New here, have a question

[resaebiunne]

Just a little background on myself. I was referred for a sleep study that I requested from my psychiatrist. The first sleep study found moderate sleep apnea (AHI of 15.9). I have regularly been sleeping 12 hours/day since December of 2014. As you can imagine, that is a lot of sleep and it really makes it hard to have any sort of life outside of work. I have epilepsy and schizoaffective disorder bipolar type. Both of these are comorbid with sleep apnea. I had a titration study done this past weekend and I'm hoping to see the results soon.

During the sleep study I tried various masks; a nasal pillow and a full face mask. Normally I'm a mouth breather but I had no problems breathing through my nose with the nasal pillows. My main issue with the nasal pillows was how dry it made my nose. When and if I get a CPAP I'm going for a model with a good humidifier.

My question is this: if I go for a FFM and start breathing through my mouth again, could this cause issues with the fitting of the mask as I open my jaw? I'm thinking a nasal pillow would be more practical and easier to adjust. I've seen various posts here that recommend the tap pap and it seems like it could be a great and comfortable mask.

I've also read that insurance companies want you to order products through a DME provider who is in-network. Once I get a RX I would prefer to just purchase a unit outright ([Commercial DME URL removed, please refer to Supplier #1 on the Supplier List] seems like a good choice). My main concern is that when I get a machine and I don't have a change in sleeping habits that it could be a waste of money. The other thing to note is that I will probably have a change in insurance pretty soon (I'm on cobra right now after getting laid off in January).

I'm really hoping that this will let me sleep fewer hours a night so I can get back on my feet again.

I've been doing some research and I'm looking at the ResMed Airsence 10 Autoset. This seems like a good machine and should be compatible with the SleepyHead software. I'd rather go for a highend machine rather than buying a cheaper model and then upgrading later as it will cost more in the long run.

What do you think? Does this sound like a good approach?

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[Sleeprider]

My opinion is for most users to get the mask with the best comfort and minimal contact that works. So much of the history you cited is not relevant to the question of whether you can comfortably breathe through your nose, while excluding pressure from your mouth. This is something most of us don't know without trying it. I have a deviated septum, but can use nasal pillows, and have never needed anything else.

Give a minimal mask a trial. If it doesn't work for you, most insurance will let you trade it in for a FFM. The Airsense 10 Autoset is a great device. I have used both Resmed and Respironics machines, and the differences are subtle, but the auto-titrating machines are the only ones I have ever used in addition to auto bilevel from both manufacturers. The feedback from a data machine is essential for starting out and optimizing treatment; however, I downloaded my data today and it had been 43 days since the last download. Once you find YOUR solution, data becomes a bit less important, but for new users, it is great incentive and feedback.

[resaebiunne]

Well, I'll be brand new to CPAP, so I don't have any history. That said though, I'm afraid to go through insurance for a CPAP machine. I suppose that doesn't have to mean not getting a mask out of pocket but I would still prefer not to. [commercial DME URL removed, instead, please refer to Supplier #1 on the Supplier List] seems to have a good return program so I'd rather take advantage of that.

The question remains though; will a FFM work for someone who is a mouth breather? Wouldn't opening my mouth cause leaks?

Edit: Would a nasal pillow mask with a chin strap work?

I don't like the idea of a FFM or a NM simply because the headgear is so much more complicated. Simple is better.

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Moderator Action: Link Removed

To maintain our status as an educational organization, the only commercial links allowed in this forum are to CPAP-related manufacturer websites. This is stated in the Apnea Board Rules with details given in the Commercial Links Policy section.

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[trish6hundred]

Hi resaebiunne,
WELCOME! to the forum.!
Hang in there for more responses to your post and good luck to you on your CPAP journey.

[Sleeprider]

Well, I'll be brand new to CPAP, so I don't have any history. That said though, I'm afraid to go through insurance for a CPAP machine. I suppose that doesn't have to mean not getting a mask out of pocket but I would still prefer not to. [commercial DME URL removed, instead, please refer to Supplier #1 on the Supplier List] seems to have a good return program so I'd rather take advantage of that.

The question remains though; will a FFM work for someone who is a mouth breather? Wouldn't opening my mouth cause leaks?

Edit: Would a nasal pillow mask with a chin strap work?

I don't like the idea of a FFM or a NM simply because the headgear is so much more complicated. Simple is better.

First, be sure to avoid naming any vendors with the .com suffix, or you will hear from the moderators. You refer to Vendor #1 on the Supplier List. http://www.apneaboard.com/forums/Thread-...plier-List

They do offer a replacement guarantee if it doesn't work out, and you can apply the full cost to a replacement mask. By the way that vendor is better to call for the best price, rather than just check out. You might save a few $$. I still think you try the pillows, and if they don't work, you move to the "less comfortable" bigger mask. Seriously, most of us are able to do just fine on a nasal pillows mask, but if you can't get leaks under control, then an exchange is easy.

[Kyle]

Hey new to the forum, but not to CPAP. I help with CPAP management at my job and also have severe Sleep Apnea. First off don't get overwhelmed with all the information they throw at you in the beginning. If you can find a place that has a store front that will work with you as far as CPAP. you will commonly see the words DME thrown around, that simply means Durable Medical Equipment. Each insurance is different and has different policies on DME coverage. The Best thing you can do is ask around for a sleep doctor that is upfront and will help guide you and not just throw a prescription at you and send you on your way. When checking for coverage through insurance you need to ask about if you have a deductible, its usually a dollar amount that they want you to reach before your coverage increases. If they say the entire amount will be applied to your deductible, you are probably best to buy from the website you mentioned and have it set by your Sleep Dr. I can't vouch for all brands but i work commonly with Resmed and Respironics and both seem to work well and very user friendly. Just make sure you buy the correct type of device such as CPAP,BiPAP or Autotitrating unit. Its hard to determine what type of mask you will need. you can try on mask all day but the true test is when your sleeping with them. FFM is usually a solid bet for mouth breathers but they range in size and the way they are made. All fit a little differently with the same concept. A Nasal mask and a chin strap will work, I have met many people that if they have higher pressures still report some air leakage unless they tighten it down. See if there is a place that will help guide you in person on mask. I hope this ramble helped a little.

[PaulaO2]

If you think the headgear of a FFM is complicated, wait until you have the headgear for a pillows mask AND the chinstrap. It gets old after a while. It is why I use a FFM.

[Sleeprider]

If you think the headgear of a FFM is complicated, wait until you have the headgear for a pillows mask AND the chinstrap. It gets old after a while. It is why I use a FFM.

Paula, I would agree that if you can only control leaks or mouth breathing using a chinstrap, taping or some other uncomfortable addition or modification, then the pillows mask is not ideal. No one solution is right for everyone, but hopefully everyone finds a solution that is comfortable and right for them.

[resaebiunne]

Thanks guys. The mask I am looking at has a split band that goes over the back of the head. To loosen the strap, you separate the two pieces and to tighten it, you move the two parts closer together. I used this style mask during the titration study. I had no problems with it and it felt very comfortable. I can't say how long it's been since I breathed through my nose. I was even a bit stuffy but the CPAP pressure cleared that up. The only bad thing was that instead of my mouth being dry, my nose dried out pretty bad.

From what I've read, the chin strap can be used until you "train" yourself not to breathe through your mouth. I'm not sure about taping; I have a beard so I imagine tape wouldn't stick well. Also, I think it could be bad if you wind up sick. Obviously the chin strap would add more to the headgear making it more complex.

As far as insurance goes, the DMEs I saw on Aetnas website only seemed to offer masks and replacement parts, not CPAP machines. I'm a bit concerned by this. If I use my provider of choice, it would be an out of network deal. I've met my deductible already this year for in network events, not sure about out of network. But if I'm correct, and I should check this with insurance, the deductible would probably apply and my out of pocket cost would be the same as buying a CPAP outright even without insurance.

Also, sorry for missing the rules on CPAP providers.

[MitchS]

I use a P10 pillow mask along with a chinstrap to control mouth leaks. It only takes about 10 seconds to mask up with the chinstrap over the mask's headgear. I find the combination is still more comfortable than the full face masks I have used. I had to use a chin strap with my FFMs also.