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Newly Diagnosed, starting my journey
#1
Newly Diagnosed, starting my journey
After around two months of appointments and back and forth.  I finally got the results of my In-home sleep study.   AHI of 38.4.  The next step (in another 3 weeks) is a in-office titration study.  Of course, with my data driven personality, I'm already trying get as much data as I can.  I've discovered that you typically need to be your own advocate when it comes to health issues.

Couple (hopefully) quick questions for people who are way more knowledgeable than me in this process.  My Dr. told me that after my titration they will have me make an appointment with a DME to pick up a machine.  At what point should I advocate for the model of machine I want?

I'd also love machine suggestions... I understand that this will be subjective and will vary quite a bit.  But maybe a kind soul could point me in a couple good directions.

During my in-home study the machine recorded 6 Central Apneas, 136 Obstructive Apneas, 18 mixed, 142 Hypopneas.

Thanks in advance for any advice and wisdom you can share.  Can't wait to finally get my machine and hopefully awake refreshed for the first time in years.

-E
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#2
RE: Newly Diagnosed, starting my journey
Welcome to the forum. Resmed machines are most frequently recommended here. You  definitely want an autotitrating machine with data capability. The Resmed Airsense 10 autoset is the best choice. It is more effective than the Phillips respironics dreamstation for treating obstructive apnea and hypopnea. The Resmed auto algorithms are sensitive to flow limitation, hypopnea and snores so the machine quickly increases pressure quickly before an obstructive apnea occurs.  By comparison, the Dreamstation is much slower to increase pressure, and tends to reduce pressure too quickly, allowing many more obstructive apnea and hypopnea to occur.  In addition to the better preventive pressure algorithm, the Resmed uses exhale pressure relief (EPR) which is a true bilevel pressure with up to 3 cm pressure difference between inhale and exhale.  Philips machines use CFlex, CFlex Plus or AFlex which provides pressure adjustment as respiration cycles to exhale and triggers inhale, but it tends to be poorly timed for people with flow limitation.
The best approach is to ask your Dr. to prescribe the Resmed Airsense 10 autoset dispense as written. That way the DME will have no choice. If he does not be sure the DME supplies Resmed machines and refuse to accept anything other than the Resmed Airsense 10 autoset or the Resmed Airsense 10 autoset for Her. Insurance pays the same for a full featured machine as for those with lesser features. Some DMEs will try to give you a lesser machine because it costs them less and increases their profits.
The machine has a slot for and SD card. The DME may supply one if you ask. If not be sure to get one.
Mask selection will be one of the biggest challenges. See the link below for the mask primer.
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

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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#3
RE: Newly Diagnosed, starting my journey
I was lucky, as I was prescribed a ResMed AirSense 10 AutoSet. It came with a ClimateLine heated hose and an AirFit F20 FFM. 

I didn't know anything about SA equipment until I became a member of this forum. My in-lab sleep study said my AHI was 170 during regular sleep, and 160 during REM sleep. I was told that's borderline severe SA. 

Anyways, my CPAP machine is dead quiet. It's easy to use and easy to navigate the menu, once you become accustomed to it. 

From what I've read on here, you can't do much better than it. 

Hope this helps and good luck to you.
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#4
RE: Newly Diagnosed, starting my journey
ResMed AutoSet. Best advice on masks is to start least invasive on facial real estate then go more “invasive” as needed. Least invasive is the pillows. Next is a nasal mask. Finally there’s the full face. There’s also a hybrid type as well. You’ll have to determine if you mouth breathe or not. If you do, you’ll likely need to train yourself not to do this. There are methods to do this and things like tape if mouth leaks occur. Failing that, you may consider full face. Then there’s other things like the actual pillow and consideration on whether a cervical collar could help. Yes lots of stuff to think about and learn. It’s doable though. Grab a coffee and get to it.

Oh and welcome to the AB.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#5
RE: Newly Diagnosed, starting my journey
Thanks, for the welcome and advice.  It's fantastic to have a community like this when trying to navigate things.

and thanks for the advice on masks.  I didn't give them much thought before now.  I know that I'm a mouth breather when I sleep (I blame extensive SCUBA training.)  I'm also a side sleeper, so I imagine the quest for a perfect mask will be interesting.

I'll be sure to update when I get things sorted out, but between the advice above and the excellent resources in the forum.  I'm feeling good getting started.
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#6
RE: Newly Diagnosed, starting my journey
ResMed is so weird about slapping “For Her” labels on things. You’d think they’d realize many men will assume it’s not for them. The ResMed Airsense10 Autoset For Her does everything the non-for-her machine does, and gives you a few more options to try.

I was titrated at home for a week on a Respironics and hated it. It always seemed to want to rush my next breath. I was so relieved when I got my ResMed. It follows my breathing perfectly.
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#7
RE: Newly Diagnosed, starting my journey
I'm a mouth breather, sleep on my side, and use a full face mask with no problems. I rarely see leaks. I use the Resmed AirFit F20 which is very comfortable and durable. I've been using the same mask and cushion for over two years. Of course, what works for me may not work for you.
Download OSCAR

Organize Charts
Attaching Charts

Mask Primer
Soft Cervical Collar

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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#8
RE: Newly Diagnosed, starting my journey
Good luck! Newbie here too and my short list was the ResMed S10 or the Philips Dreamstation Go w/ humidifier.
Take control of your machine
pick your weapon (ResScan/ OSCAR)
and be informed guys!
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#9
RE: Newly Diagnosed, starting my journey
Eldon, welcome to the forum. Good questions, most of which have been answered well. 

Quote:Couple (hopefully) quick questions for people who are way more knowledgeable than me in this process.  My Dr. told me that after my titration they will have me make an appointment with a DME to pick up a machine.  At what point should I advocate for the model of machine I want.  ?

Now.  The most effective way is to request that your doctor prescribe auto CPAP and that he specify the Resmed Airsense 10 Autoset by name, and write "dispense as written".  You can call the DME and ask what auto CPAP they normally dispense, and if that is agreeable to you, that's good enough  Before accepting an appointment to pickup the machine, you must ask what they are dispensing. If it is not what you want, decline the appointment and let them know why.  You have a choice of DMEs, and it helps to have a complete list of in-network DME suppliers from your insurance, rather than just assume that you have been referred to the best in-network choice by your doctor.


Quote:I'd also love machine suggestions... I understand that this will be subjective and will vary quite a bit.  But maybe a kind soul could point me in a couple good directions.


I think the Resmed Airsense 10 Autoset is the unanimous choice here.


Quote:During my in-home study the machine recorded 6 Central Apneas, 136 Obstructive Apneas, 18 mixed, 142 Hypopneas.


You may have complex apnea which puts you at a higher risk that you may need an advanced bilevel (ASV) machine, however, you will be started on CPAP, and you must demonstrate that you tolerate or cannot achieve efficacy with CPAP before advanced PAP will be approved.  It is common for individuals to have some central events when starting out, but we can usually tell pretty quickly how things will work out.  In any event, the high number of hypopnea will be easier to treat with the Resmed Autoset, than with other alternatives due to the exhale pressure relief being more like bilevel.

Quote:Thanks in advance for any advice and wisdom you can share.  Can't wait to finally get my machine and hopefully awake refreshed for the first time in years.

Good luck! You are off to a good start by starting here before you get the machine.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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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