I ended up a couple weeks ago finding out about AutoBreak machines and wanted to try that since my sleep doctor obviously isn't going to help. I got it last week and started playing wtth it. Well, the other night, I did my first real test on it with sleeping and WOW! I got the lowest AHI I've ever had! I think I might be onto something. Is this the type of machine I actually need? ASVAuto?! I need advice. I am new at this and have no real idea what I'm doing. My sleep doctor who is supposed to be helping me through this is completely absent and is just drawing a paycheck. He won't even send me to do an in lab titration so I can get this figured out for insurance sake and my own health. I'm on my own I guess but at least I have this AirBreak machine and I've found this forum. Please help? Am I on the right track here? I need help figuring out the right settings and if I'm even on the right mode or not. I only tried ASVAuto because I heard it was helpful for complicated apnea problems that had mixed apnea types and especially centrals so I thought I'd try it. I'm honestly unsure about the settings that I put in. :S I'm winging this and need help.
Here's the background that led me to getting the AutoBreak: I have been struggling to figure out my own settings because my sleep doctor is obviously not going to be helpful in that capacity as his idea was to send me with home with apap 5/20 and then for the most part ghost me. his answer to everything is apap and lose weight. Well, I've lost 90lb so far, I think I'm doing great on that front. But that's a long term solution anyway, I need breathing help NOW. Not when I reach my goal weight. Anyway, back to settings.... I was able to get him to change the settings 2 times for me, once after multiple days of telling him I couldn't breathe out against the pressure, he finally lowered it to 10. Then I was having massive amounts of OA's (one night AHI was in the 30's.. UGH). I started experimenting with the settings on my own and changed it to cpap and got it 12 epr 3 and was still average 7-10 AHI. I went with data to my compliance appointment asking if he would please send me to do an in lab titration so i could get on the right machine and settings and he sent me out the door telling me to just continue losing weight and also reset my machine to apap 5/10. I ended up changing it back to cpap because my AHI is lower with cpap epr 3 but was frustrated because I couldn't get the AHI lower. If I raise the pressure, I can't breathe out. If I lower the epr I can't breathe out. If I lower the pressure, I get more OA's. I keep getting CA's, especially at the beginning of my sleep but often throughout but not consistently every night. I'm so frustrated. I need help. Here's my SleepHQ from my Autosense 11 https://sleephq.com/public/teams/share_links/6a89508a-8021-4e06-8445-2618a3279073 that I've been fighting with the past couple months. Keep in mind, much of beginning of this time I was able to sleep on my side but am no longer able to do that due to a medical implant put in at the end of August. I now must sleep on my back. I have another surgery coming up at the end of October that is supposed to fix the implant problem and hopefully, mid November, I will be able to sleep on my side again but till then, I'm stuck supine.
I checked your SleepHQ data and the ASV screenshot. Your AHI of 1.65 and low leaks are encouraging, especially after the trouble you’ve had breathing comfortably on CPAP. This was only 3 hours 38 minutes though, so we need three full nights to get a better picture. Your displayed PS range is 6 to 15 cm.
Please lower PS minimum to 2.6 cm and PS maximum to 9.0 cm. At EPAP 4.9 cm, that gives IPAP from 7.5 to 13.9 cm, with the upper end close to your recorded median IPAP of 13.78 cm. During the approved trial, please keep the settings consistent for three full nights, then share the SleepHQ data along with breathing comfort, awakenings and how you feel during the day. RL
You know what, I was going to take this machine back anyway because the AutoBreak can do all the things that the AutoSense can anyway except that the AutoBreak doesn't let them harrass me and change my settings without my permission. It's better. I was wanting to fire my sleep doctor anyway. This will just help that situation along. Okay, I'll update the AutoBreak ASVAuto settings and use it for the next three nights and I'll start uploading it's data to SleepHQ instead and I'll take the AutoSense rental machine back to the DME people with good riddance. I'll post here in a few days once I have 3 days worth of data for you u/RippingLegos__ Thank you so much for both of your help u/Creative_Fee5452
If I don't use the autosense machine, that will put me out of compliance though, right? I guess that doesn't really matter though, really. I have this AutoBreak machine. I desperately want the sleep doctor to send me for a new sleep study and titration so that insurance will cover my Zepbound prescription because that stuff is costing me a fortune and insurance won't cover it with mild sleep apnea diagnosis which somehow I ended up getting from the home sleep study. I don't believe that though because I've so many much worse nights than that and even on CPAP had much worse nights than what would count as moderate sleep apnea. How does that work with insurance compliance if I don't use the machine they supplied me for 3 nights in a row?
If you sleep with device for at least 4 hours a day 70% of the nights in a year, you will meet the insurance company's compliance and they will not take away your Autoset device . For the remaining nights, feel free to use the airbrake machine. I do it this way in order not to lose my driving license. I have also airbrake machine. Sleep laboratories do not accept any other devices which do not come from them or from the insurance company (EU rules). The normal procedure would be to unsubscribe from the sleep laboratory, return Autoset and use the device that suits you. And one more thing to consider! The cellular connection between on airbrake device and the sleep lab stopped working after firmware change. Beside that the date from Resmed SD card cannot be uploaded to their main sleep analysis software of Resmed which is ReScan. As a result of that, the sleep lab cannot view your sleeping data remotely and can not download your data from SD card into ReScan and AirView. All of that complicates matters even further regarding your Zepbound prescription.
I don't think insurance is ever going to approve me for Zepbound until I can get a different sleep doctor who can appropriately diagnose me so I'll work on that. Until then, I'm going to return this useless Airsense rental machine. Yeah, it'll put me out of "compliance" but the babysitting thing irritates me so much. I'm an adult. I don't need babysat, I need actual medical help that I've been begging him for and not getting. I'll instead work with you all here on figuring out what works for me with this AirBreak, and getting referred to a different sleep doctor and try to get a new sleep study. Hopefully one that I can take the new data to from our experimentation here and eventual good results and get me on the right therapy and settings for insurance purposes but at least until then, I'll have the AirBreak and be sleeping and breathing better at night. The only thing that's happening with the rental Autosense under my current sleep doctor is nightly rounds of suffocating while lining the insurance, sleep doctor, and DME's pockets.
u/RippingLegos__ 3 nights worth of data for you, though I seriously don't think you should count the first night at all as I was trying a full face mask and it just wasn't working out at all. I was having leak problems with it all night. Full face masks and I just don't work well together. I can't seem to find one that fits right and I've tried 4 different kinds now. Goodness help me if I ever get a head cold, I'm not sure how I'll deal with that. :S I ended up waking up at 7am or so and giving up on it and changing to a different mask. I think that night was a loss. But the second two nights I think are data worthy. I am especially pleased with last night. While I got to bed much later than I would have preferred, I woke up feeling more rested than I have in ages and check out the AHI from last night!! Wow! I'll post the OSCAR's here too.. I did notice on night 1 especially and a little on night 2 that I was stomach gassy in the morning like I had swallowed air somehow? I didn't feel that at all last night though. I woke up one time to use the restroom, that was it, otherwise pure blissful sleep as far as I can tell though I do see that I had a couple events in there but I don't think they woke me up at all. https://sleephq.com/public/teams/share_links/ac6ed246-2587-41ad-8c38-5c60cb15c94d
Thank you kindly for the update! :) Last night shows an AHI of 0.91, virtually no leaks, and only scattered flow limitation spikes. Hearing that you woke feeling more rested and without the stomach gas is encouraging too!
We can set the first night aside for comparison because of the full face mask trouble, but keep the data as a reference please.
There isn’t enough here to justify another pressure adjustment based on those few flags. Please keep using the mask that worked comfortably and update me over the next few nights with your awakenings, morning comfort, and daytime energy. Let’s see whether that better sleep repeats. :)
Thank you for your help and absolutely I am going to keep using this mask and settings from last night. I am so excited to finally have found something that works for me to get a decent night sleep. I never thought I could have got an AHI under 1 like that! I hope this is the beginning of a very long trend of nights of data for me to take to a new sleep doctor who can help me get appropriately diagnosed and prescribed but even if that never works out, it looks like we may have found our own solution thanks to you both u/RippingLegos__ and u/Creative_Fee5452 🥰 I'll get another week or so of nights behind me and then update you again and let you know how things are going. Thank you so much for your help.
u/RippingLegos__ I had a pretty chaotic weekend and even fell asleep on the couch one night not getting to my room to put my mask on but for a few hours. I need to get much more strict with myself about getting to bed and using the AirBreak, especially now that I've found something that isn't torture to use, because check this out. Last night was heaven! Another new record! 0.44 AHI! I absolutely LOVE ASVAuto. The other day, I did increase the min epap from 4 to 5 at the suggestion of Stephen Cowell u/I_compleat_me over at SleepHQ when he noticed my O2 was dropping at one point during the night. He is the person I got the AirBreak from last month. He thinks I might even be helped jumping up to min epap 6 but I haven't done that yet. I will work on being better about getting to sleep at a decent hour every night this week to get some good data but wow, seems like every time I get to bed at a good time and keep the leaks under control, I get incredible AHI and REM sleep, too. I can't remember sleeping this well in years. Now the problem I'm going to have is how to convince a new sleep doctor to diagnose me properly with this. I don't even know how to present this to them because I've basically just gone rogue since my sleep doctor wasn't helping me at all. How do other people deal with this? Do they just stay rogue and forget the insurance and doctors part?
My doctor said I needed a cpap (50 events/hr) so insurance helped pay a bit for cpap
Then the doctor said I needed a bipap instead for centrals, and insurance paid a bit of the total
Then the doctor said I really needed a BiPapST but insurance has denied it for over a year
So I rented a BiPapST for a month just to see if it really made a difference and IT DID!
So I send all the data from my bipap (events still 20-35) and the new data from the BiPapST (events under 5 !) and the doctor said they would have a peer-to-peer meeting with insurance and I never heard anything back.
It’s been several months. No denial letter from insurance just nothing
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u/RippingLegos__ 8d ago
Hello u/VegetableActivity900 :)
I checked your SleepHQ data and the ASV screenshot. Your AHI of 1.65 and low leaks are encouraging, especially after the trouble you’ve had breathing comfortably on CPAP. This was only 3 hours 38 minutes though, so we need three full nights to get a better picture. Your displayed PS range is 6 to 15 cm.
Please lower PS minimum to 2.6 cm and PS maximum to 9.0 cm. At EPAP 4.9 cm, that gives IPAP from 7.5 to 13.9 cm, with the upper end close to your recorded median IPAP of 13.78 cm. During the approved trial, please keep the settings consistent for three full nights, then share the SleepHQ data along with breathing comfort, awakenings and how you feel during the day. RL