Buying an APAP without sleep study

[eyestar]

Hi everyone,

Total newbie here and first post. Cut a long story short, I am absolutely convinced I have sleep apnea. Every telltale sign under the sun including the big one, no decent sleep in years hahaha. I also catch myself stopping breathing all the time when I'm awake, let alone asleep........

However, I live and work in rural, rural Japan and intend on staying here for years. Money isn't an issue, but hospitals, language, equipment and just the all round hassle of it all is. Therefore, I'm wondering what all you experts think about me just going out and buying an APAP machine? I've been looking at the forums and I like the sound of the APAP as it regulates air flow automatically seems.

So my basic questions are:

1. Is it perfectly safe to buy an APAP machine without seeing a sleep specialist? And are there any health related concerns in buying one without seeing a specialist? (I have read the 'Not every patient needs to go to sleep specialist here http://www.apneaboard.com/sleep-study-n ... essary.pdf)

2. For a total newbie who travels a lot, would the Transcend Auto be a good choice?

3. Are there simple instructions on how to set it up for someone who's never used anything like it?

4. When I buy a machine, do they come with hose and all necessary parts included, or do I need to order them separately? If yes, what parts do I need?

Any other info you think might be relevant would be most appreciated. I am no longer in denial, I am on a genuine quest to get to the bottom of my health issues and after talking with my wife and doing lots of research, I hope this may be the first big step. I look forward to your input

[kteague]

If one has garden variety obstructive sleep apnea with no complicating factors, like centrals or complex apnea or lung disease, treatment can be pretty standard. However, in view of not having a sleep study, I would want to be sure the machine chosen reports treatment data that includes recognition of centrals. There is always a risk that you'll get a machine that ends up not fully meeting your needs if something shows up later, but that can happen even with a sleep study. Some people develop centrals in response to pressure. Some need a pressure high enough to need a bilevel machine. If none of the outliers apply to you, you'll probably do just fine with your plan. Machines do not generally come with the rest of the needed equipment. You will likely need to purchase separately any hoses and mask, and maybe even the humidifier and filters. Pay attention to if any small connector hoses are needed with your mask choice. When you say "rural, rural Japan" I'm wondering if the available power is reliable? If not, backup power may affect your machine choice. I'll leave machine recommendations to others more informed.

Don't know where you are located in Japan, but family members have been in the Sendai area a few times and they absolutely loved it. Good luck with treatment endeavor.

[JimP]

The problem would be centrals.

I suppose you could get a bipap machine, set it to automatic and use a recording oximeter to track your oxygen level. If your oxygen drops where it shouldn't, you'd know that you have more going wrong (possibly centrals). Taking that route, you'd take a chance on buying the wrong machine but that might be the still be the best option.

Then you've got the whole mask business to deal with. Don't know how you'd deal with that short of buying two or three mask and try them out. That can get expensive.

The prevailing thought is to go to a sleep lab but as most of us found out the hard way, they get things wrong and we wind up taking our treatment into our own hands anyway.

[eyestar]

Thanks for the advice, its much appreciated. It seems like the prevailing thought is that a test in a lab would be most efficient and effective. But otoh, if they can sometimes/often get things wrong, then what exactly is the point of that?
You mention a bipap machine. No recommendations for the APAP?
And as for trying out masks, are there not specifically recommended masks that go with certain machines? Or are masks/tubes etc completely independent of machines?
Typically, the medical service here is great, but when it comes to highly specialised things they are miles behind the west. Hence my reluctance to both er with something that could ultimately be pointless anyway......

[Pugsy]

Don't go with the cheap Transcend at all...
If you want to go the DIY route get either a ResMed AutoSet or a Respironics APAP...and given your circumstances I would lean heavily on the ResMed AutoSet because if you do have OSA and happen to need pressures in the teens then I think that Resmed's form of exhale relief is likely to offer more relief...ResMed's exhale relief (EPR) makes the machine work like a bilevel machine of sorts.

Either one of the 2 brands (in the newer model lines that use SD cards) will flag centrals...so if centrals are an issue you will be alerted to them and can then cross that bridge if you come to it.

People do self diagnose and self treat and it will work as long as there are no complicating factors and you don't have any complicating underlying health conditions (mainly lung issues).
It does take some serious education on your part and using a machine that has full data that is easy to obtain and comprehensive with software. The Transcend isn't the machine to use at all.
Stick with one of the two main players in the cpap/apap market.

Check out secondwindcpap.com for machines.
Be aware though....Japan's customs may throw a monkey wrench into the mix. I know one person who had to produce the RX so he could get the machine I sent him out of customs jail .

Masks are separate purchases...setting up these machines is easy though.

[grayghost4]

I have several new and used machines that I can ship to you, no script required
... do you have a reshiper in the US ... not sure about shipping to Japan.

http://sfbay.craigslist.org/eby/hab/5300386429.html

http://sfbay.craigslist.org/eby/hab/5286998773.html

or a bipap:
http://sfbay.craigslist.org/eby/hab/5286996463.html

PM if intrested

[Guest]

Thanks so much for the info. Im tied up now but will write more later this evening. I have no underlying health issues except stubborn high blood pressure that wont go down despite my 4th round of BP meds. Im 42, male, 63kgs, very physically active and a horrible horrible sleeper. I often catch myself stopping breathing in the day and often just before im about to nod off. Suffer from anxiety too so im really hoping that this horrible sleepless life i have may be the cause of it all. If it isnt, at least i hope it will give me more than 2 hours uninterrupted sleep each night.......

[Guest]

Oh, and as silly as it sounds, i have a tongue the size of gene simmons, i kid you not. Great party trick, but im wondering whether this giant fat tongue of mine might be somehow related to all this.....

[Julie]

Most likely is a big part of the cause of your OSA... when you lie down (esp. on your back) and it falls backward, blocking your airway... classic, really.

[eyestar]

Yes I figure my fat tongue may be more hindrance than help..... So a problem i have now run into is the sneaky japanese health system doesnt allow individuals to purchase CPAP.....rent only at extortionate prices. So my issue is this: what about will the difference in voltage have on any machine i bought in the US?? The area in Japan i live uses 100v and 60hertz. I understand the US uses 120v and 60 hertz. I dont particularly want to shell out the money for a machine to be shipped from the US only to find it doesnt fun tion properly, if at all. Does anyone have any exerience with this, or know where i can purchase a machine specifically designed fr exPort to Japan? I am looking at the resmed s9 auto at the moment. Thank you!!

[Julie]

You just need to get a converter or adapter (it plugs in the wall between your machine and the wall) at whatever passes for a hardware store there. Hard to believe it's the only time you've run into this issue, but I doubt if you'll find appliances or accessories sold in the US for overseas countries. Now watch someone else come along here and tell me otherwise!

[eyestar guest]

Thanks. No its not the first time ive had this issue, but it is with a purchase that could potentially head towards $1000. Plus, for whatever reaskn, some appliances seem to work well via adaptor, some not so well. There are long lists on japan related boards regarding the type of products that seem affected/unaffected by adaptor use.
If Japan rents out machines to people, then im guessing there must be skme machines that have power systems adapted specifically for use here......i wonder if they can be contacted?
Anyway, everyone's help is much appreciated!

[Julie]

I think the only issue (should) be that we use 120 here and they use ... whatever they use, and in Europe it's something else. But while you can buy adaptors here to use there - and if you have contacts here to help, great, but wouldn't it be faster and easier to get something there if possible?

As far as diff. appliances using diff. voltages, etc., I don't think that's an issue. Obviously large ones like washers, fridges, etc. might use different grades, but the basic power thing should be the same... and all Cpaps and most small appliances here all use the same thing. I'm sorry I don't know the terms well enough... not that techy , but I get the concepts. Went to Australia a couple of yrs ago and had o trouble with anything.