Need lots of answers #1 pressure of 19.9

[SleepingBearDoNtWake]

Hi Everyone,

I haven't been on here in a while, and I could really use your advice, wisdom and thoughts on several things. I think maybe it is better to do one topic at a time.
I went for another sleep study, but failed as I couldn't do it, because they wanted me to fall asleep with out my mask. I have tried for months to get another one, and can't get anyone to respond to me.
Ok, so this topic will ask 2 questions, since I have sleep apnea, and it is confirmed, why do I need a baseline, can't I just where the mask and let there machines take the readings. My through closes up, if I don't have the machine, and it scares me and hurts, when I fall to sleep and gag, so I will stop myself.

Second, my machine is at 19.9 pressure. It only goes to 20, what happens next, if I am almost maxing out my machine, am I in trouble, is there now way to get a machine that uses more pressure.

I need some answers to tell the doctors so they take me seriously, and I get the treatment I need, as I am sleeping all day, due to several medical problems.

Thanks,

Mike

[palerider]

I went for another sleep study, but failed as I couldn't do it, because they wanted me to fall asleep with out my mask. I have tried for months to get another one, and can't get anyone to respond to me.
Ok, so this topic will ask 2 questions, since I have sleep apnea, and it is confirmed, why do I need a baseline, can't I just where the mask and let there machines take the readings.

tried to get what, another mask, or sleep study? anyway, it seems pretty stupid to me, the should either just give you a new auto machine, or titrate you for a bilevel and be done.

Second, my machine is at 19.9 pressure. It only goes to 20, what happens next, if I am almost maxing out my machine, am I in trouble, is there now way to get a machine that uses more pressure.

bilevel machines (bipap/vpap/aircurve) go to 25, NIV machines to 30.

[robysue]

I went for another sleep study, but failed as I couldn't do it, because they wanted me to fall asleep with out my mask.

I'd suggest talking to the doc who ordered the sleep test.

I have tried for months to get another one, and can't get anyone to respond to me.

Who is the "anyone" here? What I mean by that is who are you trying to get to respond to you? The DME? Your insurance?

It would help to have a bit of background: When was your first sleep test that showed you have OSA? How old is the mask that is worn out? And who is insisting that you have a new sleep study without the mask before authorizing you to legally purchase a new mask?

Ok, so this topic will ask 2 questions, since I have sleep apnea, and it is confirmed, why do I need a baseline, can't I just where the mask and let there machines take the readings. My through closes up, if I don't have the machine, and it scares me and hurts, when I fall to sleep and gag, so I will stop myself.

Yes, this sounds ridiculous, but with the way our health care system in the US works, there are all kinds of nonsensical requirements that can be put on patients.

The answer to "Why is a baseline is required?" depends on who is requiring it. Is the doc insisting on a baseline before writing a new script? Is the DME insisting on a baseline before allowing you to continue to purchase equipment based on a current (or new) script? Has there been a change in insurance coverage and is it it the new insurer that is requiring a baseline study before paying for any new equipment?

And how old is the original script? And are you trying to purchase the mask from the same DME that sold you the CPAP equipment in the first place?

Regardless of the answers to these questions, it seems like the starting place is to try to talk to the doc who has authorized the sleep study. And explain how difficult it is for you to try to sleep without the mask. Perhaps a split night study could be done, where you'd only be sleeping without the mask for an hour or two.

Second, my machine is at 19.9 pressure. It only goes to 20, what happens next, if I am almost maxing out my machine, am I in trouble, is there now way to get a machine that uses more pressure.

Bilevel machines can go up to 25cm. But it does seem likely that the DME and insurance company will both insist on a sleep study before authorizing a bilevel. But if you have documented OSA from a past diagnostic sleep study, it seems like they could just require a titration study.

Does your current machine record efficacy data? Has the doc seen that efficacy data?

I need some answers to tell the doctors so they take me seriously, and I get the treatment I need, as I am sleeping all day, due to several medical problems.

Do you have a copy of the original sleep study that put you on CPAP in the first place? If you have that, then perhaps you should start by making copies of that study and sending them to all the parties who are being stubborn.

And I am confused: Are you currently sleeping at home without the CPAP? Or are you using the CPAP, but with a mask that is so old that you are having trouble getting it to seal correctly.

If the main problem right now is that you need a new mask, you might try several different things:

1) Scour sites like E*bay to buy individual mask parts and assemble them into the whole mask.
2) Tell your sleep doc that you can no longer use the current mask because it is worn out and ask for a new script for just the mask. Then buy the mask on-line from a place like cpap.com
3) Let people here know what kind of mask you are using. Perhaps someone here has an unwanted, lightly used mask that they could either sell or give you.

[SleepingBearDoNtWake]

Hi,

Sorry that I didn't make my post much clearer. When I refer to them, I am meaning the hospital that I go to, that did the sleep study, is not responding to me or calling me back, I have called the doctor and left a message, I have talked and left a message for a nurse, I also called a person that I was suppose to do a follow up with, and no one has called me back after several attempts.

I have a new mask as of a few days ago, so I am all set there.

The reason for the test, was to see what was going on with my brain, not so much the effects of CPAP but to see if I am spending too much time in one brain state or too little time. I am sleeping so much I cannot function anymore.

I had to go on disability. When I got my paper work, from my sleep study years ago, it said patient did not enter into REM sleep, patient should be refereed to a sleep specialist. I am trying to find out why I didn't get into REM and if this is still a problem and why I am not feeling better. I am grasping at straws as it is so bad.

[robysue]

I had to go on disability. When I got my paper work, from my sleep study years ago, it said patient did not enter into REM sleep, patient should be refereed to a sleep specialist. I am trying to find out why I didn't get into REM and if this is still a problem and why I am not feeling better. I am grasping at straws as it is so bad.

On the sleep study from years ago, how bad was the OSA? People with severe untreated OSA often don't get much REM and it's not uncommon for people with really severe untreated OSA to get no REM at all on their diagnostic sleep study. Usually initiating CPAP therapy is all it takes for a person with severe OSA to then start getting an appropriate amount of REM.

Give that you're compliant with therapy, but still sleeping so much that you can't function, it would make sense to have another sleep study done with the machine, preferably at its current settings. If your OSA is under control through the use of CPAP and you are still not getting into REM, then it's possible that you have more than one sleep disorder. But why the doc or hospital would want a new baseline study is strange: All the baseline study would reveal is that you've got OSA ....

When I refer to them, I am meaning the hospital that I go to, that did the sleep study, is not responding to me or calling me back, I have called the doctor and left a message, I have talked and left a message for a nurse, I also called a person that I was suppose to do a follow up with, and no one has called me back after several attempts.

Phone tag is frustrating. At one point I found that the only way I could get one doctor's office to respond was to make a daily phone call politely, but persistently reminding the person that answered the phone that I was still waiting to speak with the doc.

If the doc's office has a "patient portal" system, you need to find out about it and get an account. My sleep doc is part of a large neurology group that uses a patient portal. I've found that making inquiries through the portal system gets me more useful feedback quicker than playing phone tag does.