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Newbie Help
#1
Newbie Help
Hi guys.

Thank you for all the advice that is given on this forum.  I’m so happy I found it.

I was hoping you guys could recommend a machine and some advice based on these test results.

My background:

I started snoring heavily and feeling tired in my late teens.  I could sleep forever and not feel refreshed since then.  I had two sleep studies done over the past 20 years that only showed mild sleep apnea that doctors didn’t advise to treat with CPAP.

I was diagnosed with PLMD both times as a possible explanation for my tiredness and given medications.  I felt no relief from the meds and had terrible side effects.

I just had this home sleep study done because I’ve been feeling more tired than ever and these are the results.  The sleep time is actually wrong.  I actually was only able to sleep for about 5 hours, but the report shows that I slept for 8 hours.

Do you guys think this report is accurate?  Is it possible my mild apnea was responsible for my sleepiness this whole time?

I’m scheduled to pick a machine in 2 weeks.  Any recommendations based on these results?

Thank you so much!


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#2
RE: Newbie Help
From what is there I would think they will give you a Cpap not a bipap. The ResMed AirSense 10 AutoSet is fine. My suggestion is not to get a Phillips dreamstation. The supplier will probably recommend it because they make a larger profit from the dreamstation. The ResMed is a much better machine IMO. IF they say a bipap then a ResMed Aircurve VAUTO. But again I’m sure they will give you a Cpap. My Dr would ONLY prescribe the bipap but again they cost more than a Cpap. Hope this helps. If you have questions ask before you get to the supplier.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed 
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#3
RE: Newbie Help
Your apnea and hypopnea are in the moderate range not mild, and underestimating AHI is a common problem with home sleep studies because they don't accurately record sleep. In this case they estimated sleep for 8:55 out of 8:59 test time. The missing data is a chart that shows the timing of events, and that is useful in seeing graphically when events occur and in what sleep position. Anyway, there is more than enough here to justify positive pressure therapy, and I simply won't recommend anything but the Resmed Airsense 10 Autoset or Autoset For Her. In addition to providing the fixed pressure needed to maintain your airway against obstruction, the Resmed actually works like a bilevel providing a separate inhale and exhale pressure channel that can be separated by up to 3-cmH2O pressure. That difference in inhale (IPAP) and exhale (EPAP) pressure is known as pressure support, and it is not only comfortable, but very effective in treating flow limitation, snoring, respiratory effort related arousals and hypopnea.

That is a big paragraph to absorb. You should do very well using CPAP, and the best CPAP machine is the Resmed Airsense 10 Autoset. You can self-titrate (adjust pressure by yourself) using that machine and our help and very quickly optimize your results without any further sleep studies. If you have good insurance get your prescription, and find out what suppliers are in-network for your coverage. If your insurance has high copay or deductibles, it may be less expensive to use an alternate supplier. Let us know an and we can give you some ideas.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
RE: Newbie Help
Welcome to the forum

Call your DME and tell them you are confirming your getting a ResMed AutoSet.  Is that what is ordered.  If not then is that something you can fix?  If not that's ok, I'll go to your competitor and get one, are you sure you can't fix that?  If no, and this is the hard part, "Please cancel my appointment"

Note: we can help you get one for about what your copay is.

Why ResMed and not PR?

ResMed AutoSet Dreamstation Auto comparison
Why ResMed?
1. Faster algorithmic response to events than PR.
2. ResMed Responds to Flow Limits
   PR responds to Snores
3. Lower average pressure (PR require a higher pressure to ward off obstructive events)
4. Better to avoid Aerophagia.
5. EPR provides for better treatment of hypopneas, RERAs, Flow Limits, UARS, and snores
6. EPR acts like a BiLevel up to a limit of 3cmw (1,2, or 3cmw) and a max pressure of 20 cmw
7. EPR follows your breathing whereas Flex predicts it with a feeling of fighting to get a breath when it predicts incorrectly
8. More flexibility in treating a greater variety of Apneas and respiratory events.
9. In general provides better therapy.
I have frequently told many DreamStation users that they need to get either the ReaMed AutoSet or BiLevel to get better therapy.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Newbie Help
If you get a machine I would suggest the Resmed Airsense 10/ autoset and others have mentioned it already. I just bought a new one to replace my 5 year old Resmed Airsense 10/ autoset and it work faithfully all those years and with EPR it feels like normal breathing to myself.
The Resmed Airsense 10/ autoset has dealt with my mostly Obstructive and Hypopneas apnea's with no problems, I would make sure if you go with Resmed that you ask for the Autoset model because you can adjust your settings a little to your comfort level. Folks here can help you with issues if you are having any. Autoset is nice feature because it makes adjustments as you sleep with in predetermined parameters for your comfort.
My first Cpap a older model Respironics Remstar 60/aflex auto just before the Dreamstation's came out (same machine basically) but use different Algorithms to make decisions when in auto mode, My Resmed Airsense 10/ autoset when l look back gave a little better feel for breathing normally and I kept my pressures the way I wanted it to perform. I know use my old retired reliable Airsense 10/ autoset as my backup for what ever reason that comes along (approximately 13,500 flawless hrs on it).
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#6
RE: Newbie Help
a cpap of some sort will help your apnea but not plmd. in fact, the machine may respond to plmd flow limitations by raising pressure. that can be disturbing in itself, on top of the disturbances caused by plmd. in my experience, sleep docs churn diagnoses of obstructive apnea & cpap/apap machines & show little interest in helping with rls/plm so you might have to be assertive about it with your doc.
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#7
RE: Newbie Help
Thank you all for taking the time to respond. This forum and community is amazing. I’ve read some of the threads on masks, and I’m going to go and try the different types lying down at different pressures.

I’m excited and nervous for this whole process. I hope the pressure therapy works.
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#8
RE: Newbie Help
I finally got my ResMed Airsense 10 Autoset today!  I'm so excited to try it.  Unfortunately, it did not come with an SD card so I will pick one up.  Does anyone have recommended settings?  My sleep study attached recommended one thing, but they set it at 8 and 13.

Thank you!
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#9
RE: Newbie Help
A good starting point is 7-20 with full time EPR of 2. We can then fine tune based on Oscar data. Don't worry about the high of 20. The pressure won't go any higher than is needed.
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.

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