Granny7 - Newly Diagnosed- Looking for Help

[Granny7]

I was recently diagnosed by a home sleep study with mild apnea with an AHI of 15.3. I will be getting a Resmed Airsense10 Autoset in a few days. My dr. recommended a heated hose and since I am a mouth breather when sleeping, a full face mask. I have spoken with the RT at the local Lincare office and she recommended the Airfit F20 for her. Does this seem reasonable? The Dr. has prescribed a pressure range of 4-20.

I have a concern about how well I will adapt and have a question about Medicare compliance. The requirement is  at least 4hrs a night for 70% of 30 consecutive days during the first 90 days. Does this mean I do not need to meet that requirement during 60 of the first 90 days? I suspect from speaking with friends who use CPAP that the first 30 days may be problematic.

Thanks in advance for your help.

[SarcasticDave94]

Welcome to the Apnea Board,

I've had the ResMed F20 mask, it's ok for me, but I found better. I've not tried an F30 but it could be one to consider. Or my current go-to is a Fisher and Paykel Vitera, yet another full face.

The 4-20 default pressure settings are going to be more of an issue. This means doc isn't doing anything but default and hopes for the best. And that almost never works. Much like a car driver seat has adjustments to fit you best, there's settings on the PAP so therapy will fit best for you specifically.

Download OSCAR our free report tool so you can see more data about your therapy then doc will bother to look at. Also request your sleep study detailed report for your records and you can post it here too, redacted. If they balk at the request, tell them HIPAA law permits you to request and receive.

Last thing, if you have vanilla Obstructive Apnea, the ResMed AirSense 10 or 11 AutoSet will be great. Ask for it specifically.

[Granny7]

Thanks Dave,

I'm already set up to get te Airsense 10 Autoset. They mentioned that there is a newer model but that the differences are largely cosmetic and it is on back order.
I will be picking up a copy of my sleep study report tomorrow. I assume a scanned pdf file can be posted. My Dr. is family practice. Should I see a sleep specialist?

I hope someone has an answer to my concern about compliance. I don't know what happens if I fail compliance. My worry is that Medicare coverage will go away and I may be stuck with a bill for the retail cost of the machine and supplies.

[SarcasticDave94]

Compliance gives 3 months to get 21 of 30 days. It's been a while since I've had to deal with this so memory is a bit fuzzy.

If you get the report scanned into your PC, you can attach the files below the post textbox. As long as it's therapy oriented, you may use this feature. See image for finding the New Attachment.

If your primary doc is willing to support your CPAP needs, I'd do that. A sleep specialist isn't required and in fact most are moonlighting from other medical fields.

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[staceyburke]

As far as compliance- it is the machine is used for 4 hrs a day. You can “use” it while watching g tv or reading. There is no way for them to know you are asleep. Of course you need it while you sleep to help your apnea but compliance should not be a problem. 

We suggest you wear it for a while each day just to get use to having it on and running.

[Granny7]

The other compliance requirement is that I meet with my Dr. in about 90 days and show evidence that I am benefiting from CPAP. How does running the machine alone accomplish that? Are you sure the RT at the supplier or Dr. can't tell if it's used while asleep or awake.

[SarcasticDave94]

I'm quite sure RT and doc are not looking closely at your data. Unless you're hooked up with EEG, as in a lab sleep study, they can't tell definitely.

This using it in the daytime isn't to pad your usage but to get used to PAP therapy.

Showing evidence? You're likely going to be asked if CPAP is benefiting. Sleeping better? More rested? Etc. You aren't expected to have charts, even if you're using OSCAR.

[OpalRose]

Compliance:

Medicare requires that a patient use CPAP for more than 4 hours per night on 70% of nights (21 nights) during a 30-day consecutive period any time in the first three months of use.  

Patient must also have a face to face appointment with their doctor any time after the first 30 days, but before the 90 days expires.

[Granny7]

Thanks all. I'll try to post my sleep study in the next day or two.

[Granny7]

I scanned my sleep study and tried to post it but got a message that the type of file was not allowed. It is a PDF file. What do I nee to change?