New member of the nose hose club

[AliceInWondrmnt]

So, I had been complaining to my PCP about being exhausted all the time, even with sleeping 12-14 hours a day. So he sent me for a sleep study.

Got a call a yesterday from the DME company that they have an order for a bilevel major for me, when is a good time for me to make the appointment to come in? This was news to me... hadn't heard anything about the results from the doc. Set up the appointment with DME company for Wednesday, the 10th, to come in and get my new friend. Called PCP to find out if results of sleep study were available in my online medical record. Was told they should be, they weren't. Called PCP back to let them know and set up a time to go down and pick them up from the office.

Just got home with, not any kind of graph or numeric data, but the pulmonologist's report/ interpretation. It was a split night study. First portion of the study, no REM sleep, sleep efficiency 55%. N2 for 82%, N3 for 16%. After they started CPAP, sleep efficiency went to 82%. N2 for 30%, N3 for 31%, and REM for 34% of titration time.

Once I was finally asleep, 157 obstructive hypopneas for AHI of 77 per hour. During diagnostic portion of the study, O2 sats went as low as 81%. During titration portion of study, started on CPAP of 6 and titrated up to 12 with "suboptimal control of sleep disordered breathing". Switched to BiPAP of 16/12 and titrated up to 18/12. On that, had 46 minutes of sleep with 3 minutes of REM, AHI of 0, sats of 92%.

They also noted tachyarrhythmia, so suggesting that I may benefit from a Holter monitor.

So, a week from today I get to go get my new bed companion. It appears my DME company has the ResMed Airsense 10 Autoset, PR System One BiPAP Auto with Bi-flex, and the S9 VPAP Auto. I'm supposed to be getting nasal pillows with a chinstrap because I'm a mouth breather, but felt claustrophobic with the full face mask. I was actually looking at the Optilife nasal pillows/mask as it has the chinstrap as part of the headgear.

Thanks for reading this much. Any and all suggestions are welcome.

[Julie]

Just curious, but did no one suggest trying your low (Apap) pressure a bit higher, e.g. 8 or 10, before jumping straight to a bipap? Kind of unusual, regardless of how 'severe' (and it was) your study results are. The severity has nothing to do with how much pressure is needed to keep YOUR particular airway open and in fact people who test at just e.g. 15 or 20 events/hr often need higher pressures than people who test high but have relatively adequate airways and only need fairly low pressure therapy.

[AliceInWondrmnt]

Just curious, but did no one suggest trying your low (Apap) pressure a bit higher, e.g. 8 or 10, before jumping straight to a bipap? Kind of unusual, regardless of how 'severe' (and it was) your study results are. The severity has nothing to do with how much pressure is needed to keep YOUR particular airway open and in fact people who test at just e.g. 15 or 20 events/hr often need higher pressures than people who test high but have relatively adequate airways and only need fairly low pressure therapy.

Not really sure of all the terminology (yet), so not sure about APAP. All I know is what the report says about them starting with CPAP and that not working, so switching to BiPAP.

[palerider]

Just curious, but did no one suggest trying your low (Apap) pressure a bit higher, e.g. 8 or 10, before jumping straight to a bipap? Kind of unusual, regardless of how 'severe' (and it was) your study results are. The severity has nothing to do with how much pressure is needed to keep YOUR particular airway open and in fact people who test at just e.g. 15 or 20 events/hr often need higher pressures than people who test high but have relatively adequate airways and only need fairly low pressure therapy.

Not really sure of all the terminology (yet), so not sure about APAP. All I know is what the report says about them starting with CPAP and that not working, so switching to BiPAP.

unfortunately, Julie is assuming things you've not said, and just leading to confusion for you.

go for the resmed.

[Julie]

Excuse me? That was completely uncalled for! I ASKED about things, did not make blanket statements or assumptions!

[robysue]

Just curious, but did no one suggest trying your low (Apap) pressure a bit higher, e.g. 8 or 10, before jumping straight to a bipap?

Julie,

The OP says that they titrated her up to 12 cm on CPAP before switching over to BiPAP.

Since they titrated her on BiPAP with a PS of 4, it's reasonable to assume that there was evidence that she was struggling ---possibly with exhalation--- on CPAP at 12cm. Or she may have been having too many non-respiratory related arousals on CPAP.

Regardless, it seems that the switch to BiPAP was a good idea and the OP's insurance company doesn't seem to be giving her grief over starting with a BiPAP instead of a CPAP. That's *good* news for the OP.

[chunkyfrog]

Just to clarify, (as far as I can tell) the OP is just starting out, with no equipment yet.
The APAP was used in the LAB, but not used at home.
Luckily, the OP was paired with a bilevel machine instead of a lower model.

[AliceInWondrmnt]

Just to clarify, (as far as I can tell) the OP is just starting out, with no equipment yet.
The APAP was used in the LAB, but not used at home.
Luckily, the OP was paired with a bilevel machine instead of a lower model.

You're correct. I have no equipment at home yet. My appointment to get the equipment is a week from today.

The main reason for my post was to get opinions/ information on the machines it seems are available through the DME company as well as the mask/ nose pillows I am most interested in.

[chunkyfrog]

PaleRider knows. Follow his advice.

[AliceInWondrmnt]

Just curious, but did no one suggest trying your low (Apap) pressure a bit higher, e.g. 8 or 10, before jumping straight to a bipap? Kind of unusual, regardless of how 'severe' (and it was) your study results are. The severity has nothing to do with how much pressure is needed to keep YOUR particular airway open and in fact people who test at just e.g. 15 or 20 events/hr often need higher pressures than people who test high but have relatively adequate airways and only need fairly low pressure therapy.

Not really sure of all the terminology (yet), so not sure about APAP. All I know is what the report says about them starting with CPAP and that not working, so switching to BiPAP.

unfortunately, Julie is assuming things you've not said, and just leading to confusion for you.

go for the resmed.

Ok, which of the resmed (if given the choice), the AirSense 10 or the S9 VPAP? I'm going to go out on a limb with a guess that you meant the AirSense.

[Julie]

Robysue - thx for the explanation.

[palerider]

Excuse me? That was completely uncalled for! I ASKED about things, did not make blanket statements or assumptions!

I believe that if you'll go back and read the original post, you'll determine that the OP does not have a machine yet. so your comment about "apap" was simply confusing, as evidenced by the reaction to your assumption/question.

[palerider]

Ok, which of the resmed (if given the choice), the AirSense 10 or the S9 VPAP? I'm going to go out on a limb with a guess that you meant the AirSense.

they're functionally the same, the aircurve takes up less space on the side table...