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[Pressure] Help for a newbie: titration failed
#31
RE: Help for a newbie: titration failed
I would suggest nothing special for the first night, but we did notice a possible positional apnea problem earlier. That may still be in play if you didn’t take our suggestion of using a soft cervical collar
Sleeprider
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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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#32
RE: Help for a newbie: titration failed
If you have a preference for a certain mask for any reason, don't accept another. IMO next time you get a little voice that says "I don't care what you like; I'm the one who will be wearing it!!!" let it rip out nice and loud. I don't care what the reason is, if you like mask x but they're telling you no you can't have your choice, NO I've selected that one. Don't buy it can't work for high pressure of other lame excuses.
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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#33
RE: Help for a newbie: titration failed
That's great advice, all!

I tried a cervical collar (Releaf) but find I'm taking it off in the middle of the night because it's uncomfortable. Actually uncomfortable is maybe too strong a word; it's not causing me pain, I just can't get used to the sensation of it pressing against my chin. I have a short, skinny (37 cm) neck, I don't know if that's what's causing me problems? I'd be willing to try another brand if it's possible it would make a difference.

Also, the nurse recommended that I sleep at a 45 degree incline to reduce the risk of aerophagia. Does that sound right???

P.S. Really liked the sleep medicine nurse so she's a keeper. PCP is getting dumped. I'm also really pleased so far with the DME I've selected. The RP ordered a machine for me before he had script & insurance approval in hand so I wouldn't have to wait the extra week for it to make it through the mail.

P.P.S. I was disappointed to learn that aside from disposable filters and chin straps, my insurance only covers new supplies once a year. I sure hope that face mask is in it for the long haul!
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#34
RE: Help for a newbie: titration failed
Sleeping on an incline is a well known technique to reduce aerophagia, but it increases the likelihood of positional apnea. There are many collars out there, and they come in different heights, firmness and circumference. The first one you try, is often not the one you live with, and all I can say is they are relatively cheap, and you will eventually land on one that works. It's been a while since we saw a chart to see if the positional issue is still in play.
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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#35
RE: Help for a newbie: titration failed
45 degree might be a bit much, but the concept has merit.
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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#36
RE: Help for a newbie: titration failed
I'd give you a chart if I had it but I'm still waiting on delivery of my machine!!!
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#37
RE: Help for a newbie: titration failed
Posting again just because I'm feeling discouraged and could really use a pep talk. It's been 8 weeks since I was diagnosed with severe OSA and I'm still waiting on delivery of my machine. Now there's some sort of problem with my insurance company being able to issue payment to DMEs. I called them yesterday and there's nothing I can do but continue to wait. I've been wearing my collar and have finally gotten used to it enough that I don't take it off it the middle of the night, but according to SnoreLab my snoring is still "epic" and I wake up in the morning exhausted and with a stiff neck. I've lost 10 pounds since my diagnosis and that hasn't helped either.

I'm starting to wish I'd never gone for a sleep study.
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#38
RE: Help for a newbie: titration failed
Congrats on the weight loss, it does help a little on apnea but maybe more of an impact on general health. I lost 100 pounds by way of bariatric surgery and now netted 75 pound loss. The impact to my apnea was to halve it from about 75 AHI to 37, but I still need a machine.

As for the PAP machine not being delivered and insurance has yet to approve, call the doctor, the DME, and/or the insurance every day. I had to do this when waiting on the ASV in 2017. All 3 amigos messed up some aspect. Doc wrote the medical necessity info with incorrect info causing the request to stall. The DME kept automated calling saying PAP will be delivered tomorrow, yet it wasn't yet ordered. Insurance departments supposedly lost the order or otherwise stated something was wrong. I had to call each one in turn; certain days I called doc's office, then to the DME, then to insurance until each got their act together. I do mean this literally. Call someone daily until they get it into your hands.
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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#39
RE: Help for a newbie: titration failed
While you're waiting, get a copy of any sleep studies and prescription that you may not have in hand. Call the DME and ask what device they are going to deliver, or try to get approval for. Ask why they seem to have such a problem with a simple CPAP and ask them if you should consider using a different supplier. That might get their attention. There is no reason for things to take this long. While you're at it, it would be nice to learn what co-pay or deductible they estimate will be required. Usually delays like this are because someone really dropped the ball. Time to explain that you consider this urgent.

What are your thoughts on just buying your own?
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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#40
RE: Help for a newbie: titration failed
On Dave's advice (God bless you, Dave) I called my insurance company again, who called the DME...

What I failed to understand when I talked the insurance CSR earlier in the week is that the DME actually canceled my order (without notifying me) and told me to try another DME.

I called a second DME this afternoon. I asked them if they carry the ResMed Aircurve 10 VAuto and they said yes. I asked if they take my insurance and they said yes. I asked if I could make an appointment and they said no, but you can send us your prescription. So I emailed it to them along with my phone number and asked them to please call me to set up an intake. The rep I talked to told me to call them back if I haven't heard anything from them by the end of this week.

My out-of-pocket with insurance will be $0. Even a used machine would be a huge expense for me, so I'm stuck going the insurance route.

I continue to be grateful for all the support I get here.
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