Another Newbie

[Mbarb]

Hello,

I'm one of the new folks here, so be gentle. A bit about me. I'm a 40 is year old guy, average activity level and slightly over weight. Over the last 18 months I noticed my 20 minute naps turned into 2 hours. My Saturdays required 2 naps when I could get it. I started falling asleep at lunch if I was not active. I knew I has OSA, just needed to hop through the hoops to prove it. My PCP said they normally do a home evaluation before referring to a sleep doc, but he could tell I had it based on my build, so I go the referral. The sleep doc took a look at my throat and said in a surprised voice, you have a tiny throat. She also said a number of time "Oh.. My.. You have it, again, got the referral.

A few days before the sleep study I went in to see the sleep study facilities and try on a few masks. On the night of the study I arrived at the appointed time, got all wired up, cracked a few lame jokes, and hung out until I was ready for bed. I was able to go right to sleep since I had gotten but 3 hours of sleep the proceeding nights due to a endurance event I was in. Half way through the night they placed me on CPAP using the full faced mask we had agreed upon. I slept the rest of the night, and did not get up until much later than I do on a normal day. The next morning the tech from the sleep lab had a few charts to show my periods of chaotic interrupted sleep before the CPAP and the smooth non interrupted sleep with the CPAP.


Today I got the call from the sleep center. I had 102 incidents per hour off the CPAP and 14 per hour while on the CPAP. I realize the 14 is still a bit high, but a big improvement.

Now I wait for the DME to get pre-approval from the insurance CO before I can make an appointment with them to talk about a C-Pap. I've read the horor stories on this board and others about DME's and hope I have a better experience.

Does anyone on the board have any experience with Bel-Regional?? I'm a geeky numbers guy so I'm looking to try and get a ResMed 9 Elite or Auto...Hopefully that will happen.


Seems like this is moving awfully slow!!


Sorry for the long rambling post.....

[elena88]

Well first, congratulations on being diagnosed, then getting into your sleep study, and actually sleeping! woo hoo, thats not easy!

Also, welcome, you have come to the right place if you want to take charge, get the best therapy and be informed..


Im semi new, four months or so.. but if you have been reading the posts, you know there are some really sharp folks here.


I personally cant tell you about YOUR dme, but I can tell you about mine..

I was not prepared for what went down... I went into the sleep doc, thinking she was going to say I didnt have it, and then she says Im severe,
and by the way, now you go next door and they give you a mask and machine you use the rest of your life..
what?
I was in a state of shock, and signed papers I tried to read but didnt quite get, and took home a friggen expensive machine I could have got for half the price on the internet because our deductable was not met.. they will cost you thousands of dollars if your insurance wont pay for it!
You probably read they want to give you a cheap machine, and keep the rest of the money, because, there was only one code for cpaps..
Get yourself resmed s9 autoset with the humidifier.. and get the climate line tubing too.
check to see if your insurance will pay for it, if not buy it on line, and stay the heck away from the dme.. really, I will not have any use for mine now,
I paid my bill, returned the last mask they gave me, and see you later! They were OH SO NICE, when they thought they could get more money out
of me for another mask here and there, but when they found I out I was done, they wouldnt even come to my house to pick anything up, I had to
mail it back.. STAY AWAY From them IF YOUR insurance wont cover it.. they are sharks! smelling the blood in the water with every breath you dont take!
good luck!

[Mbarb]

WOW!!

Lots of good info. This place ROCKS!

Luckily (or not) with the cost of my sleep study I will be meeting my deductible for the year. Surprisingly the DME is handing out Resmed s9 Autoset machines with the Humidifier and the heated tubing. My insurance rents the machine for 2 months and then buys it outright if I meet compliance.

Their idea of "Mask Fitting" was a joke. Only offered the Resmed Mirage Quattro to try because "It's the best". I said it may be for some, but may not be for me.. Did not seem to change the course. They said here try this and then lean back in the chair to see if it leaks. They also do not offer an exchange program for masks.

As we went through the machine setting I did ask for one or two to be enabled so I can see how I'm doing.

Next year when I have not met my deductible I surly will not be setting foot inside any DME. I always like to shop locally but I don't rally like paying twice the price at the local DME verses a trusted online store.

[Mbarb]

Also.. Just for comparison here are the results of my split night sleep study..

Sleep Study Results

N1 4.6 %
N2 47.5%
N3 41.4%
Rem 6.5%
Baseline 02 92 %
Nadir of 70%
Percentage of sleep below 88% = 15%
RDI 102
REM RDI 92
AHI 89
Notes.. Multiple Hypopnea Like events without desaturations even while awake which were not scored.

Second part of the night after CPAP…Much better sleep!!
N1 7.9%
N2 26.9%
N3 28.6%
Rem 36.5%
Baseline 02 96 %
Nadir of 90%
Percentage of sleep below 88% = 15%
RDI 14
REM RDI 4
AHI 9

[topdragster]

Welcome aboard mbarb. I have the S9 auto with humidifier and climate line also and love it. Been on the hose for only two months and seeing the difference it makes in my sleep already even though I was diagnosed with mild osa. I hope you have a positive experience with cpap also.

[elena88]

I also have the s9...
If you get it, make sure you get the hypallergenic filters with it..

get the climate line tubing, even though summer is here, you can get your insurance to pay for it this year, and buy the plain
slim line hose later for yourself..

I dont know if you have tried nasal pillows, I LOVE These things, and have tried several masks and failed with all of them..
this is my gear, and I learned to mouth breath so I tape my mouth with a little medical paper tape and put a quarter inch slit in the middle
so I can cough if I have to..
https://www.cpap.com/productpage/fisher ... -Mask.html

You know what is strange about the dme I had?
there was never ONE price on any paper I was given.. nada!
no return policy was ever given either..
ASK ABOUT THAT.. ask what their return policy is because even if insurance is paying for it, if you keep a mask too long,
you are stuck with it, and insurance wont pay for another one.. only a replacement if you hand one that doesnt work in on time.
ask for the return policy in WRITING..
Make sure you read everything, fine print too.
You sound like you had a great start and actually slept with the mask on, so I hope when you get everything situated, it will be a smooth
transition.. dont change anything in your room or your routine, just add the machine, and get some sleep kiddo!
good luck!
elena

[Jaylee]

Hello and welcome.

[Mbarb]

Well... Made it through the first night without any huge problems. I did run into some leakage issues, but those will get solved with time. Due to some problems at work I only got 3.5 hours of sleep, but I fee remarkably good for that little sleep. I can't wait for the weekend to sleep in and play catch-up..

Last nights stats 4.8 (False starts between work phone calls) hours usage and AHI 0.2.

I think I need to reduce to time on the Ramp setting tonight.

Also need to get the data into ResScan to see when I had the leakage issues....

[scbeaver]

Check with your Insurance about replacement part policy. They may cover them at 100% or high enough percentage that it may be in your best intrest to stay with the DME. Just make certain that they know that you have options, them or elsewhere. That way, you may have a better chance getting what you want. BTW, I use the ResMed Swift FX. When I showed it to my new DME, He ordered one for the store.

Sleep Well

Steve

[Mbarb]

Here is night 2....These are mostly for me to keep track of my progress. Sorry about the rambling....

Took the ramp down to 15 minutes, and I was sleeping long before the pressure got up to my prescribed lever. ResScan shows a bit of a snore on the graphs until the ramp finished and the pressure hit 13. Most of the night I had very few apnea or hypopnea events. Later in the night I had about an hour of pretty sever mask leaks with snore, hypopnea and apnea events. AHI last night jumped to 11...About what I was masked up at the sleep study, but still above the magic number of 5

Need to work on the mask leaks or consider a nasal mask or pillows....

Hypopnea

[KatieW]

Welcome the forum. A few thoughts:

- with newbies, getting used to cpap, finding the right mask, and managing leaks are the biggest challenge. The AHI will drop once you settle in, assuming your titration was correct. Did your report say that you had no events at 14 cm, supine and during REM?

- the magic number of 5 really is just an arbitrary number of events, and one of the indicators of whether sleep apnea needs treatment. What is your breakdown of AHI? Central Apneas, Obstructive Apneas, Hypopneas? I might get 1 or 2 Centrals a night, which is normal. I don't worry about the hypopneas, and really just look at the Obstructive Apneas--and if I can figure what might have caused it: leaks from mask or mouth, sleeping on my back, head pillow shifting the mask causing leaks, or during REM sleep, correct pressure.

- while AHI tells you about events, you might consider an inexpensive pulse oximeter to test your oxygen desaturations

[Mbarb]

This is so true..

with newbies, getting used to cpap, finding the right mask, and managing leaks are the biggest challenge

What is your breakdown of AHI? Central Apneas, Obstructive Apneas, Hypopneas?

Here are thee last 2 nights. Looks really good if you pull out the Hypopneas
AHI 11.5 5.4
C .1 .5
O 4.5 1.7
H 6.5 2.9

Here is night 3...
Leaks are getting better, but still an issue. Still sleeping all night on CPAP. Waking up about 4:00 evey day and then back to sleep until the alarm goes off. This may be TMI, I've stopped waking up to go to the bathroom, but more importantly I'm not soaking my bed and pillow from sweat every night... X10000000

How about the daytime changes I'm seeing. In a nutshell, this was the first Saturday in a large number of years where I did not feel the need to take two naps. In reality, I only took a 15 minute snooze mid afternoon... I'm not sure if it's all in my mind but I really feel good. I feel less foggy and like I'm on a caffeine buzz.

[pdean44]

Welcome aboard you are well on your way to good sleep and better health because of. It took me two weeks to get settled down with the leaks and getting used to sleeping with the gear. My ahi numbers were high for a while have slowly improved over time. I am sure before too long you will be very pleased with the results of your therapy.