Need some guidance please (newbie)

[realshelby]

I lived with a deviated septum for 40 years. Couldn't breathe through my right nostril at all without pushing my nose to the right.

Please go to a good ENT Doctor and get that fixed asap.

I had no idea what I was missing. But I add this is more important should you still have sleep apnea. Deviated Septum will complicate what mask you can use effectively. You probably would not be able to use a nasal version of anything based on what I know about them and thinking back to when I couldn't breath through one nostril.

I would use a full face mask if that was the only way. I much prefer the nasal masks!

[Pugsy]

ODI is oxygen desaturation index...and probably needed to have a 3 or 4% drop to get counted. So it's just an average for the number of times the oxygen level changed.

If the lowest it went to was 89%....not bad as long as you didn't spend much time down there.

Don't assume that a deviated septum will prevent using a nasal mask...it all depends on how bad the deviation is.
See what Perrybucksdad has to say about that here.
viewtopic/p663440/Mouth-Breathers.html#p663440
I had to just about twist his arm off to even try a nasal mask because he too thought his deviated septum would be a problem...it wasn't.

The test results reference supine/non-supine/upright, but I don't really know what that data is meant to represent; for example, it says Supine Time-hr 5:05 Percentage 97.5 HI: 7.3. Is this saying supine for 5 hours? Or 5:05 am? If it's meant to be a total number of hours, I really don't understand how it got that data because I was up walking around and sitting in a chair until 2 am

It is saying you were supine for 5 hours and 5 minutes...and a common problem with home sleep studies is that they don't always get the position correct. They use an accelerometer thingy for position changes and sometimes it's not always accurate.
Sleep stages...depends of the type of sleep study.
See here for explanation...sounds like you had a Type III
http://freecpapadvice.com/home-sleep-tests

[Pharaoh90]

I lived with a deviated septum for 40 years. Couldn't breathe through my right nostril at all without pushing my nose to the right.

Please go to a good ENT Doctor and get that fixed asap.

I had no idea what I was missing. But I add this is more important should you still have sleep apnea. Deviated Septum will complicate what mask you can use effectively. You probably would not be able to use a nasal version of anything based on what I know about them and thinking back to when I couldn't breath through one nostril.

I would use a full face mask if that was the only way. I much prefer the nasal masks!

Thanks I'm definitely going to follow up with my GP about the deviated septum. I mouth-breathe virtually 100% of the time, not through habit but through necessity. Sometimes I will focus my attention on trying to breathe through my nose and very quickly realize I'm not getting enough air and have to take a big gulp. Particularly true if I'm walking or running or doing anything strenuous - it feels like I'm holding my breath. So it's not just a bad sleep habit - I'm mouth breathing all day.

[Pharaoh90]

Don't assume that a deviated septum will prevent using a nasal mask...it all depends on how bad the deviation is.
See what Perrybucksdad has to say about that here.
viewtopic/p663440/Mouth-Breathers.html#p663440
I had to just about twist his arm off to even try a nasal mask because he too thought his deviated septum would be a problem...it wasn't.

So interesting! Thanks for sharing this! Once I mentioned the possibility of a deviated septum to the sleep center (I was told I had one as a kid by a pediatrician; I don't have any x-rays or diagnosis as an adult to back it up), the conversation switched to full face mask and that was the end of it. I didn't stay at the fitting appointment long enough to actually put a mask on, but it looked like what they had set out for me on the table was full face. Part of the reason I freaked and absconded with my test results!

[MrsRinPDX]

Don't assume that a deviated septum will prevent using a nasal mask...it all depends on how bad the deviation is.
See what Perrybucksdad has to say about that here.
viewtopic/p663440/Mouth-Breathers.html#p663440
I had to just about twist his arm off to even try a nasal mask because he too thought his deviated septum would be a problem...it wasn't.

So interesting! Thanks for sharing this! Once I mentioned the possibility of a deviated septum to the sleep center (I was told I had one as a kid by a pediatrician; I don't have any x-rays or diagnosis as an adult to back it up), the conversation switched to full face mask and that was the end of it. I didn't stay at the fitting appointment long enough to actually put a mask on, but it looked like what they had set out for me on the table was full face. Part of the reason I freaked and absconded with my test results!

I agree Pugsy! I'm enjoying this thread and learning much. Thank you!

[realshelby]

Don't assume that a deviated septum will prevent using a nasal mask...it all depends on how bad the deviation is.
See what Perrybucksdad has to say about that here.
viewtopic/p663440/Mouth-Breathers.html#p663440
I had to just about twist his arm off to even try a nasal mask because he too thought his deviated septum would be a problem...it wasn't.

So interesting! Thanks for sharing this! Once I mentioned the possibility of a deviated septum to the sleep center (I was told I had one as a kid by a pediatrician; I don't have any x-rays or diagnosis as an adult to back it up), the conversation switched to full face mask and that was the end of it. I didn't stay at the fitting appointment long enough to actually put a mask on, but it looked like what they had set out for me on the table was full face. Part of the reason I freaked and absconded with my test results!

If you can breathe some through both nostrils that would probably be different. Pugsy would know!

At any rate the full face masks are rather frightening to look at. Look like medieval torture devices at first. That is why I pushed the use of the nasal pillows style. There is a DRAMATIC difference in what you see, feel, and look like when wearing them. I know I should not even think about it, but I feel sort of ashamed thinking of what I look like to my wife when wearing a mask. She tells me it does not matter. What a good wife! The P 10 works very well and has a low "fright" level!

[Pharaoh90]

At any rate the full face masks are rather frightening to look at. Look like medieval torture devices at first. That is why I pushed the use of the nasal pillows style. There is a DRAMATIC difference in what you see, feel, and look like when wearing them. I know I should not even think about it, but I feel sort of ashamed thinking of what I look like to my wife when wearing a mask. She tells me it does not matter. What a good wife! The P 10 works very well and has a low "fright" level!

I'm sure she's pleased that it's helping you and willing to overlook the appearance. My wife was prepared to do the same
I certainly wasn't prepared for what was presented to me in terms of masks. One covered the whole face (total mask?) and one was nose & mouth. Nasal pillows weren't offered as an option based on suspicion of deviated septum. I was hoping to drive the initial appointment towards exploring cpap alternatives but that didn't fly.
I should add too, I have terrible eyesight (-70 nearsighted) and obviously don't sleep with glasses. So the idea of waking up to a bump in the night and not being able to see while being totally encased in plastic and tethered to a machine... I just couldn't even go there mentally.
But... I was prepared to try!

[realshelby]

If nothing else I hope you are gaining confidence and knowledge here to proceed.

I can tell you that I was skeptical. I thought the sleep study was a waste of time. How in the *&^% could they tell anything with that crap stuck on me while I was trying to sleep? Then the DME person that came to the house to outfit me for the machine and mask........that said "I see you are a mouth breather so we will try the full face masks". There was a time that was true, but not after the nose job.

The first day after my first night of cpap, I knew I wanted to make it work. It was that obvious.

I think there is more collective knowledge here than many Doctors might be able to offer a new patient on how to accept therapy.

[Pharaoh90]

I can tell you that I was skeptical. I thought the sleep study was a waste of time. How in the *&^% could they tell anything with that crap stuck on me while I was trying to sleep? Then the DME person that came to the house to outfit me for the machine and mask........that said "I see you are a mouth breather so we will try the full face masks". There was a time that was true, but not after the nose job.

For me it was just a home test (no lab test offered), so there was a lot of self-doubt about if I was even putting the equipment on right. They had given me a youtube video to watch to figure it out

I think there is more collective knowledge here than many Doctors might be able to offer a new patient on how to accept therapy.

I am witnessing that first-hand! Thanks to all who have taken the time to reply

[Pharaoh90]

Good morning!
Thanks again, all, for your invaluable advice. I'm hoping you'll share a bit more wisdom with me

I am awaiting an appointment with an ENT to talk about my deviated septum issues and how it may be impacting my sleep. I also took some of the sleep positioning advice provided earlier in this thread and guess what - big difference in sleep quality!
In the meantime, the sleep center (I think you all call them DME? This is the place that fits and provides the cpap) has been calling pretty regularly to try and re-schedule the APAP fitting I walked out of. Due to recent work travel I missed 2 of their calls, but I'm reluctant to call back to reschedule.

My question is, can a patient pursue alternate treatments FIRST or must they go down the CPAP/APAP route no matter what?

With the sleep center I went to, I felt like it was all about getting on CPAP and no consideration was given to alternative therapies based on individual concerns (e.g., in my case, a deviated septum). As a matter of fact, after I turned in my home sleep test equipment, the very next call I got from the sleep center was to come in and get an APAP. Nobody explained the test results to me, gave me a diagnosis, defined what an APAP was, or had any conversation whatsoever. They had an admin person who couldn't/wouldn't discuss any medical results with me call and schedule an appointment. I forced the issue and asked the NP to call me before I made an appointment; the NP seemed highly annoyed when she did call and didn't seem to understand why I wanted to have my results explained to me... Not a very good patient experience.
I guess I just want to take a more holistic approach to this and consider any contributing factors and treatment options before diving right into a single treatment method. Maybe I'm naive? I am prepared to accept APAP if that is where the course takes me but I feel like I have valid reasons to explore other avenues first.

What would you do??

[Julie]

Sleep centers = labs where testing is done, DME's (Durable Med Equipmt) are dealers who sell you equipment... they don't test at all and must follow MD's prescriptions re setting machine pressures, providing which machine is specified, etc.n FWIW, only doctors are allowed to interpret and explain test results to you... lab techs aren't (and DME's certainly aren't!).

[Pharaoh90]

Sleep centers = labs where testing is done, DME's (Durable Med Equipmt) are dealers who sell you equipment... they don't test at all and must follow MD's prescriptions re setting machine pressures, providing which machine is specified, etc.n FWIW, only doctors are allowed to interpret and explain test results to you... lab techs aren't (and DME's certainly aren't!).

Hi Julie,
Thanks for the clarification. In my case the lines are a bit blurred: the pulmonologist I went to (saw a nurse practitioner there) occupies office space on the same floor as the sleep center; the physical layout implies close collaboration. After I saw the NP, she referred me next door to the sleep center where I got the testing equipment. I returned the testing equipment to the sleep center. The sleep center then called me for an APAP fitting. It's the sleep center that has been calling me trying to get me back in for a fitting. So in my case, the sleep center (their actual business name is Epoch Sleep Centers) and the DME are one and the same.

[Pharaoh90]

Sleep centers = labs where testing is done, DME's (Durable Med Equipmt) are dealers who sell you equipment... they don't test at all and must follow MD's prescriptions re setting machine pressures, providing which machine is specified, etc.n FWIW, only doctors are allowed to interpret and explain test results to you... lab techs aren't (and DME's certainly aren't!).

Hi Julie,
Thanks for the clarification. In my case the lines are a bit blurred: the pulmonologist I went to (saw a nurse practitioner there) occupies office space on the same floor as the sleep center; the physical layout implies close collaboration. After I saw the NP, she referred me next door to the sleep center where I got the testing equipment. I returned the testing equipment to the sleep center. The sleep center then called me for an APAP fitting. It's the sleep center that has been calling me trying to get me back in for a fitting. So in my case, the sleep center (their actual business name is Epoch Sleep Centers) and the DME are one and the same.

To further explain the closeness of the entities involved: when I did get a copy of my test results, they have the sleep center's letterhead printed at the top, with the 2nd page containing the pulmonologist's digital signature under an "Interpretation" section. So the collaboration between DR/Sleep Center/DME seems pretty close.

[Julie]

Which usually means they're getting kickbacks and/or are owned outright by the same people (doctor, DME, etc), but you should talk to your insce. co. and ask which other DME's you can use because you want the most freedom of choice when picking machines, etc.

[zonker]

My question is, can a patient pursue alternate treatments FIRST or must they go down the CPAP/APAP route no matter what?

well, i have two answers.

1. this is CPAPTALK.com, so folks are here, in the main, to promote and help with cpap. (yeah, i know, that was me being a bit of a wise ass, but it's true.)

2. in my little time of three years here, i haven't seen any of those alternate treatments actually work and allow some one to put their cpap aside. oh sure, every now and then we have some drive by poster tell us that some alternate thing "cured" them. but they rarely, if ever, show us follow up sleep studies that SHOW they have been cured.

just my two cents worth.

good luck!