report it says that at 19/15 my AHI goes down to 0. Good, glad to hear it.

The report also says I should be retested in 2-4 weeks. I presume this means 2-4 weeks after I get the new machine, but no one in the doc's office has even mentioned this retesting. My intention is to be as well prepared as possible. Maybe I should just relax and use the ST. But if there is any reason to be pushing for the ASV, and some of the responses, particularly from JohnBFisher, suggest I need to look into more of this.

I haven't yet read the article that John links to, I just saw it now, but I will print it and read it. Further comments are welcome.

I promise to, after a few more weeks, summarize everything I learn during this introductory stage of my treatment in case it is useful to another beginner.

krb39 wrote:... I think my immediate concern is the pressure of 19/15. ... Is this something that should concern me? ...

Do read the article. If the ST does the job, fine. But it might not in the long haul. I suspect that's why the sleep lab recommended a follow up study. As you note, the pressure is pretty high. That can cause some problems with sleep and swallowing air.

Here's hoping however, that you find a therapy that works for you and leads to good sleep.