Hello! I'm new.

[Shirokuma]

Hi,

I had my sleep studies about two months ago. My AHI is about 10.4, 0 with a CPAP machine set at 11 cm H20. I got my machine March 7th. My primary care physician set me up for the sleep study, because I complained of fatigue. I was sleeping on the way to work (good thing I'm not behind the wheel), on the way home, and almost immediately after a late dinner.

With just one night of using the machine, I can feel the difference. I have no sore throat and new energy. I'm still adjusting. I wake up around 3AM and take off the mask. As a result, I am only 37% compliant with my insurance. I have worn glasses since age 9. I thought this would be easy, but most nights I wake up with a razor burn under my nose.

I'm doing my best to keep the mask on. I have a tendency to return to old habits, not use the machine, and resume the zombie life I'm familiar with. My sleep doctor suggested I try other masks. My question to him was, "What are they going to allow? If I find something highly recommended by other CPAP users, then are they going to get that for me?" I would like to try the nose pillow, but this didn't start out with, "What would you like to try on first?" but more like "This was recommended by your sleep lab (who also gave me only one choice)."

It's late, good night!

- Jeff

[sleepyb]

You have a really good machine, but your mask is obviously not the best for you (or you have it too tight). The DME should give you a different mask. If they don't then it's time to start pestering your insurance company, which will expect to see at least 4 hours compliance.
When dealing with your DME be prepared. Not all, but many DME's will stretch the truth quite a bit. You don't need a prescription for a mask, so you can choose any mask you want even though the DME may say no.
The only good I can see with buying through a DME (besides the insurance thing) is that you can try on a variety of masks. If they are not giving you that option then that's a problem.
Only using it for 4 hours is also a problem, so is the high AHI number (possibly leak induced?). If you cannot get what you need to use the equipment succesfully you'll need to work with your doctor, DME, and possibly insurance company to figure out how to make it work for you.
Be prepaired for a fight, but once you get this stuff working correctly for you it will be worth it.

[Julie]

Many places insist on a prescription for a mask...

[sleepnationtv]

Hi Jeff,

It is good to look at what mask options are out there to find the best one to you. Here is a link to videos that we have that give you a good look at some options. http://www.cpaplibrary.com/mask-education

Also we do have a mask trial program that can be a good option if your DME will not let you try other masks. http://www.cpaplibrary.com/mask-trials

Good Luck,

Dane

[Shirokuma]

My sleep doctor wrote a new referral(?) after my visit on April 10th. "Interface--refit patient with different mask-current one causing facial irritation".That looks wide open for negotiation for something other than what I currently have. I'm a marshmallow when it comes to fighting, but I will walk out of the supply center with a different mask. I am at least prepared to waste as much of their time as they are willing of mine.

Thank you all for links to new ideas for a mask. I didn't know what was out there until I came here.

I'm not sure about my machine, it just reads "S9" for model. It doesn't start automatically when I breathe into it. The data files on the SD card look really small as if only tracking date and hours of use.

- Jeff

[moondoggy]

I'm new to this whole business myself but I'll share my experience with masks.....

My air pressure is 13 -17 and because of that pressure my DME said that they did not recommend nasal pillows and I also was told this by the sleep center who tried to put me in a nasal pillow mask the night of my study. I did not want a full face mask so settled on a nasal mask. I started with a Resmed Mirage Micro as this was the one recommended by my DME as being the most popular mask of that type. The Micro however made a sore on my nose and mad terrible red marks. I tried a F&P Zest mask next but that one pressed so hard on my cheek bones that one didn't work either. I then tried a larger size Zest but I didn't like how it felt either. I was then put into a larger size Mirage Micro and although it didn't create sores on my nose, the mask continue to leave terrible red marks on my nose. I then tried a Mirage Softgel and this mask is the one I went with. The mask leaves fewer marks on my nose and is heavier than most and tends to leak if you lay on your side due to the weight of the mask but it was the most comfortable mask I could find at that time. I was thinking that I was going to have to go for another round of mask trials after 3 months of use but I recently tried a mask liner from http://www.padacheek.com which is custom designed for my particular mask. The results of this liner are simply amazing. No more marks on my nose and if the mask is leaking I sure can't tell. My AHI reading on my machine is significantly lower since I put the liner on.

I guess what I'm trying to say is that the search for the best mask can be time consuming and problematic. That being said there is some mask out there that will provide you the highest level of comfort and leak the least but you're going to have to be patient. Also keep in mine that your DME is supposed to be helping you find the best mask so don't let them make you feel like your a pain by trying on more and more masks.

[Emilia]

There are a few different models of the S9.... Escape, Elite, Autoset. The best of the lot would be the S9 AutoSet which is what you chose in your profile. Please double check to see what the machine says on top...exactly! Then we can tell you what kind of data is available. Others with your machine can help you once we know.

See Janknitz's blog on machines...and take some time to read her other informative posts: http://maskarrayed.wordpress.com/

[Maxie]

I called my insurance company and asked for specifics on what they do pay for ( and not pay for). Somehow I have gotten more masks that my insurance says they pay for and I offered to my RT to return them but he said to keep them. I guess they are backups now.

[Shirokuma]

I updated my machine. It is an S9 Escape. I don't know that it has EPR. I don't know what EPR is, so I'm past due to read the user guide.

Thank you all for the feedback. It is helping me with things I have not considered.

- Jeff

[Pugsy]

The S9 Escape collects no data beyond how many hours you use the machine each night.
Nothing else. Compliance data to prove to the insurance company that you aren't wasting their money.
From what you say...you aren't meeting compliance usage requirements.

Did you read Janknitz's blog at link above? If not...read it. Without any data there is zero way to even know if your therapy is optimal or if leaks are an issue or any possible reason that might make it difficult to be compliant.

EPR is exhale pressure relief. Settings of 1, 2 and 3 are available and each setting corresponds to a per cm drop in pressure during exhale phase of your respiration. Makes it a little easier to breathe against the pressure for some people. Sometimes the reduction allows some events to sneak past the defenses so the pressure settings sometimes need adjustments to allow for the EPR. Again....this is something that the data from a full data machine would help with.

[chunkyfrog]

Pad-a-Cheek makes soft fabric mask liners for many models of full face or nasal masks.
So nice, just thinking about mine (on my F/P 432), I would take a nap right now, but my boss might walk by. . .