Just diagnosed

[gschamel]

I recently had an in home sleep test performed over a 3 day period. (in home because I live at high altitude, 9600 ft). The test results show and AHI/RDI of 20, 49 and 56 with an O2 saturation of less than 90% for 80% of the recorded time. The lowest reading was 79%.

I am 6ft tall, weigh 220 lbs and am reasonably active (weight training and biking). So this came as a last resort test after a couple of years of various treatments for insomnia, frequent waking being my most common symptom.

The recommended treatment is APAP with 2Lpm O2 supplementation. I have just purchased a recording pulse/ox device and am waiting on my prescription for the APAP.

Any helpful hints or recommendations for a specific brand of APAP?

George

[JohnBFisher]

I recently had an in home sleep test performed over a 3 day period. (in home because I live at high altitude, 9600 ft). The test results show and AHI/RDI of 20, 49 and 56 with an O2 saturation of less than 90% for 80% of the recorded time. The lowest reading was 79%.

I am 6ft tall, weigh 220 lbs and am reasonably active (weight training and biking). So this came as a last resort test after a couple of years of various treatments for insomnia, frequent waking being my most common symptom.

The recommended treatment is APAP with 2Lpm O2 supplementation. I have just purchased a recording pulse/ox device and am waiting on my prescription for the APAP.

Any helpful hints or recommendations for a specific brand of APAP?

George

I like both Respironics and Resmed. But there are several manufacturers of APAP devices. The field and devices have advanced to the point that most are fairly comparable. Do be certain to request the doctor include "data capable" in the prescription. You want to be able to track your therapy as best as possible. While you will not often monitor it, if you have problems, it's good to have the data.

Sounds as if you have a good set of doctors. I know it can be frustrating to reach this point, but the good news is the therapy should make a big difference for you.

Here's hoping with the good sleep you will feel much better soon. Being in good health and having a reasonable weight will help you "bounce back".

Best wishes, and keep us updated.

[archangle]

Welcome to our community.

Beware the DME (Durable Medical Equipment provider), the local person you buy the equipment from. Some of them are worse than used car salesmen.

I'll recommend to buy a PRS1 (Philips Respironics Series One) REMstar Auto with AFLEX. Be sure it says, "Philips." There are some older Respironics REMstar Autos models. The PRS1 series are MUCH better than the older models in several important ways. It's like paying a 2011 model year price for a 1990 model year car.

ResMed makes equally fine machines. Get the S9 AutoSet. Do not accept an "Escape Auto" machine. Do not accept a ResMed S8 machine. S8 is good, but S9 is better in several ways.

There are some other good brands. I won't disparage them, but I do know about Respironics and ResMed.

Get a heated Humidifier.

Do not let them start you out with a Full Face Mask (FFM). These cover both the nose and mouth. Try to use one that just covers your nose. It's much less invasive to your life, and you can still talk, drink, or even eat while you're doing CPAP. Sometimes you can't make a nasal mask work because of leaks and do need the FFM. Most manufacturers will let you exchange masks for free within 30 days. Be sure your DME will handle this for you.

Where are you by the way? Not a lot of places at 9600 feet.

Find out who your local DMEs are who are "in network" for your insurance. Sometimes, it's good to be able to walk off the lot and go shopping at another used car dealer. Get your prescription directly from the doctor. Don't let him send the prescription to your DME without giving it to you first. It will help you later if you want to save money by ordering supplies online. Or if you want to change DMEs or doctors.

You can order CPAP machines online, but you may not be able to get reimbursed by your insurance. A good local DME can be a great resource to get help with your machine setup as well. It's also a lot easier to try on and exchange masks at the DME. You do pay heavily for the convenience, though.

After that, read up here and ask questions if you have problems.

[gschamel]

Thanks for the comments gentlemen. I've been reading this web site all morning trying to educate myself.

archangle - I live just west of Denver Colorado on top a mountain (as you might expect)

[archangle]

I live just west of Denver Colorado on top a mountain (as you might expect)

If you're going to Denver for a DME, you should have a choice of a number of DMEs.

[cowlypso]

Was your testing purely diagnostic, or did they do some testing of treatments as well? I just wonder because most people don't need additional oxygen while on CPAP. If the only reason your O2 sats are dropping at night is because your airway is collapsing, then if you fix the airway problem, the oxygen problem is fixed too.

I know nothing about CPAP and OSA at altitude, however, so the use of supplemental oxygen could be completely normal and standard there. Or it could be medically necessary in your particular case for a reason that is not readily apparent from your initial post. I would just make sure that it makes sense to you why you need the oxygen before you go through the expense and hassle.

[chrissv]

Do not let them start you out with a Full Face Mask (FFM).

Hi, I was just diagnosed, and am waiting for the CPAP "installation" (therapist comes to the house to set it up).
Regarding FFM vs. nose mask, what about people who breathe through their mouth (primarily) at night?

Thanks for your info,

Steven

[archangle]

Do not let them start you out with a Full Face Mask (FFM).

Hi, I was just diagnosed, and am waiting for the CPAP "installation" (therapist comes to the house to set it up).
Regarding FFM vs. nose mask, what about people who breathe through their mouth (primarily) at night?

Thanks for your info,

Steven

Sometimes you can use a chin strap to stop mouth breathing. Sometimes you can make yourself stop mouth breathing. If that fails, use an FFM.

It's better to breathe through your nose. FFMs tend to have more leak problems since there's a larger contact area. FFMs can push your jaw backwards and make your apnea worse. They're still better than losing all your air due to mouth leaks.

I think a lot of lazy DMEs give out FFMs simply because they don't want to have to bother with exchanging nasal masks for mouth breathers. I think a lot of people who would be better off with a nasal mask end up suffering through FFM problems or even drop out of CPAP because of it.

[gschamel]

Was your testing purely diagnostic, or did they do some testing of treatments as well? I just wonder because most people don't need additional oxygen while on CPAP. If the only reason your O2 sats are dropping at night is because your airway is collapsing, then if you fix the airway problem, the oxygen problem is fixed too.

I know nothing about CPAP and OSA at altitude, however, so the use of supplemental oxygen could be completely normal and standard there. Or it could be medically necessary in your particular case for a reason that is not readily apparent from your initial post. I would just make sure that it makes sense to you why you need the oxygen before you go through the expense and hassle.

Purely diagnostic testing. The testing company sent a package via UPS that had a chest strap, pulse-ox and breath flow device. All attached to a large wrist unit that had a microphone in it and that attached to a bedside unit the size of a large book. Self set-up and take down, UPS it back and they analyze the data. I do know one other person up here on the mountain that uses a CPAP with O2 but I don't know if it is standard. The O2 graphs provided were consistently low throughout the entire night and dropping even lower during the apnea events. I have ordered a "Choicemmed Oxywatch W11 Pulse Oximeter" to check on O2 levels on a ongoing basis.

[ameriken]

Thanks for the comments gentlemen. I've been reading this web site all morning trying to educate myself.

archangle - I live just west of Denver Colorado on top a mountain (as you might expect)

That is exactly what I expected when you said 9600 feet, I figured you had to be somewhere in the high country just west of here.

[gschamel]

Thanks for the comments gentlemen. I've been reading this web site all morning trying to educate myself.

archangle - I live just west of Denver Colorado on top a mountain (as you might expect)

That is exactly what I expected when you said 9600 feet, I figured you had to be somewhere in the high country just west of here.

I guess you're down in the flatlands then?

[Sharppointy1]

Was your testing purely diagnostic, or did they do some testing of treatments as well? I just wonder because most people don't need additional oxygen while on CPAP. If the only reason your O2 sats are dropping at night is because your airway is collapsing, then if you fix the airway problem, the oxygen problem is fixed too.

I know nothing about CPAP and OSA at altitude, however, so the use of supplemental oxygen could be completely normal and standard there. Or it could be medically necessary in your particular case for a reason that is not readily apparent from your initial post. I would just make sure that it makes sense to you why you need the oxygen before you go through the expense and hassle.

Actually, cowlypso, there are many people who need supplemental oxygen in addition to our xpap. I am one of them. I have a lung disease I acquired from my years in the Peace Corps in the Sahara desert. I use cpap @14 with 2 liters oxygen bled into my mask.
For gschamel, welcome! I am a ways to your west and live at about 5000 ft. I use a ResMed machine and like it a lot. There was recent ruling by the FDA that it IS OK to used oxygen in a heated cpap hose. That used to be taboo, which was a pain because I like to sleep with my bedroom as cold as possible and when I couldn't use the heated hose cpap was unpleasant.
If your supplier doesn't show you the trick for hooking your oxygen up AND using the heated hose, ask us here and one of us sneaky warm oxygen users can tell you how to set it up!
Welcome to cpapland; sorry you had to join us.

[gschamel]

Was your testing purely diagnostic, or did they do some testing of treatments as well? I just wonder because most people don't need additional oxygen while on CPAP. If the only reason your O2 sats are dropping at night is because your airway is collapsing, then if you fix the airway problem, the oxygen problem is fixed too.

I know nothing about CPAP and OSA at altitude, however, so the use of supplemental oxygen could be completely normal and standard there. Or it could be medically necessary in your particular case for a reason that is not readily apparent from your initial post. I would just make sure that it makes sense to you why you need the oxygen before you go through the expense and hassle.

Actually, cowlypso, there are many people who need supplemental oxygen in addition to our xpap. I am one of them. I have a lung disease I acquired from my years in the Peace Corps in the Sahara desert. I use cpap @14 with 2 liters oxygen bled into my mask.
For gschamel, welcome! I am a ways to your west and live at about 5000 ft. I use a ResMed machine and like it a lot. There was recent ruling by the FDA that it IS OK to used oxygen in a heated cpap hose. That used to be taboo, which was a pain because I like to sleep with my bedroom as cold as possible and when I couldn't use the heated hose cpap was unpleasant.
If your supplier doesn't show you the trick for hooking your oxygen up AND using the heated hose, ask us here and one of us sneaky warm oxygen users can tell you how to set it up!
Welcome to cpapland; sorry you had to join us.

Just got off the phone with Apria. They will be bringing a ResMed S9 Autoset with heated humidifier up to the house on Tuesday with the O2 concentrator. I requested that they bring a selection of nose masks to try.

On the heated hose, is that an option you need to buy separately or does it come with the heated humidifier? I also keep the bedroom cool/cold especially in the winter whe it is likely to develop condensation.

[gschamel]

Was your testing purely diagnostic, or did they do some testing of treatments as well? I just wonder because most people don't need additional oxygen while on CPAP. If the only reason your O2 sats are dropping at night is because your airway is collapsing, then if you fix the airway problem, the oxygen problem is fixed too.

I know nothing about CPAP and OSA at altitude, however, so the use of supplemental oxygen could be completely normal and standard there. Or it could be medically necessary in your particular case for a reason that is not readily apparent from your initial post. I would just make sure that it makes sense to you why you need the oxygen before you go through the expense and hassle.

Purely diagnostic testing. The testing company sent a package via UPS that had a chest strap, pulse-ox and breath flow device. All attached to a large wrist unit that had a microphone in it and that attached to a bedside unit the size of a large book. Self set-up and take down, UPS it back and they analyze the data. I do know one other person up here on the mountain that uses a CPAP with O2 but I don't know if it is standard. The O2 graphs provided were consistently low throughout the entire night and dropping even lower during the apnea events. I have ordered a "Choicemmed Oxywatch W11 Pulse Oximeter" to check on O2 levels on a ongoing basis.

Just received the pulse Ox meter and my daytime active O2 levels run right at 90%. Probably shouldn't be surprised given the altitude and being a former smoker...

[sister]

hi, be sure to try the swift fx, it is the greatest pillow mask,hardly anything on your face,very light.
my husband and i both use the swift fx,(i use the swift fx for her) and we love it!
i had been trying all the hard masks for 5 years and never could find one that i could use.
when i got the swift i was in heaven.
i have to use a chin strap,my husband does not.
let me wish you the best of luck and hope everything you try goes good!
GOD BLESS YOU!