GF has sleep apnea - new user needing help

[derek.vandreat]

Hi everyone! My name is Derek (obviously) and I'm here to help find options for my girlfriend. 
We recently moved across country, right in the middle of the diagnosis process of her sleep apea. She had done 2 nights of somnography with the sleep specialists in our old hometown (CA). We moved here (to kentucky) in October, and immediately setup an appointment to ci\ontinue to diagnosis process. I'm seeing that many people on these forums also have extended wait times for appointments - we are no different. Her appointment was schedule for April 12, which, surprise surprise, has now been cancelled due to COVID. 
This is the main reason I am here. She is on the line right now trying to get her medical info about those 2 appointments. We vaguely remember her AHI to be around 38 or so, but we are looking down the barrel of insurance possibly not assisting us in getting this resolved before the pandemic comes to a solution, as well as having to bite the bullet and buy a machine and learn to use OSCAR out of pocket. She is desperate, as I KNOW many of you can sympathize with. This is a problem she likely has been dealing with for years, but only in the last year have we realized we should be working towards a solution on THIS topic, rather than other medical health issues. 

My ask: Where should I begin? I am already mass-digesting information from the forums and the amazing wiki here, and am hoping that anyone with experience can help guide us to exactly where we should be looking for help FIRST. Do we pick out a machine and then do research? Do we try to get insurance to approve us based off of 2 visits last year? What is the best all-around device (still reading the "Machine Choices) wiki, apologies if I should know the answer to this)? She is dejected and having difficulty staying positive about this process, as it seems hopeless now that everyone is on self-isolation or outright quarantine. 

Any advice, ALL ADVICE, is helpful to me right now. I just need help navigating the massive library of information stored here in these forums. I am going to encourage her to set up her own account here as well, as you are the master of your own health and should be involved, but right now I am just trying to show her that we have options to find relief. 

Thank you all so much for any potential help you may offer. Stay safe everyone.

[Gideon]

Welcome to the forum.  We can and will help.

We would like to see full copies of her redacted sleep studies, both of them as it would help us to confirm which machine would be best for her.  This mostly depends on what kind of apnea she has.  Often the details, the art and charts contain critical info about what kinds of apnea are present.

For most people, the ResMed AirSense 10 AutoSet or the AutoSet for Her (slightly better) would be the machine of choice.

The best path would be to

1. get a full copy of her sleep studies. You are entitled to them per Hippa and you definitely want the\m in your personal permanent records
2. get a copy of her CPAP prescription, legally you need a prescrip[tion to purchase a CPAP and/or Mask. Again Hippa says you are entitled to this and you want this for your permanent records
3. redact personal info and post them here, we will interpret them for you and likely indicate issues your doctor never mentioned.
4. Based on the above, Identify the machine that will provide the best therapy for you.
4a. This will be an "auto" machine to allow for an Auto-Titration and avoid any additional sleep studies due to the COVID-19 Coronavirus, (This is a good thing) likely one of the following 3 

• ResMed AirSense 10 AutoSet or the AutoSet for Her (slightly better)
  
• ResMed AirCurve 10 VAuto (this is the step up from the above)
  
• ResMed ASV if there is a fair amount of Central Apnea.
  

5. Post Nightly charts from OSCAR and we will help you to optimize therapy.

It is not uncommon for the cost of getting a device from insurance and self-pay is about the same because of the amount charged by a DME and insurance deductible.

Does this help?

[derek.vandreat]

Absolutely fantastic information, thank you so much. We are waiting on info back from the original sleep studies and then we will post them. I don't know the specifics at this time, but I remember her being that she had "both types" of apnea. i am unsure what that means for us right now, but we will find out as we go forward.

Another question she has as we are learning together is that we see sites like Lofta which have an at-home diagnostic process. Do you (or anyone) have experience with this system? Is it worth the investment (289 up front + 69 a month) to reach a diagnosis. I believe this includes a machine, although they may mandate which we can try. They do list a variety of ResMed options, from what I can tell. 

Thank you very much for the quick reply. She is very much a "pull the trigger" kind of girl and may have made an impulse purchase to try and find some relief - a sentiment I can sympathize with, but don't support at this time, as SA is such a complex bug to troubleshoot.

[Gideon]

If she has had sleep studies, that should be all that is needed to get started.
If she has significant centrals then she needs the ASV and its higher cost.

We can provide guidance on purchasing used, what vendors etc, and some general cost info, as well as what vendors typically have the best deals, though we do not provide links.

[derek.vandreat]

Once again, thank you very much. Once we have those data from the study, I'll post them up for review. Is ti better to continue this thread or start a new one for that? (Assuming it may take time, possibly a week or more, to get the data back).

[DeepBreathing]

G'day Derek.

Just reiterating what Fred said above, if you already have two sleep studies there is little or no value in doing more. There should be sufficient data in the original studies to lock in a diagnosis, and from that get a prescription. Your main task at the moment is to get hold of those studies, strip out any personal ID then post them here. We'll look at them and make suggestions about the appropriate treatment.

If there was already a prescription prepared after the second study, then you can use that. If not, there is a wide range of medical professionals who can write a script. This includes your GP, dentist and others. If all else fails, some of the online suppliers have doctors who will review your studies and provide the prescription.

Please check back here before you commit to any particular machine.

Don't forget the mask! The mask is the interface between the machine and your (girlfriend's) body. Getting a mask that doesn't leak, that fits properly and is comfortable is probably the hardest part of this process. Ensure your supplier has a mask return deal so if one mask doesn't work out you can try another.

Depending on the machine she ends up with, and your insurance position, it might be more economical to get a "gently used" or new old stock machine from Supplier #2 or Supplier #33.

Hope this helps.

[OpalRose]

Hi derek,
It would be best to stay with this thread.  As soon as you get the sleep report, post it here.  

In the meantime, for her to find some relief while sleeping, have her sleep on her side rather than on her back, or sleep slightly elevated if possible.
I used to sleep in a recliner before I received my machine.  

I know our health care system can be agonizingly slow, more so in sleep medicine.  If you find that the process is taking too long with insurance, and if finances allow, you can purchase out of pocket.  Check out Supplier #2,
as they sell good low hour used equipment and open box new.  

If you go that route, we can help her get the machine dialed in.  You can still go through insurance, and use the extra machine as a backup. But, it would be preferable to see the report first before purchasing yourself.

Good luck, hope you get that sleep report soon.

[70sSanO]

A number of years ago I saw the suggestion given to someone waiting for a machine to wear a soft cervical collar.

The logic Back then was that EMts tilt the head back to open airways for CPR.

I wear one for another reason, that isn’t relevant to your GF’s situation right now, but it might provide a bit of relief.

John

[Sleeprider]

Derek, probably the worst place to go for treatment of sleep apnea is a "sleep specialist". Get the sleep study results and a prescription can be written from that. If you know she has obstructive sleep apnea, then we already know we're going to recommend a Resmed Airsense 10 Autoset. Just to cut to the chase, that is the machine you are probably looking for, and if you are paying out of pocket, then it will be pretty easy to source one where you currently live through Craigslist, Offerup, Facebook Marketplace, DotMed and other market places. I'm pretty sure Supplier #33 is not a stickler about a prescription. Any medical professional, primary doctor, dentist, PA etc can actually meet with your GF and prescribe CPAP based on her responses to some simple questions, and of course if you have the test results, then it is much easier. What is her insurance situation? Is this covered with reasonable copay, or do you think an out-of-pocket purchase at a lower price makes sense?

I'll just say now, there is a Resmed Aircurve 10 Vauto in the Louisville Craigslist for $400.00. This is an outstanding deal and can treat virtually any obstructive sleep apnea or upper airway resistance (UARS) with great comfort and efficacy. This is superior to any CPAP. It is listed under " CPAP/BIPAP MACHINE like NEW with ACCESSORIES - $400 (Bloomington) "

[ardenum]

I'm not sure a USED machine should be an option now. There is a growing evidence of covid-19 spreading and infecting people through used xPAP's.