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Cannot get answers!!
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Lambsydoats Offline

Preferred Members-2

Posts: 117
Joined: Oct 2014

Machine: ResMed AirSense 10 AutoSet for Her
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit ™ P10 Nasal Pillow
Humidifier: AirSense 10 AutoSet for Her-integrated
CPAP Pressure: 8
CPAP Software: SleepyHead

Other Comments: Initially: AHI=52; 2nd: AHI=18; CPAP 11-10-14; as of 8-18-15: AHI consistently under 5.0

Sex: Female
Location: Southwest Michigan, USA

Post: #1
Cannot get answers!!
Can you please help?

Today I got the call that my CPAP titration had been read, and that my doc would be sending it to a nearby DME who works with my insurance company. That's the good news.

The bad news is that I CANNOT get in touch with anyone who can discuss my results with me. The assistant isn't qualified, of course, the PA is "booked until December 8," and when I asked if I could discuss it with the doctor then, she said, "No." What the heck?!

My concern is that I show not only OSA but CSA as well--and that scares me. A lot. I've had no TBI, stroke, nor any other damage to my brain. So what's going on?? It's obviously a neurological problem (it appeared on the second of my two take-home tests too), and the CPAP won't do any good when it comes to resolving that issue; I'll still stop breathing during sleep.

Attached is the Rx.

Is the # of sleep apneas the number per hour, or the total number for the time I was asleep?

My other question is this: Because of what my doctor checked, does it mean I will be unable to get the AirSense 10 Autoset for her (i.e., CPAP and not Auto-CPAP)?

Thank you for any insight you have to offer! (And if I should have posted this somewhere else, please just let me know.)

Lamb


Attached File(s)
.pdf  Rx for CPAP data only2.pdf (Size: 161.96 KB / Downloads: 180)

To all, to each, a fair good-night,
And pleasing dreams, and slumbers light.
Scott—Marmion. L’Envoy. To the Reader.

Diagnosed with OSA September 2014
AHI=18
Lowest SpO2: 79%
10-29-2014 07:49 PM
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retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #2
RE: Cannot get answers!!
It says the DME is to supply you with a machine set to straight cpap of 9 cm.

It also says they have to supply a machine that provides residual ahi and leak numbers. That should eliminate "bricks," but could be filled with any brand the DME has. For instance it could be filled with a S9 Elite, or S9 Autoset, as well as comparable products in the Respironics line. Odds are very good that they will NOT provide an A10 machine.

But talk to them. Ask them what machine they are going to provide. Ask them if they will give you the A10 if that's what you want. If not, you have your prescription in hand, and we have a very nice list of on-line suppliers that would love to help you with your needs.

You do not have to purchase from the "chosen" DME unless you yourself choose to do so.
10-29-2014 07:58 PM
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retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #3
RE: Cannot get answers!!
P.S. I would not worry about the CA's on your report. It's way too early in your treatment process to feel they are anything other than goofiness occurring at your sleep test. The script asked the question, "Did CPAP Fail?" and the answer was no. That is the signal that the techie feels you will do just fine with a straight cpap machine. Or an auto running in cpap.
10-29-2014 08:02 PM
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Lambsydoats Offline

Preferred Members-2

Posts: 117
Joined: Oct 2014

Machine: ResMed AirSense 10 AutoSet for Her
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit ™ P10 Nasal Pillow
Humidifier: AirSense 10 AutoSet for Her-integrated
CPAP Pressure: 8
CPAP Software: SleepyHead

Other Comments: Initially: AHI=52; 2nd: AHI=18; CPAP 11-10-14; as of 8-18-15: AHI consistently under 5.0

Sex: Female
Location: Southwest Michigan, USA

Post: #4
RE: Cannot get answers!!
Thank you so much for your quick response, retired_guy!

My insurance requires me to rent a machine for the first three months (they'll pay for that) and then buy it after that if the results show that it worked (they'll pay for that too other than my co-pay). They treat all DMEs as in-network, considering that they don't ... whatever they do (certify?) DMEs. When I asked them about buying on line, I was told that they would cover it the same as any local DMEs if the on-line vendor "participates" with them--so they won't balance bill.

So won't I have to work with a local vendor to find the right machine, mask, etc. those first months?

I'm trying to learn how all of this works....

Lamb

To all, to each, a fair good-night,
And pleasing dreams, and slumbers light.
Scott—Marmion. L’Envoy. To the Reader.

Diagnosed with OSA September 2014
AHI=18
Lowest SpO2: 79%
(This post was last modified: 10-29-2014 08:17 PM by Lambsydoats.)
10-29-2014 08:16 PM
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PaulaO2 Offline
Wiki Editor
Moderators

Posts: 8,067
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #5
RE: Cannot get answers!!
If that is from your titration, don't worry about the number of central events. If the doctor isn't concerned with them, then don't be. They are most likely "pressure induced" central events. Meaning the higher the pressure was raised, the more central events. This happens to a lot of people. They go away with time. Your brain just gets confused with the air coming in and the pressure and all that. Seriously, don't worry about it. You'll get a data capable machine and you can watch them yourself. As you watch the data, don't view each night on its own. You want to see trends. Gather a week then sit back and see what happened. Gather another week. Repeat.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-29-2014 08:17 PM
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Lambsydoats Offline

Preferred Members-2

Posts: 117
Joined: Oct 2014

Machine: ResMed AirSense 10 AutoSet for Her
Mask Type: Nasal pillows
Mask Make & Model: ResMed AirFit ™ P10 Nasal Pillow
Humidifier: AirSense 10 AutoSet for Her-integrated
CPAP Pressure: 8
CPAP Software: SleepyHead

Other Comments: Initially: AHI=52; 2nd: AHI=18; CPAP 11-10-14; as of 8-18-15: AHI consistently under 5.0

Sex: Female
Location: Southwest Michigan, USA

Post: #6
RE: Cannot get answers!!
What does the 9cm tell me (you)? Is that a mild, moderate or high pressure (if there are such terms associated with this)?
Thank you, Paula.

The CSA showed up on my take-home test as well (i.e., no CPAP).

But I'll try (TRY) to just wait and see....

Lamb

To all, to each, a fair good-night,
And pleasing dreams, and slumbers light.
Scott—Marmion. L’Envoy. To the Reader.

Diagnosed with OSA September 2014
AHI=18
Lowest SpO2: 79%
(This post was last modified: 10-29-2014 08:20 PM by Lambsydoats.)
10-29-2014 08:18 PM
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PaytonA Offline
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Posts: 3,016
Joined: Dec 2013

Machine: ResMed S9 VPAP Auto
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
Humidifier: H5i(distilled-top up)
CPAP Pressure: VAuto MinE14.0 MaxI 20.6 PS4.0
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Orange County,California

Post: #7
RE: Cannot get answers!!
The 9 cm does not say anything other than that is what was required to splint your airway open.
10-29-2014 08:31 PM
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retired_guy Offline

Preferred Members-2

Posts: 2,744
Joined: Jan 2014

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Resmed Airfit P10
Humidifier: ResMed
CPAP Pressure: 10.6/14, EPR 3
CPAP Software: ResScan SleepyHead

Other Comments: Is it bedtime yet?

Sex: Male
Location: Beautiful, albeit very wet Oregon Coast

Post: #8
RE: Cannot get answers!!
(10-29-2014 08:16 PM)Lambsydoats Wrote:  So won't I have to work with a local vendor to find the right machine, mask, etc. those first months?

I'm trying to learn how all of this works....

Lamb

What I would do? I would first call the local DME and tell them what machine I would like to have and see if they will provide it. Then if not, I would call one of the on-line suppliers and discuss the insurance issue with them, and ask them if they would supply the machine you want. The answer to the later would be "yep, you bet!"

So it comes down to how bad I really want the machine of my choice.

The mask thing can be worked out with the on-line providers as well. There's nothing really magic about what the DME does. They make a big deal about "fitting" you, but in reality all they do is open the package, put it on your face, and turn the machine on. We can help you do that if need be.

Here's how we would do it......

1. Ok, put it on your face. Did that? Good.

2. Now take it out of it's package.

Wait! I think I got that wrong. But we'll figure it out.
10-29-2014 08:42 PM
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bwexler Offline

Advisory Members

Posts: 563
Joined: Mar 2012

Machine: PRS 1 BiPAP autoSV Advanced, with Heated Tube humidifier
Mask Type: Nasal mask
Mask Make & Model: Sleepweaver Élan
Humidifier: Resperonics Heated Tube humidifier
CPAP Pressure: Max pressure 25.0 cm H20, Max
CPAP Software: SleepyHead EncorePro

Other Comments: CMS 50i with Software for SpO2

Sex: Male
Location: San Marcos, CA, USA

Post: #9
RE: Cannot get answers!!
Decide which machine you want, the A10 for her is an excellent choice. Call the first DME and see what they say. If no, call the one down the street and the one accros town or the online providers until you find the one that will provide exactly what you want and need.
Stick to your guns and bring a picture of what you want so they can't switch you to something else without telling you.

Remember if it is midnight and a DME tells you it's dark outside, go out and check for yourself.
10-29-2014 11:09 PM
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DeepBreathing Offline
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Moderators

Posts: 2,296
Joined: Sep 2013

Machine: Resmed S9 VPAP Adapt
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: Resmed H5i
CPAP Pressure: EPAP: 9 - 15 PS: 3 - 10
CPAP Software: ResScan SleepyHead

Other Comments:

Sex: Male
Location: Perth, Western Australia

Post: #10
RE: Cannot get answers!!
(10-29-2014 08:18 PM)Lambsydoats Wrote:  The CSA showed up on my take-home test as well (i.e., no CPAP).

Hi Lambsydoats, what was your AHI and percentage of central apneas on your home test? It's true that a lot of people get centrals when they first go on PAP therapy, and these generally resolve themselves over a short time. However if you're getting a high percentage of centrals without CPAP pressure, then yes that is something to be concerned about. Not because you'll just stop breathing and wake up dead, but because you can potentially waste a lot of time and money messing around with machines which don't treat centrals. To treat central apneas you need a bilevel ASV machine (eg Resmed VPAP Adapt). These are expensive, so they won't just hand them out.

With the greatest respect for some of the advice in this thread I think you need to take a bit more time and get to the bottom of the problem before deciding that a particular machine is "the best". This will involve talking to your doctor (or whatever level of assistant you can get to) and work out a strategy for going forward. This may involve starting out on a CPAP or APAP then changing to an ASV machine if the more basic ones don't fix the problem. But you don't want to get locked into a situation of buying an APAP then have to change over later at your own cost.

Central apneas are not trivial - they are a cessation of breathing every bit as troublesome as obstructive apneas. They can be caused by the therapy and resolve themselves, or they may be an inherent component of your total apnea. In which case they need to be treated properly.

DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
10-30-2014 12:24 AM
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