New to this. . .

On November 28th, I brought home my CPAP machine and thought to myself "piece of cake, I got this." It has not been a piece of cake, I had a nasal mask but it was a challenge to breath only through my nose due to how my nose and throat developed due to my chromosome disorder. Luckily my health provider had put in the prescription that I could choose between masks to see what was more comfortable, naturally I went with the full-face mask. I'm still having issues falling asleep with the machine and mask on; usually about two hours in, I grow frustrated and take the mask off. The past few days, I had the pressure adjusted so it wasn't so high, I was originally set for 9.0, not sure what it is set to now. When I had the pressure set to a new level, the clinician did tell me that I do need to start getting the minimal four hours a night in, so that Medicare will continue to pay for it.

Before posting, I did a little reading and seen a suggestion about wearing it while awake. This begs the question, I thought ResMed AirSense 10s auto-sense when you're asleep? Is this not the case? I'm a bit confused but I'm glad to find a support group.

No, the machines do not know if you are asleep or awake, they know you're using the machine and that you are breathing... an auto machine (mine is PRS1 560) senses when you're using the machine, and will automatically turn on when it does so. my DME told me that practicing while awake helps to desensitize your brain, which initially thinks the mask is an alien being. It is perfectly OK to use it that way. I had to do it too, as did many of us here on the forum.

It works best if you can read during this practice time, but watching TV is also acceptable. Don't just shoot for 4 hours a night, try for all night. The 4 hours a night doesn't have to happen every single night so if you have a few shorter nights in the beginning that is OK, as the standard for that is "90% of the time. Don't be concerned about an occasional short night...

kbh209 wrote:I thought ResMed AirSense 10s auto-sense when you're asleep? Is this not the case?

These new ResMed machines have a feature that is designed to detect sleep breathing patterns and it mainly for the AutoRamp feature...meaning if using AutoRamp the machine will sense your breathing pattern change when/if you fall asleep and it discontinues the ramp at that time. That's all it is and I think that is probably what you read that is confusing you. Otherwise these machines don't/can't report if you are asleep or not but they will report if you aren't attached with something like "machine on but no breathing detected" or some similar wording on the reports depending on if you have Smart Start engaged or not and have the mask on with machine running.

I got cleaning instructions about sanitizing after cleaning, one part white vinegar and three parts water. Math isn't my specialty, but I'm assuming a half of a kitchen tub of water and a 1/4 of the vinegar would be enough?

Also one other question: does Medicare only cover Respironics masks or do they cover other brands as well like the ResMed?

kbh209 wrote:but I'm assuming a half of a kitchen tub of water and a 1/4 of the vinegar would be enough?

It would depend on the size of the tub.

kbh209 wrote:Also one other question: does Medicare only cover Respironics masks or do they cover other brands as well like the ResMed?

Medicare covers all the brands...who told you they didn't? Your DME who probably only sells Respironics products? If so...that's a bold face lie.

Medicare pays by HCPCS billing code...and NOT by brand name. Brand names don't ever enter the billing codes for Medicare billing (or really any insurance company billing).

See page 4 of this document for an example of what I mean by HCPCS codes for cpap mask equipment
http://oig.hhs.gov/oei/reports/oei-07-12-00250.pdf
Brand is never mentioned.

kbh209 wrote:I got cleaning instructions about sanitizing after cleaning, one part white vinegar and three parts water. Math isn't my specialty, but I'm assuming a half of a kitchen tub of water and a 1/4 of the vinegar would be enough?

pick a measuring thing, spoon, cup, mug, bucket... whatever, your choice.

fill it with vinegar.
dump it into something larger
fill it with water
dump it into the larger thing with the vinegar
fill it with water
dump it into the larger thing with the vinegar
fill it with water
dump it into the larger thing with the vinegar

done.

I use the Res Med Air sense 10 and have been using this new machine for almost a year. When I first started using a machine I had to force myself to keep it on. Eventually you will get so used to the machine that it is difficult to sleep without it on your face! I have not used vinegar but soapy water (a mild soap). It seems my doctor did tell me to use vinegar and perhaps that is why I get some smells from the hose and nose piece that I don't like. Thanks for the info.

I use the basic blue Dawn and have no issues with scent residue. Feel like it cleans better than vinegar. YMMV.

kbh209 wrote: . . . I thought ResMed AirSense 10s auto-sense when you're asleep? Is this not the case?

The RAMP on my Airsense 10 has an "Auto" setting, where it guesses when I fall asleep, and then brings the pressure up to therapy level. I prefer not to use that setting, as the greater airflow helps me fall asleep.

I use Seventh Avenue dish soap for the cleaning. It was my DME that gave sanitization instructions as well as cleaning.

Pugsy, I just assumed Medicare covered Respironics only, since my DME provider (Lincare) only has supplied me with said brand in both the nasal and full face mask. They do have the ResMed masks on display.

i did a lot better last night time wise with the mask. I decided to play my Nintendo 3DS with the mask on for a couple hours, and then after I was tired enough, I kept the mask on for an hour and a half more, a total of 3 1/2 hours. It's not the Medicare 4 hour minimal but it is a start.

Medicare requires that you use the machine for at least 4 hours for 70% of 30 consecutive nights and you have 90 days to get those 30 consecutive nights in. Plus you need to have a face to face meeting with your doctor prior to the 91st day after treatment started documenting that you are using it and it is helping.

So 21 out of 30 nights but the nights need to be consecutive...can't pick or choose out of the 90 days.
But you have so time to work up to using it longer.

I'm definiteley noticing a difference in breathing even after taking the mask off, my throat feels more open. I have an appointment with the Pulumonary specialist this Monday to talk about my therapy so far. My DME did tell me last week that I should start wearing the mask while awake, along with trying to get to sleep with it, just so I can at least get the required time in for Medicare. At first I panicked and thought "stay awake?" It takes me a minute to understand "oh, watch tv, read a book, etc etc with it on."

Update: 4 1/2 hours last night using the machine. This is an accomplishment

Pugsy, I finally looked at my tub, it's a 17qt

17 QT is a whole lot more water than you need to clean or soak anything.
At most all you need to do is barely cover whatever you are soaking.

Fill the tub just to the level that is sufficient to cover whatever you want to soak....then pour that water into a measuring cup so that you can see how much water you will be using and then do the vinegar to water ratio figuring if you want it to be perfect.

Okay I'll cut the water down to 1/4 filled, that'll be enough. I *did* notice that half a tub is a bit much, and I don't need the water police knocking at my door.