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Newbie questions
#1
I was diagnosed with mild sleep apnea on my side and moderate on my back (ahi of 16.7) with an overall on ahi of 7.5. My oxygen averaged 93 but dropped to 87 during the night.

The part that I found very surprising was my arousal index was 45-58 per hour in the two studies. So in about 4 hours of sleeping I had over 200 arousals. I have been VERY tired even though I'm sleeping 9-11 hours a day. Is this something that is likely to get better with CPAP? I am waiting for the DME to schedule my appointment to get the CPAP. They use Resmed equipment but I was assigned a pressure of 14 so I assume I won't get an APAP. What should I ask when I go? I used a full face mask during titration because I have a deviated septum.

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#2
I would insist on a Resmed S9 Auto set, even if you have to fight for it.
You will also want the H5i humidifier and climateline hose.
The mask is personal, what works for me may not work for you.
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#3
(09-02-2013, 11:53 AM)bwexler Wrote: I would insist on a Resmed S9 Auto set, even if you have to fight for it.
You will also want the H5i humidifier and climateline hose.
The mask is personal, what works for me may not work for you.

Thanks for the info....my concern is that the sleep doc (who I never saw) suggested to my doctor a setting of 14 and the DME said they would have to give me a standard CPAP unless an APAP was specifically prescribed. Is this true?
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#4
It might be true according to that DME supplier's policy, but it isn't true as far as the law and how the prescription can be filled. S9 AutoSets can be set to "CPAP" mode and set to static pressure. The DME could supply the AutoSet set at CPAP with pressure of 14cmH2O and that would completely comply with the prescription (of course it could always be changed to "Auto" when you get it home or at any time in the future); but, they don't want to do that because they can make a few extra bucks by giving you an S9 Elite (which isn't a bad machine because it is fully data capable even though it isn't auto titrating) and they can increase their profit margin even more by giving you an S9 Escape (dumb brick).

I'm betting they plan on giving you an Escape. If I were you I wouldn't take it - I would demand an AutoSet and if they refuse, I would take my business elsewhere...why am I saying "would"? That's not what I WOULD do, that's what I did!

Also, I agree that you should get the humidifier (H5i) and ClimateLine hose.

Sleep-well
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#5
Thank you for letting me know they can if they want to. I believe that since I have a large difference on my side versus back that it should justify the Autoset. Also I called my insurance company and the limit is $3,500 per year for all DME items. So I would assume UHC will pay for it.
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#6
There are other autoPAPs out there. The Phillips-Respironics System One (PRS1) auto is cheaper and just as good. The Icon has an auto, too, but I'm not a fan of them.

Find out who says the auto has to be justified. Make sure they do not mean a "bilevel" has to be justified, which is true since they are more expensive. Most insurance companies pay the same amount for CPAPs so the DME loves to sell you their cheapest model so they get the most profit.

Do NOT accept a Respironics mode with the word "Plus" in the name or a Resmed with the word "Escape" in the name. They are not data capable. http://www.apneaboard.com/wiki/index.php...ne_Choices

But as for your initial question, yes, the arousals will decrease with CPAP use.
PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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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#7
(09-02-2013, 03:12 PM)PaulaO2 Wrote: There are other autoPAPs out there. The Phillips-Respironics System One (PRS1) auto is cheaper and just as good. The Icon has an auto, too, but I'm not a fan of them.

Find out who says the auto has to be justified. Make sure they do not mean a "bilevel" has to be justified, which is true since they are more expensive. Most insurance companies pay the same amount for CPAPs so the DME loves to sell you their cheapest model so they get the most profit.

Do NOT accept a Respironics mode with the word "Plus" in the name or a Resmed with the word "Escape" in the name. They are not data capable.

But as for your initial question, yes, the arousals will decrease with CPAP use.


Thank you Paula! I'm very hopeful that I will be less tired. I wake up yawning and tired no matter how much I sleep and when I take naps I'm out for hours and still not refreshed. I just want to get better!
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#8
Hi TiredinFL,
WELCOME! to the forum.!
What jgjones1972 said.
Best of luck to you with CPAP therapy.
trish6hundred
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#9
(09-02-2013, 09:58 AM)TiredinFL Wrote: I am waiting for the DME to schedule my appointment to get the CPAP. They use Resmed equipment but I was assigned a pressure of 14 so I assume I won't get an APAP.

(09-02-2013, 02:44 PM)jgjones1972 Wrote: The DME could supply the AutoSet set at CPAP with pressure of 14cmH2O and that would completely comply with the prescription (of course it could always be changed to "Auto" when you get it home or at any time in the future)....

I'm betting they plan on giving you an Escape. If I were you I wouldn't take it - I would demand an AutoSet and if they refuse, I would take my business elsewhere...why am I saying "would"? That's not what I WOULD do, that's what I did!

(09-02-2013, 02:59 PM)TiredinFL Wrote: I believe that since I have a large difference on my side versus back that it should justify the Autoset.

Hi TiredinFL, welcome to the forum!

First, to possibly make everything easier, it is well worth the effort to call your doctor or schedule an appointment if needed, to ask the doctor to prescribe a pressure range. As you point out, your needs vary with position, and your insurance would likely cover the cost and, if nothing else, an APAP machine would offer future treatment options which a CPAP device cannot.

Any DME is able to fulfill your present prescription by providing you with an APAP set up in CPAP mode. But a new prescription specifying a pressure range would give them no choice but to provide an APAP. Then the battle is merely to ensure you receive a fully data-capable model.

Whether or not you are able to get a new prescription, do not schedule a time to pick up your machine until you know you will get the machine you have chosen. It is not unlikely that you may need to make it clear that you will change DME supplier if needed, to get the machine you feel you need.

Even if your prescription is for a fixed pressure, the prospect of seeing you give your business to someone else can give a DME a whole new perspective on the matter. It may take some looking around, but you will probably be able to find a DME who has the good sense to recognize that even a little profit is better than no profit at all (better than losing your business).

No doubt, you are free to use any DME which is in your insurance company's provider network. You can probably find a list of approved providers on your insurance company's website. You can call up each DME provider and explain that you are looking for a DME who can provide the machine you have chosen.

Be persistent and never give up.

Take care,
--- Vaughn
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#10
Fight for the S9 Autoset. Worth the effort.

My prescription was for a "set" 11 CWP. But after struggling for several nights with the set pressure I got into the machine and eventually ended up with an Auto setting of 7-13. Last night was my 24th night of PAP use and I had my first AHI of 0.0! My average pressure last night was 7.47 with my 95% pressure at 8.12 ... considerably lower than my original prescription.

Also, I've done this all on my own. Still don't see the sleep doc until Sept. 19, so if I had left things the way they were originally prescribed, I wouldn't have made the progress I have to date.

Arm yourself with lots of information and strongly advocate for what you intuitively know is best for you. Smile
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