New here with questions of course

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Chris333
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New here with questions of course

Post by Chris333 » Tue Mar 03, 2015 4:24 am

After telling my doc I was tired a lot during the day and took naps all the time even after 8 hrs sleep. He had me do a sleep study. I work at night so I did a home test. They got 7.5 hrs of info and told me my AHI was 27. Now they want me to go back and do the titrate test at their place at a time I would usually be at work wide awake. I told them I'd never be able to sleep at that time. They also started asking about where I'd be getting my equipment from. They do DME as well.

So I read all day online and found I don't really want to go back there if possible. I found an unused 0 hour Resmed S9 autoset and bought it myself. I do still need to get a mask.

My questions... The titrate test. That just tells me what pressure to set the machine, correct?

And with the Resmed s9 autoset would the machine find out the pressure for me, as in autotitrate?

I have insurance, but it sounds like it's almost a draw if I pay myself. I can get my own supplies and I really don't want to keep "going" somewhere. It is hard enough going to the doc as I work at night and sleep during the day.

My main question is about the pressure and do I need to get the number or will my machine find it for me?
Any help would be appreciated.
Thanks
Chris

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archangle
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Re: New here with questions of course

Post by archangle » Tue Mar 03, 2015 5:49 am

Chris333 wrote:My questions... The titrate test. That just tells me what pressure to set the machine, correct?

And with the Resmed s9 autoset would the machine find out the pressure for me, as in autotitrate?
It's not quite that simple. Sometimes, problems will be noticed in the titrate test. This could be central apnea, restless leg syndrome, or a number of other things.

You usually want to set an auto machine to something near to the pressure you're going to need so you don't have to spend part of the night at the wrong pressure waiting for it to figure out the right pressure.

Some people do self titrate successfully, but the in-lab titration isn't just a waste of time.

If you do go get titrated, make sure the doctor gives you a sleeping pill to take in case you can't sleep in the lab, especially if it's at the wrong time of day for you to sleep.

Read the useful links in my signature line below for some hints on how to not get screwed in the CPAP process.

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Sheriff Buford
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Re: New here with questions of course

Post by Sheriff Buford » Tue Mar 03, 2015 6:02 am

My gut says to take the titrate test. Most folks here are an advocate of taking charge of your issues, but we need the medical folks to tell us what we have and to diagnose our issues. We do the treating. But, since you are askin'... I'd put my upper setting at 18. The lower setting... I would put at 6 or 8. A 6 may not be as comfortable ("having enough air to breath - wise") as an 8. The lower setting is the most important because it will be the setting the machine has to travel (upward) to treat an apnea event. As far as the top number, it is not that important because the machine won't go any higher than it needs to treat an event. Depending on the brand of your machine, the 90 or 95 percentile reading will indicate where your machine hovered most of the night, and will give you an indication what your setting should be.

You need to get a prescription. You have to have one to by masks from a DME. The only place you can get masks without a prescription is buying it used or on Ebay.

Again, I'd take the second test, and we'll help you through the journey to treat yourself successfully.

Good Luck, Sheriff

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Julie
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Re: New here with questions of course

Post by Julie » Tue Mar 03, 2015 6:18 am

Actually you can buy masks without a script - as long as you do it with 'replacement' parts rather than as one piece - see Cpap.com, look first for the page of 'the' mask, and then click on replacement parts.

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Pugsy
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Re: New here with questions of course

Post by Pugsy » Tue Mar 03, 2015 7:22 am

There's a good chance that you will have plain old plain vanilla OSA and be able to find a suitable pressure doing the auto titration at home. It will take some education on your part and a little work but it can be done and really isn't all that difficult.
You can keep the option for the sleep lab titration on the back burner should any problems come up.

We have several forum members who have successfully done both the self diagnose and self treat thing. Some insurance companies actually prefer to send patients home with APAPs and do it that way...and save the in house sleep studies for the people who have problems.

Depending on your insurance coverage you may still want to use a brick and mortar DME store for masks. That's up to you and you would need a RX if you do. An advantage might be the mask swapping policy of a DME so you could try several masks and not have it cost an arm and a leg. You don't have to buy a machine from them to buy masks from them.
Masks are expensive and don't have much resale value once they are used or package is opened...so when buying privately you really have to do your research.

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palerider
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Re: New here with questions of course

Post by palerider » Tue Mar 03, 2015 10:19 am

I toss in a +1 to what Pugsy says. she gives great advice.

it's ok to spend your first night on the machine at the factory defaults (4-20 pressure) then, pop the sd card into your computer and pull the data into sleepyhead, post the results here, and the next night, raise the minimum pressure to something closer to where things got to last night.

you *could* be one of those rare people who only need four or five cm pressure, though it's unlikely.

strap the machine on for a while and watch tv, or read.... something to 'get used to it' before going to bed, it will set you up for a better first night.

how-to for posting charts: https://sleep.tnet.com/resources/sleepyhead/shorganize

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Chris333
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Location: NE Ohio

Re: New here with questions of course

Post by Chris333 » Tue Mar 03, 2015 2:06 pm

Thanks guys for the replies.

When I got the first sleep test they told me about a machine I could take home for a few days that would find my pressure, but now they want the in shop test. I'm pretty sure they just want me to take it because I have insurance and they can get it approved. And they get more money, like they just see dollar signs. Every question I had for them, the answer always started with "what insurance do you have?"

I'm still not sure if I will have the second test. The night of the first test it snowed and snow plows where up and down the street many times. I do believe I have a sleep problem, but that night was worse than most.

Guess I'll sleep on it

Chris333
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Location: NE Ohio

Re: New here with questions of course

Post by Chris333 » Wed Mar 04, 2015 2:44 am

New question.

I bought a Resmed swift FX nasel pillow mask to start with. Will the S9 autoset be able to tell me if I end up sleeping open mouthed? I downloaded the Sleepyhead software to read the card.

Thanks again.
Chris

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Sheriff Buford
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Re: New here with questions of course

Post by Sheriff Buford » Wed Mar 04, 2015 5:59 am

Chris333 wrote:New question.

I bought a Resmed swift FX nasel pillow mask to start with. Will the S9 autoset be able to tell me if I end up sleeping open mouthed? I downloaded the Sleepyhead software to read the card.

Thanks again.
Chris
Two ways to tell if your mouth is open:
1) Your mouth is very dry
2) It will show up on your leak rate. Lots of folks use a chinstrap or tape and eventually you can "train" your mouth to stay closes at night.

Sheriff

Chris333
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Location: NE Ohio

Re: New here with questions of course

Post by Chris333 » Fri Mar 06, 2015 3:46 pm

Well my machine showed up in the mail and instead of the autoset shown in the photos I received an escape I'm a little upset because I paid a little more for a brand new machine. It is brand new, still has the plastic covers on everything. The seller was a respiratory therapist and didn't know there were different models, just pulled a photo off the web

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grayghost4
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Re: New here with questions of course

Post by grayghost4 » Fri Mar 06, 2015 3:51 pm

I hope you are going to return the Escape ... it will provide no usefull data !

I don't beleve a tharpist does not know the differance between machines !
If you're not part of the solution you're just scumming up the bottom of the beaker!

Get the Clinicians manual here : http://apneaboard.com/adjust-cpap-press ... tup-manual

Chris333
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Location: NE Ohio

Re: New here with questions of course

Post by Chris333 » Fri Mar 06, 2015 4:10 pm

Yeah trying to send it back now... craiglist... and through the mail. I paid $350 because it was brand new with 0 hours. I can get used "autosets" for $250.

Was hoping to try it out tonight.

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grayghost4
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Re: New here with questions of course

Post by grayghost4 » Fri Mar 06, 2015 4:15 pm

when purchasing on craigslist always ask for the REF number off of the machine ... they you are sure what your are getting

by checking here you can tell what each model number is :

https://sleep.tnet.com/equipment/cpapmachines
If you're not part of the solution you're just scumming up the bottom of the beaker!

Get the Clinicians manual here : http://apneaboard.com/adjust-cpap-press ... tup-manual

Chris333
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Joined: Tue Mar 03, 2015 3:45 am
Location: NE Ohio

Re: New here with questions of course

Post by Chris333 » Sun Mar 08, 2015 1:39 pm

So I now have an Autoset machine and I using a full mask right now. I set the low at 8 and the high at 14, with the ramp at 30 min.

Seems like I go to fall asleep and shortly after the air down my nose finds it way into my cheeks and then my mouth pops open and I swallow to re-set myself. This whole process goes on and on till I get fed up and pull the mask off so I can fall alseep.

Does this sound normal for a first timer?

Chris333
Posts: 40
Joined: Tue Mar 03, 2015 3:45 am
Location: NE Ohio

Re: New here with questions of course

Post by Chris333 » Sun Mar 08, 2015 3:59 pm

I guess for tonight I will set the low at 5 and the high at 10 and see how that goes. I already have the EPR set to 3