Need Advice

[stepht]

Hi, I am posting my first time tonight. I have been using cpap since 5/30/07 every night except 9/18 when I flew to Brussels. I am so grateful for cpaptalk.com. I have learned so much here as a guest the last month. Finally, I registered yesterday. I am currently using the mirage ff mask and the swift II nasal pillows. The mirage is causing pain and red marks. I have tried the lanilon product but it didn't help much. I now have the pad a cheeks for the mirage and the swift. They are helping but not with the deep marks from the mirage around the smile lines. I have experimented with a number of chin straps. The tiara ruby seems to work the best.

I have the remstar plus with a smart card. I was really disappointed when I discovered that it only monitored compliance. I need to be able to better monitor my apnea. I don't have a clue about my leaks or ahi numbers, etc.
I spoke with the director of my sleep lab who is willing to do what I need, but I need to be clear about my needs. I had 60 events per hour in REM on my back and much less on my side during my first night's sleep study.

I think I want a fully data capable machine probably a remstar auto with aflex. Also, I want to try out more masks and will measure my face with the directions on cpap.com before I go to the sleep lab to see what full face masks will work better with my facial structure.

The sleep lab director recommended another sleep study especially since my events were mainly in REM. I want to know if my pressure of 11 straight cpap is still working well. I don't seem to be feeling as good as I did right after I started cpap.

Does anyone have any other advice for me or things to consider before I call him this week to follow up? Thanks again for all that you have taught me here.

Stepht

[stepht]

I have the Mseries Plus with C flex.
Stepht

[RosemaryB]

I've had 2 mask fittings when I first started cpap in April, one at the DME and another at a mask fitting clinic given by a local hospital. I looked on cpap.com and found a list of the masks that looked like they might work for me. I was able to try on most of them. This helped me rule out certain masks.

I have problems with my face being marked up by some masks, too. I have rosacea and don't want to make it worse. Here are the masks that work best for me for that:

Headrest (previously called Aura), Nasal Aire II, Swift II, Bravo.

The Headrest is the best one for not marking my cheeks.

I think that you are doing the most important thing (besides compliance) and that is getting the software so you can monitor your treatment. You could have mouth leaks and not know it.

[rested gal]

stepht, the Respironics REMstar Auto / A-flex M series machine you are considering is a very good one. That would be my choice, too, if I were buying an autopap.

That's good to hear that the Medical Director of the sleep lab is willing to help you. Is he an M.D.? If so, he could write you a new prescription for "autopap with A-Flex" and he would have to state a range of pressure for it to be set at, like 7 - 15 cm H2O (or whatever range between 4 - 20 he wanted to state on the Rx.)

If he's not an M.D., then you'd need to contact a doctor to get that prescription. Perhaps your family doctor would write it for you if you explain what it is you want, and why.

Since the Medical Director is talking about another sleep study, he might not be that cooperative without your going through it again. I personally don't see that another sleep study is necessary so soon if the Director's only reason for suggesting that is because most of your events were in REM and on your back, and less on your side. That's when most apneas/hypopneas do hit people...in REM, and when on their backs. Sounds like your problem -- OSA -- has already been diagnosed, and now the only issue is what machine you get to have.

That's where an autopap shines -- varying the pressure depending on what's actually needed throughout the night. I don't understand why he wants to do another sleep study at this point.

An alternative to getting a doctor to write a new Rx for "autopap with A-Flex" is this:

If you are willing to buy the machine with your own money instead of going through the hoops of dealing with insurance and a local DME, you can use your current prescription that says "cpap" set for a single pressure to buy an autopap from an online store like cpap.com. All the Rx has to say is cpap -- doesn't have to have a range of pressures stated on it because it comes preset at the factory for 4 - 20 cm H2O. They will send the Setup Guide with it so you can set the machine the way you think best.

A lot of people on the message board like to use a range fairly close around their single prescribed pressure for the first settings they try. A couple of cm's below the prescribed pressure, and 2 or 3 cm's above the prescribed pressure.

Good luck stepht, and let us know how it goes.