RE: New CPAP user here
(12-28-2020, 02:22 PM)Sleeprider Wrote: Read the Mask Primer wiki article to help in deciding where to start http://www.apneaboard.com/wiki/index.php/Mask_Primer
CPAP titration studies are helpful, especially to individuals with more complex problems, or that do not intend to be involved in their own therapy analysis and decisions. If you intend to be more involved, then the titration will end up causing further delay for the study, review, follow-up and giving you a prescription for pressure rather than just issuing an Auto CPAP and self-titration. I don't know why anyone would want to do that as their first option, but do what makes you comfortable.
I was not even given a choice in the matter. They called and told me I had moderate apnea, then a scheduler set me up to go in for a CPAP study. I think maybe I will just stick with the CPAP study as I'm not really comfortable with messing with my machine especially as a new CPAP user. My doctor only took 2-3 days to review the study and confirm that I had apnea. I would love to just be using a CPAP now with auto air pressure and not go back for a second sleep study.
My options maybe very insurance driven, and my insurance may demand I go for a CPAP study to get correct air flow or else I'm boned. I am on a very fixed income, so just outright buying my own CPAP machine, masks, etc as out of the question.
I know some may not like that, but it's what I feel I want to do. If I go with the CPAP study, which ResMed machine should I get for when they find my right air pressure?
RE: New CPAP user here
Please do whatever you feel most comfortable doing. I would suggest you check if you have a deductible for the “sleep study”. Mine did (which I did not know) for 500 dollars which was quite a shock for our budget as we are also on a fixed income.
RE: New CPAP user here
You should get a ResMed Airsense 10 Autoset, ideally the model "for her." (It has an extra type of setting that is helpful to some people, both men and women.) This machine will cost the DME the same as a Phillips Respironics machine. I recommend that you NOT get a PR machine. They are less nimble and offer fewer useful options, plus some people find they can't get them to sync up with their breathing.
If you breathe through your mouth during the day, you can do it at night, with some help. You might need a chinstrap or soft cervical collar to keep your jaw up, and some tape to help you keep your lips closed. With time, you might not need these props. The advantage of a nasal pillow mask is that there are fewer running inches that touch your face and therefore fewer ways for the fit to be imperfect.
But plenty of people do well with a FFM. Just be sure you can try out the one they want to send you home with, and that while you try it out, you can be hooked up to a machine and lying down.
RE: New CPAP user here
Insurance REQUIRES a diagnostic study. Most insurance will pay for a titration study subject to copay and deductible conditions, however they really prefer that a split study be done where titration is done during the second half of the diagnostic PSG, or simply issuing auto CPAP. While things are insurance driven, you have choices, but they must be clearly expressed. If you decline a titration study, due to costs, COVID concerns or anything else, you will simply get the auto CPAP option, and you can go pick up a Resmed Autoset as soon as that gets processed. Just as your titration study takes one-night, so does using your new Autoset to now what optimum settings are likely to be. It is entirely your choice. It may well be that with Medicare/Medicaid you do not have deductibles.
12-28-2020, 05:01 PM
(This post was last modified: 12-28-2020, 05:17 PM by dogdemon.)
RE: New CPAP user here
(12-28-2020, 02:46 PM)staceyburke Wrote: Please do whatever you feel most comfortable doing. I would suggest you check if you have a deductible for the “sleep study”. Mine did (which I did not know) for 500 dollars which was quite a shock for our budget as we are also on a fixed income.
My copay is supposedly $40, but Medicaid SHOULD cover that. Humana is first, Medicaid is secondary insurance for me.
(12-28-2020, 04:27 PM)Sleeprider Wrote: Insurance REQUIRES a diagnostic study. Most insurance will pay for a titration study subject to copay and deductible conditions, however they really prefer that a split study be done where titration is done during the second half of the diagnostic PSG, or simply issuing auto CPAP. While things are insurance driven, you have choices, but they must be clearly expressed. If you decline a titration study, due to costs, COVID concerns or anything else, you will simply get the auto CPAP option, and you can go pick up a Resmed Autoset as soon as that gets processed. Just as your titration study takes one-night, so does using your new Autoset to now what optimum settings are likely to be. It is entirely your choice. It may well be that with Medicare/Medicaid you do not have deductibles.
Yes, I know they require you to be dx with sleep apnea before insurance would even pay for a machine. I was more so wondering if the message was "screw the cpap study and just go with a auto cpap machine". Some people do have bad experiences at these sleep clinics. Not so much with staff, but just panic attacks, etc. I've read one about a woman's husband went in for a sleep study (think it was that or his cpap study), and he had a panic attack in the middle of the night. I assume the tech had enough to go with, and the husband went home. I'm not worried about that happening to me, but would like to avoid ANOTHER study. It was hard to be comfortable at just a normal sleep study, let alone with a mask and cpap machine.
What is this cpap study even for? Is it just to find my air pressure on the cpap machine? No one even explained WHY I need this done....sooo yeah.
Edit: Final editing for now -- I decided to message my sleep docs office and express I'd like to just be on an auto CPAP machine and avoid a CPAP study.
RE: New CPAP user here
dogdemon, the CPAP titration study is a rigid protocol in which you are connected up to sensors similarly to the diagnostic study. Your job is to do your best to sleep while outfitted with a mask connected to a positive pressure machine and sensors very similar to what we all have in our data-capable machines. The technician starts you at a low pressure, usually 4-cm H2O, and as events occur, increases pressure. As pressure gets close to your requirements to keep your airway patent, the changes in settings slow down, and you may spend an hour or more at a given pressure while recording your sleep stage, position, oxygen saturation and pulse rate. Usually pressure is increased to see if there is any benefits to higher pressure. By morning, it should be apparent at what pressure the "best" efficacy was achieved. Ideally this is a pressure that prevents apnea, hypopnea, minimal respiratory related arousals and enables good oxygen saturation and REM sleep. That "ideal" outcome is great when it happens, but what is "acceptable" may end up being your prescription, and you won't know the difference. Also a prescription infers a single fixed pressure which means it is not obligatory to dispense an auto CPAP, although you may or may not get one.
There is very little information that can be obtained from a titration study that cannot be obtained from a night on a data capable Resmed Autoset, but one keeps updating the information night after night, and the other is just a snapshot.
RE: New CPAP user here
(12-28-2020, 07:19 PM)Sleeprider Wrote: There is very little information that can be obtained from a titration study that cannot be obtained from a night on a data capable Resmed Autoset, but one keeps updating the information night after night, and the other is just a snapshot.
Yeah, this is what I suspected. I got a response back from my doctors nurse who said the doc just now said it was fine to go on auto CPAP. I talk to a lady at a place I ate at occasionally, and she even said they want you to do all this cause $$$$.
I think this CPAP study is kind of a waste of time, and am glad my docs nurse did this.
SADLY the nurse did say that my insurance MAY require a second sleep study, but that they wouldn't know for sure till the DME runs the prior auth. I am HOPING my insurance will not require a second sleep study.... I think finding out you have apnea is more than enough to say yes you need to be on CPAP even if an auto machine.
RE: New CPAP user here
Did you state which machine you want?
RE: New CPAP user here
(12-28-2020, 08:08 PM)Dormeo Wrote: Did you state which machine you want?
Yes, said the machine that was stated here. Resmed Airsense s10 Autoset
RE: New CPAP user here
Excellent! If for any reason they try to give you something else, don’t accept it. With luck, your doc will back you up on that.
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