Newly Diagnosed - questions about timing of start of treatment

[wintersummer]

Hello forum members,

I'm newly diagnosed and have been using these forums to start my learning process. I appreciate you all being here, I appreciate the guidance.

Here's the background for my first question. My sleep study was this past weekend. AHI was 29.8. I slept in supine position for 190 minutes: supine AHI was 58.0. I slept on my side 189 minutes: lateral AHI was 1.6. I'm hoping that's enough background info for you all, enough to give guidance with my questions.

My titration study is scheduled in 4 days. I understand prescription will be written at that time. Here's the question: we are leaving town for a business trip 7 days after the titration study. I have no clue about time to acquire CPAP. If I can acquire CPAP in that 7 day window, would you recommend starting therapy while away from home? Would that just be too much for me? Or, is it better to start therapy in a somewhat controlled environment? I hope these questions make sense. I am pondering whether to attempt to rush getting the CPAP to take with me while traveling VS waiting until we return in 2 weeks, delaying treatment for two weeks. We travel quite a bit, so I am going to have to conquer using CPAP while on the road/airplanes/etc. I just don't know if that's the best way to start CPAP.

The other question is related to the AHI difference in the supine (58.0 AHI) vs. lateral position (1.6). I have already started working on lateral sleeping. If I can work out way to assure lateral sleeping, would that support delay of CPAP therapy until we return?

Last question - is it normal to have delay of up to 3 weeks before starting treatment? Maybe my questions are not of great concern, but any advice is appreciated.

[Pugsy]

See how well you adapt during the titration sleep study and see how easily you adjust to the mask and stuff.
Some people find it's a piece of cake and some have great difficultly adjusting to the whole set up.
If you find it easy enough...and you can get your equipment soon enough...take it with you.

If you can't get your equipment soon enough...try the side sleeping thing but it's easier said than done...but try the best you can. If you can stay off your back you will be fine.
The problem is that people can't always stay off their back no matter how much they try. It just isn't all that easy.
I don't believe in trying stuff that disturbs sleep as a way to learn to stay off one's back. Just what I don't want is to trade one sleep disturbing thing for another like pain from tennis balls or a back pack worn while sleeping.

Finally yes...sometimes there is a delay between diagnosis, titration study (if even done) and actually getting the equipment.
Sometimes a lot of delay. The whole process for me took longer because of the time between the diagnostic study and the titration study more than the titration study and the getting of the equipment. A lot depends on how quickly the doctor reads the study and the DME gets all the paperwork run through your insurance. They often take the slow road just because they won't work fast. It doesn't take all that long to get insurance approval despite what they say if they will just do their job.
I have Medicare...took 90 minutes from time of submission to get the okay to dispense equipment.
I know this because I rejected the first DME, because they lied to me about what they were dispensing and wouldn't give me what I wanted, and had all the paper work sent to the second DME and by the time I got to the second DME office they had the approval from their submission of the paper work to Medicare.

If you can get your equipment before the trip...take it. If you simply have to fight it too much to be able to even get much sleep and it is ruining your trip...do what you can with the side sleeping thing and don't worry about using the cpap if it is simply too stressful.
But hey, you might take to it like a duck to water and have no issues...you will have a clearer idea once you actually do the titration study part.

[TheDuke]

I thoroughly agree with "Pugsy's) post. If you get the machine in time, by all means take it along. My own experience is that for some reason, I often sleep better when I am traveling, and in any case the sooner you can begin treatment, the better for you.

TheDuke

[wintersummer]

Pugsy and theDuke - thank you for your prompt and encouraging replies!

[D.H.]

Yes, take it along!

BTW, what type of travel is this (plane, train, driving, bus, etc.)? Also, is it international (if it is, you may need an adapter)?

[wintersummer]

DH - to answer about type of travel. Domestic. Two flights outbound, two flights returning. Rental car and driving when we get there. Staying in 2 hotels, during different parts of trip.

[D.H.]

FAA rules allow you to carry on your bag without being counted against your baggage allowance. Remember to pack all the parts (cord hose mask, headgear, etc.). Also pack an extension card, the outlet might be far from the bed.

Some are able to use CPAP immediately, others have to adjust. Hopefully, you'll be in the former category.

[ChicagoGranny]

I slept in supine position for 190 minutes: supine AHI was 58.0. I slept on my side 189 minutes: lateral AHI was 1.6.

Do you have a copy of the summary of your sleep study (usually one or two pages)? If not, you should get a copy.

Obstructive sleep apnea (OSA) is often much worse in the REM sleep stage. The question would be how many minutes of REM sleep did you have in each of the two positions. If you had little to no REM sleep in the lateral position, there would not be enough information to make conclusions about how effective lateral sleeping would be for your OSA. Your sleep study summary should show the number of minutes of each sleep stage in each sleeping position.

In any case, I would try to limit sleeping to the lateral position until CPAP usage commences.

[wintersummer]

Obstructive sleep apnea (OSA) is often much worse in the REM sleep stage. The question would be how many minutes of REM sleep did you have in each of the two positions. If you had little to no REM sleep in the lateral position, there would not be enough information to make conclusions about how effective lateral sleeping would be for your OSA. Your sleep study summary should show the number of minutes of each sleep stage in each sleeping position.

I have copy of my sleep study. I can't find exact answers to your questions but here is some data I was able to extract:

"190.2 minutes in supine position with total of 135 events in NREM sleep in supine position and 49 events in REM sleep in supine position. The supine AHI is 58.0"

"189.8 minutes in a side body position with 5 events in NREM sleep in lateral decubitus positon and 0 events in REM sleep in lateral decubitus position. The lateral positional AHI is 1.6 events per hour.

"328 minutes in NREM sleep with 140 events during NREM sleep. The NREM AHI is 25.6"

"52 minutes in REM sleep, of which 52 minutes were supine and 0 minutes were lateral. 49 events occured during REM sleep. The REM AHI is 56.5, and REM lateral AHI is 0"

[Cardsfan]

I will tell you my story. When I first picked up my machine to begin treatment, it was one day before we left home for a month long road trip. I used it my first night ever on. vacation. I got by just fine. I think it may have been easier because I didn't have time to dwell on the little things that could go wrong. I just traveled all day, checked in to the travel condo, set it up and went to sleep. Now, I know I was lucky that it went well, with little hiccups. Take it with you if you can. The best thing is your trip may be better because you are getting some real sleep.

[ChicagoGranny]

I have copy of my sleep study. I can't find exact answers to your questions but here is some data I was able to extract:

"190.2 minutes in supine position with total of 135 events in NREM sleep in supine position and 49 events in REM sleep in supine position. The supine AHI is 58.0"

"189.8 minutes in a side body position with 5 events in NREM sleep in lateral decubitus positon and 0 events in REM sleep in lateral decubitus position. The lateral positional AHI is 1.6 events per hour.

"328 minutes in NREM sleep with 140 events during NREM sleep. The NREM AHI is 25.6"

"52 minutes in REM sleep, of which 52 minutes were supine and 0 minutes were lateral. 49 events occured during REM sleep. The REM AHI is 56.5, and REM lateral AHI is 0"

I don't believe you can conclude from this that side-sleeping would effectively treat your condition. However, it's certainly seems much better than supine-sleeping while waiting for CPAP.

[zoocrewphoto]

FAA rules allow you to carry on your bag without being counted against your baggage allowance. Remember to pack all the parts (cord hose mask, headgear, etc.). Also pack an extension card, the outlet might be far from the bed.

Some are able to use CPAP immediately, others have to adjust. Hopefully, you'll be in the former category.

Just wanted to add - for the airport security, put your cpap inside a clear bag, then inside the cpap bag. Put the hose and mask inside a clear bag as well. That way, if they want to take it out o fthe bag, they are handling the clear bag, not the actual machine. For the conveyor belt, I put the cpap bag in its own tray with the bag open. They didn't bother to mess with it at all. They did find my bag of almonds very interesting...

[palerider]

They did find my bag of almonds very interesting...

Probably wanted to steal them.

Friend of mine told me that there's a type of fancy french chocolates that routinely get confiscated, even though they're completely legal... Guy said next time he comes over, he's going to put some cheap stuff in the fancy box, after injecting them with habanero oil.

[zoocrewphoto]

They did find my bag of almonds very interesting...

Probably wanted to steal them.

Friend of mine told me that there's a type of fancy french chocolates that routinely get confiscated, even though they're completely legal... Guy said next time he comes over, he's going to put some cheap stuff in the fancy box, after injecting them with habanero oil.

Too funny. They just had me open the bag, and the lady shook it a little to see that it was just almonds. I guess it was hard to see through.

[wintersummer]

My titration study is scheduled in 4 days. I understand prescription will be written at that time. Here's the question: we are leaving town for a business trip 7 days after the titration study. I have no clue about time to acquire CPAP. If I can acquire CPAP in that 7 day window, would you recommend starting therapy while away from home? Would that just be too much for me? Or, is it better to start therapy in a somewhat controlled environment? I hope these questions make sense. I am pondering whether to attempt to rush getting the CPAP to take with me while traveling VS waiting until we return in 2 weeks, delaying treatment for two weeks. We travel quite a bit, so I am going to have to conquer using CPAP while on the road/airplanes/etc. I just don't know if that's the best way to start CPAP.

This is an update to my original question, specifically about being a newbie and traveling while getting used to CPAP. It's all worked out, really quite well. I got my CPAP (ResMed AirSense 10) on a Wednesday, used it 2 nights at home, then had to leave town for 2 weeks. Travel consisted of 4 flights and 6 hotels. I did great traveling with the unit. Thanks for all the positive words of encouragement here.