What questions should I ask my sleeep doctor?

[Scuba_Steve]

I am going in Thursday to see my sleep doctor to get the results of my triation study. Also, I hope to finally get the settings for my CPAP machine, it was issued to me 4 weeks ago with just the default settings. I have a little over 200 hours on my CPAP machine and in the absence of any information from my doctor I have played with all the settings. This is my first visit since the triation study, and I want to make sure that I ask all the right questions. It has been a painfully slow process, it's taken me a little more than 2 months to get to this point. Thus far it's been very discouraging so I am anxious to start seeing some results pretty soon. There are really only two issues that I have.

1) My nasal pillow mask seems to need adjustment whenever I change sleeping positions at night. I am hoping that I can switch to another style. I am concerned that after wearing the nasal pillow mask for a month they may not allow me to exchange it.

2) I am far more tired now than before I went on CPAP. By my own experimentation I've settled on a pressure setting of 11.5. Assuming that my settings are in the ball park of the "prescribed" settings, is there anything else I could request to get better results?

Are there any other questions I should be asking? This whole CPAP experience has been very disappointing, and very expensive too. I want to give it a fair chance, but so far I'm ready to chuck it out the window. Any advise on what to do during my upcoming doctor visit would be greatly appreciated.

[snoregirl]

I see you have a swift like I do. I love mine but there are issues wtih any interface.

There are a couple things you can do to make it more stable. If you have any hair you can put the bottom strap under the hair. I use an ace bandage from under the chin to the crown of the head. Stabilizes it even more. Overall though, the Swift can get bumped around and it is tough (for me at least) to really side sleep without practice.

There are many other threads on using the swift with other opinions.

Is your machine an APAP? since you were setup with no real pressure?

See what you were titrated at. Can you get data from this machine? If so you might want to get a look at that. Or if you can't consider a machine that can give data.

Waking up to adjust the interface can be as bad as the apnea itself. All does the same thing. Stops you from progressing into deep sleep. That said, if you can't tame the swift, you might want to consider trying another type of interface.

Are you mouth leaking? If so have you tried tape?

[Sleepless_in_LM]

First, I find it hard to believe that anyone would issue you a CPAP without a programmed pressure ordered by your doctor. That is just plain crazy. Are you sure they didn't set it up according what your doctor ordered, and they just never told you what the pressure was? That is not to say that the pressure learned from a titration study is always accurate. Mine certainly wasn't what I needed.

As for the swift, it is like every other mask. It works great for some people and not so great for others. If it is not working for you, ask for a different mask. Explain how you sleep and your problems, and they will probably have some suggestions for you.

Questions to ask....hmmm...let me see if I can get you a start and others can add to it.

First I would discuss your sleep study. Ask for a copy of the complete study. Find out where your AHI was. Is it all Obstructive Apnea, or were there centrals, or a mix. Playing with your pressures without knowing this can really be dangerous.

Ask for a copy of the prescription or order for your CPAP machine. It should list the proper pressure. Talk to your Doc about why the pressure you started at didn't feel right and discuss your experimentation up to this point.

Discuss the actual machine you have. I looked it up off your profile and must admit I never saw that one before. Although its selling point is humidity, it has no data capability that I can see. Most on this board find being able to track their data a key to tweaking their therapy.

Discuss the possibility of trying an auto machine for a while to find the most optimal pressure. Even discuss the possibility of changing your order to have an auto with data capability. Then you really have the best equipment to move forward.

Notice I used the word "discuss" a lot. Hopefully your Doc is one willing to do this. It takes more than just a few yes and no questions to understand where your at and what direction you need to go. And if you don't get real far with the Doc, then come back here with info from your sleep study, your pressure, your equipment, etc and these wonderful/knowledgeable people will help you find a way to get where you need to be.