New Here - Suspect I Have OSA (Story Inside)

[needtobreathe]

Hi everyone,

First off, I just wanted to thank you all for the time and effort that you put into helping others with this condition.

I am a 27 year old male, currently uninsured, and I suspect I suffer from long-undiagnosed OSA. I have suffered from continuous exhaustion, depression and anxiety for the past 7 years, and it has steadily gotten worse as my weight has increased. I have been told that I snore very loudly - to the point of angering otherwise extremely relaxed/laid-back roommates.

I have started on a serious diet / exercise plan, and have lost 21 pounds so far on it (with just over 100lbs left to go). However, I can't shake this brain fog, inability to focus, and just plain fatigue that I feel on a daily basis. It takes all of my energy and willpower to make it to the gym and eat right - and I need some additional energy to get a new job (with health insurance!) and just feel OK about life in general.

I barely make enough to cover my rent, groceries, and gas, and am currently uninsured - so no sleep studies will be happening for the foreseeable future.

I'm wondering if its possible to just go ahead and purchase a cheaper CPAP from secondwindcpap.com (they have one listed for $95 with free shipping), and just start experimenting with pressure levels until I feel better. Does anyone here have experience with this?

I feel like the last 7 years of my life were just robbed of me, and now that I think I might have a handle on the issue, I really want to get this under control. Any advice you have would be greatly appreciated.

Thanks,

NeedToBreathe

[kaiasgram]

Hi needtobreathe -- Secondwindcpap requires a prescription. Also, if you're flying "blind" (no sleep study and no prescription), you'd need to start with an auto-adjusting machine, not a straight cpap machine (I think the machine you were looking at on secondwind.com is a straight cpap machine. To start, do you have access to a doctor for just an office visit and consultation about your suspicions of sleep apnea?

Some people have come to this forum like you, they purchased an APAP machine from an established member here or from Craigslist (best to go with a known forum member when possible), and were able to get PAP therapy working for them without insurance and without having had a sleep study. But you want to do that carefully and with guidance from knowledgeable users. It would also be important to get software (free) to monitor the results of starting to use a machine.

Welcome -- let us know how we can help more with your situation.

Edit: STL Mark (next post) is one of our trusted established forum members, and he added something I forgot to mention which is the importance of getting a machine that provides full treatment efficacy data.

[STL Mark]

If I were going to try this on my own without doctor support I would look at an Auto CPAP unit with full data options. These can sometimes be found in craigslist or places like secondwindcpap. Units to look for would be ResMed S9 Autoset, Respironics Auto CPAP model DS550 or DS560. These will give you the information you need to self titrate and to monitor your progress.

For reference purposes I have the following unit for sale. You should not pay more than 75% of that if buying used.

- - -

Phillips/Respironics System One REMStar 60 Series Auto CPAP Machine - DS560. This is a new unit that has never been used. It is in perfect condition with the heated humidifier, humidifier tank, hose, power supply, SD card and travel case. The unit has never been exposed to a smoking environment. I will provide free shipping to a US address, or at cost shipping outside the US. References available upon request. $400

[needtobreathe]

Hi Kaiasgram - Thank you for your helpful reply. On the doctor thing - I haven't visited a doctor in years - the last time I saw one I was for a mandatory physical to play high school football. I'm not even sure how to go about getting in front of a doctor without insurance - do you just look them up online and offer to pay cash? I apologize for my ignorance on this - I've been ignoring/denying/avoiding these mounting health problems for a while now, and never learned how to navigate the healthcare system (other than a basic understanding that without insurance, you're screwed). I do know that the new healthcare law is supposed to come into effect this fall in my state, but they haven't yet released what the rates will be to get covered that way.

Hi STLMark - Thanks for the heads-up on pricing for the automatic PAP machines. From what Kaiasgram says as well, that would be the way for me to go if I were to try and do this on my own.

To both of you - what would you recommend in general? Wait for the new healthcare law? Try and see a doctor without insurance (however that works)? Go it alone with an automatic machine? I'm motivated as all hell to get this sorted out. Again thanks for your help, looking forward to hearing your responses.

[STL Mark]

To both of you - what would you recommend in general? Wait for the new healthcare law? Try and see a doctor without insurance (however that works)? Go it alone with an automatic machine? I'm motivated as all hell to get this sorted out. Again thanks for your help, looking forward to hearing your responses.

There are some options through an organization called Needy Meds. Click this link for information on free or low cost clinics in your state. If I was going to see a doctor outside of the Needy Meds list, I would be very cautious about getting all pricing up front. You may also want to inquire at your county health department as to if doctors are available for visits for free.

[ironhands]

Do a sleep study. I was convinced I had OSA, and have identical symptoms to you. Even waking up not breathing, shallow breathing, or deep breathing.

Upon completion of my sleep study, it looks like it's actually narcolepsy - I'll find out for certain in a few days. I had NO apnea events on my study.

I would strongly advise against picking up a CPAP until you have a solid diagnosis. Using one without the need can potentially harm you, and, if it's not what you need, it might not even solve your issue.

There are take-home tests you can run, that aren't too expensive from what I understand.

[oak]

mark that was a really good reference. i would just say to keep moving forward with this just a little each week so you maintain that motivation. baby steps.your persistence will serve you well. first task is to get into see a dr. if dr. agrees, once you get a prescription, things can move ahead from there. keep posting here for good ideas. it helps to have support.

[Pugsy]

Plain jane vanilla Obstructive Sleep Apnea with no complicating factors can probably be managed well on your own with proper education on your part. Not impossible but it will take work on your part if you want to do it right.

In lab sleep studies are there to pick up on the other things that might complicate the situation or maybe OSA is not the problem..that's a plus for the sleep studies but sometimes we don't get to have a sleep study.

You might consider starting with just an overnight recording pulse oximeter....though it comes with its own limitations.
Not everyone will have significant drops in oxygen levels with apnea events...so an unremarkable overnight pulse ox doesn't automatically mean no OSA...but if you have a fairly exciting overnight report with significant drops in oxygen levels then that's a good indication that sleep apnea is likely present.
http://www.pulseoxstore.com/Downloadable-Pulse-Ox.html
You have to make sure that you get one that will record overnight and has software to view the reports.
Just understand that while it might confirm your suspicions with drops in O2 levels that not everyone has significant drops in O2 with their OSA...so an unremarkable report doesn't necessarily mean no OSA.

Personally if I was in your shoes...I would get STL Mark's machine and give it a try. You won't find a better price for that machine and it's top of the line and software to evaluate things is easy to find and use and free..
I have used my machine in the past to screen both my sister and her husband. She had no evidence of OSA but her husband did. It was pretty easy to spot. Funny thing was she was the one with the greatest symptoms but it happens that way sometimes.

[kaiasgram]

And if I was in your shoes I would do what Pugsy would do.

If you don't necessarily need or qualify for financial assistance with medical care and could private pay for an office visit I'd ask friends for a good doc recommendation. Then call that doc's office and ask about fees and sometimes you can negotiate a reduced fee under the circumstances. That said I honestly don't know if a doc would give you a prescription without your having a diagnostic sleep study.

Since you're "motivated as hell" to get the ball rolling, I think you would be ok to get started. The risk is that you might not have OSA and end up not needing the machine, or you could end up needing a different kind of PAP machine. But if you get a good APAP machine and monitor with software right from the start I doubt you could harm yourself as long as you're getting and following good advice.

Then when affordable care kicks in at the end of the year you can get a diagnostic sleep study to rule in out whatever sleep issues still need to be ruled in or out, and you'll be well on your way. Good that you're pursuing this so seriously while you're still so young.

[Julie]

A sleep study at home or otherwise won't pick up on whether or not you have a thyroid problem which can manifest with very similar symptoms... so if nothing else, Google hypothyroid symptoms (I think hyperthyroid is less likely) and see if a majority seem familiar apart from tiredness. A quick blood test can confirm it, but you won't(?) or can't see a doctor, so at least do your own checking (and maybe while you're at it, look up symptoms of diabetes). Congrats on your wt. loss - it is hard, but gets easier as you go along. I'm going to get very unpopular here for a minute and tell you that the very latest research shows that hard exercise can not only increase your appetite, but in fact doesn't always help you lose much weight - but calorie restriction and understanding of nutrition can. OSA can also help you gain (long and controversial, but likely), and if you're exhausted from exercising all the time, I'd take it a bit easier at least until you know what's going on with yourself (a lot of consequences of untreated apnea or other conditions are cardiac ones), though not advocating being a couch potato. Good luck!

[oak]

At least one dr appt through a fee reduced situation might at least help rule out fairly obvious health problems that you might have instead of or in addition to OSA. As Julie mentioned, thyroid problems and diabetes are two of those. Be sure to be fasting if you do decide to go for one drs appt. You could bite the bullet and negotiate your fee or try to go through the list Mark gave you.

Something that never dawned on me with my first post to you-- Kaiasgram is right when she says that you probably wont get a prescription or an okay from a doc to start on CPAP without a sleep study. It can happen, but its rare. So you will have to decide on that based on the best info you have available and your own instincts.

If you do decide to take things into your own hands, do some checking and see if you can swing the $400 for the one Mark is selling. That looks like a really good deal, and you are going to be pretty much limited to a private party with your situation anyway, as online vendors and dme's cannot sell without a prescription. Mark has a good reputation, so you wouldn't be going blind into the purchase. Getting a gently used mask might also be possible through a private party.

I am anxious to see what happens so please keep posting. Good luck

[khauser]

Keep in mind that many times these days you get billed from:
- The doctor
- The lab
- Sometimes other providers, like radiologists for X-Rays.

So even if the doctor says he'll accept X amount of money, the lab (which often is MUCH MORE expensive) is a different issue.

[SeekSleep]

Since you mentioned roommates, have you asked them if you appear to have sleep apnea? I ask, because I knew I had it back in the 70's when I went through basic training. The bunk mates near me complained about the snoring, and said the periods where I would stop breathing then gasp made it worse. The dorm guards would make a game of tracking my longest "Not Breathing" times on a white board. My sleep apnea was kind of a flight joke. Over the years I had numerous people bringing my Apnea to my attention.

You mentioned you're now hitting the gym and working to loose weight. Hang in there with that, especially the aerobic exercise no matter what you learn about possible sleep apnea. If you start looking in to it you'll find several studies showing aerobic exercise over time can offer as much, if not more relief from depression as top of the line anti depression medications.

Finally, it sounds like you might need a little professional help in finding what if any options may be available to for financial assistance. I was pleasantly surprised to learn how much help is available in my area when I started doing some volunteer work at a local family support center. Start researching now while you have the drive and motivation to see what organizations are in your area that may be able to help. Many churches, large medical clinics, and an assortment of state and federal agencies offer either direct aid, or guidance in where and how to go about finding assistance