Sleep Med follow-up and a decision to be made

[IDontSnoreISwear]

Hey there fellow Hoseheads.

I've been using my machine faithfully since late August and have been surprised and delighted by the improvements in my health! The diagnosis was "moderate" mixed central and obstructive apnea with an AHI of 26 and desaturations into the 60s for a LOT of the night (ugh no wonder I felt like shit all the time). With desats that low, I'm kind of confused as to why my apnea was classified as "moderate" as I thought that was pretty damn dangerous. If anyone can enlighten me on that, I'd appreciate it.

Getting my first machine was a trial. Long story short, my sleep doc was taking things at a snail's pace ... It took weeks just to get in there, and according to his schedule, it was going to take weeks more until I could get the equipment for the initial home sleep study, several weeks before he got back to me with results of the home sleep study, then weeks more before a titration study could be done in the lab, and when all was said and done, yet a couplefew weeks more to wait for a machine.

People, I was losing it. I had told my PCP in June that I was falling asleep at the wheel when I had to drive any longer than 10 minutes and the sleep doc just wouldn't speed things up for me. My PCP's gatekeeper wouldn't pass along my request to advocate for me either. It made me wonder whether sleep medicine (or the medical profession in general) considers ANYTHING to be urgent? I've seen no evidence of it. If I'd gone along with what they intially said, I might still be waiting for my therapy to begin!

WTF, sleep medicine docs. WTF.

So ... by making a total nuisance of myself, with daily angry calls to my sleep doc, I was able to get on the cancellation list for the home sleep study, got them to hurry up with results of the home sleep study, then got my titration study referred to another lab that could see me that same week (which if one existed in my hometown why the FUCK didn't they refer me there in the first place without me having to scream at them amirite???), and was able to get the titration study results within a couple days of that. Then when they said "10 business days more to get you a machine" I said "Not just no but hell no!" and had them fax my Rx to cpap.com which sent me a machine by FedEx and I had it in my hot little hands the next night.

The monetary price of going rogue in this way was high however. Insurance wouldn't reimburse a cent for my therapy because it hadn't been preapproved, and even though my sleep doc was in-network, cpap.com isn't, so for all intents and purposes they refuse to recognize the fact that I have sleep apnea and require treatment.

WTF, insurance companies. WTF.

Anyway. I continued with my rogue therapy and returned to the sleep doc for my first follow up last week. Although they had never heard of my (DeVilbiss) machine and their data card reader couldn't see my data, I was able to demonstrate compliance via reports from SleepyHead (which they had also never heard of). THANK YOU SLEEPYHEAD! <3 <3 <3

Sleep doc and I are now going through normal channels to get me a machine through insurance so they will 1) recognize my need for therapy and 2) pay for my therapy going forward. Luckily during this process which is bound to take way too long, I can breathe easy instead of being angry and oxygen-deprived. Not that I can guarantee that delays won't make me angry -- but I can at least be more rational with them instead of just screaming at them like a demented banshee. Which is exactly how I felt.

Now for the decision: I just got a call from the DME. I told them I wanted to have input into the type of machine I get, as I want to be able to continue to use SleepyHead. They said fine, you have a choice of two machines as the sleep doc only prescribes ResMed and Philips Respironics machines.

These are my choices:

* Philips Respironics System One Remstar Auto
* ResMed AirSense 10 Autoset

Both appear to be data-capable, which is awesome. I'm leaning toward the ResMed AirSense based on the reviews I saw at cpap.com, but would love to know what people in here think of these machines.

Many thanks in advance!

P.S.: I want to thank each and every one of you who shares your stores, tips, and information on this board. You have been my primary source of support in my therapy thus far and I can't even imagine where I would be without you. *blows kisses*

[RebornSleeper]

Wow. Good for you for advocating for your LIFE!

I have only ever had the ResMed Autoset. I absolutely LOVE IT! I don't feel like I am working against a machine. The machine is working WITH ME. I don't know about the PR one.

Best of luck!

[Heart Jumping]

These are my choices:

* Philips Respironics System One Remstar Auto
* ResMed AirSense 10 Autoset

I am in a very similar situation to you, even paid for my own sleep test to bypass the insurance insanity, I am getting my CPAP today. While I have no experience (yet), I did research here and the consensus is that both machines are very good, but the ResMed AirSense 10 seems to be the preference. That's what I am going with.

[Pugsy]

I'm kind of confused as to why my apnea was classified as "moderate" as I thought that was pretty damn dangerous. If anyone can enlighten me on that, I'd appreciate it.

It doesn't make much sense but the classifications of mild, moderate and severe are base on the AHI and not necessarily the O2 levels. They don't have a system in place to make a diagnosis based on O2 levels and it isn't necessarily a bad thing because a person can have a really high AHI and not have the O2 levels drop all that much.
In the end though..it is what it is and what we deal with.

Which machine?
In your situation I think I would lean towards the ResMed AirSense 10 AutoSet.
Of the 2 choices that is the newest and it's rare to hear of someone not liking the ResMed. Without knowing your pressure needs...if they run higher I think that the ResMed exhale relief (called EPR) is maybe a little better at the higher pressure needs....just a little bit better than the way that Respironics does its exhale pressure relief at the higher pressures.

[IDontSnoreISwear]

Without knowing your pressure needs...if they run higher I think that the ResMed exhale relief (called EPR) is maybe a little better at the higher pressure needs....just a little bit better than the way that Respironics does its exhale pressure relief at the higher pressures.

Good to know! My pressure settings are currently 13-18 which I understand is pretty high.

[Pugsy]

At those pressures...get the ResMed...you won't be sorry.
If you want to see what all it can do...here's the clinical manual.
https://sleep.tnet.com/home/files/resme ... -guide.pdf

At your pressures with your O2 desat history...I doubt that you would be needing the "for Her" apap algorithm mentioned in the manual. I think you likely would best benefit from the regular apap algorithm but if they offer the "for Her" model..it sure wouldn't hurt anything to have it.

[IDontSnoreISwear]

Thanks Pugsy! My mind is made up.

I hadn't considered the "for Her" machine because I'm no delicate flower -- which means not just fat, but big boned on top of it (I'm that girl Jerry Seinfeld won't date because of her "man hands.") LOL But cute. At least according to Hubby.

[Sheffey]

Insurance wouldn't reimburse a cent for my therapy because it hadn't been preapproved, and even though my sleep doc was in-network, cpap.com isn't, so for all intents and purposes they refuse to recognize the fact that I have sleep apnea and require treatment.

WTF, insurance companies. WTF.

Insurance companies develop networks of providers they have negotiated contracts with. This saves the industry huge amounts of money in processing costs and purchase costs. This saves the consumer on the insurance premium costs.

[IDontSnoreISwear]

Insurance wouldn't reimburse a cent for my therapy because it hadn't been preapproved, and even though my sleep doc was in-network, cpap.com isn't, so for all intents and purposes they refuse to recognize the fact that I have sleep apnea and require treatment.

WTF, insurance companies. WTF.

Insurance companies develop networks of providers they have negotiated contracts with. This saves the industry huge amounts of money in processing costs and purchase costs. This saves the consumer on the insurance premium costs.

Not really. The machine I bought out of pocket cost $490. The one I'm getting through the proper channels will wind up costing them over $1000, plus supplies and extra medical visits that will be required to "begin" therapy. I worked in the insurance industry for decades and "cost savings" is just another term for "opportunities to deny claims for life-saving treatment, hoping people will just go away and not bother us to pay for it even though it's covered."

SINGLE PAYER NOW