CPAP prescription pending followup?

[ncgncg]

After my recent sleep study at a prestigious teaching hospital, I was told that I won't be able to have another appointment with the doctor, let alone start treatment, until August. The doctor is apparently a fellow in the teaching program, and all the fellows are apparently graduating soon, which apparently messes up the schedule. Basically, I'd have to wait for the new class of doctors to arrive.

Fortunately, one of the research staff helped out and arranged for the doctor to write and mail a prescription for an "auto CPAP" machine, which she says I could start using without a second sleep study because it titrates automatically. I would still meet the doctor in August to see how things are going. I'm glad I don't need another sleep study, but I'm a little nervous starting treatment without seeing the doctor again first. Nobody is telling me whether my condition is serious, how well I should expect treatment to work, or anything like that.

Please tell me I'm overreacting and I'll be fine...

For reference, the AHI was 18.5 (with "alternative scoring", whatever that is).

[patrick_a]

You're over-reacting. Relax, get the Rx, get the auto mach and follow the MD's instructions... you're going to be fine.

Kinda shocked that the MD is trusting the mach over the sleep lab, but I guess this is more and accepted with the newer auto cpaps.

[LSAT]

18.5 is considered low moderate. With an auto machine the unit will adjust to whatever is necessary to stop apneas. Be sure that the auto you get is data capable... ask for a Resmed Autoset or PR system One auto.

[SleepingBetty]

I don't know what "alternative scoring" means, but I am quite sure you will be fine. Your AHI indicates moderate OSA. Mine is in the same category, although it is severe during REM which is a great reason to have an auto machine. I actually started out by doing an overnight oximeter test which indicated I might have a problem. I didn't pursue it for over a year until my endo questioned me about it. He had originally written a Rx for an "auto CPAP trial" so he immediately renewed that and I found myself picking up a machine a few days later. I was determined to use that thing every night to ensure that I got as accurate a report as possible. After two weeks and mostly lousy sleep, I returned the machine and got the report. It was pretty obvious I needed a machine, although we didn't know exactly what my AHI was. But to get one, I needed a Rx. To get my insurance to pay for it, I needed a sleep study. Two actually, as it turned out.

Meanwhile, I had mentioned to the DME (CPAP provider) that I could probably tell better if I had the machine longer whether it was really benefitting me. He actually let me keep the machine until I was able to get my own which took two months! The machine I had was originally set "wide open" with the pressure range from 4 cm H2O to 20 cm H2O. Just before I exchanged it for my own, more updated machine, I increased the minimum pressure to 6 cm H2O. I didn't die! I didn't have some horrible, unthinkable thing happen to me! I am still here and continuing to adjust to my machine and mask which are both different from what I started with.

This forum has been a huge help in my understanding what is going on and in monitoring my own treatment. I don't have a sleep doc, just a GP who is more than happy for me to take things into my own hands. In fact, he knows that is what I usually do! So, get the auto machine and hang around here for help. It may be tough, at first, but we'll help you through it. There are some very, very knowledgeable people on this forum! Oh, be sure to do what LSAT said about the machine. You need full efficacy data capability.

[ncgncg]

Thanks everyone!

I strongly believe in measuring any parameter you try to control, so I'll definitely be asking for a full data machine.

Does anyone happen to have a particularly good experience with a particular DME in the Palo Alto area?

[Sir NoddinOff]

I think this whole episode was probably a blessing in disguise. Some new sleep doc will show up in August and maybe they're great, maybe not. Who knows. If indeed you do have moderate Obstructive Sleep Apnea (OSA), then you're in good hands here. The senior members on this site, chomp that stuff down for breakfast

IMO, take your new machine and exit the DME's office with a smile on your face. I'd advice checking in with your new doc in August, just to double check your therapy, but don't wait until then to take it into your own hands.

[Sir NoddinOff]

Thanks everyone!

I strongly believe in measuring any parameter you try to control, so I'll definitely be asking for a full data machine.

Does anyone happen to have a particularly good experience with a particular DME in the Palo Alto area?

Please, if you do find a great one, PM as soon as you confirm their greatness Something about "rare as hen's teeth'?"

[caffeinatedcfo]

Don't worry. This is exactly how I started and was practically an expert by the time I had my second (titration) study. When you get your machine, fill out your equipment in your profile, download Sleepyhead software (it's free), and post your nightly Sleepyhead data graphs here and we will help you.