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Only Hypopneas & RERAs
#1
Only Hypopneas & RERAs
Just got the results of my sleep study/titration (after an initial diagnosis based on home sleep study), and I'm trying to determine next steps. Here is a summary of the sleep report respiratory information:

RESPIRATORY INFORMATION

Respiratory events occurred, numbering 0 obstructive events, 54 hypopneas, 0 central events, 0 mixed events and 27 RERAS. The total apnea-hypopnea index was 19.8/hr, and respiratory disturbance index was 29.7/hr. REM sleep accounted for 5.0 minutes with a REM related AHI of 36.0/hr, and REM related RDI of 60.0/hr. The patient had 50.5 mintes recorded in the supine position, 0 minutes left, 113.0 minutes on the right side and 0 minutes prone. 50.5 minutes of sleep were recorded with the patient in the supine position, for a supine AHI of 22.6/hr and supine RDI of 30.9/hr. Patient had 0 apneas and hypopneas while REM supine with an AHI of 0.0/hr and REM supine RDI was 0.0/hr.

OXIMETRY DATA

The basal O2 saturation was 89% with a low SaO2 of 81%. There were 54 desaturations ≥ 4%. Time spent below 90% was 52.9% of time in bed. Time below 88% was 34%.

My doctor's Rx is for 'CPAP @ 9 cm H2O - DX:05A

So, some questions:

1. I obviously need some machine assistance to get my O2 levels up. Will this Rx allow me to get an APAP (Airsense 10 Autoset) or am I going to get stuck with a brick CPAP?
2. Does the Rx cover the mask as well, and can I get any mask I want?

Our local DME dealer is a small town outfit - what am I likely to run into when (if) I go in there to get a machine?  I'd like to get Medicare to cover some of the cost, but if I'm going to be dictated to about what I can get or how I have to use it, I'd rather buy a machine on my own (if I can find one!!). I do plan to follow up with my doctor (GP - not sleep doctor.  Small town medicine) after about three weeks on a machine (at her request).

This forum is a great resource, and I am glad I found it.  It has allowed me to educate myself about the CPAP situation, and I would greatly appreciate any council you wise folks have on what my path forward should be.

Thanks in advance!!
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#2
RE: Only Hypopneas & RERAs
Make sure you tell them you want a Resmed device. Yes they should help fit you with a mask.
The prescription should cover all needed supplies so they can be ordered.

Read the wiki related to Medicare.

Tell them you want a copy of your full sleep study and your prescription. You need to keep this for you own records.

You will need the prescription if you plan to go away from insurance.

If that happens look at the Supplier list. You find what you want.
Thank you,
Brent aka Factor

Just a Regular guy.
My untreated AHI was 87.  You can do it hang in there.
"You can if you will"   Jerry Kramer

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#3
RE: Only Hypopneas & RERAs
I would suggest you call the Dr. and ask for a Rx for a specific model not just the setting. The machine you want is a ResMed s10 AUTOSET. ResMed makes a lot of different s10 machines. It is like getting a Ford - is that a fusion, Lincoln, f150 etc.

If you do that they must give you that model not the cheapest one they have on hand.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#4
RE: Only Hypopneas & RERAs
I believe your best outcome would be the Resmed Aircurve10 VAuto, but it is almost certain that you would have to buy it out of pocket. ApneaBoard has a list of vendors it trusts most, based on reports from buyers. I believe it is No. 2 in a listing of sources for all kinds of devices for sleep apnea treatment, but it is tops for machines (Secondwind . . ., the name, I think). 

I say that after having much the same home sleep test results myself and getting an Rx from my PCP who was a sleep apnea patient using PAP. I was issued the Resmed Autoset, went through a hellish couple of months before I learned enough and was advised here at AB how to reset the machine and get much better results. But the Autoset left me with a lot of flow limitations, both flagged as FL and not flagged (the latter as I later came to realize) and the related concerns about RERA.

Your test differed from mine in the absence of obstructive apnea. You would likely find that an Autoset would raise your O2 levels, some if not enough. Further, it would likely reduce FL and hypopnea some. RERAs? Some probably. Enough of either, doubtful, IMO. Your case and evident high awareness level suggest not. IMO, a cervical collar would help a lot with positional effects.

I believe VAutos at vendor 2 run about $800. Craigslist, fb Marketplace and OfferUp have private party and vendor listings, the former with lowest prices. I've used and done well with CL, a face-face buy (with pre-close test) and done well with OfferUp (nationwide). The latter has two programs that provide a bit of buyer and seller protection. At least and for free, you have 48 hours from delivered time to undo the transaction if the item is not as it was described. In CL and OU low hour VAutos run about $300 to $400. If the offer is unclear with inadequate information, my approach is to use the OU "ASK a question" dialogue box to state your conditions for making the offer you will immediately make thereafter. Make screenshot copies of all exchanges. 

With VAuto at bedside, I still use a Autoset if I take a nap, (rare). I hide one behind the recliner and I have another one in a "go bag" as my wife, bless her, demands--should I go to a hospital again.

I believe one prescription will cover both the pump and the necessities like mask, etc.

Others, far more expert than I,  can better advise on all I wrote, particularly whether to go with the Autoset initially--the easy insurance covered route--or to buy a VAuto out of pocket.
I have no particular qualifications or expertise with respect to the apnea/cpap/sleep related content of my posts beyond my own user experiences and what I've learned from others on this site. Each of us bears the burden of evaluating the validity and applicability of what we read here before acting on it.  

Of my 3 once-needed, helpful, and adjunctive devices I have listed, only the accelerometer remains operative (but now idle). My second CMS50I died, too, of old age and the so-so Dreem 2 needs head-positioning band repair--if, indeed, Dreem even supports use of it now.



 
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