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Questions about re-starting therapy, researching before doctor visit
#1
I was on CPAP therapy for a year or so back about 10 years ago.  At that time, I was re-evaluated and my doctor said that I could avoid its use if I could stay sleeping on my side.  The equipment and settings I had back then made it very difficult for me to sleep.

Over the past few years I have become much more tired during the day to the point where I would need extended daytime naps.  I often joke I'm so tired because I have so many wild adventures in my dreams.  About half the time I wake up with headaches.  I have a high deductible insurance plan so everything I pay for myself but I told my primary care physician I wanted another sleep study (about $800).  I was not looking forward to the experience as my prior sleep study experiences resulted in several interruptions and little sleep.  I had my latest study 8 days ago and it was a vastly different experience.  I slept for about 2 hours without CPAP and then put on CPAP with a nasal mask.  I recall how much my mask 10 years ago leaked a lot and the air flow was very uncomfortable.  This experience was completely different.  I really only noticed the air flow for the first few minutes, mostly when I yawned.  I never heard the machine.  I quickly fell asleep and woke up 4 hours later.  I could have gone back to sleep but it was time to go home anyways.  I felt like I had not moved at all but the technician told me I did go to my side for a while.  I felt more rested than I have for a long time.  I can't get over it, really.  I didn't feel sleep at all that next day.

Unfortunately, my follow-up with the doctor isn't for another 8 days (16 days after my sleep study).  I've called them twice to see if they have an earlier opening because I want to get started.  They also don't have my sleep study results dictated yet so I can't get those yet.  I may be jumping the gun but I don't think so and I hate waking up tired every day again.  I plan to outright buy equipment from one of the approved vendors and want to make sure my prescription allows me to get the equipment most helpful that will be most helpful to me.

Is there any way I can start investigating which models I might want to ask the doctor about without having my sleep study results?  A family member has been using Respironics 560 with heated humidifier for a few years and likes it.  I see many people here are using the ResMed AirSense 10 AutoSet and like it.  Cost is not the primary factor but it seems that this is a more expensive unit for me to buy.

Do you have any other recommendations to best prepare me for my follow-up appointment?  This doctor even works weenends in trying to keep up with patient load so I probably won't be seeing him again for a while after my next appointment so I want to get everything taken care of next week.

Thanks!
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#2
You'll get some specific suggestions from others, but one critical part is that it is full data and auto adjusting.  Both the models you mentioned are, but each machine has sub-standard versions, and you'll need to look for some specific things to ensure you get the best version.  your doctor may find you have a more complex apnea, but it seems like your experience in the sleep study were good, so maybe the easier to treat apnea is what you have.  I hope for that.

I was advised to sleep on my side to reduce the effects while waiting for my machine to be dispensed.  This helped me, but way better once I got the machine.

Good luck.

QAL
Dedicated to QALity sleep.
You'll note I am listed as an Advisory Member. I am honored to be listed as such. See the fine print - Advisory Members as a group provide advice and suggestions to Apnea Board administrators and staff concerning Apnea Board operation and administrative policies. 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.
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#3
Welcome to the forum, for anyone with apnea, this is a good place.

Your machine class choice will be determined by what the Sleep Study shows.
For the CPAP class machines read CPAP-Machine-Choices-read-this-before-you-accept-a-new-machine

Without question you want a full data capable machine, what we are talking about can give you very detailed breath by breath information.
Almost any machine can give you "Compliance" information which is hours of use.  Insurance cares about this because these machines are not cheap anjd they want to make sure they are used.

DMEs (Equipment suppliers) care about giving you the cheapest machine that meets the written Rx.  That way they make the most money.

What does the data, the full data do for you, your Dr, your RT?  It gives them, and more importantly you, the information needed to make treatment decisions in the future.

The other read you need is to read the mask primer (see my signature).  Getting the best mask for you can be the hardest part of the treatrment.

Fred
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#4
Thanks for the replies.

I should have said I had read a fair amount here already and know that I want a machine with full data, I've seen how others have posted their sleep results here and been helped with adjustments, etc.

Since I will be paying for the machine myself, whatever DME provider won't be motivated to provide me the cheapest machine but whatever one they can make the largest profit on (which may or not be the most expensive, I suppose). I want whatever machine I think will work the best and help ensure the best compliance.

Thanks Fred for the link to the Mask Primer. I think I'd be happy with the one I slept with last week! Smile But I'll still read the primer so that I'm prepared for other options.

When I get my sleep study results should I post here to get suggestions on equipment?
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#5
Welcome CrazyDreamer.

I concur with the prior suggestions about getting a full-data, automatic machine. The prime choices are Resmed Airsense 10 AutoSet, Resmed Airsense 10 AutoSet-for-Her and Philips Dreamstation Auto. All these are good machines for ordinary obstructive sleep apnea. If your sleep study showed up central, complex or mixed apneas, then you will need to discuss these with your doctor to determine the appropriate treatment, which may ultimately involve an (expensive) ASV machine. However the great majority of people will do fine on one of the autos I listed above. Be careful not to get one of the lower grade machines which superficially look the same but which have limited capabilities.

There are other machines on the market, which I'm sure are excellent products. These include DeVilbiss, Fisher & Paykel and others. There are also some new Chinese makes coming on to the market. I recommend you avoid these and stick to the Resmed and Philips. The reason being that these two brands are the market leaders, so it's easy to get support when required. Also, both these brands are supported by SleepyHead software, which will help you track and optimise your treatment. (Some of the other brands have SleepyHead support while others have limited or no compatibility).

Be aware that many sleep doctors favour a fixed pressure rather than an autoset. You may need to advocate for getting an autoset, which needs to be spelled out on your prescription. Advantages of the autoset include
a) It will adjust to your changing pressure requirements caused by sleep posture (ie back v side sleeping);
b) It will adjust for any changes in pressure requirement brought on by illness (coughs, colds, flu);
c) It will adjust for pressure changes required as you get older or gain (or lose) weight;
d) By changing pressure to respond to your needs, an autoset is a bit like a mini-titration test every night. Remember the pressure prescribed at your sleep test relates only to a particular snapshot of time, which may or may not be representative of your needs when sleeping in your own bed over a long period of time.

Hope this helps
DeepBreathing
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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#6
Thanks, I had those models at the top of my tentative list to talk to my doctor about but didn't know of all of those advantages.

Since I'm paying for the equipment myself, I don't expect the doctor would have a problem prescribing whatever I ask for as long as it meets my medical needs.
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#7
When you go to purchase a DME is much more than what you can get elsewhere. Ask here for your options.
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#8
As bonjour said, you will likely pay more going through a DME when you are self paying.
Have you looked at some of the prices from the suppliers list at top of page. Start with Supplier #1 and compare. If you don't mind lightly used or new open box units, you may find a deal with Supplier #2.

You can always check back here for advice.
OpalRose
Apnea Board Moderator
www.ApneaBoard.com

How to Organize and Post ScreenShots

http://sleep.tnet.com/resources/sleepyhead/shorganize
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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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#9
Thanks again. My family member has previously purchased from suppliers 1 and 3 and I had checked them already but supplier 2 that I found from here the other day does seem to have better deals.

My insurance company told me that for the purchase to count towards my $5,700 deductible I would need to purchase through one of their approved companies. The first one they mentioned was Apria. Over my dead body (terrible on-going problems with them with my father's equipment and I was pleased to hear my doctor mention that they lost their contract with Medicare). During my initial visit with my doctor a few weeks ago he said that he could also furnish the equipment but I told him I figured I would find the best prices online and he was fine with that. Isn't it unusual for a doctor to offer to provide equipment??
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#10
Hi CrazyDreamer,
WELCOME! to the forum.!
Better luck to you this time around with CPAP therapy.
trish6hundred
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