Intro

[SleepyWabbit]

Another newbie here. I had my sleep study back in Dec of 2013. I did the initial sleep study follow by the titration a week later. Due to the holidays I wasn't able to make a followup appointment until the end of January 2014. Due to my wife having back surgery around that time, the appointment fell off my radar and due to my own procrastination, I didn't make another followup.

1 1/2 years later my PCP, wife and ex-wife are on my case that I need to get my sleep in order, so I am following up like I should have a long time ago.

I've had trouble for quite a few years, but mostly blamed it on allergies. I joke around saying "If it's green and produces pollen, I'm allergic to it". My friends joke that I can fall asleep at the drop of a hat and I have often fallen asleep leaning against a wall waiting for someone. I have caught myself in that twilight area between sleep and fully awake, wondering what the loud buzz-saw noise was before realizing it was me snoring. So I was relived to find out that I have sleep apnea and there is something I can do about it. Now I need to actually do it.

My study results were an AHI of 45 with an RDI of 47.5. The AHI was a mean of 9 apnea events to 36 hypopnea events per hour. The mean apnea/hypopnea length was 22.6 seconds with the longest being 57.3 seconds. This makes me wonder what the mean length is for those who have an AHI above 100?

My oxygen was at 90% or above 85% of the time, 88% or lower for 9.5% of the time with a low of 77%. Math tells me that I was at 89% for 5% of the time.

The titration study tested my at 4/6/8/10/12 with being the least apnea/hypopnea events. 10 had me at 15 hypop & 7 apnea events. 12 had me at 1 hypop and 11 apnea events. My oxygen for the whole time was at 90% or above for 96% of the time an at 88% or below for 3% of the time. Much better that before. My overall apnea events seemed to go up slightly, but my hypopnea events were at 90% less events that the original study. I understand this is only one night across the whole gamut of pressures, and the OSA and CSA events are likely to go up until I get used to sleeping with a mask.

The recommendation is 12 cm with a c-flex setting of 3. The recommendation from the initial study suggests a RemStar Pro DS 450 with SD card reader and a Quattro Ultra (M) mask with humidifier. With my constant allergies, I'm usually pretty stuffed up, especially in the spring and fall, so I am starting with a FFM which makes sense to me. It looks like the DS 450 is a regular CPAP machine instead of an Auto. I'm going to push the DME for an auto but don't know what is actually written on the prescription. I'll have to go back to my doctor for a copy of it for my records. I asked the sleep doctor about the difference between auto and straight, and he said they want me on straight 12cm. If I can get an auto CPAP, I would still stay on the straight 12 for the initial 90 day trial, but would like the option for later down the road.

Looks like my insurance (UHC) works with neighborcare/rotech, so I'll see what I can get out of them. The sleep office said they would send the prescription over last friday, so If I don't hear from them by Wednesday, I'll be beating down their door.

Overall, I am looking forward to better sleep.

[Sheriff Buford]

Welcome to the forum! It's refreshing to hear from a newbie that has educated himself. Several points I'd like to make/suggest: get a copy of your prescription and try to get two separate prescriptions. One for the mask that reads "mask of patient's choice" and the other for a data-capable autoset machine. Tell the doctor you want an autoset for the comfort and because of your allergy situation. The full face mask is probably a good start because of the allergy and you can mouth breath wearing a full face. Be sure the cpap prescription includes a humidifier. Know that you may go thru several masks before you find one you like. I went thru 6 or 7 before , I cound mine. The mask should be comfortable and leak-free. It's a journey. Work all your issues here and don't give up! We will help you! Before long you will start feeling better and enjoying a healthy life.

Blessings, Sheriff

[JDS74]

Another newbie here. .... It looks like the DS 450 is a regular CPAP machine instead of an Auto. I'm going to push the DME for an auto but don't know what is actually written on the prescription. I'll have to go back to my doctor for a copy of it for my records. I asked the sleep doctor about the difference between auto and straight, and he said they want me on straight 12cm. If I can get an auto CPAP, I would still stay on the straight 12 for the initial 90 day trial, but would like the option for later down the road.

Overall, I am looking forward to better sleep.

The 450 is a discontinued model. The current one is the 460 so insist on at least that model. You should also get the heated humidifier and heated tube. That will make life a little easier. Yes, it would be better to get a 560 auto set to a fixed pressure in case you have changing needs in the future. If the scrip is written for a 450, take it back and get it re-written. The doctor can write the scrip for an auto at a fixed pressure and the machine will come that way. The cost to you will be the same as the reimbursement code for insurance will be the same for either the 460 fixed or the 560 auto models.

If you are going for a FFM, then you might want to go to Amazon.com and order a soft cervical collar. That will help prevent your jaw from dropping down while you sleep and minimize the resulting mask leaks as well. They are pretty inexpensive and work well. Where I live, the cervical collars from local suppliers are not very soft so they are not as comfortable as the ones I have been getting from Amazon.com.

[SleepyWabbit]

The 450 is a discontinued model. The current one is the 460 so insist on at least that model. You should also get the heated humidifier and heated tube. That will make life a little easier. Yes, it would be better to get a 560 auto set to a fixed pressure in case you have changing needs in the future. If the scrip is written for a 450, take it back and get it re-written. The doctor can write the scrip for an auto at a fixed pressure and the machine will come that way. The cost to you will be the same as the reimbursement code for insurance will be the same for either the 460 fixed or the 560 auto models.

If you are going for a FFM, then you might want to go to Amazon.com and order a soft cervical collar. That will help prevent your jaw from dropping down while you sleep and minimize the resulting mask leaks as well. They are pretty inexpensive and work well. Where I live, the cervical collars from local suppliers are not very soft so they are not as comfortable as the ones I have been getting from Amazon.com.

Thanks for the tips. I had a feeling that the 450 had been upgraded since the recommendation was from over a year ago. I called ASM this morning and asked what was on the current script. She said there preferred machine they put on all of their scripts is the PRS1 Auto. It's on my short list, which made me very happy.

Now I'm making a short list of masks to try out over time.

[JDS74]

Check with your DME, if you are getting your equipment locally, for their policy on mask exchanges.
Ask how many, what time period, etc.

When they fit you for a mask, be sure that you are lying down in sleeping position with your machine running at pressure with RAMP turned off. Fitting in any other way gets a fit that is likely to be not optimal.

[BlackSpinner]

When they fit you for a mask, be sure that you are lying down in sleeping position with your machine running at pressure with RAMP turned off. Fitting in any other way gets a fit that is likely to be not optimal.

YES this. Fitting for mask should be approached like getting shoes for running a marathon or going for a 100 mile trek through the mountains.