Well talked to doctor and this is what he said I have.
Sleep Fragmentation
Hypopnea, quite a bit.
Blood Oxygen level goes down as the night goes on.
The machine will be 14cm pressure.
Looks like I need a cpap set-up.
Now they mentioned someone would call to make an appointment and show me how to use machine. My question is this, what if I don't like what they offer to me? Do I have a choice? Do I have a choice in Heated Humidifier or not, what type of mask... and so on?
How did some of you purchase your set-up?
Would someone please let me know what type of things I may not know?
Thanks
Steve
Results are in, Apnea or Hypopenea
5 posts
• Page 1 of 1
Results are in, Apnea or Hypopenea
_________________
| Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear |
| Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control |
| Additional Comments: SleepyHead, daily tracking |
I have only been using mine for a short while now, and you will find MANY other people here who have MANY other pieces of advice, and you should listen to them. However, if this is your first time with this I would recomend going with what the folks bring you at first. Then, take the time to read some posts about different types of masks and machines. But don't ask your supplier to wait until you have decided what equipment you want.
1) it may be hard to decide before you have tried to sleep in your own home with the equipment,
2) depending on your supplier (DME) and your insurance, you may not have a choice, and even if you do it may delay your getting a machine.
So at least get started on your therapy with the gear they provide, and the worst that will happen is that you will not get better sleep, and you can get a different mask and/or machine. The best that will happen is that you will start feeling better right away.
The middle ground is that you will start to feel better, but still want a different mask or machine and you are at least getting some therapy even if it can get better. Does that make sense? I think I could have written that more clearly. Basically, don't delay getting the therapy started, but do the the research.
Quest
1) it may be hard to decide before you have tried to sleep in your own home with the equipment,
2) depending on your supplier (DME) and your insurance, you may not have a choice, and even if you do it may delay your getting a machine.
So at least get started on your therapy with the gear they provide, and the worst that will happen is that you will not get better sleep, and you can get a different mask and/or machine. The best that will happen is that you will start feeling better right away.
The middle ground is that you will start to feel better, but still want a different mask or machine and you are at least getting some therapy even if it can get better. Does that make sense? I think I could have written that more clearly. Basically, don't delay getting the therapy started, but do the the research.
Quest
I'm scared, but I used to be very scared. - a quote used by the Freshman Class my senior year in HS (oh so many years ago) and have managed to use in just about every major step I have made in my life since.
-
twistedcherokee
- Posts: 75
- Joined: Sun May 01, 2005 9:38 pm
- Location: Falcon co
If you have ins, it may be different than if you don't. I don't have ins, so I was limited on what I got. The machine that I got was a F&P HC220LE, it has a heated humidfier incorperated into it. That is the one I rented for a month from the DME. It would have been cheaper to just buy it from hear and waited a couple of days. But it may have not been a good idea. I am actually surprized that I am still a live, and don't know how I survived with out the CPAP machine. I opted for a full face, since I don't breath well thru my nose. The DME sold me a Comfortfull FF and never gave me a choice. It works for me now but I was not sure when I first started to use it. I learned that tighter is not better, and some times you need to loosen it up for it to seal better. I have a beard and mustache and so getting a great seal may never be there and I boosted the pressure and I am now sleeping great and for the most part thru the night with no waking up. I was waking up every hour on the hour, sometimes more. If you have ins. dont be scared to try different masks. May try to get a APAP from what I have been reading. Sometimes I think thats what I should have done. But mine works, so I will stick with it until it goes bad. Hope this helps.
Toby
Toby
-
rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
Hi Steve,
Quest and Cherokee gave you very good advice.
I'd add this: 14 cm H20 pressure is a pretty good wallop for most people, especially someone just starting.
As Quest said, you may not have much choice in the matter of what machine the DME is willing to give you. Since it's more profitable for them, they almost surely will give you a straight (single pressure) CPAP machine. If you are lucky, it will have a feature that will drop the pressure a few notches every time you exhale. That would make it much, much easier to breathe out against the pressure.
At this time, there are only a few straight CPAP machines that can give any kind of pressure relief when you exhale. Most DMEs seem to carry Respironics machines. Most of the Respironics machines have "C-Flex" (their trademarked name for their exhalation relief feature.) So, if they are giving you a Respironics straight CPAP machine like the Respironics Plus or Respironics Pro 2, look on the top of the machine for a blue sticker that says "C-Flex".
Have the DME set C-Flex at "3" to give you the most possible relief when exhaling. If you don't have them do that, they'll probably set C-Flex at 1 or 2, which give less relief.
Even with the C-Flex sticker, don't let them give you just a "Pro". Insist on Pro 2, not just "Pro" which is an older machine no longer manufactured. The DME might still have some of the older ones on their shelves.
Of the two straight CPAPs by Respironics, I'd try to get the "Pro 2" rather than the "Plus". The Pro 2 can give you quite a bit of overnight data if you ever wanted to buy the software for it. The Plus records only how many hours the machine is used.
Don't even bother to ask the DME about software. Insurance won't pay for software, and besides...the DME wouldn't want you to have software to see what's going on in your own treatment anyway. You can purchase software without any prescription at an online store like cpap.com, if you decide you want software later.
The cpap machine will have a "Ramp" feature. This will help, as Ramp makes the machine start at a lower pressure than the 14 prescribed for you. The pressure will gradually increase over whatever period of time the DME sets (likely 30 minutes or more) - the idea being that while you're waiting to drift off to sleep, you won't be getting the full 14 yet. Presumably you'll be asleep by the time the machine ramps up to the full pressure and you won't "feel" it.
Ramp can be set to start as low as 4 cm H2O pressure. Personally, I'd feel suffocated (would feel that way, wouldn't actually be suffocating) for air trying to breathe through a mask at 4. Be sure to try out "Ramp" for a few minutes at the DME's.
If you feel stifled trying to INHALE at 4, ask them to set the ramp to start at 5, or 6, or 7 ...whatever you feel comfortable with when breathing through the mask. A lot of people don't use "Ramp" at all, preferring to get their full treatment pressure right from the start. But at a prescribed pressure of 14, you probably will like "Ramp".
I may be alarming you unnecessarily, but I keep thinking of what a pressure of 14 would have felt like to me at the beginning. Might be a piece of cake for you.
Pressures above 12 seem to be where some people suffer from aerophagia (inadvertently swallowing air.) While that won't harm you, it can sure cause bloating and gas, sometimes very painful. May not happen to you at all, but just in case.......
If you get painful bloating, don't let the DME or the doctor tell you "Oh, you just have to get used to it, it will eventually subside." It may, or may not subside. It does eventually stop happening for some people, as they get more used to cpap treatment. But the point is, it's a discomfort that you don't have to put up with just because they say so.
Unless a person has experienced extreme aerophagia, they have no real idea how disrupting to sleep it can be, or how painful it can be even well into the next day. Or how many days you might have to endure it before "getting used to it" (if ever.)
Many doctors are willing to lower the prescribed pressure to just under where it causes aerophagia (that point varies with the individual) for a week or more, gradually raising the pressure as the person becomes more used to cpap pressure.
I think that's a good plan...better to be able to stick with getting used to this kind of treatment even if it means not getting the prescribed pressure for a few weeks, rather than have such extreme discomfort that one begins to not use the machine long enough or simply quits altogether.
After scaring you with the thought of something that might not even happen to you... sorry 'bout that!! ....
Personally, I'd not put up with being given a straight cpap (even with C-Flex) at pressure of 14. Higher pressures are more difficult for masks in general to handle without springing leaks. I'd ask the doctor to let me have a trial with an autopap, set for a range of 5 - 16, to see if I really, REALLY, need a pressure of 14 most of the night.
If it turned out that I needed 14 only occasionally during sleep, and that lower pressures took care of things fine during most of the night, I'd get an autopap even if I had to bypass insurance completely and buy the machine myself online.
If it turned out that I did need 14 most of the night, I'd give the Respironics REMstar Pro 2 with C-flex a try. The C-flex might do fine. But if after a week or two, I felt like it was too much work exhaling, I'd get a bi-level machine (like the Respironics BIPAP Pro 2) so that an exact lower pressure could be set for exhaling, rather than the vague (albeit welcome) exhalation relief that C-Flex can give.
Masks are a very individual thing. Everyone's face is different.
If you don't have to use a full face mask, I'd suggest getting the ResMed Activa (covers the nose) or the ResMed Swift (nasal pillows) or the Puritan Bennett Breeze (nasal pillows.) Try not to let them make you accept any mask made by Respironics, which is what most DME's carry and which might feel very comfy during the scant few minutes you try it on there.
Take your pillow along with you, leave your dignity at the door, and try out as many masks as you can while lying down, even if it means lying down on the floor right there in their office. Best to have the machine going too - at full prescribed pressure.
Try out your usual sleep positions as well as you can. A mask that seals fine when it's fitted on you sitting up can be a leaky disaster when you are trying to sleep on your side at home.
Don't let them rush the mask choice and fitting in any way. The mask can be the most important key of all in getting good treatment. And, most of all, comfortable treatment!
I bought all of my equipment online from the start. Nothing from a local DME. I don't have insurance. But even if I did, knowing what I do now, if insurance wouldn't cover the machine and mask I wanted or the DME didn't have it, I'd buy what I wanted for my treatment.
Some people have had success in getting their insurance company to agree to reimburse for online equipment purchases, but you'd want to get that very clear with the insurance company if you went that route, expecting to get paid back.
The only advantage I see in using your local DME is if they will let you rent machines, swapping until you find the machine you like best. And for swapping masks, but only if they let you bring back masks that don't work for you at home.
As for any benefit in getting to try on some masks at the local DME, that's useful only if they happen to stock some of the better masks in the first place. Getting to try on and choose between 3 or 4 cheap-made masks (the prices will ALL look like "premium" stuff, even if it isn't!) is not much benefit.
Good luck, Steve.
Quest and Cherokee gave you very good advice.
I'd add this: 14 cm H20 pressure is a pretty good wallop for most people, especially someone just starting.
As Quest said, you may not have much choice in the matter of what machine the DME is willing to give you. Since it's more profitable for them, they almost surely will give you a straight (single pressure) CPAP machine. If you are lucky, it will have a feature that will drop the pressure a few notches every time you exhale. That would make it much, much easier to breathe out against the pressure.
At this time, there are only a few straight CPAP machines that can give any kind of pressure relief when you exhale. Most DMEs seem to carry Respironics machines. Most of the Respironics machines have "C-Flex" (their trademarked name for their exhalation relief feature.) So, if they are giving you a Respironics straight CPAP machine like the Respironics Plus or Respironics Pro 2, look on the top of the machine for a blue sticker that says "C-Flex".
Have the DME set C-Flex at "3" to give you the most possible relief when exhaling. If you don't have them do that, they'll probably set C-Flex at 1 or 2, which give less relief.
Even with the C-Flex sticker, don't let them give you just a "Pro". Insist on Pro 2, not just "Pro" which is an older machine no longer manufactured. The DME might still have some of the older ones on their shelves.
Of the two straight CPAPs by Respironics, I'd try to get the "Pro 2" rather than the "Plus". The Pro 2 can give you quite a bit of overnight data if you ever wanted to buy the software for it. The Plus records only how many hours the machine is used.
Don't even bother to ask the DME about software. Insurance won't pay for software, and besides...the DME wouldn't want you to have software to see what's going on in your own treatment anyway. You can purchase software without any prescription at an online store like cpap.com, if you decide you want software later.
The cpap machine will have a "Ramp" feature. This will help, as Ramp makes the machine start at a lower pressure than the 14 prescribed for you. The pressure will gradually increase over whatever period of time the DME sets (likely 30 minutes or more) - the idea being that while you're waiting to drift off to sleep, you won't be getting the full 14 yet. Presumably you'll be asleep by the time the machine ramps up to the full pressure and you won't "feel" it.
Ramp can be set to start as low as 4 cm H2O pressure. Personally, I'd feel suffocated (would feel that way, wouldn't actually be suffocating) for air trying to breathe through a mask at 4. Be sure to try out "Ramp" for a few minutes at the DME's.
If you feel stifled trying to INHALE at 4, ask them to set the ramp to start at 5, or 6, or 7 ...whatever you feel comfortable with when breathing through the mask. A lot of people don't use "Ramp" at all, preferring to get their full treatment pressure right from the start. But at a prescribed pressure of 14, you probably will like "Ramp".
I may be alarming you unnecessarily, but I keep thinking of what a pressure of 14 would have felt like to me at the beginning. Might be a piece of cake for you.
Pressures above 12 seem to be where some people suffer from aerophagia (inadvertently swallowing air.) While that won't harm you, it can sure cause bloating and gas, sometimes very painful. May not happen to you at all, but just in case.......
If you get painful bloating, don't let the DME or the doctor tell you "Oh, you just have to get used to it, it will eventually subside." It may, or may not subside. It does eventually stop happening for some people, as they get more used to cpap treatment. But the point is, it's a discomfort that you don't have to put up with just because they say so.
Unless a person has experienced extreme aerophagia, they have no real idea how disrupting to sleep it can be, or how painful it can be even well into the next day. Or how many days you might have to endure it before "getting used to it" (if ever.)
Many doctors are willing to lower the prescribed pressure to just under where it causes aerophagia (that point varies with the individual) for a week or more, gradually raising the pressure as the person becomes more used to cpap pressure.
I think that's a good plan...better to be able to stick with getting used to this kind of treatment even if it means not getting the prescribed pressure for a few weeks, rather than have such extreme discomfort that one begins to not use the machine long enough or simply quits altogether.
After scaring you with the thought of something that might not even happen to you... sorry 'bout that!! ....
Personally, I'd not put up with being given a straight cpap (even with C-Flex) at pressure of 14. Higher pressures are more difficult for masks in general to handle without springing leaks. I'd ask the doctor to let me have a trial with an autopap, set for a range of 5 - 16, to see if I really, REALLY, need a pressure of 14 most of the night.
If it turned out that I needed 14 only occasionally during sleep, and that lower pressures took care of things fine during most of the night, I'd get an autopap even if I had to bypass insurance completely and buy the machine myself online.
If it turned out that I did need 14 most of the night, I'd give the Respironics REMstar Pro 2 with C-flex a try. The C-flex might do fine. But if after a week or two, I felt like it was too much work exhaling, I'd get a bi-level machine (like the Respironics BIPAP Pro 2) so that an exact lower pressure could be set for exhaling, rather than the vague (albeit welcome) exhalation relief that C-Flex can give.
Masks are a very individual thing. Everyone's face is different.
If you don't have to use a full face mask, I'd suggest getting the ResMed Activa (covers the nose) or the ResMed Swift (nasal pillows) or the Puritan Bennett Breeze (nasal pillows.) Try not to let them make you accept any mask made by Respironics, which is what most DME's carry and which might feel very comfy during the scant few minutes you try it on there.
Take your pillow along with you, leave your dignity at the door, and try out as many masks as you can while lying down, even if it means lying down on the floor right there in their office. Best to have the machine going too - at full prescribed pressure.
Try out your usual sleep positions as well as you can. A mask that seals fine when it's fitted on you sitting up can be a leaky disaster when you are trying to sleep on your side at home.
Don't let them rush the mask choice and fitting in any way. The mask can be the most important key of all in getting good treatment. And, most of all, comfortable treatment!
I bought all of my equipment online from the start. Nothing from a local DME. I don't have insurance. But even if I did, knowing what I do now, if insurance wouldn't cover the machine and mask I wanted or the DME didn't have it, I'd buy what I wanted for my treatment.
Some people have had success in getting their insurance company to agree to reimburse for online equipment purchases, but you'd want to get that very clear with the insurance company if you went that route, expecting to get paid back.
The only advantage I see in using your local DME is if they will let you rent machines, swapping until you find the machine you like best. And for swapping masks, but only if they let you bring back masks that don't work for you at home.
As for any benefit in getting to try on some masks at the local DME, that's useful only if they happen to stock some of the better masks in the first place. Getting to try on and choose between 3 or 4 cheap-made masks (the prices will ALL look like "premium" stuff, even if it isn't!) is not much benefit.
Good luck, Steve.
Thanks so much for all the information. Certainly gives me something to sleep on (pardon the pun)
I did use the Swift nasal pillow during the study, seemed to work for me... of course I couldn't move with all the wires attached... I was told the DME would make an appointment to come to the house. I think I will talk to them and see what they suggest. Because of you all I can ask some good questions and rattle off some machines that have a few options.
I have been told that warm air humidifier is something I really should get??
Ok well thanks to you all that helped. I am sure you will be seeing me around here from time to time.
Thanks,
Steve
I did use the Swift nasal pillow during the study, seemed to work for me... of course I couldn't move with all the wires attached... I was told the DME would make an appointment to come to the house. I think I will talk to them and see what they suggest. Because of you all I can ask some good questions and rattle off some machines that have a few options.
I have been told that warm air humidifier is something I really should get??
Ok well thanks to you all that helped. I am sure you will be seeing me around here from time to time.
Thanks,
Steve
_________________
| Mask: Swift™ FX Nasal Pillow CPAP Mask with Headgear |
| Humidifier: S9™ Series H5i™ Heated Humidifier with Climate Control |
| Additional Comments: SleepyHead, daily tracking |
5 posts
• Page 1 of 1