Just Diagnosed with Sleep Apnea - Have Question

[bwak]

Hi Everyone! My name is Barbara. I am 60 years old and I was just diagnosed with Sleep Apnea. I had my sleep study last Monday and now will be going in on the 20th for another sleep test this time on a CPAP. I have COPD and am also on oxygen 24/7. I do not have any details yet on results of the test on how bad my sleep apnea is yet. What should I ask about or question when I go in for my next test. Your input and help would be much appreciated. Thanks, Barbara

[archangle]

Read all the announcements at the top of the forum list to start with.

[Janknitz]

You should read up on machines BEFORE your titration appointment so that you will be prepared to ask for what you want, instead of taking whatever you get. Above all, don't let them "help you" by sending you directly to a DME after your titration--you want to know exactly what you are getting and have some say in the DME (unless your insurance limits you to a preferred provider).

You might like to read "What you need to know BEFORE you meet your DME" which is linked in my signature below. That will help you understand something about machines, DME's, and insurance. Learn all you can before so that you will come out of your titration appointment as an educated consumer rather than a sucker who might get stuck with lousy equipment that doesn't meet your very complex needs.

With COPD and oxygen already, you may need a more sophisticated machine (i.e. a BiPAP or ASV), and some insurers require you to "fail" standard CPAP/APAP before they will let you move on to these machines. That can make the early stages of treatment difficult.

[Slinky]

Barbara, I've TRIED 3 x to respond to your post w/a long list of advice and questions and all 3 times my post went off to cyberspace.

Please go into the Control Panel and allow PMs (Private Messages).

I'm 69, female, have COPD, am on 02 and a bi-level PAP.

[bwak]

I really appreciate each of you for taking the time to respond to my post - it has been so helpful. My plan between now and the 20th is to read as much as I can so be prepared for more questions!! Thanks again, Barbara

Archangle - Thanks for directing me to read to read the info in the announcements. I plan on having a busy day reading up on everything.

Janknitz - Thanks for letting me know about reading up on the different machines before my appointment. I am not sure yet on what my insurance will cover. I hope to read the actual report/results of my sleep study prior to my next visit also.

Slinky - Thanks sounds like we have a lot in common. My profile shows now that it does except private messages - hope to hear from you soon.

[bap40]

Ditto on all the others posts. Read and ask questions now before you are faced with the DME and what THEY want you to have. Since the insurance codes for either a cpap or an auto pap are the same most DME's will try and foist off one of their cheapest machines in order to make more $$$ off of a patient. An informed patient is a much happier patient in the end. Get what you want the first time around so you don't end up fighting for what you want later on.
Good luck!

[bwak]

Thanks Bap40. The equipment I have seen looks so uncomfortable and cumbersome but I am sure after a while, you get used to wearing it.

[Slinky]

PM sent.

Now that the Resmed S9 VPAP, VPAP Auto, S, ST, etc. are finally out I would personally push for a Resmed S9. Assuming your first script may well be for a CPAP insisting on the S9 will make all your accessories compatible w/the S9 VPAP (bi-level) should you be switched to a bi-level later.

Not to say the PR SystemOne BPAP Auto isn't one heck of a good bi-level!!! It is. BUT - the Resmed ResScan software is easier to install and use (in my experience) and easier to understand the data. On the other hand, I have one of the early PR S1's which had some problems, including no backlit LCD screen, which have now been rectified w/those coming out in 2011. So if you get a PR S1 instead of a Resmed, take a look at the plate on the bottom w/the manufacture date and INSIST on a 2011 production date and that the provider show you the LCD screen lit up before accepting it. Since you are already getting your 02 supplies from a DME provider you've got a lot of heavy weight bargaining/negotiating room going for you. I'm sure they aren't going to want to lose your 02 business quibbling over what brand and model PAP you want. *wicked grin*. Don't be bashful about using that leverage if you have to to get what you want, w/in reason, of course.

I would call your insurance company (or secondary insurance if Medicare is your primary) and ask them what local DME CPAP providers they are contracted with. Hopefully you will have the option of more than just your current provider. Just a little more leverage if you need it to get what you want to have the option of moving all your business elsewhere. And, you CAN, even w/Medicare, use one provider for 02 and another for PAP and accessories. I did that for a while until I could "get rid of" my first DME provider who was a real sheister. You can make this call whilst you're waiting for you in-lab PSG study. Be prepared is the Girl Scout or Boy Scout motto.

Ask to try the new Resmed Mirage FX nasal cushion mask and the Resmed Quattro FX full face mask and the Resmed Swift FX nasal pillows mask and an oro-nasal mask at your PAP titration study. One of each style to see what seems to work best for you. They'll do the mask selection and fitting prior to tucking you into bed for the night. Well, just a figure of speech, you crawl into bed yourself.

That's all I can think of right now. Plus what I PM'd you so I didn't have to repeat myself. I'm sure I will think of more and don't you be bashful to ask questions!!!!

[Mr Bill]

...With COPD and oxygen already, you may need a more sophisticated machine (i.e. a BiPAP or ASV), and some insurers require you to "fail" standard CPAP/APAP before they will let you move on to these machines. That can make the early stages of treatment difficult.

Quoted for emphasis! I hope you have a friendly talkative sleep tech like I did. That person will give you more information than anyone else you are likely to meet in this process. Be sure and ask all you can. Mine let me sit down at the console after the study and he explained to me all the squiggles. It really helps you get your head around whats going on.

[bwak]

Slinky - Thanks for all of the info - will send you a PM.

Mr. Bill - Thanks - hopefully, I will get the same tech I had for my sleep study. She was very helpful.

[Mary Z]

I wouldn't count on seeing the sleep study before your appointment with the doc, unless they did that you before.

[bwak]

Had the sleep study done last Monday and now going in for the CPAP sleep study. Hoping to see the first study along with getting my numbers from all of my breathing tests that were done. Not sure if I will be successful but am going to try. Thanks

[builta]

Welcome,

One last thing, when you are trying on the different masks at the next study, it is important to do it while you are laying down in bed (with your pillow). The masks fit your face differently when you lay down (and of course you use the mask laying down). Have the tech adjust the masks with the machine running and have her change the pressure some so you can make sure that the fit holds and you don't have too many leaks. Leaks into your eyes are not good.

Good luck, read, read read. Then ask more questions. There is a lot to learn but there are lots of people here who want to help ad have been where you are at. You will have a great support team. I am so happy that you found us before you had the titration and the initial DME visit! I'm sure that you will do great. Just finding this forum practically ensures it.

I know that it is a lot and its a little scarry. The second study will have the masks. Have the tech show you that you can breath through each of the masks when the machine is turned off. The mask will always let you breath. CPAP is very very personal and kind of invasive but, all of us here do it and it really can help.

Cheers

[bwak]

Builta, Thanks for all of the helpful tips. I am glad I found this forum prior to additional testing. I plan on reading everything I can find on this site and then start writing questions I want to ask. I am amazed and thankful at all the info available here and really appreciate the help and advice from everyone that have posted to my question. I am sure there will be more questions to come. Again thanks!! Barbara

[bwak]

I went to the doctors and got the "technical findings" of my sleep study. They do not make much sense to me but hopefully, someone can help me understand my sleep apnea and how severe it is. Here it goes!

Patients respiration's indicated sleep disordered breathing with an overall apnea/hypopnea index of 8.3/hr in all sleep positions and sleep stages. The REM index was in the moderately severe category at 20.1/hr. There were 48 apneas and hypopneas. There were also 11.0 RERA's noted per hour. The overall RDI was 19.3/hr.

The mean SaO2 during study was 93.3% with a nadir of 85.0%

EKG showed normal sinus rhythm with a heart rate from 23.0 to 122.0 b.p.m.

The sleep Efficiency was 78.6%. REM sleep and Slow Wave sleep constituted 19.7% and 16.2% of the total sleep time.

Oh, and I guess I snore pretty load rated a 7 on a scale of 1 to 10!!

Thanks! Barbara