Newly dx'd, need suggestions

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
RosieSoaring
Posts: 2
Joined: Wed Oct 22, 2014 11:23 am

Newly dx'd, need suggestions

Post by RosieSoaring » Wed Oct 22, 2014 12:12 pm

Hi! I just received my sleep study report and will be fitted with equipment tomorrow. I would appreciate any suggestions for equipment to request.

I have severe OSA, a neuromuscular disorder, bilateral Tracanteric Bursitis (so, no side sleeping), GERD, and dry eye. Past history of Left Temporal Lobe Epilepsy and parasomnias (controlled with 5 mg Clonazepam).

Insurance company is forcing me to start with CPAP with no hospital titration, even though my doc has said I need hospital titration and BiPAP. With my equipment choices, I am concerned about mouth breathing and dry mouth, air blowing in my eyes, GI bloating (which I believe causes me breathing difficulties), and TMJ.

Overall apnea/hypopnea index: 32/hrs (hypopneas); 32/hr supine; 52/hr in REM.
Lowest desaturation: 83%; average desaturation: 95%.
Total recording time: 301 min w/ sleep efficiency of 72%.
Sleep and REM latencies: 10 and 160 min respectively.
Increased stage I of 12%, 47% stage II, 16% slow wave sleep and 25% REM w/ 2 REM cycles.
Sinus rhythm from 51-86 beats/minute.

Any suggestions of CPA and mask options I should consider? From my research so far, I am interested in Resmed Airsense Autoset for Her with heated hose, nasal cushion mask (one of the Resmed Swift models) and chin strap. If I must go with a full face mask, I would prefer Resmed Mirage Liberty.

Is there any way the Airsense for her could work for someone who really should have a BiPAP? I can't imagine having to endure another month or more of torture to appease my insurance company before I will receive the proper equipment.

Thanks very much for any feedback you can offer!

Rosie

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Pugsy
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Re: Newly dx'd, need suggestions

Post by Pugsy » Wed Oct 22, 2014 1:08 pm

RosieSoaring wrote:Is there any way the Airsense for her could work for someone who really should have a BiPAP?
Actually yes..it might work. It all depends on pressure needs and if aerophagia is a problem how much pressure support is needed to keep aerophagia away.

Bilevel machines have 2 pressures...one for inhale and one for exhale and the difference between inhale and exhale is called pressure support.
Example...exhale at 10 cm and inhale at 14 cm...the pressure support is 4. It's this pressure support that offers the comfort with exhaling and helps with aerophagia issues. The most commonly used pressure support numbers are around 4 or 5.

With the AirSense for Her AutoSet...it has EPR exhale relief and it has 3 settings available..1,2 and 3 and each setting is a per cm reduction during exhale..with a setting of 3 being the greatest reduction. For all practical purposes it is working like a bilevel pressure machine but it can only go to 3 cm where the real bilevel can go higher than 3.
It's very possible that the 3 cm relief offered with the ResMed EPR exhale relief will get the job done for you.

I actually compared EPR of 3 to both PS of 3 and 4 on my ResMed bilevel machine (it had cpap mode where I could use real EPR) and it actually felt the same as bilevel with PS of 3 and was only faintly different from PS of 4 when using bilevel. Unless you happen to need a really large PS number (very unlikely) the 3cm reduction using EPR exhale relief stands a good chance of working.

Now if you end up needing pressures in excess of 20...you have to go to bilevel because they will go to 25 and the cpap/apap machines will only go to 20.

Masks are a crap shoot...you just have to try them to see how you like them. One man's treasure is just another man's trash when it comes to masks. I prefer nasal pillow masks myself but I did get a chance to use the ResMed Swift FX Nano cushion mask and had great success with it which for me is saying something. For sure if someone it looking at nasal cushion masks...the Nano definitely needs to be on the list to try. Also, the Swift FX nasal pillows will fit on the Nano headgear...if you get the Nano and want to try the nasal pillows..just send me a private message...I have some new unused pillows you can have for cost of postage. I don't have any mediums but I do have the other sizes and they would be close enough for you to figure out if you hate or not.
Don't let anyone tell you that you can't use nasal pillows if you want to try them...I see pressures over 20 every day and have great success with nasal pillows.

I can't help at all with ideas about full face masks...I hate them and don't own one.

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If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

RosieSoaring
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Joined: Wed Oct 22, 2014 11:23 am

Re: Newly dx'd, need suggestions

Post by RosieSoaring » Wed Oct 22, 2014 4:55 pm

Wow, Pugsy! Thanks so much for explaining "pressure support" so clearly! I hope the Airsense Autoset for Her is offered as an option and that I can take it home tomorrow!

My husband has used the Swift FX mask with his BiPAP, and it feels very comfortable to me. I appreciate the info about the interchangeable cushions on the Swift FX Nano and your offer of extra pillows! The medium feels best to me on my husband's Swift FX.

Tomorrow, I will report back on my CPAP prescription and what equipment I end up with. I am desperate for an end to the torture!

P.S. I was not able to figure out how to paste excerpts of your text into my reply... 'sorry!

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Pugsy
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Re: Newly dx'd, need suggestions

Post by Pugsy » Wed Oct 22, 2014 5:01 pm

Hey, no problem about the quotes. I don't think it all that important myself unless we have multiple people in a thread talking about multiple things and we use the quote function so people know who we are talking to.

I think it's kinda waste of space to copy what I might write unless something needs clarification or something.

_________________
Machine: AirCurve™ 10 VAuto BiLevel Machine with HumidAir™ Heated Humidifier
Additional Comments: Mask Bleep Eclipse https://bleepsleep.com/the-eclipse/
I may have to RISE but I refuse to SHINE.

If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

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Julie
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Re: Newly dx'd, need suggestions

Post by Julie » Wed Oct 22, 2014 5:10 pm

http://maskarrayed.wordpress.com/

for everything you wanted to know re buying or renting equipment... what kind, and how to work with DME's (and when not to) and insce. co's.

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palerider
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Re: Newly dx'd, need suggestions

Post by palerider » Wed Oct 22, 2014 5:12 pm

RosieSoaring wrote:P.S. I was not able to figure out how to paste excerpts of your text into my reply... 'sorry!
hit the 'quote' button and edit out the parts you don't want to reply to

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