About to purchase my CPAP machine-Questions

[cdnduck]

Next week I will meet for the last time with my doctor and service provider. I have been using the rental machine now for 3 weeks, on mask #5 getting better but still now there yet. I have managed only twice to sleep through the night with my mask on. (The first time was the very first night on CPAP and the second was during the second overnight sleep test).

The service provide told me last week (when I was there getting my 5th mask) that on the 9th, you will have to choose which machine you want. HELP is needed

Since I'm still new, I don't know all the terms but this is what I learned from the first sleep test:

PSG Summary Report

Total Recording Time: (TRT) 383.3 minutes
Total Sleep Period Time (TSPT) 373.8 minutes
Total Sleep Time (TST) 265.5 minutes
First Sleep Latency: 9.5 minutes
Number of REM periods: 3
Number of Stages shifts: 356
Number of Awakenings: 86
Sleep Efficiency: 69.3%

Apneas + Hypopneas: 372
Apneas + Hypopneas Shifts: 84.1
Min SaO2% 59.0


Can someone explain to me what all of this means, and guide me towards what machine I should purchase? Currently my pressure is set at 12 mmH2O and the starting pressure is at 5 mmH2O. I used the ramp up option almost every ngight however I believe my breathing patterns are not matched by the machine as it is still differcult to exhale.

Thanks

[TiredMominCanada]

Hi Cdnduck, (Does this mean you are a fellow canuck?)

I'm pretty new to this whole thing too. I still have my loaner machine and haven't really played around with masks too much yet. I go next Thursday for my appt with the RT at the supplier. I think at that point they will encourage me to buy the machine however my second sleep study isn't until October 10th so I will push them to wait until I get my final prescription.
If you are someone that wants to track your progress and your numbers I advise getting one of the fully data capable machines. (Of course these are the most expensive ones)
My loaner machine is the RESMED S9 and I really like it, it's quiet and has the heated humidifier and hose option which will be great in the winter (otherwise the hose gets full of condensation). It has a feature that lowers the pressure on exhale. Also it is a fully data capable machine so I can keep track of my own progress. I truly believe that you need to be informed and not count 100% on the doctor to make the best choice for you. I'm sure someone much more knowledgeable than me will pop on and give you some info about the data that you posted (I think your AHI number is going to be pretty high but I'm not going to guess!!)
Anyways, welcome and good luck!

[JO'M]

If you are Canadian, tell us what province you are from. purchase/rental/reimbursement of CPAP machines are handled differently in each province.
There are members from different provinces who can help you out.

[cdnduck]

I live in Ontario in a small town outside the Greater Toronto Area. The numbers to me mean nothing, however the doctor stated that I'm one of the worse cases he has seen, and he told me that usually he can give his patients a few options, but for me there is only the CPAP machine option.

[Xney]

Since CPAP is the best option, that's quite alright.

[DiverCTHunter]

Since I'm still new, I don't know all the terms but this is what I learned from the first sleep test:

PSG Summary Report

Total Recording Time: (TRT) 383.3 minutes
Total Sleep Period Time (TSPT) 373.8 minutes
Total Sleep Time (TST) 265.5 minutes
First Sleep Latency: 9.5 minutes
Number of REM periods: 3
Number of Stages shifts: 356
Number of Awakenings: 86
Sleep Efficiency: 69.3%

Apneas + Hypopneas: 372
Apneas + Hypopneas Shifts: 84.1
Min SaO2% 59.0

Here's a quick breakdown of what your numbers mean. Please remember that most of us are not doctors

You fell asleep 10 minutes after lights out and slept for about 4 1/2 hours. I'm assuming that you had a split study based on your min SaO2 number (more about that later)

While you were asleep, you hit REM (dreaming) sleep 3 times, and your brain shifted between the 4 sleep stages (N1, N2, R, N3) a total of 356 times. 84.1 of those shifts were caused because you stopped breathing. This is a problem, but here comes the worse part.

While you were asleep, you stopped breathing 372 times and your blood oxygen level dropped to 59%. Anything below 90% is cause for concern, but your level was in organ damage territory.

At this point I'm assuming that the sleep tech stopped your baseline study and put you on a CPAP then. Not doing so would be criminally irresponsible. The rest of the night would have been your titration study, where the sleep tech slowly increased the CPAP pressure until you breathe normally.

Next week I will meet for the last time with my doctor and service provider. I have been using the rental machine now for 3 weeks, on mask #5 getting better but still now there yet. I have managed only twice to sleep through the night with my mask on. (The first time was the very first night on CPAP and the second was during the second overnight sleep test).

The service provide told me last week (when I was there getting my 5th mask) that on the 9th, you will have to choose which machine you want. HELP is needed

I assume by the 9th, you mean 9 October.

Based on the humidifier you chose, you have some flavor of the Phillips Respironics System One xPAP series. If you disconnect the blower from the humidifier and flip the blower over, the sticker will say which model you're using. This particular series uses a 3-digit number like 550, 560, 350, etc... to indicate the model and revision.

[Janknitz]

The AHI was 84 per hour the way I see it. 372 Apneas and hypopneas divided by 4.41 hours of sleep. That means you stop breathing for at least 10 seconds 84 times per hour, more than once a minute. Try holding your breath for 10 seconds or more 84 times in a single hour. I promise you'll get at least a splitting headache.

You need this treatment, and you need to use it EVERY night, ALL night and whenever else you sleep. With your O2 sats going so low at night, you are in grave danger.

Push for a machine that has full EFFICACY DATA--that means that it shows more than just hours of use, it also shows how many apneas and hypopneas you have each hour, leaks, and waveform data. Even if you have to pay a lot out of pocket, you NEED an efficacy data capable machine to ensure your therapy is working optimally.

We can help you get used to the machine and mask, but try to get the best machine you can get so that we can help. My "What you need to know before you meet your DME" is geared toward US residents with US insurance, but there's basic information on my blog about machines and the types of data they offer.

[TiredMominCanada]

OHIP will pay $780 towards your machine. My quote for the RESMED S9 machine was almost $1800 for the machine, humidifier, hose etc. I think they also include a basic mask and some other stuff like mask wipes. My out of pocket after OHIP pays will be about $1000. If you have health insurance through work, they may cover some of your out of pocket. The basic machine (no data) quote was around $1000 (so about $200 out of pocket).
All the best to you. I'm really glad you are getting treatment!

[JO'M]

Are there any other suppliers in town or nearby? You should be able to try out the machine and masks before committing to buy. If this DME, will not let you do this , then I would find another supplier if possible.

In my case, I borrowed a CPAP machine from the DME for 5 weeks, until I saw the sleep dr for a follow up appt, during that time I tried out about 6 different masks. When I went back to the sleep dr, he decided to try me out with APAP, so now I have a PR APAP machine for 2 weeks and then I go back to the DME to pick up a S-9 autoset to try for 2 weeks.

As far as what is covered in ON

Your Dr should give you your prescription and fill out the application for the Assisted Device Program. You take the completed app to the DME and they should submit to to the Ministry of Health. ADP will pay 780 towards a CPAP system or 1180 towards an APAP system. A system is the machine, a heated humidifier, basic mask and headgear, carrying case, 6 ft tubing. If you have supplemental insurance, they may pick up a portion of the remainder.

Here are a couple of threads on the subject.

viewtopic.php?t=81041
viewtopic/t81041/viewtopic.php?f=1&t=77 ... 11#p707311