Just Diagnosed with Sleep Apnea - Couple Questions

[clinty76]

Hello,

I had my sleep study last week and I just spoke to my Doctor earlier today for the results. He said I have a pretty bad case of Sleep Apnea. The Doctor told me that I wake up an average of 174 times per hour. I'm going to be honest, I really don't know what that means or if it's low, high, good, bad, etc...!

I go in for my CPAP fitting Wednesday and I was hoping for some tips or advice for the actual fitting. I also have a few questions!

Will I be able to pick my machine brand or type?
Will I pick out the mask or do I just have to use what they give me?

Thanks in advance for all your help!

[Pugsy]

174 times a hour...that's pretty impressive.
You only need 30 times per hour to get the "severe" category.
AHI/RAI Scale is a measurement of both the Apnea/Hypopnea Index (QHI) and the Respiratory Arousal Index. If a person has less than 5 events per hour then that person's AHI/RAI would be 0 and that person would not have apnea. 5 -15 events/hour = (mild); 15-30 events/hour = (moderate); >30 events/hour = (severe).

Please read this blog
http://maskarrayed.wordpress.com/what-y ... me-part-i/
and her other page
http://maskarrayed.wordpress.com/

and your questions about machine choice, etc will be answered

Mask choice...you are the final decision maker on it. Finding the right mask is probably the most difficult part of this therapy.
Mask preference is highly personalized. One person's treasure may be another person's trash.
If you can normally breathe through your nose during the day I would opt for nasal pillows as the first mask type to try.
They simply are lighter, have less of a presence on the face and are easier to get and keep a good seal because there is minimal surface area to mess with.

Welcome to the forum. Do lots of reading and asking questions about what you might not understand.
For sure educate yourself on full data machines...don't let yourself get stuck with a brick...explained in the second link above.

[clinty76]

Another question.

Is it strange that I'm going to be fitted for my machine at the hospital I did the sleep study at?

[Pugsy]

The sleep lab at the hospital is also acting as a supplier of equipment. Not unheard of.
Might be a conflict of interest there especially if your doctor owns part of the sleep lab.

Check out what they want to give you before worrying about it though. If they are going to give you a good machine...who cares as long as you get what you want.
Though often they try to dispense the brick machines to make more money. Be prepared to say "no thank you" "I want so and so and if you won't dispense it then I will find someone who will"...and be prepared to do it.
Don't let anyone rush you into anything you aren't ready for.

What is your insurance? Medicare by any chance?
Medicare stuff is pretty standard rent to own thing but private insurance is a totally different animal and that is why we say for you to contact your insurance company directly (don't trust what DME suppliers say) so that you know exactly what is going to happen.

[clinty76]

I have Blue Cross Blue Shield. Yes, my Doctor owns part of the hospital.

I've been trying to do a lot of research, but what is a "brick" machine.

What is a good machine? I've noticed a lot of people talking about the S9

[chunkyfrog]

Yes, but if you are in an HMO, it may be the only way.

[BlackSpinner]

I've been trying to do a lot of research, but what is a "brick" machine.

What is a good machine? I've noticed a lot of people talking about the S9

A "brick" is one without any efficacy data. In other words the only data on the machine is hours used which they require to get paid. It doesn't tell you about leaks or events so you don't know what your therapy is really like.
Don't accept a resmed "escape" anything or anything called a "Plus"

[Pugsy]

A brick machine doesn't offer any data beyond hours of use.
Please read the 2 blog links I put in my first response. Full data vs no data is explained in detail in the blog.

The 2 main players in the cpap/apap machine market are Resmed (they have the S9) and Respironics (they have the PR System One).

I happen to own both of those brands in a bilevel machine. To be honest its a toss up which one might be better. Each has a few minor pros and cons but none make one brand far superior than the other.
Both offer excellent data in the full efficacy data models and both have easy to use (and obtain) software.
These 2 brands would be what I would zero in on studying the models.

In the S9 line the 2 machines that I would look at...the S9 Elite and the S9 AutoSet. Avoid anything with "Escape" in the model name because either no useful data at all or the data is so limited it is almost useless.

In the Respironics machines...the PR System One 60 series Pro (model number 460) would work like the S9 Elite
and the PR System One 60 Series Auto CPAP with AFlex (model number 569) would work like the S9 Autoset.

The Elite is a single fixed pressure machine which is cpap mode...and the Autoset has variable single pressures (apap mode) along with a separate cpap mode (so 2 machines in one).

[sleeplessinaz]

Love my S9. It's a great machine as i have the Elite one that runs apap which means adjustable pressure. It's quiet and gives data right on the screen if you want to see your data every morning. It's a great reliable machine. I love my nasal pillow mask, so please,do,try on several,types while laying down not sitting up! The masks fit differently when you lay down. Good luck to you!

[kaiasgram]

Love my S9. It's a great machine as i have the Elite one that runs apap which means adjustable pressure. It's quiet and gives data right on the screen if you want to see your data every morning. It's a great reliable machine. I love my nasal pillow mask, so please,do,try on several,types while laying down not sitting up! The masks fit differently when you lay down. Good luck to you!

Just so as not to confuse a newcomer -- the Elite is a different machine from the S9 Autoset. The Elite does not run in Auto mode, only straight CPAP mode. But the Elite is a good machine, not a brick.

[jweeks]

The Doctor told me that I wake up an average of 174 times per hour.

Hi,

I think that is the highest number I have seen so far. That is waking up, on average, of every 20 seconds. Since it takes about 10 seconds to be scored as an event, that means nearly every breath you take at night is obstructed, and it leads to a wake up.

Fortunately, severe Apnea doesn't mean difficult to treat. There are some people with very severe cases that are easily treated with just a little pressure, while there are other people with mild cases that doctors find very difficult to treat. It depends on the exact breathing problem and the specific geometry of your airway.

If I recall right, my AHI was 108. Once they found the right machine and got the pressures dialed in, my apnea was easily treated. It did take me a while to catch up on sleep and learn all over again how to sleep through the night, but once that was done, I slept better on CPAP than I had ever remember sleeping in my entire life before CPAP.

Good luck getting started. You are going to feel like a new person once you get into the groove with the treatment.

-john-

[tbhit]

I am new as well, but I can testify to the S9 -- it is great! You can't go wrong with it. As far as masks go, usually they are very willing to work with you to let you try out as many as you want within a set period (mine is 30 days).

[JamesW6175]

Check out the equipment that I have, been very pleased with it. Easy to use and easy to clean. I use distilled water, Walgreens generic baby wipes to clean the full face mask. I would recommend my equipment to anyone that is just starting out. Good luck.

[DreamStalker]

I've noticed a lot of folks being Dx'd in the 100's lately.

When I first got here almost 7 years ago I thought I was high at 102.

Has the sleep industry changed their criteria for calculating AHI?

My 102 was the sum of total apneas (obstructive and central) + hypopneas.