Newbie: Buy apap before study?

[JohnTor]

Hi,

I'm in Toronto and will be seeing my family doctor on Wednesday to arrange for a sleep study. I already have an oximeter with readings that suggest I have sleep apnea.

viewtopic/t174019/Interpret-newbies-oxi ... sults.html

The two sleep clinics I contacted said they are booking for early January. This would be followed by a diagnostic report and a titration study. Both clinics said I should have my new machine by early February.

I understand that if I follow procedure, the Ontario government will pay 75% of the base cost of the machine, about $750. I may or may not be eligible for the subsidized purchase of an apap machine.

To get a subsidized apap machine, the sleep doctor would have to certify the following on the government form: "Individual has a documented diagnosis of OSAS where there is a change in pressure of a minimum of 4 cmH2O on a prescribed fixed CPAP level of 10 cmH2O or more" and "The change in pressure occurs between REM vs. NREM or supine vs. non-supine.".

I want to start sooner than this and I want an apap machine for the flexibility it offers (I've learned from this forum that it can be run in cpap mode). I can afford to forego the government subsidy. When I see my family doctor on Wednesday for the sleep study referral, I plan to ask him for a prescription for "autoset cpap". I've booked a tentative appointment on Wednesday afternoon with a cpap vendor (cpapclinic.ca) who says he can sell me the well-regarded resmed airsense 10 autoset with that prescription. The vendor said I could get a free 1 month loaner of the machine and may still qualify for the government subsidy once the sleep study is concluded.

https://www.cpapclinic.ca/CPAP-store/Re ... logID=1675

I like the idea of getting started ASAP. It's going to take time getting used to sleeping this way. And it will take time to find the best mask for me. I've read of some positive experiences in this forum titled 'self-treatment' and 'DIY', an option that really is only possible with the helpful advice of cpaptalk regulars (thank you!). I've read in this forum that the default minimum of 4 might give a false feeling of suffocating to a newbie. Instead start with a minimum of 6, 7 or 8. Similarly, I've read that a newbie might wake up if the default maximum of 20 kicks in. Try a maximum of 16 to start. I can always lower my minimum and raise my maximum after I'm more experienced and less spooked by the pressure extremes. Now I'm trying to learn about ramp and EPR.

Note that I will be using sleepyhead to monitor my progress.

Do you think this is a reasonable plan?

Thanks for your advice,

John

[palerider]

Instead start with a minimum of 6, 7 or 8. Similarly, I've read that a newbie might wake up if the default maximum of 20 kicks in. Try a maximum of 16 to start. I can always lower my minimum and raise my maximum after I'm more experienced and less spooked by the pressure extremes

Do you think this is a reasonable plan?

Yes, except leave the max at 20. Too many people are unnecessarily scared of the max pressure, and hinder themselves.

start with 6-20, and adjust as needed based on the data.

[BCman]

Yes.
Ive had nothing but problems dealing with respiratory therapist and many others on this forum have the same experience. Ive learned so much from this forum and whatever improvements or changes that I needed to make actually came from this forum and not from my therapist.

I would caution that your problem may not be just simple Obstructive Sleep Apnea so you might purchase a machine only to find out its the wrong one. I believe I did that exact thing as my AHI numbers are down but Im experiencing lack of sleep and horrible physical issues from the CPAP and believe I need a Bi-lateral machine.

[palerider]

I would caution that your problem may not be just simple Obstructive Sleep Apnea so you might purchase a machine only to find out its the wrong one.

However, the odds are that the OP will be served fine with an APAP.

Yes, it's *possible* that they may need something else, but, statistically speaking, it's unlikely.

[BCman]

Palerider never saw a post he couldn't find a way to disagree with and make "it" wrong so as to make himself right.

[Janknitz]

The vendor said I could get a free 1 month loaner of the machine and may still qualify for the government subsidy once the sleep study is concluded.

If you are certain you would have your sleep study and results within the 1 month trial period it seems like low risk to give it a try while you're waiting. However, be wary of the word "may" because there's at least a 50% chance that it means "May not". If you are OK with that risk financially, then it's up to you.

[bombayone]

Palerider never saw a post he couldn't find a way to disagree with and make "it" wrong so as to make himself right.

Agree with your observation.

[palerider]

Palerider never saw a post he couldn't find a way to disagree with and make "it" wrong so as to make himself right.

I can't make your post wrong, it's either wrong or right on it's own merit.

What I said is correct, no matter how you "feel" about it.

[Dog Slobber]

I understand that if I follow procedure, the Ontario government will pay 75% of the base cost of the machine, about $750. I may or may not be eligible for the subsidized purchase of an apap machine.

To get a subsidized apap machine, the sleep doctor would have to certify the following on the government form: "Individual has a documented diagnosis of OSAS where there is a change in pressure of a minimum of 4 cmH2O on a prescribed fixed CPAP level of 10 cmH2O or more" and "The change in pressure occurs between REM vs. NREM or supine vs. non-supine.".

I want to start sooner than this and I want an apap machine for the flexibility it offers (I've learned from this forum that it can be run in cpap mode).

If you want an APAP machine, but only have a CPAP prescription then get the ResMed AirSense 10 AutoSet for Her. Although it's an APAP, for some odd reason it's eligible as a CPAP device under OHIP's Assistive Device Program.

Here's a list of the eligible devices:

http://www.health.gov.on.ca/en/pro/prog ... manual.pdf

CPAP machines are listed on Pages 3 and 4, note the for Her model is listed amongst the CPAP devices and not the APAP devices.

And don't be put off by the for Her branding. It's actually a better machine than the standard AS 10 AutoSet, it has all the same functionality but with an extra optional female target algorithm. The only other difference is the colour, the standard model is black, the for Her model beige with vines on it.

The for Her model is one of the most popular devices amongst both male and female.

The vendor said I could get a free 1 month loaner of the machine and may still qualify for the government subsidy once the sleep study is concluded.

I'm in Ontario, and the DME provided me with a free loaner for titration purposes and while waiting for my machine. The DME gets grumpy if you change the settings while they're monitoring you.

[JohnTor]

Thanks for the responses. I feel good about my plan, just hope my family doctor is OK with writing the script.

I had read about the extra functionality of the airsense 10 autoset for her and very surprised to see it in the CPAP category in the government list provided by Dog S. If my sleep doctor won't sign the government form saying I must have an apap rather than a cpap, I can get the 'for her' model from the 'cpap' list. A backdoor to getting an apap and cheaper, too. Great find, Dog S!

john

[palerider]

Thanks for the responses. I feel good about my plan, just hope my family doctor is OK with writing the script.

I had read about the extra functionality of the airsense 10 autoset for her and very surprised to see it in the CPAP category in the government list

Somebody screwed up, hope they don't fix it before you get yours

[Sheriff Buford]

Be sure to get two prescriptions. Get one as Slobber states and get another one that states "Cpap mask of patient's choice". Make copies of both prescriptions. I scanned mine. That way you can use the mask prescriptions at several places.

I started my son on cpap without a sleep study. I set the lower setting at 7 and the upper setting at 20. The 7 was too low for him because he felt as if he was suffocating. I bumped it up to an 8, and he ended up with an 8.5. His AHI's were a .9 to a 2.5. Does he have sleep apnea? Heck yes. He's a 2.5 AHI with a machine. Do I need to know what his sleep study shows? It would be nice.... a sleep study tells you a lot more than just an AHI. Good luck and work your issues here. You'll probably go thru many masks until you find one that is comfortable and doesn't leak.

Sheriff

[DavidY]

Be sure to get two prescriptions. Get one as Slobber states and get another one that states "Cpap mask of patient's choice". Make copies of both prescriptions. I scanned mine. That way you can use the mask prescriptions at several places.

I started my son on cpap without a sleep study. I set the lower setting at 7 and the upper setting at 20. The 7 was too low for him because he felt as if he was suffocating. I bumped it up to an 8, and he ended up with an 8.5. His AHI's were a .9 to a 2.5. Does he have sleep apnea? Heck yes. He's a 2.5 AHI with a machine. Do I need to know what his sleep study shows? It would be nice.... a sleep study tells you a lot more than just an AHI. Good luck and work your issues here. You'll probably go thru many masks until you find one that is comfortable and doesn't leak.

Sheriff

In Canada, masks don't require a prescription. One for the machine is fine.

In Alberta, my sleep clinic wouldn't give me my prescription....why would they when they can sell (they did) me an APAP package for CAD$2500 vs. the exact same package at a Canadian online dealer for $700-$900 (BF and Cyber Monday, these were as low as the mid $500 range with a selected mask). Luckily, I got my family doc to write my prescription for a backup APAP. One bonus in Canada, there are a couple of online dealers who don't require a prescription for an APAP machine.

Dave