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Confused in Australia - Trying to sort out the system
#1
Hello,

I'm a newb here and to CPAP. My sleep study done last month showed severe sleep apnea, which didn't surprise me much, and was a relief in a weird way.

I came to this through my dentist, which is probably a bit unusual. The guy the dentist uses for his sleep studies has rented me a Resmed S9 Autoset for a month for $200 (seems high), but I'm finding him pretty useless. He's yet to help me with any of my questions (his stock answer is, "I don't know"), and I'm feeling a bit lost.

So, I'll try to get organised with my questions here:

1. Who should/can provide my prescription(s)? Dentist? GP? Sleep physician?

2. I have had no direct dealings with a sleep physician. Should I bother to try to work with one?

3. For those of you in Oz who have bought machines from the US, have any of you come to regret it from a maintenance/repair perspective?

4. If a US equipment provider requires a prescription, will they accept one from Australia?

Regarding my use of the machine, I've done moderately well over the last 2 weeks. I've tried a nasal pillow and nasal mask, and had trouble with both. The nasal pillow was extremely difficult for me to breathe out, and the nasal mask got me really stuffed up and felt very claustrophobic with it. I'm a mouth breather, so with both I had really bad aerophagia and dry mouth.

I tried the Resmed Quattro FX mask, and really like the feel of it, but am having a lot of trouble with leaks at the bridge of my nose and occasionally at the side of my mouth, which wake me up repeatedly (kind of defeats the purpose of it all). I go to sleep pretty quickly with it, so it would be nice if I could stay asleep! Amazingly, I felt less claustrophobia with this one, I think because it wasn't imperative I keep my mouth closed. Still had moderate aerophagia with this one.

I think the tech set the pressure to 4 to start, and I think the max it's gone to in auto mode was 12 or 14 (dont' have my notes with me now). My results have ben pretty good - AI between 1.0 and 4.3, and the leak rate is well below the desired threshold for Resmed (around 12l at the most). It's the physical impact of the air blowing on my face that is so bothersome.

So, I think I need a full face mask, but need to find one that won't leak. I have a long narrow face, and a little nose with a very narrow bridge. I'm thin, so my face doesn't have much fat on it.

Any suggestions for a full face mask that would suit me?

Thanks for any help you can offer.

Dooley
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#2
Dooley
Where have your done your sleep study?
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#3
I'll PM you Zonk, as I would rather not broadcast my complaints on the forum.
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#4
(06-14-2012, 01:19 AM)Dooley Wrote: I think the tech set the pressure to 4 to start, and I think the max it's gone to in auto mode was 12 or 14 (dont' have my notes with me now). My results have ben pretty good - AI between 1.0 and 4.3, and the leak rate is well below the desired threshold for Resmed (around 12l at the most). It's the physical impact of the air blowing on my face that is so bothersome.
Thanks for PM. Usually the sleep center write the prescription and follow-up with sleep physician is recommended.
The S9 report unintentional leak (mask leak) and as long as its below 24 L/min, the S9 will have no problem compensating for the leak and delivering quality therapy. But if you,re bothered by leak even a small one than it need to be fixed as it can affect therapy quality and cause sleep fragmentation. I started with full face mask but after few trials with different masks ended up with Activa LT nasal mask and a chinstrap works best for me but everyone is different its matter of trial and error to find the right mask. There,re few forum members who uses the Quattro and Quattro FX probably they,re sound asleep now but will definitely have some good advice for you.
If you fit the mask at the start pressure 4 and as the pressure ramp up its going to leak, it does help to use the mask fit feature.
S9 setup information and video:
http://www.apneaboard.com/resmed-s9-cpap-setup

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#5
Also, when you're fitting the mask, do so lying down, on your back. That'll get you the best results for getting the thing adjusted and leak free.

Something that Paula often suggest here, and I agree with her... take some time to wear the mask, with the machine running, when you're *not* sleeping, just seated comfortably (in a recliner is good) or in bed reading and relaxing. Getting used to it while you're awake makes adjusting to it a lot easier.
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#6
(06-14-2012, 01:19 AM)Dooley Wrote: It's the physical impact of the air blowing on my face that is so bothersome.

That should subside with a bit of time. Same for the aerophagia.

It's amazing how adaptable we are. We get used to things rather quickly. Things that used to bother us just don't anymore once we get used to them.

If you can't get your mask to stop leaking, you will have to try a different one. Don't worry as this is very common. There are lots of masks out there and it takes time to find one that will fit you comfortably.
Sleepster
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www.ApneaBoard.com


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#7
Thank you all for your helpful replies. Sorry I took so long to respond. I've just started a new job, so kind of have my hands full with that and trying to get used to CPAP at the same time.

I've switched over to the Mirage Quattro, and am doing much better with that mask. The leaks have decreased, both measurably and annoyance-wise, my AHI has been below 1 most nights, and I'm sleeping through longer.

I can't say I feel much better yet, but that could be just because I'm having to get up early every day (in the dark - it's winter here) and also due to the lack of sunlight this time of year.

I guess I should bite the bullet and go ahead and buy a machine, but there's a part of me that still isn't certain I'll be able to tolerate this long term. Thinking about renting for another month or two, but that seems like money down the toilet.

Dooley
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#8
(06-18-2012, 09:25 PM)Dooley Wrote: I can't say I feel much better yet, but that could be just because I'm having to get up early every day (in the dark - it's winter here) and also due to the lack of sunlight this time of year.

Try vitamin D. I'm in North America and doctors here say that two thirds of the population suffers from vitamin D deficiency, especially in the winter. We make vitamin D when UVB rays hit our skin, but UVB has a hard time getting through air. In the winter it comes in at a 45 degree angle, so less makes it through, and there are fewer hours of sunlight as well. And then we spend so much time indoors in the winter.

(06-18-2012, 09:25 PM)Dooley Wrote: I guess I should bite the bullet and go ahead and buy a machine, but there's a part of me that still isn't certain I'll be able to tolerate this long term. Thinking about renting for another month or two, but that seems like money down the toilet.

I am continuously amazed at the price difference on equipment. Your machine is one of the top machines on the market, but if I were to rent one here it would cost me twice as much per month as you are paying. On the other hand I can buy one for about half what it costs in Australia. I was looking at masks and the same mask on an Australian site was twice as much as on a US site. And I already thought that US prices were outrageous. The price differences make no sense at all. Why does it cost twice as much to rent here and half as much to buy? Dont-know

I can't comment on whether you should buy or continue to rent, because that depends on how you feel about continuing with the CPAP.
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#9
(06-18-2012, 09:25 PM)Dooley Wrote: Thinking about renting for another month or two, but that seems like money down the toilet.
No need to waste your money on rents. Prices in Aus are rip-off, you can buy new S9 Autoset/humidifier/climate line from secondwindcpap (Supplier #2) for less than half price what you pay in Aus and gently used same package for $625, recently a board member got one only 10 hours almost new. I've ordered from them mask, cleanable water tank and climate line should arrive within the next few days. You can check Supplier #10 but I've not used them also masks cheaper at ebay.
Use your local supplier to try masks which makes it easier when ordering on-line so you get the right size. I've been using Activa LT nasal mask and chinstrap for some time which worked quite well for me much better than full face masks but everyone is different its a matter of trial and error. Nasal pillows masks comes in 3 different size cushions and the shape of face doesn't matter. Be patient for some of us it might take a bit longer but it,ll get better, its said "journey of thousand miles begins with a single step".
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#10
Another thing to remember is that the low AHI isn't the only thing you need to look at. Look at the number of hours you actually sleeping every night. As we get older, many of us can't get by with as little sleep as you did when we were younger. Some us may need 9 or 10 hours of sleep, before feeling really rested. While that may be impossible with your schedule and new job, increase your sleep hours as much as you can. You might be surprised at the results.
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