Results/Picking CPAP

[Reflection]

Hello all,
I am new to this. I had a sleep study in early May and thought everything was hunky doorie, since the tech never put in on the cpap machine (I had a friend that had one recently and they fited him that night). Well, first I get a call from my doc saying he made me an appointment for an ENT, it is this Friday, plus the sleep center called and requested that I come in for a second study to be fitted for cpap as the results came back that I had sleep apnea. That appointment is next Monday.

So, I decided to pick up a copy of my results to see what all the fuss was about. I was hoping that someone could help me read the results....and then also I am looking recommendations on cpap, just to be a little educated when I go back in next week! Thanks in advance for your help!

The report was one long paragraph so I still put it hear word for word but spaced to be able to read easier.

Sleep time: 417.5 minutes
Sleep Latency: 3 minutes
Wake after sleep onset: 73.5 mins
Sleep Stages:
N1: 17.1
N2: 55.9
N3: 15%
R: 12%
Rem Latency was 134.5 mins
42 awakenings by count
284 arousals, half, 136, were spontaneous, however 38 from apnea, 39 from hypopneas, 23 from snores
Arousal index quite elevated at 40.8%
Sleep efficiency was 85%
EKG showed a steady sleep average of 74 beats per min with normal sinus rhythm
Respirations eventually showed 51 apneas, 54 hypopneas, developing late at night, for an overall AHI of 15.1. This was particularly severe in supine which really only emerged in the last hour of the study.

Fractional supine AHI 120. There were 11 obstructive apneas, 10 in supine and non-REM and 1 in supine awake, 37 central apneas, 33 in supine, 4 in non supine, non-REM, 3 mixed apneas, 2 in supine and 1 in non supine, non-REM and 54 hypopneas, 23 in supine, 30 in non supine, non-rem. Interestingly, no ever occurred in REM.

Oxygen saturation 95.4%, lowest 89%, desaturation index 3.3, mild intermittent snoring was heard

Electromyelogram showed 29 PLMs, movement index of 4.2, movement arousal index of 2.7.

Electroencephalogram showed 4b brief REM periods, none of them in supine

[CanadaColin]

I to am very new to this CPAP life. I picked up my equipment last Friday and have had a very smooth experience so far. This is because I spent about 4 or 5 hours minimum reading the various posts and clicking on the light bulb in the sites header to educate myself (over a two week period). Fortunately my costs have been covered 100% by the Gov't and my work insurance. I was able to pick the equipment I really wanted for my requirements. This choosing equipment seems to be a very personal matter. My father-in-law has a completely different setup and he to is very happy. I have asked a question on the forum and got an immediate answer. Fabulous site. Good luck.

[timbalionguy]

It looks to me like you have an apnea problem that is quite position-dependent. Since most people change position while they sleep, their therapy needs change as they sleep. Your second sleep study (called a 'titration sleep study') will help your doctor decide how much pressure you will need with your machine for effective therapy. Although your apnea (for the most part) looks to be fairly mild, some people need quite a bit of pressure to get good therapy.

I am hoping your doctor will eventually suggest an autoadjusting CPAP, or APAP. If not, ask him/her about it. These machines automatically adjust to your pressure needs, keeping the pressure as low as practical to ensure good therapy. When you need more pressure due to apneas or hypopnas, the machine will raise the pressure automatically.

You should also ask for a 'fully data-capable' machine, which will record the details about what goes on at night, and let you review them later. You often will not get this feature unless you ask for it, or purchase your machine online.

Above all, spend lots of time exploring the forum here, and learn all you can!

[Slinky]

Some of these sleep professionals, especially local DME providers, like to play dumb when it comes to CPAPS and our PAP terminology. Instead of asking for a fully data capable CPAP, ask that your scripting doctor include the phrase "access to Leak, AHI and AI" on your equipment order (script). Some of these local DME providers like to try to pass compliance data capable off as fully data capable. Duh.

And whilst you are at it you might also want to ask your scripting doctor to include the phrase: "full face, nasal cushion, nasal pillows or oro-nasal mask of patient's choice" and some of these local DME providers also like to play games w/the mask issue too and will try to avoid providing some of the more expensive masks we ask to try. The 4 different style masks have different HCPCS (insurance) codes so they can get away w/it unless you script is worded as suggested.

Now would be the best time to call your insurance and ask them what local DME CPAP providers they are contracted with. Hopefully you will have the option of more than one. And then before committing to one it will be well worth your while to "shop" each of your options first. You will want a local provider who has a lenient mask exchange policy, who has an easily accessible to you RRT and that that RRT also be someone you feel comfortable working with.

IF you have strong feelings on a particular brand of PAP you are going to want then be aware that most local DME providers buy their PAPs in bulk to get a better price and therefore prefer to provide that brand PAP and are more willing to bargain/negotiate on PAP model if you are willing to accept their preferred brand of PAP.

If Apria or Lincare are amongst your options it becomes EXTREMELY important that you check out the local office you would be working w/as neither Apria nor Lincare have particularly good repuations amongst the PAP user community and yet there are some good local Apria or Lincare offices. You have no way of knowing whether your local branches are good or bad w/o shopping them BEFORE committing to them.

And whilst you are at it you might just as well ask your sleep doctor for copies of his dicated results (1-2 pages each) and the full scored data summary reports w/condensed graphs (5+ pages each) from all of your in-lab sleep studies PLUS your equipment order (script) so that you can shop your local DME provider options to find the one most comfortable and convenient for you to work with. KEEP the originals, ONLY provide copies to any DME provider you opt to use. You never know when traveling that your PAP or accessories may be lost, stolen or broken and you would need a copy of the script to replace them where you are at.

[Reflection]

Wow. Thanks. I don't know how I will remember all this. Guess I will need to print this out or make a crib sheet. I don't understand half of this. But thanks a ton!!!!

[dtsm]

Wow. Thanks. I don't know how I will remember all this. Guess I will need to print this out or make a crib sheet. I don't understand half of this. But thanks a ton!!!!

immediately above this page is a series of 'icons', one of which is a 'new users' hotlink that leads you to: our-collective-cpap-wisdom.php. Memorize this - just kidding.....

Seriously speaking, read as much as you can digest, skips to parts of interest but eventually read it all. Lots of good stuff from lots of smart folks here....it was a tremendous help when I first started.

1. Get a fully data capable machine and the hardware/software to monitor your progress.
2. Post your equipment when you get it
3. Post some img when you're starting therapy

Lots of folks here to help you out.

Good luck!

[brazospearl]

Welcome, Reflection! You're in the right place to get lots of good info and help to improve your health. Slinky gave you excellent advice, please print that out and study it so you can get the wording correct on your prescription. It's VITAL that you have a fully data-capable machine, and the ability to exchange any masks that don't work out. Seriously. Those are key to successful therapy. An auto-titrating machine can be helpful, but many folks manage fine with straight CPAP. There's lots to learn (especially these words! Gadzooks! CPAP, APAP, BiPap, AHI, AI...what does it all mean?!) but we'll help you all we can.