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[Diagnosis] Long Time to Get Prescription for Machine
#31
RE: Long Time to Get Prescription for Machine
Make sure there is an SD card in the card slot, if not pick up a standard SD card from Walmart or where ever. Then get [url=https://OSCAR Page ----> CLICK HERE ./]SleepyHead[/url] and install it.
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#32
RE: Long Time to Get Prescription for Machine
(07-15-2017, 10:01 AM)Vesimir Wrote: As for pressure settings, I am thinking about min 8, max 20 based on doctor's recommendation from my first in-center sleep study.  Any reason to just set it 4 to 20?  (I may be wasting my time w/ the nasal pillow since I suspect I may be a mouth breather).

The only reason would be if you can't get comfortable with the 8 cm of pressure. They almost always start you out with a nasal mask, most people "learn" not to mouth breath.
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#33
RE: Long Time to Get Prescription for Machine
Good luck with the new machine. I would avoid settings like 4-20 and try to get dialed in closer to your needs. Once you have some baseline data, you can dial back the maximum and adjust the minimum to better approximate your needs. Even with the Autoset, it is best to minimize pressure fluctuations to a smaller range for less disruptive sleep.
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#34
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RE: Long Time to Get Prescription for Machine
I slept at home with the CPAP last night for the first time.  Results are below and seem really good to me.  

I feel less tired than usual even though I slept less than 7 hours.  I'm confused since my "mask pressure" never went above 11 and I had very few apneas.  The reason I'm confused is that when I did an in-center PSG on June 20th (results previously posted in this thread), I had many apneas at pressures up to 15.  One potential difference is that last night I used an Airfit P10 instead of a full face mask, which is what I used at the sleep center.  Another potential explanation is that I was not forced to try to sleep on my back last night, so I had an easier time falling asleep than when I was in the sleep center.  Is there any reason to doubt the accuracy of last night's data?  My wife said I was much quieter than usual last night, which seems to show in the data.

I really liked the P10 nasal pillow, but the inside of my nose feels sore today.  Any tips on making it more comfortable?

[Image: ahY1SaCl.png]
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#35
RE: Long Time to Get Prescription for Machine
Damn, that does look good. I think those CA's will clear up on their own, without them you would have an AHI of about 0.5.

I think that the sore nose will get better with just a little time, you might find that if I shave before bed it may help.
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#36
RE: Long Time to Get Prescription for Machine
On the P10 pressure is applied very directly, so it is not uncommon for people to use less pressure to better effect. As far as the sore nose, the mask is loosened by spreading the head straps, and tightened by bringing them together over the crown of the head. Try to wear it as loose as possible without it shifting or leaking. I don't recommend using any creams or lotions, the soreness will pass shortly.
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#37
RE: Long Time to Get Prescription for Machine
I use Ayr nasal gel.  You just need a small dab.  Others use a Lansinoh cream, found in most stores, baby isle.  Nursing mothers use this.  

If your nostrils are sore, then use one of the above.  Do not use Vaseline, as it is known to break down the silicone.   I don't advise waiting until a sore developes, as that takes a long time to heal.Sad

Another thing about nasal pillows.....you may want to try a size larger.  The pillows should not be inserted too far into nostrils, but just a tiny bit.  Try spreading the straps apart for comfort, but not so much that it feels tight and pulls on your nose.  

Your numbers look good, but you may want to change the EPR to 2 or even 1 as that may help with Clear Airway events.
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#38
RE: Long Time to Get Prescription for Machine
Update:  After a home sleep study and two in-center studies over the course of 2 months, I finally decided to buy an APAP and started treating myself (as explained above in this thread) with pressure settings of 8 to 20.  For the past 3 nights, my AHI has been no higher than 3.1 and my pressure has not gone above 11.  Got a call from my doctor this afternoon with vague results from my second sleep study from last week (I'll have to pick up a copy tomorrow) and talking about putting me on a CPAP with fixed pressure of 14.  He said I only slept for something like 150 minutes at the second sleep study and that fixed pressure of 14 was able to clear obstructive apneas.  Doctor was confused as to why pressure of 14 was successful at the second in-center sleep study, but was seemingly unsuccessful at the first sleep study (I'm confused by this as well and also as to why I am having fairly good results at home with much lower pressure, though it could be b/c I'm using a nasal pillow at home).

I convinced the doctor to prescribe an APAP instead based on the inconclusive sleep study results.  Not sure what the pressure settings will be, but I don't expect to follow them anyway since they'll presumably be higher than what I need.  I must say -- for me, this whole process of 3 sleep studies has not been very helpful other than to get the sleep apnea diagnosis.

Separate question:  I suspect I'll only be using the DME for supplies.  Will the DME initially give me a problem when I am purchasing supplies from them, but no machine?

Thanks!
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#39
RE: Long Time to Get Prescription for Machine
I think this is why some insurances are getting smarter in when they approve in lab studies. Could have avoided all the time and cost of the in lab studies if the Dr. would have just ordered the auto cpap after the home sleep study.

I don't think the mask would make that big of difference with the pressures. I would guess that the sleep tech titrated too fast or not being on your back at home. Looks like you've got yourself on good settings already.

The DME shouldn't care if you have your own machine. they may ask you for make/model and serial number of cpap to get insurance to cover cpap supplies.
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#40
RE: Long Time to Get Prescription for Machine
Final update (for this thread):  I found a local DME that is easy to work with.  They don't care that I already have a machine and seem willing to order whatever supplies I want.  Also, ayr nasal gel (only used a small amount) has been helpful for sore nose.  Thanks so much for all the helpful advice here!

I am perplexed about what pressure settings I should be using (AHI from first 4 nights were 1, 2, 3, then 4), but I will start a new thread and post some sleepyhead data to try and figure that out.
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