Final month for the insurance

[jghost]

Hi fellow CPAP users,

I have just been recently prescribed a CPAP (APAP) machine. I have a OSA index of 57.5... 20 is upper threshold for moderate apnea for those who are not aware... so I have been living most of my 30yrs of life with no therapy on that index... and I felt fine until my doc told me that my heart wall is thicker than normal, according to an EKG. I also got diabetes along the way... not sure if it's purely due to OSA as my lifestyle during grad school was questionable. Anyway... so now that I am on the CPAP machine from a sleep solutions company nearby I have gotten this email from one of their techs telling me that I've used it over 4hrs a night for only 30% of the time in the past 2 months since I got the machine. Starting yesterday I need to be using it 4hrs+ every night for 70% of the time or I'm liable to pay the full sum of the machine or return it (or go back to the doc). I am torn between the two choices.

First, I can't keep the mask on because the tip of my nose itches at night after I fall asleep. I sometimes wake up to it and the itch is very intense. I read that some people put cream on their nose and that works due to dry skin. I doubt it's that because I always wake up with an oily nose and I doubt it's dry skin from the way it itches... but I would always wake up with the mask off. I do try to put it back before I go to sleep but I'd always wake up with it off... and I don't even know when this all happens. Lately the mask started to leak too... which wasn't the case before. I also had to tighten it so much at first that I wake up with an imprint on my forehead every morning and I had to loosen it up and still worked... I don't want to return to that. I also had to get the clips replaced too at one point because I totally broke it off from tearing it off my face every night. And honestly... I don't feel different waking up with or without it on.

Second, I am thinking about just returning this machine at the end of the final month and going to a different set of health care providers period. I have the choice between the University of Michigan sleep center or this small operation in the nearby town (there are a few nearby) and I chose the small operations because I heard the U of M sleep center has a long wait. The problem was the doctor didn't at all even consider the APAP for me even with complaint of suffocation until I ended up with cases of partial sleep paralysis where I woke up to a red dot in my vision increasing and scaring the living daylights out of me. The sleep solutions center that provides me the devices provides nothing but Philips Respironics, which from what I heard is not recommended for Michigan due to the dry winters we have here... ResMed is the recommended one. I mentioned it to their technician and the guy totally went berserk on me with anger by gently recommending ResMed and APAP machines. So either way... I'm thinking of that... but that means no APAP machine until I get an appointment with U of M unless I don't mind shelling out an extra $1000.

What would you guys do if you were me?

Thanks!

[jghost]

Another note on the itch... it's exactly where the airflow drops off, like that cutoff for aerodynamics. So no wonder it itches, the airflow dips off at that point and the dip off in airflow must be what makes my nose itch.

[jghost]

Should I also try nose pillow? I at least used to have nose obstruction that forces me to breath through my mouth, which I think might be what caused the apnea in the first place. But now with control of my allergies, the Snorestopper spray and Zicam allergy spray I am only totally stopped up in the spring and when I get colds/flus... so is it worth trying the nose pillow when my nose is clear? It's quite an investment during the Christmas gift season.

[Julie]

You made no mention of using a humidifier (the one that comes with the machine), which might make a big difference to your itchy nose), or what pressures your machine's set at... might help us to advise better.

[Pugsy]

Exactly which System One machine are you using? What is the model number?
Model number is a 3 digit number on the bottom of the blower unit...might have DS or REF in front of it.
You say you have the System One humidifier in your signature line....what setting are you using?
Model number is import as it affects your choices for humidification.

Regarding compliance hours....wear the mask and machine while watching TV to get the hours of use increased. The machine doesn't know if you are awake or asleep and the hours of use will be counted even if you are awake.

[LSAT]

Hi fellow CPAP users,

I have just been recently prescribed a CPAP (APAP) machine. I have a OSA index of 57.5... 20 is upper threshold for moderate apnea for those who are not aware...


Thanks!

Actually...just so you are aware...moderate sleep apnea is between 15 and 30. Over 30 is considered severe.

[jghost]

Thanks for the response so far... I'm at work so I'll get the model number when I get back. I think the humidification is fine... because if it's too dry I'll feel it in my nose/throat. I have it on heated setting at 4 out of 5 setting... and it definitely feels sufficient. If it is at 5 out of 5 I feel like the humidity might be a little too much as it feels like i'm in the rainforest trudging along or something. One of my friends says that condensation might build and there's no condensation so my tube might be heated or something is working so that the humidity doesn't condense. Our guess right now is that sometime during the night my mask would get a leak and the airflow from the leak will cause the airflow to feel like a tickle and it adds up.

After reading the replies and talking with my friend I have decided that to play it safe I'll: start using the machine in the evenings while awake to fill the 4hr quota. Once it's filled I'll explore other healthcare providers because it really feels like my providers have a "special interest" influence on their decisions... and since U of M has a long wait I really should wait with a machine as opposed to without. My friend said it took him almost a year to not rip his mask off.

Btw, thanks for correcting me on the moderate vs. severe index. I never hit stage 4 sleep and way below average in stage 3. My oxygenation falls below 40% at times and I stop breathing for like 30secs at a time according to the study... it's pretty bad. They tell me that I'm the most awake person who should be sleepy that they've ever seen. This was while I was diagnosed under a John Hopkins professor while living in Maryland.

[Lukie]

I use a Quattro Air mask and you can scratch and itch through the hose hole. All you do is detach the hose and dig in until the itch is satisfied and then return the hose to the hose hole.

[jghost]

Would the constant detaching and reattaching the hose make it a "loose fit" and cause it to not attach tightly after awhile? At the moment I do think it's probably a better idea to unsnap the clip and reach in that way... the clip is designed to be removed on a regular basis. But yeah, it actually doesn't matter as this all happens in my sleep... I am not at the liberty of telling myself what to do while unconscious.

[Julie]

What about trying a little bit of band-aid sticky (end) on your nose to see if it helps?