Skipping the rest of my Diagnosis (?)

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Hopefullady
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Skipping the rest of my Diagnosis (?)

Post by Hopefullady » Sun Apr 26, 2015 10:47 am

During my first sleep study, the techs did not titrate me when I had 19 hypopneas per hour and my doc is requiring me to have another study which is scheduled for a month from now, even though I have serious comorbidity factors like heart problems now, all from exhaustion over many years.

Also, the sleep lab was surprisingly dated, dirty, the beds were ancient and too painful to sleep on, and the techs were young and inexperienced and incredibly rude. The place has some serious issues. Obviously I don't want to go back there.

Although I qualify for CPAP or some kind of breathing assistance, my doc required another study. I really don't feel like going through more insanity when I could just buy my own machine and cut out all the trouble - and precious time I do not have to waste. The exhaustion is debilitating.

My question is, how do I know what type of machine to buy?

I do know that breathing out on a CPAP machine is difficult for me and from the little I've read here, isn't Bipap or Apap a much better machine?

Has anyone ever just bought their own and if so, should I go through a used dealer?

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SleepDisturbed
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Re: Skipping the rest of my Diagnosis (?)

Post by SleepDisturbed » Sun Apr 26, 2015 10:54 am

Get the written results of the sleep study. It is yours, so you have a legal right to it.

Then bring it back here. Mid you have garden variety OSA, doing a self titration is pretty do-able. If the report reveals complex or central apnea, you might need to stick with the conventional process, but perhaps with a different doc and/or lab.

But getting that report is job one.

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Julie
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Re: Skipping the rest of my Diagnosis (?)

Post by Julie » Sun Apr 26, 2015 11:02 am

I hope you haven't arbitrarily decided C- (or A) pap's going to be hard because you read how others have difficulty exhaling at times. Big mistake, unwarranted assumption, plus ignorance of how to deal with it. Most machines today have features that you can set to 1-3 or 1-5 of how much relief you need on exhaling... some older machines call the feature C-flex, newer ones EPR (Exhale pressure relief), so I wouldn't go off all set to not like Cpap because you're not aware of that.

Have you asked the doctor to go to a different lab?

Hopefullady
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Re: Skipping the rest of my Diagnosis (?)

Post by Hopefullady » Sun Apr 26, 2015 11:14 am

SleepDisturbed, here is a link to where I posted my study. Hope it works. Yes, it's milder and I don't think centrals, although I wasn't on my back for long which is when I choke. I think it is still fairly milder though, not severe...just enough to wake me up. I do need to sleep on my back due to body pain. Thanks for looking:

viewtopic/t105341/viewtopic.php?t=105248

Julie, I think I mentioned that I experienced discomfort breathing out on CPAP so experience rules out my broaching the subject out of ignorance or assumptions. I believe you are saying there is more to explore regarding CPAP. Good to know.

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Julie
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Re: Skipping the rest of my Diagnosis (?)

Post by Julie » Sun Apr 26, 2015 11:23 am

Oh! You're right, I literally didn't see the 'and' in that sentence... didn't realize you'd had the experience... sorry!

Hopefullady
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Re: Skipping the rest of my Diagnosis (?)

Post by Hopefullady » Sun Apr 26, 2015 11:43 am

No problem. I'm going a little fast today myself

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Pugsy
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Re: Skipping the rest of my Diagnosis (?)

Post by Pugsy » Sun Apr 26, 2015 11:47 am

Given what you have said and if you are wanting to go the DIY route on your own and get your own machine and can't decide on what machine to get...without knowing your pressure needs...
I would target the new model ResMed AirSense 10 AutoSet for Her model..it actually has 2 apap modes available and that newest mode might be useful to you. Only the "For Her" AirSense Autoset has that mode available. You might not need it or want it or like it but it's better to have it and not need it than need it and not have it.
And ResMed's targeting women for this additional special mode is a bit short sighted IMHO... I am sure that there are men who might also benefit from this mode.

Also in terms of exhale relief I think that ResMed's EPR relief which works like a limited bilevel (bipap) device might also suits your needs a little better than the other brands form of exhale relief.

https://www.cpap.com/productpage/resmed ... idair.html
It costs the same as the regular AirSense 10 AutoSet so why not get the additional apap mode.

http://www.resmed.com/us/en/consumer/pr ... r-her.html

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Hopefullady
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Re: Skipping the rest of my Diagnosis (?)

Post by Hopefullady » Sun Apr 26, 2015 11:53 am

Thanks, Pugsy. I was curious about the difference between men and women's needs but I don't need to know that right now. I think it's more important I get a machine that will work for me ASAP.
Any way to get one at a discount cost? I know there's craigslist but chances of finding a newer good one like the one you suggested is minimal there.

Any suggestions from all would be appreciated. Thanks.

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SleepDisturbed
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Re: Skipping the rest of my Diagnosis (?)

Post by SleepDisturbed » Sun Apr 26, 2015 12:58 pm

Hopefullady wrote:SleepDisturbed, here is a link to where I posted my study. Hope it works. Yes, it's milder and I don't think centrals, although I wasn't on my back for long which is when I choke. I think it is still fairly milder though, not severe...just enough to wake me up. I do need to sleep on my back due to body pain. Thanks for looking:

viewtopic/t105341/viewtopic.php?t=105248

Julie, I think I mentioned that I experienced discomfort breathing out on CPAP so experience rules out my broaching the subject out of ignorance or assumptions. I believe you are saying there is more to explore regarding CPAP. Good to know.

Thanks for the link, I missed it.

Go with what Pugsy suggested.
The Airsense 10 models are very new, so you don't see as many used ones for sale, but some have popped up here from time to time. Also check http://www.secondwindcpap.com as I noticed they are starting to have used and open box units now.

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Matt00926
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Re: Skipping the rest of my Diagnosis (?)

Post by Matt00926 » Sun Apr 26, 2015 1:12 pm

Try to find a sleep specialist doctor who also specializes in pulmonology so that your overall cardiopulmonary needs will be taken care of, ENT doctors in my experience are not sufficient. If you can find a well recommended specialist they will commonly refer patients to a specific facility. My sleep specialist works at a cardiology and pulmonary institute and in the same building they have a sleep lab. Certain facilities have programs for expedited CPAP where you can get the prescription and device in a timely manner.

You can buy a used device yourself and titrate based on the results of your sleep study but I would just do this in the meantime until you can find a quality physician and sleep center.
Last edited by Matt00926 on Sun Apr 26, 2015 1:15 pm, edited 1 time in total.
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chunkyfrog
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Re: Skipping the rest of my Diagnosis (?)

Post by chunkyfrog » Sun Apr 26, 2015 1:13 pm

Just TELL your doctor to RX you an auto (this one is great),
and tell him you refuse to spend another night in that HELL-HOLE!

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Hopefullady
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Re: Skipping the rest of my Diagnosis (?)

Post by Hopefullady » Sun Apr 26, 2015 1:24 pm

Thank you all.

I will talk to doc tomorrow and ask him for this, yes. Or, a different sleep lab quickly.
If he says no I will check out the link SD provided to DIY, and look elsewhere online too.

Hopefullady
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Re: Skipping the rest of my Diagnosis (?)

Post by Hopefullady » Sun Apr 26, 2015 1:52 pm

Would Pugsy or anyone else who's around tell me what the "new apap mode" on the (below) machine is called?
And what does it do?
I'm just wondering why Pugsy thought it would help me
Thanks
Pugsy wrote:Given what you have said and if you are wanting to go the DIY route on your own and get your own machine and can't decide on what machine to get...without knowing your pressure needs...
I would target the new model ResMed AirSense 10 AutoSet for Her model..it actually has 2 apap modes available and that newest mode might be useful to you. Only the "For Her" AirSense Autoset has that mode available. You might not need it or want it or like it but it's better to have it and not need it than need it and not have it.
And ResMed's targeting women for this additional special mode is a bit short sighted IMHO... I am sure that there are men who might also benefit from this mode.

Also in terms of exhale relief I think that ResMed's EPR relief which works like a limited bilevel (bipap) device might also suits your needs a little better than the other brands form of exhale relief.

https://www.cpap.com/productpage/resmed ... idair.html
It costs the same as the regular AirSense 10 AutoSet so why not get the additional apap mode.

http://www.resmed.com/us/en/consumer/pr ... r-her.html

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Pugsy
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Re: Skipping the rest of my Diagnosis (?)

Post by Pugsy » Sun Apr 26, 2015 2:13 pm

Please understand that I don't know if the special apap mode in the AirSense 10 AutoSet for Her will help you or not.
It's supposed to be a gentler auto algorithm than the regular auto algorithm and whether that really translates into being "better" for someone is anyone's guess. I don't know what your problem is but my thinking when I am buying something is that I try to buy something that has as much of what I MIGHT need just in case I need it.

You may or may not benefit from the new special gentler algorithm but given that the machines pretty much cost the same with or without it...why not have it available just in case.

Without having a sleep titration results to fall back on and the pressure needs that might be involved.....I gave an estimate of what I would do if I were in your shoes. Knowing what I know about how both the Respironics and ResMed machines work and specifically how the exhale relief works (I have owned both brands) and the maybe thing about the for her algorithm...it's what I would advise to my sister or mother or even my brother given what is known or not known at the present time.
Ideally you need the titration sleep study to get pressure needs sorted out but sometimes we don't get ideal and we have to work with what we have. The 3 cm EPR exhale relief isn't as dramatic as 4 or 5 cm relief when using a bilevel device but I have tried it and it's still substantial relief and still quite comfortable.
Now if you have some sort of compromised respiratory system or lung disease that impairs lung function totally 24/7 then you need to do the titration sleep study.

I don't have the papers handy where ResMed says how the new algorithm is better suited for some women or how it works but maybe someone else has that documentation handy.

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Hopefullady
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Re: Skipping the rest of my Diagnosis (?)

Post by Hopefullady » Sun Apr 26, 2015 2:30 pm

Thanks, Pugsy. I get it now.
These machines sure are expensive. Hopefully doc will Rx me for one because I don't think that sleep clinic knows how to titrate someone.

Only question left is about this, if you wouldn't mind expanding on what you meant. I'm lost about it:

"The 3 cm EPR exhale relief isn't as dramatic as 4 or 5 cm relief when using a bilevel device but I have tried it and it's still substantial relief and still quite comfortable."

Thanks much