Getting CPAP this week need advice on headgear etc.

[Sleepy Dog Lover]

If your pressure is over 10, you have a tendency to open your mouth. Definitely try the Hybrid mask with the new premium grey headgear.

_________________

That is not necessarily true. Some people need a higher pressure than others, even if they don't mouth breathe. Some people even have a higher pressure using a full face mask. The pressure you need has nothing to do with mouth breathing, as once you open your mouth, your cpap therapy is non-existant as all the air simply rushes out of your mouth. The pressure is what is needed to keep your throat open without obstruction, some people need more pressure than others, and it has to do more with throat structure than anything else. However, if you mouthbreathe, you will need some kind of full face mask or use one of the taping methods mentioned on this forum.

Good luck with your treatment PB, make sure you try on as many masks as you need to at pressure to find the right one for you. The mask is the key to getting good treatment and being compliant, and the best mask is what works best for you. We all have our favorites, because that is what works for us.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): CPAP

[NeurosurgeryNP]

The Activa is a good starting point for a nasal mask. I started out with it, thought there was something better out there and spent lots of my own money on trying many different interfaces, pnly to switch bask to the Activa. It's a bit bulky, but easy to seal and move around with in bed without breaking the seal.

Good Luck -

[NeurosurgeryNP]

Whatever you choose as far as interfaces go, make sure you try them on, lie down and move around (bring a pillow). Test the waters. If you don't you may be very frustrated. Each mask does not work for each person and it helps a lot to try several of them out while in a sleeping position and while moving aorund.

[Linda3032]

PB, you've already gotten some good advice here, so I'll just reiterate some things.

1. Ask for the M Auto -- because (in your case) the Auto can be set from 10 to 14. Which means that most of the night, your pressure will be 10 and the only time it will go up is when you begin having an apnea. Then it will "auto"matically bump up to stop the apnea. Being at a lower pressure most of the night will allow you to be more comfortable, more compliant, and less likely to get "aerophagia" (bloating, swallowing air).

2. As stated, the M Auto would allow you to get the software and card reader, download data from your smartcard, and monitor your progress.

3. There are many good masks available -- but are different for each person. Here are some that are least objectionable.

Nasal mask: Activa, and Soyala

Nasal Pillows: Comfort Lite 2, Swift, and Invacare Twilight NP (Aura) which is my favorite.

I would recommend trying a nasal mask or pillows before a full face mask because full face masks can be very difficult to conquer.

Whatever mask you end up with, will need "tweaks". There are threads here that discuss every tweak imaginable. So once you get a mask you can search or ask where those threads are at.

The mask will probably be the most difficult part of your therapy. Be prepared.

Good Luck

[Linda3032]

And PB, as low as your oxygen got, I can't believe the VA is going to make you wait for the doctor to come back. Surely someone can authorize a "loaner" machine until he gets back.

Does the VA really want to take responsiblity for you having a "stroke or heart attack" just because the doctor is out of town?

[sleepingBear]

My titration pressure was 11 and here are the reasons I gave the VA for wanting an Auto instead of a straight CPAP.

1) During the sleep study I never reached REM sleep, so even with a titration I don’t think it will accurately represent my sleep conditions at home.
2) The titration study concluded that since I did not sleep on my back during the study I may need an Auto CPAP to compensate for the lack of data during the titration study.
3) I am commonly congested, so my pressure needs change according to how congested I am.
4) From one night to the next my pressure needs have changed as indicated by using an auto for a trial.
5) I sleep on my back and both slides, so my pressure needs vary depending upon my body position.
6) In the research I’ve done I have found several studies that indicate that it is easier too adapt to the therapy with Auto CPAP since it provides the needed pressure instead of a constant one size fits all pressure.
7) The average pressure is lower than on a straight CPAP
My titration pressure from the study was 11, according to my data from my trial my average pressure has varied between 6.4 and 11.5, my 90% pressure has varied between 8 and 14, and my Max pressure has varied between 10 and 17.
9) An Auto can be set to straight CPAP if that is recommended
10) The Auto would allow me to do periodic titrations at home to verify that the pressure settings are correct for my conditions and interface.
11) The Auto is only $100.00 more than a comparable straight CPAP
12) Studies have shown that the long term medical costs are lower for patients that are prescribed Auto CPAP as compared to straight CPAP.
13) By changing from an Activa Large to Activa Standard size mask my overall pressure readings (Avg, 90% and Max) all dropped by about 2 points.

Give all the vaiables of life it just makes more sense to me that my needed pressure will change from night to night and for that reason alone I wanted an Auto CPAP. Looking at my data for the past 2 weeks use verifies what I though and I'm very happy I pussed to get the Auto.

In case anyone is interested yes I can provide links to some of the studies I noted if you wish to have them, but a quick google search will bring up several studies.

[sleepingBear]

Linda,

Unfortunately the VA is way understaffed and in most cases are only 1 Dr deep in any given field. It is not uncommon to have to wait because of this and in many cases 1 Dr will cover different VA hospitals on a rotating basis.

I requested my VA sleep study last year, I'm still waiting on that, so I had my private insurance cover the sleep study and send the results to the VA. I'll actually meet my VA sleep Dr at the end of March.

no excuses, just the way it is with the VA.

[ThePBMinistry]

When I was talking to the lady at the VA she said "I dont know who gave you all this information about your test, the doctor hasent even looked it over yet. When the doctor comes back he will look at your test in the order it sits in the file. (the sleep tech put it in the front) And after all sir, you have been living this way for a long time...." and I thought to myself um yeah and having serious medical issues because of it.

The VA is a government run facility, sometimes you get people who are rockstars and will go to the ends of the system to make sure you get the best they can give, and on the other end of the spectrum you get this lady who is all government by the book, just as lame as the people who wrote the rules in the first place. Remember you cant sue the VA so who cares right?