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Advice for American suffering from sleep apnea in China?
I'm really inspired by the stories of personal transformation here and would like some advice.

I'm a 39 year old American living in China, I've never been diagnosed with sleep apnea but have all the symptoms (extreme snoring/stop breathing/have palpitations in the middle of the night, wake up tired/with a headache no matter how long I sleep) and lately some very concerning symptoms such as numbness in my left side when I wake up.

I don't have insurance but sleep studies here would be very expensive with a western doctor. And I really don't care to work with a local doctor, as in China they tend to only prescribe treatments they can take kickbacks on.

I have a couple options, would like to know what you guys would do:

1) Get insurance for about $1800/year and hope that they will cover the study/machine (chances are 50/50)

2) Buy a machine myself here (you don't need a prescription) and try to configure/fit it myself

3) Fly to Malaysia and do a sleep study/buy a machine/get it configured there (would cost about 1/2 the cost of doing it with a western doctor here and Malaysian medicine is much better than in China)

Really appreciate you investing your time to read my story and concerns.

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Sounds like you are "between a rock and a hard place". I am rather new in these forums myself. I would advise you (if you are not going to have a sleep study) to still have a thorough medical checkup to determine whether there is anything else going on with you.
Can you not discover upfront whether an insurance company won't cover a CPAP machine?? Why the uncertainty? That is probably the route I would go, because of course then you are covered for other contingencies as well. Seems to me that with no insurance in a foreign country involves considerable risk.
Even with a sleep doctor involved, a significant percentage of patients never adjust to a machine and the purchase is then wasted. One often needs a fair bit of coaching through the adjustment phase. I suspect there are many CPAP machines gathering dust in a dark closet in many homes because of this difficulty.

If option 1 is not in the cards, I would probably opt for a trip to Malaysia and do your sleep study there at 1/2 the price and twice the efficiency. Then follow the advice on this board to help you to adjust to the machine. Be forewarned that most sleep doctors really do not know the subtler aspects to adjusting to a machine nor do they have the time to counsel you and to tweak your approach to the machine. I have been written off as being "non-compliant" by one doctor (just blame the patient instead of the doctor). Another one simply prescribed a sleeping pill to help me adjust. All to no avail

It took a respiratory specialist who took the time to interview me thoroughly. And he discovered that it;s a bipap machine that I needed. Problem solved. Well.. more or less. I am still only getting about 5 hours per night, but I am now getting some rem sleep.
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I will take the position that it is fairly easy to purchase and setup an Auto CPAP and use it to self-titrate, and at least determine if it makes you feel better. The cost of purchasing a machine, mask and any accessories would be, by far the lowest cost option. I would pursue a quality machine that produces easy to read data in SleepyHead software, and be prepared to do some trial and error. BTW, trial and error is the fundamental method of a CPAP titration.

A relatively fast responding machine like the Resmed S9 Autoset or Airsense 10 Autoset would be ideal. Where you are currently located, the Remsmart would be the easiest and cheapest to obtain, however Sleepyhead does not support that machine. Remsmart and Apex auto machines are definitely second tier, but serviceable for your needs. Both use manufacturer proprietary data to report your treatment efficacy. The biggest challenge you will have is finding a comfortable effective nasal interface. I think nearly everyone should start with lightweight and minimal nasal pillows, and prove they won't work before progressing to a full face or other mask interface.

Good luck, and stay connected here.
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Hi moebius,
WELCOME! to the forum.!
I would think that the least expensive option would be to get an APAP machine and self-titrate. Get the "SleepyHead" software and keep in contact with us for help along the way as you fine-tune your therapy. The next option would be to go to Malaysia to get a thorough checkup to make sure nothing else is going on. Hang in there for more suggestions and good luck to you.

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