Posted by mollythed on January 18, 2005 at 09:48:51:
I'm part way through titration for a CPAP. First, I "flunked" a sleep study at a hospital because I only slept an hour and a half all night, but had 38 "events" in that time. The protocol didn't allow the tech to start titration unless I had 40. A month later, when I finally had a follow-up appointment with a sleep specialist, he sent me home with a ResMed Auotset Spirit rental unit for two weeks. There's a window that displays the current auto setting, and I saw lots of numbers between 9 and 10 if I awoke in the night, but never even a 10.1, so when I went back to have the tech download the data, I asked if it was set to 10 as the upper limit. She said no, but when it turned out that the machine said 10.0 was my setting, and lots of hypopneas remained at that level, she double-checked, and sure enough, the machine HAD been set to an upper limit of 10. Now, with the upper limit corrected, I'm going for another week to see what the new setting will be. But I digress.
Before she discovered the problem, she was talking about swapping the APAP for a CPAP. Apparently my insurance will lease for ten months and then buy the unit. I said I'd like to keep the APAP, even if I had to pay the difference. It seems that it would give more flexibility in the future. She said no, a single setting would be more effective because I wouldn't have to put up with the time lag while the machine gradually worked up to the proper setting. As my son (an experienced CPAP user) pointed out later, the APAP could be set to a smaller range (say 10 to 14 if 12 was my optimum number)to allow for less ramp up time, but still give some flexiblity and a change to watch for changes in the future, without needing to go back for a new study.
Now that I have a little more time to mull it over, I'd like to hear more opinions one way or the other. Any ideas?
I'm used to dealing with diabetes, where patients are encouraged to take on responsibility in their own treatment, and even patients on insulin pumps have full access to make changes to their own treatment as needed, so I'm feeling sort of hemmed in by the lack of information and the level of control I'm sensing. What's up?
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