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bpowell10 - Therapy Thread
Got called in early after first sleep test.
Hey all first post here finally decided after a very long time of being soooooooo tired pretty much every day of the week and being very irritable to go in and speak to the doc about getting a sleep study done and he sent me off with an at home test and a follow up 2 weeks after. I did my test and the results showed up late yesterday and today I got a call from the doc canceling my follow up and saying the test results were very bad and he was prescribing me a machine and getting me in tomorrow to pick up a machine and be taught how to use it but didn't talk much about the numbers at all so hoping for some help with that as this is all new to me. He did say it would be smart for me to get a full mask since im such a heavy mouth breather while I sleep. Nervous because I see lots of bad things about full masks reading through things online trying to learn about all this. I am just curious since this is all going so fast is there anything I can do tomorrow to better myself for success like things to ask or a machine to look out for or what to watch for on fitment etc. I just hope this helps as I have been feeling idk what to say maybe depressed because I find myself being so irritable with my wife and daughter most of the time for very petty things. Thanks here is part of the chart 2nd page was some graphs with snoring and oxygen saturation thanks so much!    
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RE: Got called in early after first sleep test.
From my experience just because you were a heavy mouth breather without cpap doesn't mean you'll need a full face mask. overnight i stopped breathing through my mouth when i started cpap, nasal mask has been working great. asked my doc for a chin strap but never even used it. i was snoring like a bear before and would instantly open my mouth if someone tried to close it to shut me up.. maybe something to consider. ask what is the procedure if you want to swap masks maybe you can try a nasal mask (with or without chin strap) if you don't want the FFM.

98 AHI am i reading it right? what is pAHIc? if so it should help a lot! and it'll stop your snoring!
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RE: Got called in early after first sleep test.
Thanks for the advice very much apricated!! Yeah its 98 per hour this was a little of what he had wrote on the test results I just wasnt sure what any of it means yet lol. 

Sleep was in the supine position for 283 minutes. The overall
Watch PAT estimated apnea-hypopnea index (pAHI) was 98 events per hour and
the overall Watch PAT estimated respiratory disturbance index (pRDI) was
98 events per hour. The mean oxyhemoglobin saturation was 88% and the
minimum oxyhemoglobin saturation was 58%.
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RE: Got called in early after first sleep test.
yeah 98 events per hour definitely qualifies as very bad, it should help a ton. you stopped breathing more than once every minute... i was qualified as severe with 48 events /h.
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RE: Got called in early after first sleep test.
When you do go pick it up make sure it is a ResMed Airsense 10 Autoset or a ResMed AirCurve 10 Vauto. An Airsense 11 AS or Vauto is fine as well. ResMed Airsense 10 Elite or AirCurve 10 S is not recommended as they are fixed pressure only machines.

No Philips machine is acceptable unless it is strictly a short-term loaner whilst waiting on more ResMed to come in. If that is what they try to give you politely refuse. 

It is your therapy, so don’t be afraid to be firm, but polite.
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RE: Got called in early after first sleep test.
I believe the c stand for centrals. Your central number doesn't appear high enough to qualify for an ASV, but I think you should at the very least be prescribed a BiLevel. You should ask for a ResMed AirCurve 10 VAuto BiLevel.
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RE: Got called in early after first sleep test.
Good catch by OpalRose on the pAHIc. That means the WatchPAT detected central apnoea’s using peripheral arterial tonometry,

Thanks OpalRose! I missed that.
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RE: Got called in early after first sleep test.
My 2 cents worth.  The machine you are given is one that will be paid for by insurance.  It is 5 to 8 years before insurance will pay for another one.  You want the correct machine now.

You want a bipap ask for Resmed AirCurve 10 VAuto It is by far the best machine if you do not have a lot of central apnea.

The Resmed AirSense 10 Autoset is the next in line.
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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RE: Got called in early after first sleep test.
For masks, you could ask about a hybrid mask. It fits just under the nose but also covers the mouth and so it works well for mouth breathers. I started with a full mask and didn’t like it for a number of reasons, but the hybrid mask is much more comfortable and less intrusive. Resmed, Fisher & Paykiel and Phillips Dreamwear all have hybrids and they all work with the machine that’s being recommended.
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RE: Got called in early after first sleep test.
I'm so glad the docs have caught your apnea issue before it became truly dire. I'm sure your loved ones must be relieved as well, since it's difficult for most people to hear someone struggling for breath.

IMO ask for a biPAP (Aircurve 10 VAuto) prescription just in case your inspiration pressure needs to be high and your expiration pressure needs to be quite a spread lower. Since your doc doesn't seem to be communicative about pressures, and you might have to self-adjust to whatever is the best for you, a biPAP will give you more freedom to address your pressure needs. You might find the Airsense too limiting after a short while. IMO.

IME most doctors will oblige if you ask for a specific unit and mask. Their primary goal is to have you get your AHI below 5 and be compliant with consistent use. It's a numbers thing as far as how docs need to satisfy insurance companies. Same with your DME.

I started with a nasal mask, and it proved to be a no-go because my nose wasn't up to it. However, you can always start with one mask, and request a replacement if it doesn't work out. It is normal for newbies to trial a second mask, different sizes, etc.

Given that, I wouldn't get too consumed about initial mask choice. Mask is a very trial and error kind of thing, and, as I say, you can request a different one from your DME.

Personally, I use a Resmed F40 (full face) mask and love it. It sits under my nose and below my lower lip. It's VERY minimalist, and can come with versatile sizes. So, not every full-face mask is the more traditional shape.

While we're giving you recommendations, in the first days, consider plugging all your equipment in, donning the mask, and turning it on while you're awake. Watch TV or read or something. Get used to breathing through the mask and all of the fiddle. It's quite a lot to adjust to, and fiddling with knobs and masks while you want to sleep is very disruptive. Do some dry runs awake.
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