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Introduction and questions
#1
Hello all! My name is Zach and I've been using a CPAP for a little over a year now. I've found myself having questions about my machine and other issues and that's how I stumbled upon this forum.

A little background: I'm 33 and in my late 20's I started having sleep issues. I was in the navy for 8 years on submarines and it seems like sleep apnea is fairly common in that community. I don't know why but there are tons of former submariners that I have talked to that are now using CPAP. My wife said that I would make weird noises in addition to my LOUD snoring and sometimes she could tell that I stopped breathing. I did the sleep study and they told me I stopped breathing over 100 times in an hour long period. I was starving my body of oxygen. Prescription: CPAP

I went to a local sleep foundation and got outfitted with my equipment. They explained use, care, cleaning, etc and sent me on my way. About a month later I had to bring in my SD card and since then I haven't really had any communication with them. I get notifications via email every so often to reorder supplies and that's it.

I have a few questions that I was hoping some of you could help me with...

- I wanted a way to monitor my sleep (software like SleepyHead) but now I realize that my machine (PR 260P) doesn't collect data. Does insurance typically replace the machine every so often? I'd like to get a machine that can collect data but I'd rather not go out of pocket if I don't have to.

- I'm currently using a full face mask (ResMed I believe). I sometimes roll on my side and it will leak a little. I was thinking about trying a different style of mask but are they all compatible with the various types of machines?

- Should someone be checking in on my sleep patterns (or should I be talking to my physician about it)? It's been about a year an a half since an actual person talked to me about my CPAP equipment.

The more I look at this forum the more I realize that after a year and a half I really don't know anything about how this process is supposed to work... other than put mask on, turn on machine, sleep.

Sorry for the long post,
Zach
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#2
Hi Zach

I can't help with the insurance question but as far as the pillow causing mask movement is concerned sleeping on the edge of a firm pillow is my best suggestion. Personally I've bought a special pillow with a cut out section which accomodates the mask quite nicely.

As far as monitoring is concerned i went for 7 years with only an annual safety check on the machine and a new mask.

If you feel well and have lost all your previous symptoms of tiredness, maybe you should be content with that.

Best wishes
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#3
Hi Zach,

I'm just sitting here trying to cope with the idea of a submarine full of guys with sleep apnea snoring tendencies. Scary thought.

It would be good if you had a data capable machine. I really think you could pick that bone with the doc that prescribed you a brick. The theory of your prescription and machine is "doctor knows best, do this, live long and prosper." But things change. Even the initial pressure setting cannot be relied on without statistics. So I think you need to have a quality conversation with the doc and ask him/her what they are going to do about this.

Are you on VA? If they are not the ones to prescribe for you in the first place, and it doesn't sound to me like they are, call your primary care provider and ask him/her to prescribe a consult with the sleep lab with the goal of having them take over your sleep apnea management. They actually do that very well, and they provide top line equipment.

Welcome to the site, stay above water, and keep us informed as to how you're doing.


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#4
Many insurers follow the medicare guidelines for CPAP replacement. The medicare guideline is 5 years minimum for CPAP machine replacement and as I understand it. The best thing to do is check with your insurer. Your DME should also be up on what your insurer's requirements are.

If you decide to go out of pocket, Supplier #2 on the supplier list on this board sells lightly used and open box units at reasonable prices or you can watch Craigs list or the like for machines. If you decide to buy from Craigs list or the like, make sure that you know exactly what you are getting. It would be best to shop by the model number of the machine and if the seller does not know have him/her give it to you off the machine. Somewhere on the board there is a list of Resmed and Philips Respironics model numbers and names I just do not remember where.

As far as masks are concerned, I would wait until you have a fully data capable machine and the Sleepyhead software before changing mask types. For either a nasal mask or a nasal pillows mask to be used effectively, one must not be a mouth breather and be able to control mouth leakage which is difficult to impossible for some of us.

The reason that I say one should be fully data capable before switching from a full face mask to either type of nasal mask is that it is entirely possible to have serious mouth leaks and be totally unaware of it. I had a nasal mask and was quite sure that I had trained myself to not mouth breathe or leak for a period of over a year. I found this forum and got myself equipped to download and look at my data and lo and behold I had large leaks almost all night long. I tried a chin strap and it did not work for me. Ended up going to a full face mask and have had no more leak problems but I know this because I can see it in my data.

My experience with doctors is that even my sleep doc only looks at the long term data. He does check my machine and ask me questions about my therapy. I do see him once a year or so but I am beginning to think that maybe it is a waste of money.

Best Regards,

PaytonA
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#5
Insurance will usually buy a new machine earlier if there is supporting diagnostic - changing pressure, high pressure, etc. Getting a rx for an auto titrating cpap due to pressure requirement changes by position can trigger them to pay for a new machine, for instance.

Getting a new mask is easier. You should be able to get a new mask every 3 to 6 months depending on your plan.

If you have to pay 20%, or have a big deductible that you wouldn't otherwise meet, make sure it isn't cheaper just to buy out of pocket, The preferred providers insurance companies use tend to charge a price that winds up costing as much or more since they will rent for a time before buying at a hugely inflated price.
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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#6
(02-09-2015, 12:22 PM)retired_guy Wrote: I'm just sitting here trying to cope with the idea of a submarine full of guys with sleep apnea snoring tendencies. Scary thought.

I snore and sleep like a rock so it never bothered me. I think most of us with sleep apnea are former submariners. I only remember 1 guy using CPAP in 8 years on a sub. It wasn't until AFTER I got out that I found out about the high probability of sleep apnea for submariners. I've read theories about low oxygen atmospheres (not uncommon for O2 levels to get down to 16-17%. I've also read stuff regarding atmospheric pressures. Who knows?

Quote:It would be good if you had a data capable machine. I really think you could pick that bone with the doc that prescribed you a brick. The theory of your prescription and machine is "doctor knows best, do this, live long and prosper." But things change. Even the initial pressure setting cannot be relied on without statistics. So I think you need to have a quality conversation with the doc and ask him/her what they are going to do about this.

Good advice. I was planning on getting w/ my doctor soon so I'm looking for talking points.

Quote:Are you on VA?

No. I've heard horror stories about the VA around here and my company pays for my insurance so I have avoided the VA so far.

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#7
(02-09-2015, 12:26 PM)PaytonA Wrote: As far as masks are concerned, I would wait until you have a fully data capable machine and the Sleepyhead software before changing mask types. For either a nasal mask or a nasal pillows mask to be used effectively, one must not be a mouth breather and be able to control mouth leakage which is difficult to impossible for some of us.

I mis-typed my mask type in the initial post. I actually have a nasal mask right now (pretty sure it's a ResMed Mirage). I couldn't find a way to edit my post... not sure if this forum allows that? The info about my equipment under my username should be correct.

I was wondering about switching from a nasal mask to a nasal pillow style. I'm fairly certain that I'm not a sleeping mouth-breather. I do remember one time waking up because the air was shooting out of my open mouth. I had been drinking a good bit that evening and I think that's what caused my mouth-breathing. I think I've pretty much "trained" myself to close off my mouth from my nasal passages with my mask on.

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#8
(02-09-2015, 12:34 PM)DariaVader Wrote: Insurance will usually buy a new machine earlier if there is supporting diagnostic - changing pressure, high pressure, etc. Getting a rx for an auto titrating cpap due to pressure requirement changes by position can trigger them to pay for a new machine, for instance.

If insurance won't cover it, do most of you here think it would be worth it for me to pay out of pocket for a data collecting machine? Or would you recommend me continuing the use of my current machine until a time where insurance will replace it?

I guess what I'm asking is is it essential to monitor your sleep data to ensure that your machine is actually taking care of the sleep apnea? I do feel much better now than I did before getting my machine so is that enough to say that I should wait on the data collecting machine?

Quote:Getting a new mask is easier. You should be able to get a new mask every 3 to 6 months depending on your plan.

If you have to pay 20%, or have a big deductible that you wouldn't otherwise meet, make sure it isn't cheaper just to buy out of pocket, The preferred providers insurance companies use tend to charge a price that winds up costing as much or more since they will rent for a time before buying at a hugely inflated price.

I get a 'kit' every 3 or 4 months through an auto-renewal program. I think I pay out of pocket around $80-90 for the kit that includes: ResMed Mirage nasal mask (complete), hose, and filters for my machine.

I might look into getting my own supplies through an online source. I believe there are ways to get reimbursed through my insurance company?


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#9
(02-09-2015, 01:18 PM)zach Wrote: If insurance won't cover it, do most of you here think it would be worth it for me to pay out of pocket for a data collecting machine? Or would you recommend me continuing the use of my current machine until a time where insurance will replace it?

I guess what I'm asking is is it essential to monitor your sleep data to ensure that your machine is actually taking care of the sleep apnea? I do feel much better now than I did before getting my machine so is that enough to say that I should wait on the data collecting machine?

That is (IMO) totally a matter of personal preference/finance combined with whether or not you have cpap or apnea related issues that are important to resolve. If there are issues, you need data Smile Speaking for myself (and many others i suspect) data is itself a goal... Wink

Quote:I get a 'kit' every 3 or 4 months through an auto-renewal program. I think I pay out of pocket around $80-90 for the kit that includes: ResMed Mirage nasal mask (complete), hose, and filters for my machine.

I might look into getting my own supplies through an online source. I believe there are ways to get reimbursed through my insurance company?

Reimbursement amounts depend on plan... My insurance reimburses at different rates depending on "in network" status. In my case, "in network" is 100% while "out of network" is 80% after a deductible. If I was not paying extra every month for "premium plan" it would only reimburse 80% after ded for "in network" and not at all for out.
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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#10
I'd get a VSO and file a claim with the VA. They may stall; but it seems the literature supports sleep apnea due to high CO2 and low O2 levels in submariners.

BTW -- by drinking, I assume alcohol. That's a bad mix for sleep apnea. It suppresses the central respiratory center of the brain.

Also, you need to know if your apnea is obstructive or central. If central, you may need an entirely different machine.
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