CPAP Supply Costs

[tazmania]

normally wake up after getting about 4 or 5 hours of sleep with an extremely dry mouth. The Dr. is having me play around with the machine's pressures. His theory is that I'm having trouble pushing back enough through my sinuses and thus I begin to breathe out my mouth where there is no resistence. Once I'm awaken to the dry mouth or an apnea occurence I take the mask off and sleep without the machine. It's hard for me to get back to sleep using the machine so I normally just shut it off.

It's possible that you have one major problem - mouthbreathing while using a nasal-only interface. The therapeutic CPAP pressure is lost out the mouth, and you are having apneas. After four or five hours of sleep, your body is filled with cortisol due to the apnea. Then the cortisol makes it hard to fall back to sleep using the machine. If this is the case, it's unlikely you will solve the problem with changes in machine settings. The exception would be if your settings are much higher than a therapeutic level.

I'd be nice to monitor myself

Given your situation, this is more than a nicety. You are unlikely to get your therapy straightened out without data.

Thanks for your replies.

From what I can decipher I typically get about 4 to 4.5 hours of sleep on the CPAP before I'm awakened. Remembering what the Dr said when he showed me the machine's stats, he said I had no issues with leaks and very little apneas, etc while wearing the machine. His conclusion was that the machine was working very well for me so for now he recommended I continue to use this same machine even though, to quote him, "it's aged".

He drew the conclusion that eventually when I become extremely relaxed or in deep sleep the resistance through my sinuses was enough that causes me to start breathing through my mouth. For certain I have dry mouth because my humidifer drains quite quickly unless I have a night's sleep where I didn't have dry mouth. Theory being the forced air was just going in through the nose and out my mouth. I've now reduced my pressure from 12 to 9.

However,

It has now been several weeks of trying to reduce the pressure and I am not getting a better night's sleep. For the last week or so I have been using the new mask and nasal piillows just to see if that was a factor. I may be now averaging around 4:30-5 hours of sleep before I wake up which is barely more than what I was getting before.

So it is probably time for me to get back in with Doc and talk about next steps.

I have decided not to buy a card reader seeing the Doc said the next steps for me may be to have another study and see if a bi-pap is a better machine for me.

[tazmania]

ChicagoGranny,

You said this:

After four or five hours of sleep, your body is filled with cortisol due to the apnea. Then the cortisol makes it hard to fall back to sleep using the machine.

I was confused by your statement "due to the apnea". Was that an assumption that I wasn't truly getting good sleep without apneas with the machine?

I'm thinking the machine is working well for me and helping me avoid apneas.

I suspect once I start breathing through my mouth I do start to have apnea occurences which is what wakes me. Then, because my mouth is so dried out, wrecked, I pull off the mask trying to fix the dryness. People have recommended a spray to fix the dry mouth. Would the spray help avoid dry mouth when the CPAP air is simply going from my nasal passages out my mouth?

[tazmania]

Thinking on this a little more I'm thinking I could get plenty of sleep on the CPAP machine if I can find a way to avoid waking up after 4 hours of sleep or so.

I do know I can fall back to sleep easy enough after waking but that is after I stop the CPAP. From that point on I spend the rest of the morning sleeping but constantly waking, turning from one side to the other and then back to other, etc. I awaken feeling unrested due to a lack of a full night's sleep and probably having dozens of apnea occurrences for the last 2 to 3 hours of sleep.

[ChicagoGranny]

I'm thinking the machine is working well for me and helping me avoid apneas.

I suspect once I start breathing through my mouth I do start to have apnea occurences which is what wakes me. Then, because my mouth is so dried out, wrecked, I pull off the mask trying to fix the dryness. People have recommended a spray to fix the dry mouth. Would the spray help avoid dry mouth when the CPAP air is simply going from my nasal passages out my mouth?

If air is going out your mouth, it's likely the therapeutic pressure is lost and you are having apneas. You need to find a solution to mouthbreathing. Solutions are full face mask, chinstrap or soft cervical collar.

I don't like the idea of running back and forth to the sleep doctor. In the long run, it might be cheaper to buy a machine that you can use with Sleepyhead. You can manage your own therapy and forget the doctor - most of the regulars on the forum do it this way. This is the way to get the best results.

[tazmania]

I'm thinking the machine is working well for me and helping me avoid apneas.

I suspect once I start breathing through my mouth I do start to have apnea occurences which is what wakes me. Then, because my mouth is so dried out, wrecked, I pull off the mask trying to fix the dryness. People have recommended a spray to fix the dry mouth. Would the spray help avoid dry mouth when the CPAP air is simply going from my nasal passages out my mouth?

If air is going out your mouth, it's likely the therapeutic pressure is lost and you are having apneas. You need to find a solution to mouthbreathing. Solutions are full face mask, chinstrap or soft cervical collar.

I don't like the idea of running back and forth to the sleep doctor. In the long run, it might be cheaper to buy a machine that you can use with Sleepyhead. You can manage your own therapy and forget the doctor - most of the regulars on the forum do it this way. This is the way to get the best results.

Interesting. I guess I didn't pick up on the fact that most here are monitoring/diagnosing themselves outside a doctor's care. I assumed everyone was doing both but doing it themselves in-between doctor's visits.

For some reason I was under the assumption one couldn't simply walk into an online store and purchase a machine without a Dr's prescription/diagnosis. Didn't it used to be this way?

Sorry I am definitely not the most educated on this stuff. I don't know what type of machine to buy let alone what brand/model. The Dr mentioned a bi-pap may be a better option for me which leads to my confusion. These devices are very expensive so I'd hate to waste money on a device that isn't going to be my best option.

Next steps could be any one of the recommendations you make for a mouth breather. I'm being a bit of a mule here but none of them sound great to me. Just one more (bleep) thing I have to gear up with each night. It's depressing.

Full mask. Not sure how I feel about that. More encumbered, not to mention I just dropped a couple hundred bucks on another nasal mask. sigh.
Find a good chin strap. FYI I did try to use one a year or so ago. The one I bought didn't seem to work well and so I soon gave up on it. Just one more thing that makes me feel more encumbered. It's interesting that the Dr didn't mention this as an option. I guess they can't be trusted to always provide the best solution.
soft cervical collar. I doubt I'd want to use one of those collars.

I was thinking I could try another chin strap but here's my concern. I don't think it is my jaw being shut that keeps my airway shut. I think it is my tongue positioned against the roof of my mouth that prevents air from moving through my mouth. Thoughts?

I do know that my dentist gave me a device that trained my jaw to be open partially while I sleep. I grind my teeth. This device provided a separation of my upper and lower jaw. I haven't used it since I started CPAP but I think it may be part of the reason why I tend to open my jaw. When I go to the dentist in April they are going to size me and discuss the cost of a tooth guard/mouth guard.

[tazmania]

I'm watching dvejr thread on chip straps.

I guess I could try taping my lips shut or just break down and get a FFM.

[OkyDoky]

Interesting. I guess I didn't pick up on the fact that most here are monitoring/diagnosing themselves outside a doctor's care. I assumed everyone was doing both but doing it themselves in-between doctor's visits.

For some reason I was under the assumption one couldn't simply walk into an online store and purchase a machine without a Dr's prescription/diagnosis. Didn't it used to be this way?

A lot of members are working with their doctors after educating themselves and proving to their doctors that they know what they are doing. You sleep with the machine every night and may have a pressure that needs changing but can't get an appointment to see the Sleep Doctor for months. So some have determined to learn all they can and make it work for them. The last thing my doctor said was call me if you need me. Although some do get upset with changing pressures, you still have to make it work for you or it's useless.

To buy through insurance or DME a prescription is required. Once you are started on CPAP you have a prescription and you should get a written copy for yourself of it and the copy of your sleep study. They are your medical records. If you don't have a prescription there are used machines that can be bought and sometimes new ones. If you need a new prescription the doctor can write on but he may require that new sleep study and it may be a good idea so you have a basis to start your therapy over again and for insurance payment purposes.

Bilevel machines are usually given for higher needed pressures or lung conditions, so I'm not sure why your doctor stated that you might need a bipap unless it was that you needed a higher pressure but were not able to tolerate it on your machine. You do need a full data machine to see what is happening and a bilevel is probably a good idea.

Remembering what the Dr said when he showed me the machine's stats, he said I had no issues with leaks and very little apneas, etc while wearing the machine.

This doesn't really make sense because if you were mouth breathing it shows up as leaks. And with large enough leaks your therapy may be compromised. So yes you need to see your data.

[ChicagoGranny]

tazmania

Are you self-motivated to learn, take control of your therapy and invest in your health?

[tazmania]

tazmania

Are you self-motivated to learn, take control of your therapy and invest in your health?

Yep. It just takes a bit of coaxing (and educating myself) before I kick it into gear (if you haven't noticed that yet).

Been absorbing all the great advice on this forum.

First steps were:

1). Adjust the pressure on the CPAP. Eliminate that as the cause of the mouth-breathing. Done. I don't think the doctor was right. This has made minimal difference in the amount of quality CPAP sleep I'm getting.

So next steps for me:

1). Practice breathing as much as possible through my nose, training my tongue.
Note: Hoping the dental mouthguard the dentist is going to provide me doesn't impact that effort and doesn't mess with my CPAP sleep.
2). Purchase a quality chin strap that keeps my jaw closed.
3). Purchase a new CPAP that allows me to read my own statistics.

If I still continue to get an inadequate amount of sleep then:
4). FFM. I'd rather not have to shave my facial hair so this will be a last resort.

[OkyDoky]

A list always helps!

[tazmania]

2). Purchase a quality chin strap that keeps my jaw closed.
3). Purchase a new CPAP that allows me to read my own statistics.

Is there a stickie post or any post for that matter that discusses the best chin straps and another that discusses what type of CPAP machines are the best?

If not can you all provide your opinion directly to me? I don't want to rely on the ratings seen on websites and they aren't always that trustworthy.

1. What brand/model chin strap work the best? I have an average side head with a stubble beard if that matters.

2. Do I buy a CPAP or an Auto Adjusting CPAP?

2. Which brand/model CPAP would you recommend?

[OkyDoky]

1. What brand/model chin strap work the best? I have an average side head with a stubble beard if that matters. No experience here.

2. Do I buy a CPAP or an Auto Adjusting CPAP? Auto adjusting is better because they can also be run in CPAP mode but CPAP machines can not be auto adjusting

2. Which brand/model CPAP would you recommend?[/quote] Either of the 2 major manufactures Respironics are 12 volt easier for battery use but ResMeds are nice machines. Must be full data capable. Check out this link and do not buy one with a Red NO. https://sleep.tnet.com/cmd

[tazmania]

Thanks Oky and Canada.

I'll do some digging.

[ChicagoGranny]

tazmania

My personal favorite to purchase at this time is ResMed's current top-of-the-line model - https://www.cpap.com/productpage/resmed ... idair.html

Chinstraps fail to work for many people. Plus, they can interfere with the mask headgear. To start, I would make a trial of a soft cervical collar. Sized properly, it can be a big help in keeping the jaw from dropping plus it keeps the neck/airway in the best position for breathing. Here is the one I have used every night for about five years - http://www.amazon.com/OTC-Cervical-Coll ... cal+collar I am a small person and use the average depth size. You might want to try the wide depth ( ).

If it doesn't work, you have little money sunk and can move on to a chinstrap trial. Although, I think you eventually will enjoy a FFM.

[Gasper62]

FWIW, one of the best deals on an APAP currently is a ResMed S9 Autoset For Her (in pink) closeout deal. They're being offered online for $470 - $550 which is pretty darned cheap for a full-featured APAP in my estimation. YMMV however. Good luck. ~ https://www.cpapman.com/auto-cpap-machi ... p-853.html