Posted by SleepyTimeGal on July 26, 2009 at 08:18:11:In Reply to: perspective on my sleep study posted by SleepyJohn on July 20, 2009 at 14:26:59:
I don't blame you for being more than a little concerned. There may be two reasons that I can see for the doctor going the sub-optimal routine.
1. Cost of the adaptive servo-ventilator which apparently is quite new. Insurance companies may be very reluctant to cover it.
2. Concerns about patient resistance to treatment with CPAP; it's my understanding many patients just give up on it. I've personally spoken to a few people who have said, "Oh, yes, I'm supposed to use it, but I hate it and I just don't." Perhaps your doctor wants to see whether you'll stick with it.
However -- and this is my opinion only -- I think patients get discouraged because suboptimal treatment doesn't work as well, thus causing discouragement and it becomes a vicious circle.
Eight years ago my insurance company would not pay for an autopap which I believed, after much research, was the best treatment for me. I saved my money and purchased my own, incidentally from the same company that came up with the ASV, and I've been oh-so-happy I did. I'm more in control of my treatment and the cost has been much less. With insurance, I would have had a monthly co-pay forever, which, for me on a fixed income, was substantial.
My doctor is happy with my ability to monitor my sleep and give her accurate reports so she supports all my efforts toward health. For example, eight years ago I was able to purchase the software to download nightly stats to my computer. I think the DME suppliers, perhaps even the manufacturers themselves, have become much more resistant to providing end users with this software and I think the doctor would need to get more involved in insisting the patient needs this.
Again, my opinion only, but in light of my own experience, you might want to consider aiming for the ASV. Hopefully the BiPAP will help, as CPAP helped me, but the ASV could help you more, as the autopap helped me more. Good luck. Sorry this was so long.