New to CPAP

[Tekcor1]

Hi all. My name is Paul. I was diagnosed with Apnea a few weeks ago. I finally got my machine on Wednesday. Of course, I didn't do my due diligence and read up here first before I met with my DME. Ended up with an ResMed Escape Plus. No data - at least no useful data. I also was set up with Nasal pillows. The DME let me try on the nasal pillows, nasal mask, and full face mask. I told her that I generally breath through my mouth at night and she assured me that I probably wouldn't any longer once I started cpap. Hopeful, I decided on the nasal pillows, knowing that I had 30 days to exchange in case it didn't work out.

I tried it out the first night and after an hour took it off because all I wanted to do was open and breath through my mouth. I should have went with my initial inclinication and went straight to the full face mask, but as I stated I was hopeful. In retrospect it was pretty silly because I have chronic nasal congestion, not just at night, so I breathe through my mouth a lot, not just at night. Anyway I called on Thursday and requested to change out the mask. Unfortunately she couldn't get me in until Monday.

In the meantime I did a lot of reading on here and came across the "WHAT YOU NEED TO KNOW BEFORE YOU MEET YOUR DME" blog post and realized that I was suckered into taking a brick. So then I read the other blog post "Help, I’m stuck with a brick*!" and realized that there may be hope for me yet. I am on a rental for the first several months, so Monday before I go in to exchange the mask I will call another DME and see if they will agree to get me the S9 Autoset if I return the Escape Plus to Lincare. Hopefully this will pan out and give me the leverage to get one with full data from Lincare. Wish I had done my research beforehand!

I also haven't tried to use the Escape since that first night. I'm hoping that only having one hour of use will help in my quest for exchange. Not sure if that is sound reasoning or not but that's my reasoning. I'm also going to try to exchange the mask for the ResMed Mirage Quattro Full Face. The reviews on this mask seem good, and I read that Lincare has a contract with ResMed so hopefully they will have this mask in stock.

As a side note, I only got the sleep study done because I was having heart palpitation and my heart checked out fine so my cardiologist ordered it to rule out other things. I slept very little (and terribly) during the sleep study, but I had 29 events per hour for the time I was asleep. It will be interesting to see how things work out once I get going with the cpap.

Lastly, I just want to say that I appreciate all the great adice on this forum!

[thud]

Hi Tekor1...

I am new to CPAP too(1week). I have nasal. pillows and also just got a Mirage Quattro FFM. When you tried your pillows did you also use a chin strap? I am normally a mouth breather too but using a chin strap allows me to use the pillows. I was suckered(maybe suckered was a bad word because I don't know what their real intent was) into the S9 Escape but the next day I called my DME and asked for a better model that does data recording. He swapped it for an S9 Elite without any problems at all. I am pleased with the S9 Elite. Yes, get on it immediately to have a better chance of swapping but I don't think you will have a problem. I read those articles you cited, very helpful, but for me I've had nothing but praise for me DME thusfar. He really seems like my interests are of his concern. Good luck to you.

[Mary Z]

I hope you can get your machine switched out without problems. If we don't know what we want in a machine I don't think we can blame the DME for giving us a compliance data capable machine. Many people are not interested in their data- you won't find them on this forum. They either use the machine, or don't and it ends up in the closet. In either case I believe a data capable machine for someone not interested in the data is a waste of resources.

It sounds as though you have a positive attitude and will work to make your therapy work for you. Keep us posted on how you're doing. Good luck.

By the way, I also am a mouth breather with occasional nasal congestion and find a FFM to be my best option. What the tech told you was tue though, most people breathe through their nose after going to sleep.

[BlackSpinner]

I hope you can get your machine switched out without problems. If we don't know what we want in a machine I don't think we can blame the DME for giving us a compliance data capable machine. Many people are not interested in their data- you won't find them on this forum. They either use the machine, or don't and it ends up in the closet. In either case I believe a data capable machine for someone not interested in the data is a waste of resources.

They only do it for their profit. Your insurance doesn't pay more. One doesn't need to data AS LONG AS EVERYTHING WORKS FINE. It is stupid to assume that be spending ONE night in a strange environment you are going to get an accurate snap shot of peoples needs. Everyone should spend their first month verifying every detail of their therapy. One does that for other equipment one buys. You need to treat you cpap therapy the same way you buy a car, invest as much time and energy as you would when buying a new car. Bloody hell, some people spend more time and money buying shoes then they do buying masks and machines.

[avi123]

When I started CPAPIng I was given the S8 Escape II (brick) and was happy with it for while because it was set by the DME to my prescribed pressure which was 6 cm H2O. It allowed me to go thru the side effects associated with CPAPing without being bothered by data numbers. Those side effects are quite horrendous to get used to. After two months on it and learning more about CPAPs I asked for a data capable machine and given the option to swap to an S9 Elite. At that point I started to follow suggestions from posters on this board to raise the pressure in it gradually until I see my events drop below 5 an hour. Well, to do that I started a to titrate my self on the S9 Elite to find the lowest effective pressure for my case. But, unfortunately, I could not find such an effective pressure. Take a look if you can decide:





So my suggestion is, especially to Paul who might have some heart problems, is to take it easy with fiddling with the CPAP set- up b/c raising pressure while having heart problems could cause real problems.

Overall, it's nice to be able to adjust pressures if you have a knowledgeable and dedicated person in the Sleep Medicine field to consult with.

[robysue]

Bloody hell, some people spend more time and money buying shoes then they do buying masks and machines.

And no doubt, that's part of why the overall compliance rate is so poor.

BlackSpinner's entire post is spot on about this issue.

[robysue]

When I started CPAPIng I was given the S8 Escape II (brick) and was happy with it for while because it was set by the DME to my prescribed pressure which was 6 cm H2O. It allowed me to go thru the side effects associated with CPAPing without being bothered by data numbers. Those side effects are quite horrendous to get used to.

Anybody who's followed my story here knows I had an extremely difficult time adjusting to CPAP/APAP/BiPAP. I've not played with my pressures, although I've had 5 different prescribed pressure settings over the past year---all set by the doctor, not me. The first pressure adjustment was made by the doc's office about 4 weeks into therapy when he switched me from CPAP at 9cm, which I simply was not tolerating in terms of side effects, to an APAP range of 4--8 based on a week of autotitration (during week 3 of therapy) that showed my median pressure level was about 6.5 and my 90% pressure level was about 7.5.

Had I not had an S9 AutoSet capable of telling me that the machine was working in the sense of drastically reducing my AHI everynight right from the start of my therapy, I would have most likely abandoned therapy by around the end of the first month: The cost of treatment in terms of the side effects and the total chaos they created in my life would simply have not been worth it had I not had the proof every single morning that the machine was doing me some objective good.

That's why I think all patients should routinely be given a machine that records full efficacy data and be shown how to find their overnight AHI in the morning: Data is a powerful thing---if it's good, it encourages you to keep on working at it in spite of the on-going problems; if it's bad, it helps justify going ahead and calling the sleep doc's office instead of waiting for a followup many, many weeks or months in the future. In either case, having the data helps encourage compliance with therapy, whereas flying in the dark when you're running into serious problems does not.

[avi123]

[quote="BlackSpinner"][quote="Mary Z"]


71. The lame can ride on horseback, the one-handed drive cattle. The deaf, fight and be useful. To be blind is better than to be burnt on the pyre. No one gets good from a corpse. The Havamal

Don't physicians get "good advice" from cadavers?
And what about Leonardo De Vince's art work?

[JohnBFisher]

... Don't physicians get "good advice" from cadavers? ... And what about Leonardo De Vince's art work? ...

You are definitely right, avi123. Doctors and researchers DO learn a great deal the deceased. For example, in neurological research, doctors learn more and more about neurological problems when they dissect the brain of someone with a neurological issue.

Of course, as my neurologist frankly admits, he won't know for certain what my neurological issue is until he can do an autopsy. We both agreed that I would do my best to try to delay a definitive diagnosis!

[JohnBFisher]

Hi all. My name is Paul. I was diagnosed with Apnea a few weeks ago. ... As a side note, I only got the sleep study done because I was having heart palpitation and my heart checked out fine so my cardiologist ordered it to rule out other things. I slept very little (and terribly) during the sleep study, but I had 29 events per hour for the time I was asleep. It will be interesting to see how things work out once I get going with the cpap. ...

Fortunately, you should see definite improvement in your situation. Personally, I found that without proper treatment my blood pressure was uncontrolled (even with medication). But with proper therapy, my blood pressure is normal (with medication). Still, adjusting to xPAP therapy can be a struggle. But as you've seen, this site offers a wealth of experience to help you make this a successful endeavor.

[GumbyCT]

In either case I believe a data capable machine for someone not interested in the data is a waste of resources.

Just how does a doc help the person who doesn't have a data machine? The insurance will only pay for so many sleep studies and certainly won't just to troubleshoot leaks.

The point is - the user doesn't have to be interested looking at (or understanding) the data to need a data capable machine.

[greatnitz]

I had the same issue as you...I didn't read this forum until after I went to the DME and got my brick. When I called back and asked to exchange my RemStart Plus brick for a RemStar Pro, they didn't ask me te twice. Then again, I only had the unit for 3 nights before I called and asked for the PRO model.

[archangle]

In either case I believe a data capable machine for someone not interested in the data is a waste of resources.

Only if you have an incompetent doctor as well as a disinterested patient.

Even if the user never looks at the data, a competent doctor will look at the data to see how the therapy is working. If the patient is still having problems despite CPAP, a competent doctor will look at the data and may be able to fix some problems without doing another sleep study.

I think that if the insurance companies were smart, they'd insist on fully data capable machines, and require someone to review the data after therapy starts. And offer a yearly review.

[GumbyCT]

In either case I believe a data capable machine for someone not interested in the data is a waste of resources.

Only if you have an incompetent doctor as well as a disinterested patient.

Even if the user never looks at the data, a competent doctor will look at the data to see how the therapy is working. If the patient is still having problems despite CPAP, a competent doctor will look at the data and may be able to fix some problems without doing another sleep study.

I think that if the insurance companies were smart, they'd insist on fully data capable machines, and require someone to review the data after therapy starts. And offer a yearly review.

FINALLY, something we can agree on

Mark your calendars folks

Just how does a doc help the person who doesn't have a data machine? The insurance will only pay for so many sleep studies and certainly won't just to troubleshoot leaks.

The point is - the user doesn't have to be interested looking at (or understanding) the data to need a data capable machine.

And now for peace in the Middle East
or shall we work on World Hunger?

[archangle]

FINALLY, something we can agree on

Yes, but I phrased it so much more clearly and eloquently.