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+--- Thread: [Equipment] UARS diagnosis - Which machine should I get? (/Thread-Equipment-UARS-diagnosis-Which-machine-should-I-get)
RE: UARS diagnosis - Which machine should I get? - cinematic6436 - 06-01-2021
I finally went to my ENT appointment on 5/27 and walked away empty handed. Surgery isn't an option (not that I wanted it) and I was told they don't prescribe CPAP devices, only focus on surgery. The doctor seemed to insinuate UARS fell into a "grey area" where an insurance company wouldn't pay for a CPAP machine (I got the feeling he thought UARS was generally a BS diagnosis), and suggested I follow up with the person who oversaw my sleep study. I contacted her & she said I don't qualify for CPAP since my sleep studies didn't result in a diagnosis for sleep apnea.
So I just bought a used Aircurve 10 Vauto. It comes with an F20 frame with headgear, an elbow, a medium cushion (which hopefully fits), power supply, and carrying case. I found a PNY 16gb SD card to transfer info into Oscar, bought a new USB SD card reader, a ClimateLine air heated tube, and filters off Amazon, and a gallon of distilled water for the humidifier. Is there anything I'm missing?
Everything shipped arrived today except the filters & SD card reader, which will arrive tomorrow. Would it be acceptable to go without a filter for a night, or use a temporary substitute, like a piece of a paper towel?
I found out about holding down the combination of buttons to enter clinician mode. What would be a good starting point for my pressure settings based on my above sleep study results? I'd love to test this out tonight. Anything else I should know for my first night's sleep with this device would be greatly appreciated!
Brian
RE: UARS diagnosis - Which machine should I get? - Ratchick - 06-01-2021
That doesn't surprise me, sadly, insurance often doesn't cover it from what I hear. I would say that you don't NEED to used distilled water (drinkable tap water is okay for most people unless you have crazy hard water) but it sounds like you have everything to start with. You might want to get a hose cover and figure out a hose hanger at some point but those aren't necessities to start with.
First off, I would double-check you understand the correct way to fit the mask (lie down, hold it to your face and use the mask fit option to push air through, then when you can hold it steady with just the pressure from your fingers without leaks (there will be some from the vents, but none around the edges, ideally), tighten the straps to match that pressure. Don't overtighten, that can end up causing leaks... and sometimes, if you are struggling to fix a leak, try tightening the opposite strap - for me, I sometimes get a leak from just under my right eye, and always the answer ends up being to snug up the left jaw strap a few mms. Once it feels comfortable (make sure it's not too low, it does fit kind of high up your nose) move around to make sure it stays snug when you move, and then you're good to go.
Regarding pressure - it will come set wide open - 4-20cmH2O. If in doubt, just leave it at that. I would turn off the ramp unless you really struggle to get to sleep with the higher pressures, but it shouldn't get too high while you're awake like that. If you find yourself feeling like you can't get enough air, turn the minimum pressure up. You might need to go to 5,6,7 - whatever feels like you're not suffocating.
If you find it really difficult to breathe out against the air as the pressure goes up, you can add in EPR to help make exhaling easier. But I would start with it wide open, if I were you, at least to start. Don't fret if you find the first night (and maybe the next few) hard to get going with it, and to get used to the noise and sensations. Some people are fine, others take a while to adjust, but hopefully this will give you some restful sleep and you will feel better.
Oh, and make sure your SD card is in the machine and send us the OSCAR data in the morning. Good luck! You'll do great, I'm sure.
RE: UARS diagnosis - Which machine should I get? - cinematic6436 - 06-01-2021
Thanks for all the great info. Do I just have to pop in the SD card and forget about it, or are there any additional steps, like formatting it? Also I have plenty of distilled water but no filters. Is it okay to go without one for a night (they arrive tomorrow), or is there something I can substitute, like part of a paper towel?
RE: UARS diagnosis - Which machine should I get? - Crimson Nape - 06-01-2021
As far as the filter, a paper towel may be a little on the restrictive side. Do you have any gauze pads? Also, if the filters are coming tomorrow, one night should not hurt, so long as you don't have the CPAP sitting on the floor. Think of the floor area 18 inches (46 cm) and below as "dust central".
RE: UARS diagnosis - Which machine should I get? - Gideon - 06-01-2021
One thing missed above. It is a used machine. Do a Factory Reset to ensure all settings are normal before you start.
Starter settings assuming no specific settings are defined.
Factory Reset
Mode: VAuto
Min EPAP =4
Max IPAP =15
PS=4
Ramp Off
Everything else default settings
In CPAP terms your starting pressure is 8
We can adjust from here based on OSCAR charts.
The 15 for Max IPAP is arbitrary. As we don't expect pressure to go that high.
You will need to learn how to identify arousal I. The flow rate and also flow Limits. Look at OSCAR - The Guide for flow rate examples.
RE: UARS diagnosis - Which machine should I get? - cinematic6436 - 06-01-2021
I was actually in the process of doing a factory reset when I read the words "Do a Factory Reset to ensure all settings are normal before you start." We're all good on that front, and I have the machine on my nightstand in a pretty much dust-free environment, so I'll just pop in a filter tomorrow. I think I'm ready to go -- just hit "start" for the first time with the mask properly fitted (I think) and it was a pretty comfortable experience. Hopefully I won't take it off in my sleep. I'll post my results tomorrow after the SD card reader arrives in the mail.
RE: UARS diagnosis - Which machine should I get? - SarcasticDave94 - 06-01-2021
It would be a good idea to enter the clinical mode and set your machine Mode and pressure settings. Enter clinical via pushing Home and Dial in together for about 5 seconds. Straight default settings aren't likely to work very well.
Standby for numbers and etc. I would consider VAuto mode with a starting EPAP probably about 6 and PS 3. Others may give better settings so I'll defer when that happens.
RE: UARS diagnosis - Which machine should I get? - cinematic6436 - 06-02-2021
I went to bed at midnight but couldn't really get to sleep until 3am. I had to adjust the humidity and the air temperature a couple of times, but I'm happy to report I kept the mask on until 9am. I might switch to a nose-only mask (maybe the N10) after I wear my current one out since I breathe primarily through my nose and didn't like having my mouth covered up like that.
Here are my results. I had 4 screenshots but there's a 3-file attachment limit. Let me know if anything useful is missing, or if anything in the second or third screenshots is unnecessary.
RE: UARS diagnosis - Which machine should I get? - Gideon - 06-02-2021
Cut your PS to one and repost. This is a quick attempt to reduce the CA events
Also post a 10 minute section of the Centrals have the CO2 driven character.
RE: UARS diagnosis - Which machine should I get? - cinematic6436 - 06-02-2021
(06-02-2021, 03:23 PM)Gideon Wrote: Cut your PS to one and repost. This is a quick attempt to reduce the CA events
Also post a 10 minute section of the Centrals have the CO2 driven character.
PS changed to one. Not sure what you mean after "10-minute section," etc. Can you be more specific?