WhiteAngel wrote: ↑Fri Aug 23, 2019 12:43 pm
Is there any type of machine or head gear I shouldn't let them try to push on me.
Short answer: Yes.
In terms of machines, to some extent the appropriate model depends on the pressure support you might need (as well as a few other issues).
To start, there are two major players in the machine world I would consider: Phillips Respironics (DreamStation) and ResMed (AirCurve 10 or AirSense 10). Both make good quality machines although I personally have a strong preference for ResMed (the breathing feels more natural to me -- and I have tried both). There are fans of both on this site (although ResMed seems to be the more popular one).
But now you need to decide on models. I will speak about ResMed models. I would want a machine that is: a) auto adjusting (our needs can vary depending on colds, sleep positions, med changes, etc.); b) full data (rather than compliance data only); and c) meets my needs medically (more on that later). Auto, Full Data, Bi-Level or other (if needed).
Any machine keeps your airway from collapsing by using positive air pressure. Two of the ResMed machines in this category (auto and full data) are the AirSense 10 AutoSet and AirSense AutoSet For Her. These machines support pressure needs up to 20, are auto adjusting, and full data. You can also set the pressure to be somewhat lower during exhalation. This can help with comfort. The for her is more than just branding -- Pugsy had a great post recently talking about her use of a feature unique to the "for her."
However, some people need a particular category of machines called bi-level. These offer a higher max pressure (25), and the ability to create a larger pressure differential between inhalation and exhalation. One example is the AirCurve 10 VAuto (what I own). Think of this as being an AutoSet except it can do more pressure and allows more tweaking. This can be especially useful for things like active asthma.
So, why not always pick the VAuto? Well, it is a lot more expensive than the AutoSet. Insurance will typically pay for the more expensive machine -- but only with a documented medical need. What might those needs be? The need for greater pressures provided by the VAuto and/or the need for a larger pressure differential between inhalation and exhalation.
So, if I needed that, I would be asking for the VAuto. If I didn't I would be asking for the AirSense 10 AutoSet For Her. (Note: there are other categories of bi-level machines that are used for specific issues -- if you have those needs, come back and ask questions.)
So, just get an auto machine now or get a titration study? If you are paying out-of-pocket, I would be inclined to do the auto; otherwise I would do the study.
Here is what can be good about the study: The monitoring equipment in a sleep lab is way more comprehensive than it is in an auto machine. It will give them more data. Ideally, you have a chance to try out several different mask styles. Ideally, they can detect whether you have any specific needs for something like the VAuto (or one of the more specialized machines) and establish a starting point in terms of pressures.
Here is what is not so good about the study: It is hard to sleep in a strange bed with a bunch of wires. It is a sample size of one night. You still need to be asleep to get the data. It costs money -- for something you can likely get to via trial and error with an auto machine.
