Back in America, how do I resume treatment?

[Prevail]

Hello,

I was diagnosed with Sleep Apnea in Korea over a year ago when I was living abroad. Because of language barriers and unfamiliarity with their health system, my current treatment is CPAP which I am using without one of those CPAP companies that monitor you. I have just been doing it by myself with the help of this forum. Now that I am back in the US, I would like to continue treatment because I still feel fatigue although my apnea events is in a health, normal range.

So I would like to know how I go about seeking treatment here in the US. I do not know where to start and what kind of doctor I should seek. I have records of my sleep study in Korea and I hope to not have to go through the cost and time of doing all the diagnostic work again.

Prevail

[adrianne]

Do you have insurance in the US? If so, they'll really tell you what you can and can't do, unfortunately. They may require another sleep study.

[Julie]

If you can be seen by a pulmonologist, that would probably be a good start, and/or a neurologist with some background in sleep problems... you may need to be referred by your family doctor depending on how things work there, but other than that everyone on the forum will help you.. Have you considered that you might still be tired because you sleep with your mouth open and lose Cpap air that way? In which case either a trial of a 'full face' mask of some kind might be a good idea, or else taping (a forum search will explain it better), and what about your habits re exercise, alcohol, etc. before bed, how many hours you get, what specific problems you've noticed along the way that could be factors.

When you talk about being monitored, I am guessing you mean that your 'compliance' is checked every so often - and that's usually done for the insurance companies, but tells you nothing about your condition or progress, so having a machine that records the important stuff like AHI and leaks, etc., is a good idea as long as you have a computer and the right software.

If you can give a bit more information about yourself, the pressure(s) your machine's set to, anything else you can think of, it would help as well.

[Prevail]

Thank you for the reply. I have insurance and I've posed the same question to them, so I'm just waiting to see what they say.

I've tried taping before but since then, I believe I've trained myself to sleep with my mouth closed. Wouldn't it show up as an apnea or leak event on the CPAP machine? My machine never showed any leaks, but I know that they used to be a problem before. It's been a long time since I woke up feeling air rushing out of my mouth or having a really dry mouth. Now, if I wake up with a dry mouth, it's because my water ran out.

I forget what my pressure is set to because I haven't adjusted it for a long time. It's pretty low though, I think it's around 6 or 7 but I can check when I get home. I experimented with the pressure to get the lowest AHI. My AHI is now around 1.5.

As for my habits: I do lots of exercise and my BMI is in the healthy range. Nowadays, I run a couple miles as soon as I get out of bed and that gives me a bit of energy during the day. I have a blu light which I use for 15 minutes in the mornings. I have also given up masturbation all together as I realize that orgasms will drain a man. I usually get 7 hours of sleep. I try to get 8 hours of sleep but when I do, I usually feel more tired or I just wake up after 7 hours and can't fall back asleep. I have tried cutting out caffeine entirely but that doesn't help. I now use it when I have a meeting or something which I want to be alert for. I drink a lot but only on weekends. With caffeine and alcohol, these are things that I staved off of to see if they'd work and when they didn't, I just went back to them to reap the benefits that they give. But isn't this all just moot given the fact that my AHI is 1.5? Before bed, I usually read a book for 30 minutes and stay away from light emitting monitors. I have started using the iPhone sleep monitor which measures movements on my mattress, it shows that I don't stay in deep sleep very much. But I sometimes get some really good nights, although I don't feel it.

When I talk about being monitored, I was referring to the DME or whatever those guys are that supply you with the CPAP machine and keep your CPAP machine output records. I don't have the software as I tried the online system that some guy made and I couldn't make sense of how any of it could help me... again, given the fact that my AHI is already 1.5, it was hard to see where it could be improved.

Prevail

[cowlypso]

Bottom line is that if you're still feeling tired with a low AHI and no other problems with your therapy (like leaks), then you just might need another sleep study to see what's going on.

If you haven't done so in a while, I would start with a visit to a doctor for a full physical. Make sure that there's no other medical reason why you might be tired (thyroid, vitamin deficiency, anemia, etc.). From there, you will likely be referred to a sleep doctor.

How long have you been back in the U.S.? Could it be jet lag or stress from moving?

[GumbyCT]

When I talk about being monitored, I was referring to the DME or whatever those guys are that supply you with the CPAP machine and keep your CPAP machine output records. I don't have the software as I tried the online system that some guy made and I couldn't make sense of how any of it could help me...

ALL that the DME's monitor is hours of use so they can get paid - is that what you want?

again, given the fact that my AHI is already 1.5, it was hard to see where it could be improved.

IF that is in fact true - what are you hoping to improve on?

Honestly, from where you are you would be wiser to go the rest of the way w/o a DME.

Remember the old saying "If it is to be, it is up to me"?

Everything you need to be successful is here in this forum.