Should I get re-evaluated?

[SusanZ]

I have a question about weight loss and CPAP pressure. When diagnosed with OSA three years ago I weighed about 200-210 maybe even more, now I weigh about 161 and still losing weight does my pressure have to be re-evaulated? I am losing weight because I want to not because of an illness. I am having problems with mouth breathing, my cheeks are filling up with air while sleeping so that wakes me up. My husband wakes me up and says you are mouth breathing, so obiovusly I keep him awake at night. I have a RESMED Tango w/ humidifier with about 8400 minutes on it and I use the RESMED Swift fx nasal pillows. Also an hour or so before I go to bed I take Zyrtec and generic Flonase for allergies which should be helping with stuffy nose problems. Anyone have any suggestions on what to do? I have called my sleep disorder clinic today, but since it is Saturday I have to wait until Monday.

[LinkC]

It's probably a good time for an evaluation because:

1. It's been 3 yrs.
2. Significant weight loss.
3. You are having problems that COULD be related to your OSA.

All of those could easily change the settings you need for optimal CPAP therapy. Since you are not monitoring it yourself, it's probably time to see your doc.

[slapmeawake]

Yes, you should. I started mouth breathing for some reason, after I lost weight and my pressure requirements went way down. You could be mouth breathing because your pressure is too high now.

[blusaber]

HI

I did a new study after 35lb weight loss and needed lower pressure I also asked for and received an auto machine since I intend to lose even more weight. My mouth was popping open and getting dry mouth where for the last nine years I had no trouble at all.

Congrats on your weight loss and keep up the good work

Gary

[SusanZ]

I am getting re-evaluated tomorrow 11/30/2010, hopefully my doctor get things to where I can sleep better at night and get my Nutrisystem diet back on track where I can start losing weight again. The mouth breathing/pucker and purging with my cheeks is annoying for both me and my husband want it to stop, glimmer of light at the end of the tunnel. It might take a few days though to get my prescription to my CPAP provider and for them to come out or me to go in to get my pressure to where it needs to be.

[jlk]

Congratulations on the weight loss!

You need to do 4 things;
1,prevent mouth breathing.... chinstrap, tape mouth shut, ffm....Can't be loosing that therapy air
2, get re-evaluated, preferrably re-titrated so your current pressure is set correctly..
3,ask for a prescription for an "auto "cpap, as you plan to loose more weight.
4,do not accept anyhing less than a fully data capable machine.
You were given one of the lowest-end units out there. The dme providers are allowed "X" amount of reimbursment for the HCPS billing code for a cpap unit, the cheaper the unit you get, the more their profit. The dme place you received your Tango unit from made over $1000 profit off you! When you get a Data capable unit, if it is a Resmed brand (S-9 auto is very popular here,) you can get free software on this forum and be able to track your therapy daily on your computer. Your insurance should accept the need for a unit even before the customary 5 year replacement period due to needing an auto, your prescription must say "auto cpap", a good dr. should not have a problem writing that prescription due to your changing needs. Keep us posted, john

[XSnorer]

SusanZ, I agree with jlk above. Beware, you can't necessarily believe everything you hear from your DME supplier. Hopefully, you have a good DME provider; one with personnel that can provide you with accurate info. Overall, I've been happy with mine but some of employees have provided me with information that I knew was incorrect... and I told them so.

After you get the script for the APAP machine and before you approach your DME provider, you should know which machine you are entitled to per your insurance coverage, and what specific machine you want. If your DME provider doesn't want to provide that machine then find another DME provider.

[SusanZ]

Thanks for the posts, am getting a sleep study (re-titterated) done December 20th. I will definately check into the 'auto' machine, that was something that was discussed when I went to my appointment. I tried a chin strap and I only wore it one night, it made the chipmunk cheeks and purging worse along with the drueling. My doctor said that a chinstrap might help and then again might not. Now I cannot wait until I get the study and they prescribe an auto machine, so I can get some more quality sleep soon. I am a wreck.

[rested gal]

Susan, even if you get a different machine, like an autopap, and even if the study finds that you can use less pressure, those two new things might not prevent mouthbreathing during sleep.

If that turns out to be the case...that you continue mouthbreathing during sleep after getting a new pressure and/or new machine, then what jlk wrote is of paramount importance:

1,prevent mouth breathing.... chinstrap, tape mouth shut, ffm....Can't be loosing that therapy air

"ffm", by the way, is "Full Face mask" -- a mask that allows you to get cpap air either way -- through nose breathing or through mouth breathing.

If you get a machine that can show AHI and leak data, whether it be a cpap or an autopap, and get the software for it (ask here on the message board about software and someone will PM you info about that) you won't be able to tell if "leaks" are coming from the mask or from the mouth (unless wearing a Full Face mask.) You'll know only that there is an excessive leak rate. But that will be a start toward being your own detective and figuring out which is the culprit for a high leak rate ... mask getting dislodged...or... mouthbreathing.

Congratulations on the weight loss!!!