Just diagnosed.

[ParanoidAndroid]

Hello All,

Just wanted to say "hi". I've had apnea for years, but only finally made it to a sleep study last week. The technician looked me over, and said, "We put the mask on midway through the test if you top 80 events in the first 2 hours. You won't do that." I said, "Don't underestimate me. I have testimonials to my snoring prowess!"

Four hours later, she came in with a mask. I smiled, and she laughed, "Yeah yeah... you were right." Admittedly, I woke up after another three hours sleep feeling surprisingly alert. So I am sold on the idea that this is going to be positive, despite all the trouble of maintaining the equipment. But I have not yet been prescribed a unit.

I will share this... the single mask I tried on was a nose-only mask. It pressed hard on my upper lip. I probably would not have noticed, except I'd read about the pressure moving your front teeth over time. Is this a real concern? Or is this just because it was one mask, fitted in the middle of the night? Should I expect less pressure on the teeth from a properly chosen/fitted mask?

Aside from that one concern, I think I'm pretty much mentally/emotionally prepared for this. I'm ready to start feeling awake again during the day.

Thanks,
Eric

[archangle]

Welcome to the board. Hope you get some relief.

A nasal mask is preferable to a full face mask as long as you don't have a problem with mouth breathing. It can be a nasal mask that has cushions that fit around your nose or a nasal pillow mask that sticks on your nostrils.

Many people have initial problems getting used to the nasal pillows sticking into/on their nostrils, but lots of people like them eventually.

Nasal masks probably have fewer problems. People tend to worry about them being bigger and more uncomfortable looking at first, but I think they're easiest to use and work well. I like my Respironics Comfort Gel Blue mask.

Any mask can give you leaks, irritation, or other problems. You can usually change masks within the first 30 days if the one you start out with doesn't work.

Read the announcement threads on the main page and the Wiki at the top.

You have a golden opportunity to get the right CPAP unit the first time. The DME (equipment provider) will probably try to shaft you with a cheap substandard unit. Read up here to figure out what CPAP unit you want to get and don't let the DME shaft you.

Get your own prescription on paper from the doctor. Do NOT let the doctor or sleep lab choose your DME and fax him a prescription. Then shop around the DMEs who your insurance will work with.

[elena88]

HI Eric!
I havent been here for awhile, but I just wanted to say hello, and I do remember what it was like to be a little newb..: )
Your best friend is research!

Do it all before you meet with the turkeys who give you the equipment..

I dont know what the latest and greatest machine is out there now, but the s nine autoset was a best bet for a lot
of folks..

Glad you got such good results already.. good for you, maybe youll have some smooth sailing and vibrant mornings
ahead!

good luck!

elena

[Breathe Jimbo]

The most important thing is to get a machine that is fully data capable, i.e. provides detailed information about your events and AHI while asleep, so that you can monitor the effectiveness of your therapy, the same way a diabetic monitors his blood glucose and someone with high blood pressure monitors his blood pressure. Do not accept any machine that reports compliance (i.e. usage) only. Those machines tell you nothing about whether your therapy is actually working.

It is probably a good idea to get a machine that uses a standard SD card, not a proprietary data card. The former you can read in any generic SD card reader. The latter requires a proprietary reader, which may be difficult or impossible to get without substantial expense.

The most widely used machines are from ResMed and Philips Respironics.

[Vladesch]

S9 is great if you have a pc to run the software (which is easy to get).
You can plug the SD card into a USB converter and straight into the back of your PC.
Makes it easy not having to lug your machine in with you when you see your doctor.

The resscan software gives extremely detailed information about your sleep. You even get graphs showing your respiration through the night, and you can zoom in on the events and see exactly what is happening.
I have a s9 and I am completely satisfied with it.

[Pugsy]

Welcome.

Sleep techs are notorious for cranking down masks way too tight. So don't judge all masks by that one experience.
If you can use something like what I use you will barely notice it.

[robysue]

Eric,

As others have pointed out, it's important that you get the right machine right from the start. And to be a full participant in treating your apnea, you should hold out for a full data machine. Janknitz has a great blog with lots of useful information that you need to know BEFORE you start talking with the DME and BEFORE you accept delivery on any CPAP machine. Her blog is at: What you need to know before you meet your DME

And then I've also included some standard information I also post here about the specific names and models of the three most commonly provided xPAP lines below. It's important to realize that the naming of xPAP machines is (intentionally?) confusing and resembles the naming of various trim lines for a given make and model of a particular car.

As for the mask putting pressure on those upper front teeth. Yes, it could be the tech tightened it too much. Or it could be that that particular nasal mask is just not for your nose. Or it could be that you'll find a nasal pillows mask more comfortable. When you try masks on at the DME make sure you try on several masks at your prescribed pressure. And I'd ask to try on a couple of pillows masks as well as nasal masks if I were you.

Welcome and best of luck!

Important Information About the Three Most Commonly Used Brands of CPAP/APAP Machines

For the three most common brands of xPAP equipment here's what you need to know about their most RECENT lines of machines:

• Full Efficacy Data Machines:
  • Resmed: The S9 Elite CPAP with EPR and the S9 AutoSet CPAP
  • Resprionics: The System One REMstar Pro CPAP with C-Flex Plus and the System One REMstar Auto CPAP with A-Flex
  • Fisher & Paykel: The Icon Premo CPAP and the Icon Auto CPAP

• Only Compliance Data Machines:
  • Resmed: The S9 Escape CPAP with EPR and the S9 Auto Escape CPAP
  • Resprionics: The System One REMstar Plus CPAP with C-Flex and the System One REMstar DS150 CPAP
  • Fisher & Paykel: The Icon Novo

Important Notes:

1) It is best to hold out for a full efficacy data machine right from the start. As soon as you accept a brick that records only compliance data, you will have a mess on your hands if you later try to upgrade it to a full efficacy data machine. So if a DME contacts you (because the sleep doctor's office sent the script) and makes an appointment to set up the equipment and then shows up with a compliance-only brick of a CPAP, REFUSE delivery of the machine. Yes, they will tell you, "This is exactly what the doctor ordered." But YOU are paying for the machine (through your co-pay and your insurance company's money) and you are under NO obligation to "accept" a machine that you believe will be detrimental to your health in the long run. Politely inform them that you will only accept <fill in list of machines that you find acceptable> and that if they are unwilling or unable to provide you with such a machine, you will take your business to a different DME.

2) The naming of two of the Resprionics System One straight CPAPs is particularly confusing:

• The System One REMstar Pro CPAP with C-Flex Plus IS a full data machine, but
• The System One REMstar Plus CPAP with C-Flex IS NOT a full data machine.

3) Technically the Resmed Auto Escape is not quite a "only compliance data" machine because it does give a minimum amount of data beyond the number of hours used. But not enough additional data for it to be considered a full data machine. If the choice is between the S9 Elite and the S9 Auto Escape, you're better off with the Elite in my humble opinion.

4) On-board Data: Each brand of machine has its own select set of data can be viewed directly off the machine's LCD. The Resmed S9 AutoSet and Elite have by far the best on-board LCD data of any of these machines since their LCDs will let you see all of the following: AHI, AI, CAI (from which you can easily compute OAI and HI); 95% Unintentional Leak rate; 95% Pressure Setting (AutoSet only); and hours used (of course). You can also easily change the reporting period from 1 day to 1 week to 1 month to 3 months and more. The on-board data for the Resprionics System One machines is limited to 7 and 30 averages for AHI (not broken down by type) and 7 and 30 averages for "Percentage time spent in Large Leak." That Large Leak data is useless in my humble opinion----in part because Resprionics leaves the definition of Large Leak undefined and in part because a Large Leak has to last an awfully long time to show up in a 7-day average (let alone a 30-day average). I've used both an S9 AutoSet and a System One BiPAP Auto so I know those machines really well and speak from direct experience. I am not directly experienced with the F&P Icons, but as near as I can tell (based on information in other apnea forums that I read), the on-board data for the Icon has the following data: 1, 7, and 30 day figures for AHI (but not broken down into type), leak rate, and the 90% pressure level and SenseAwake stats for the Icon Auto.

5) Software: The S9 needs ResScan, which can be downloaded for free once you know where to find it. (Search for posts from a forum member named Uncle_Bob since he keeps a link to the ResScan download in his signature.) The System One needs Encore Viewer (which can be purchased for $100 from a variety of on-line cpap supply stores) or Encore Pro (which is sold to DMEs and doctor's offices, but not patients). If you really want Encore Pro, there are torrent sites from where it can be downloaded. There are also two forum members who are in the process of writing free software for analyzing the System One data: Cpapdork's Onkor program is a web-based program that does not require installing anything on your machine; jedimark's SleepyHead can be downloaded as an .exe file for a windows machine and the source code is available for those who want to try to compile it on other platforms. Both Onkor and SleepyHead are still in the early stages of development, so there are still bugs that the authors know they have to work on eliminating, but both programs can usefully provide some meaningful information to the System One users who cannot or do not want to pay for Encore Viewer. The Icon uses InfoSmart, which appears to be aimed at clinics and sleep doctor offices. I have no information about how a user might find and install the InfoSmart software for their Icon machine.

6) Data cards: The S9 and the System One both use standard SD cards for the data. The Icon uses a SmartStick.

[Hawthorne]

AND - not to forget, the Devilbiss Intellipap AutoAdjust with Smart Flex. This machine also has software you can purchase or you can enter the code from the machine, each morning on cpap.com or on the Devilbiss site, and get a good amount of detailed data. It has a standard SD card.

Many on this forum have this machine and really like it. I have it as a backup machine and can't pick a favourite between it and my PR System One Auto with A-Flex.

The Intellipap autoadjust is very quiet and much cheaper than all the others!

[ParanoidAndroid]

Wow! I'm thoroughly amazed at the number of responses in just a few hours! I'm going to go back through and start researching some of the mentioned units. I agree fully that research is they key between being a hapless victim and an active participant in your care. Even if you have to parse through some internet fluff on the way, at least you walk in knowing the terminology and able to understand what the docs are telling you.

I posted a detailed description of my sleep study on Facebook so others would know what they were getting into when they went (including a photo or two of myself wired for sleep). If you think it would be helpful, I can post it here, too. Not sure how many folks would end up here even before their sleep study.

[robysue]

AND - not to forget, the Devilbiss Intellipap AutoAdjust with Smart Flex. This machine also has software you can purchase or you can enter the code from the machine, each morning on cpap.com or on the Devilbiss site, and get a good amount of detailed data. It has a standard SD card.

Many on this forum have this machine and really like it. I have it as a backup machine and can't pick a favourite between it and my PR System One Auto with A-Flex.

The Intellipap autoadjust is very quiet and much cheaper than all the others!

Thanks Hawhorne! I need to update that standard post of mine. I'll try to do that before I post it again.

[ParanoidAndroid]

AND - not to forget, the Devilbiss Intellipap AutoAdjust with Smart Flex...

Very interesting. It appears to be a travel model, though. Will it hold up as long as the pricier ones? Even if it did dollar-for-dollar (i.e. if it lasted 2/3 as long), it'd be a bargain, and it would travel well when I go on business trips!

As for right now, the overwhelming positive response to the ResMed S9 AutoSet model has me targeting that one (with the corresponding humidifier). I will be calling my insurance this week to find out how my policy (Cigna HMO) covers CPAP equipment... whether it's by allowance, approved models, or percentage. Our prescriptions are handled by a list of approved medications, undoubtedly with paybacks from the pharm companies (sorry... a little jaded concerning big insurance).

Thanks for all your help! I'm not done researching yet!

[jmcanzo]

The intellipap is TRAVEL SIZED...not any less of a machine. Actually has the longest warranty of 3yrs