Which cpap machine ? Please help save my marriage!

Hi, I am a 35 year old male from the UK. I am probably the UK's worst snorer. I am a bit overweight, which is probably at the root of my problem. My neighbour says that he can hear me snoring at night (and I live in a detached house!). My wife has great problems trying to get any sleep and as we are expecting twins in May 2007, I am trying to find something that will help before then.

I don't want to go for various sleep disorder tests just yet as I intend looking to change my job in the near future and I don't want it on my medical record if there is a problem. I have heard about cpap machines and my Mum says that she will pay for one for me to try. I know that I will have to get a prescription from my doctor first.

Would any forum member be kind enough to recommend the most suitable machine for me.
Thank you.
Phil

Hi Phil,

I'm not sure if it works the same way in the UK as in the US (I imagine it probably does), but doctors won't write prescriptions for CPAP until after you've had a sleep test. There's a diagnostic test, to determine that you have it, and then a titration test, to see which pressure is suitable for you. Sometimes, if they get enough data from the first part of the diagnostic test, they can switch to titration in the same evening and keep you from having to have two separate studies.

I can't stress enough how it's good to do things the "legal" way, since they'll also find out during that test if you have complicating factors (i.e., other sleep disorders) that are interrupting your sleep as well.

If you're deadset against a sleeptest, however, there are auction sites out there where CPAPs can be had without a prescription. Again, I don't recommend doing things this way, but...

Either way you do things, I suggest a RemStar Auto. You'll find everyone has their own favorite machine, but this one is a common favorite around here. It can be used as a straight CPAP, or as an APAP (which automatically adjusts your pressure to the pressure it senses that you need in order to prevent/stop apneas). Either way, if you also purchase the software and the card reader for it, you can check out your data, and tweak your treatment until you get things just right, and until you're feeling good and rested again.

Masks are a bit harder to suggest, as everyone has very, very different preferences. A mask that fit perfectly on me could be the leakiest thing ever on you, and vice versa.

Keep posting here. There are some very knowledgeable posters around, and they love helping newbies.

Take care, and good luck.

Hi CollegeGirl, thanks for your reply. I was checking out the 'BritishSnoring' website and when I looked at an ad for a cpap machine, it said that I would just need a private prescription from my doctor to buy one. I would like to try it first before I try anything else. Thanks for the advice on the cpap machine.
Phil

Hi

Being in the UK you need to check which is the best supported supplier there. Remstar AUTO is an excellent choice but not so good if they don't have a strong presence there.

What brands show up when you do a web search in google with choice set for uk pages ?

Cheers

DSM

Hi,
Thanks for your reply. This is the link to the machines that I was looking at on 'Britishsnoring', in particular the 'Goodnight 420G'

http://www.britishsnoring.co.uk/shop/cp ... apnoea.php

Thanks
Phil

if you can't get a Remstar Auto w/Cflex, then my 2nd choice would be the PB-420E.

Hi again,
I have a hard time believing that things are that different over there. Besides, if they just gave you a CPAP without doing any sort of titration test, they'd have no way to know what pressure you needed. How would they decide what to set it to? I'd suggest calling your doc's office and just asking. If it really IS that easy, watch your borders - there'll be lots of Americans moving to England really soon.

[quote="Flipp"]Hi,
Thanks for your reply. This is the link to the machines that I was looking at on 'Britishsnoring', in particular the 'Goodnight 420G'

http://www.britishsnoring.co.uk/shop/cp ... apnoea.php

Thanks
Phil

Flipp wrote:Hi CollegeGirl, thanks for your reply. I was checking out the 'BritishSnoring' website and when I looked at an ad for a cpap machine, it said that I would just need a private prescription from my doctor to buy one. I would like to try it first before I try anything else. Thanks for the advice on the cpap machine.
Phil

Hi Phil,

In the U.S. too, it takes only a prescription from a doctor. No sleep study (or even sleep screening) is required at all for the doctor to write a perfectly legal Rx for any type of CPAP machine. Of course, as College Girl said, it's better to have a full PSG sleep study. But I can certainly sympathize with anyone whose snoring makes them strongly suspect OSA and wants to self treat with "cpap".

I went that route myself -- extremely loud snorer all my life, no sleep study, prescription from a family doctor, bought an autopap and its software online. Worked for me. In my case it was a matter of no insurance. I decided to spend my money on top of the line equipment rather than on a sleep study first to tell me what I was quite sure I had (OSA) and then have to spend even more money on top of the line equipment. I immersed myself in reading the message boards to get as much info as I could about OSA and the machines used to treat it.

Two years after I had been 100% compliant using autopap, I was fortunate enough to get a full PSG sleep study at an accredited sleep lab. The sleep study confirmed what I had figured from my previous symptoms and from my autopap software data -- mild OSA. The sleep study also found the same pressures I had seen working well for me from my autopap data.

But the sleep study also uncovered an additional sleep disorder that no autopap or its software could tell me I had -- PLMD (Periodic Limb Movement Disorder.) Luckily, in my case, while about half the PLM's were resulting in arousals which can fragment sleep, they do not seem to disturb my sleep enough to warrant treatment for PLMD. I mention this because, if the PLM's with arousals HAD been leaving me feeling unrested, I might have concluded, "Well, CPAP isn't working for me." And have stopped using it. Actually, I would have kept using CPAP if for no other reason than to put a stop to my horrendous snoring. My other symptoms of OSA were so mild that I never even thought of them until after the fact...until after I realized that CPAP had completely eliminated a lifetime of drowsy driving on trips. I had assumed, "Well, of course everyone gets sleepy driving along on interstate highways."

But you see what I mean. If a person turns to self treatment with cpap and no sleep study, expecting cpap to make them feel great (but they don't, even after giving it plenty of time)... or if the mask they choose is too uncomfortable and disruptive to sleep in general (which it can be)... it might be all too tempting to just quit cpap. The kind of information a good PSG sleep study can give might reveal more than one sleep disorder.

Even if OSA is the extent of the person's sleep disorder, seeing the results of oxygen desaturations or sheer number of times per hour we are unable to breathe, a PSG sleep study could drive it home better that cpap treatment isn't just about stopping snoring. OSA is about being choked nearly to death, over and over and over again, all night, every night. Choked as surely as if an intruder were in the bedroom with his hands around your neck while you sleep, letting up only enough to let you catch a breath to live, then choking you again. And again. And again.

If you understand it's that serious, and if you are absolutely determined to use cpap for every sleeping moment for self-treatment of Obstructive Sleep Apnea ...and you absolutely can't or won't get a sleep study...then, yeah. Get yourself an autopap.

This one would be my top choice for comfort:

Respironics BiPAP Auto with Bi-Flex, integrated heated humidifier, Encore Pro software.

A close second choice:

Respironics REMstar Auto with C-Flex, integrated heated humidifier, Encore Pro software.

_________________________

Some interesting reading:

This link gives excellent reasons presented by a board certified sleep doctor and pulmonologist (Dr. Barbara Phillips) who advocates that in some circumstances some patients who have obvious signs of OSA should be put directly on autopaps (auto-titrating cpap) without having to go through a PSG sleep study:
Powerpoint presentation at a meeting of the American Lung Association of the Central Coast - November 2004 (Requires Adobe Acrobat Reader to view.)


And this link is to a study that found the answer is "Yes."
Can Patients with Obstructive Sleep Apnea Titrate Their Own Continuous Positive Airway Pressure?

That's true, RG (of course, you're right as always ) but how many doctors do you know that would write an Rx for a CPAP machine without a sleep test? Of course, there will be some out there, but I imagine they would be hard to find. The two primary routes I've seen people take here are either test and doctor, or no doctor and no test. I haven't seen in between very often.

JMOPE (Just my own personal experience) .

--CG

Phil

As soon as you go to the Doctor there will be a medical record.

I believe many MD's are sympathetic to those of us who have no insurance, and will write a prescription for a cpap without a study. Many years ago when I first told my MD about my problems, he did so for me. I just couldn't find a mask that I could tolerate, so I gave up. I was permitted to rent a cpap for a nominal fee for trial. Was a good plan for me at the time.

Really. Hmm. Okay, well, if there's one thing you can't say about me, it's that I don't admit when I'm wrong.

I was apparently wrong. (THIS ONE TIME! NEVER BEFORE OR AGAIN! LOL)

I just have never met or heard of a doc that would do that. Nor has my stepfather, who tried desperately to find one that would Rx without the sleep tests about 5 years ago (he since got insurance and the tests he needed, and is STILL not using his CPAP, but that's a whole other story).

Maybe it's a regional thing? Who knows.

CollegeGirl wrote:(Snip) Okay, well, if there's one thing you can't say about me, it's that I don't admit when I'm wrong.
(snip)

I cannot resist this--


CG, that sentence has a double negative....

And what isn't not your point, birdshell?