Newbie research

Diagnosed with OSA a few weeks ago. I just completed my titration study last Thursday, and the script went to the DME today. I started doing some research about CPAP a couple of days ago and discovered this site. Learning a lot from member posts already.

I will be calling by doctor today to get copies of my original and titration studies, and to find out exactly what was written for my script. I've already determined that I need to take ownership of my treatment as it seems unlikely that the doctor will do so.

My first realization of this was when I learned about all the mask options. None of these were discussed with me during the titration study. They simply put a nasal mask on me without even really discussing. I immediately went into panic mode when trying to talk or letting my mouth open even slightly. The tech then switched me to a face mask which I tolerated better. Although, not sure why they call it a sleep study when I was awake more than sleep.

So I have a nasal mask, and I know they are ordering the same face mask for me. However, I don't know about the machine itself except that I will be doing CPAP. Will work to find out more info today.

Personally, I am a technology manager with a nursing background (long story). I am extremely interested in software options for detailed monitoring and data analysis.

If I have the opportunity to direct the DME to a specific make/model of machine, which is considered to be best? I will post more information on the numbers from my sleep studies after I get copies.

Thanks again for all the great posts and information. I look forward to being able to be as helpful in the future.

The mask search is normal and to me, successful treatment is finding a mask that is comfortable and doesn't leak.
There are basically three kinds of masks and they all have advantages and disadvantages:
- Nasal masks
- Full face masks
- Total Masks

The nasal masks are less intrusive and I recommend everyone either start out using this mask or at one time or another try it out. The upside is (as I said) it is less demanding and easy to work with. The downside is that you cannot be a mouth – breather. If you breathe thru your mouth at night, the cpap air will exit your mouth instead of entering your body for therapy. If you are a mouth – breather, you can use tape, a chinstrap and some folks use a strip of pantyhose to keep their mouth closed at night. Some folks, like me, encountered sores inside their nose until they are used to wearing the mask.

-The full face mask covers the nose and mouth. This allows proper therapy for mouth breathers. A hybrid mask is also considered a full face mask, but I have always thought it wasn’t. It covers the mouth and includes nasal pillows, similar to the nasal mask. The Resmed Liberty is a popular hybrid mask. The full face is more bulky and intrusive than the nasal mask and some folks, like me, encountered sores on the bridge of their nose. I have conquered this and now use the Resmed Airfit F10.

- The total face mask is the type of mask I have used and as you can see in my profile it resembles a gas mask. Most folks don’t like it because it is a little harder to adapt to, it’s hard to stop leaks because there is more sealing area. The flip side is that the mask sealing area is around the temple and cheeks which, with most people, are smooth. The upside is there are no more inside or out nose sore problems. I use pad-a-cheek liners and they are very comfy and reduce the redness the mask seal causes. Every time I speak to my DME, she takes it upon herself to try and get me to use a full face mask. I politely tell her that I love my mask and I’m sticking to it.

A mask is like a pair of shoes. What I like and find comfortable, may kill you and vise versa. I always recommend starting with the nasal until you decide you can’t live with it for whatever reason (sores, uncomfortable, leaks, etc…). Then I would move to the full face. If you were destine for a full face, there are so many different kinds that fit differently, you’ll find the one that’s “yours”. I would then move to the total face mask. Most folks that use the total face mask “end up” using it as I did, though I know some folks that started out with the total face mask and were very happy with it. Cpap.com says they are getting more and more popular and they can’t keep them on the shelves. My DME says they will eventually stock them on their shelves due to their increasingly popularity. People’s faces are different and some masks fit some people better than others.

Sheriff

Don't forget nasal pillows - very popular with lots of users on here.

That was one of the options I was surprised to learn about. Will definitely be looking into trying those out also.

Thanks!

So I got a copy of both my original and titration studies. Not sure at this point what data points are most relavent, so if I miss something, please let me know:

Original Study:
TST = 386.9 min (N1 = 14.8% / N2 = 67.2% / N3 = 3.5% / REM = 14.5%)
AHI = 29.8 (155 OA / 0 MA / 2 CA / 36 HYP)
REM AHI = 17.1
O2 SAT MEAN = 92.0
O2 SAT NADIR = 83.0

Titration Study:
TST = 339.0 min (N1 = 15.3% / N2 = 45.6% / N3 = 19.8% / REM = 19.3%)
@PAP 6.0: AHI = 37.0 (3 OA / 0 MA / 1 CA / 25 HYP) - 34 DESAT
@PAP 7.0: AHI = 3.7 (0 OA / 0 MA / 0 CA / 5 HYP) - 6 DESAT
@PAP 8.0: AHI = 0 - 4 DESAT

From my understanding of these numbers results it looks like I'm borderline severa OSA, and that with CPAP of 8.0 my AHI dropped to 0.0 during my titration study.

I'm waiting on a call back from my DME to discuss what models of equipment they provide, but the doctor's office said it is typical ResMed or Respironics. Should I try to sway them to one or the other?

Both are good, I prefer ResMed. Make SURE you get a data capable machine, and autos are better than simple, fixed pressure (Resmed S9 or A10 for sure, don't know Respironics models)

Just spoke with the DME and they indicated that their normal machine for my script would be a Respironics 460. They indicated that it is data capable. Can anyone confirm what software works with this model, or what software is preferred?

I would push for a 560TS if it were me.
The 460 is straight CPAP single pressure (with EPR) xFLEX. I would insist on an auto adjusting machine 560 with the heated hose option (TS).

Even better would be the newly released Resmed Airsense Autoset for Her. It doesn't matter if you are not a her. This machine has a fourth mode of operation that anyone might find helpful.

Sleepyhead software is free and will work fine with any of the machines mentioned so far, except the Airsense which is being updated.
Encore software will also work on the Phips resperonics machines.
Resscan software will work on the Resmed machines.

Make sure, before you step into the DME office, you have a clear understanding of the machine you want, how to identify it, and how your insurance works. Remember, in most cases, insurance will cover a better machine than the DME will want to give you.
Read blog by member jankitz memberlist.php?mode=viewprofile&u=48201
http://tinyurl.com/2arffqx
http://tinyurl.com/2ck48rm

And all too often DME's idea of 'data capable' means compliance only data, vs data that actually tells you what's going on overnight. Don't let them pawn off a Resmed 'Escape' on you, though an Elite would be ok... tho' just ok, as it's not as up to date as the S9 Autoset, S10 Airsense or PR S1 auto.

bpvegas wrote:Just spoke with the DME and they indicated that their normal machine for my script would be a Respironics 460. They indicated that it is data capable. Can anyone confirm what software works with this model, or what software is preferred?

Yes. The 460 "Pro" model is fully data-capable. Sleepyhead or a version of Encore will generate the reports to tell you how your therapy is working.


Den

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The PR System One 60 Series Pro CPAP model 460 is a full data machine.
It doesn't have full time auto adjusting (APAP) mode but it does have some limited time in apap mode should it be needed.
The 560 model does have full time apap mode in addition to cpap mode.
SleepyHead software works just fine with the 460 model and it's free.
You can also use Encore software from Respironics as long as you have a Windows computer. Send me a private message if you want to try Encore. You can use either or both if you wish.

So I've checked my insurance coverage and it appears that DME is covered 100% with the script from the doctor.

After reading further I can see the benefit of having the APAP and it looks like the most recent model for Respironics would be the IN561TS (System One REMstar Auto A-Flex with heated tube humidifier).

I think I will push for that device model.

I see there is a bluetooth attachment available for accessing data via an iOS app. Is that worth the cost/effort or is the SleepyHead software better for analysis?

Any consumer oriented software other than Encore Basic tends to be almost worthless. If it were slightly better it might move up the scale to worthless.

If you read the NC student thread you will get some idea of what works and what enhancements some of us would like.

Forgive my ignorance, but where would I find the NC student thread you referenced?