Titration expectations

I got a new primary care physician a few weeks ago and during the initial consultation she put in an order for an at-home sleep study to test me for apnea. I had a followup appointment on Friday and was told the results came back as "severe". (I requested a copy which I expect to receive today or tomorrow, so I don't have hard numbers right now.) We had scheduled an overnight titration study next week at the local hospital, but I received a call today that my insurance company denied the service and wants me to do an at-home study instead.

I've been reading here about APAP titration studies, and see that it's common for insurance to request them. My concern is how well it will capture data. I sleep pretty close to on my stomach, with half of my face buried in the pillow and always with my mouth open. Without knowing what type of machine or mask might be sent, I assume that could pose potential problems. Is it something I need to worry about at this point? Is there something I need to tell my doctor before she puts in the order for the home test?

Also, is there a chance that the unit used for the test will be the actual machine my insurance company purchases, or would it likely be a temporary machine used exclusively for the study and then returned? From my reading here it seems I should try and lobby for specific models to keep long term, if possible.

Dang... a lot of questions.... I'll give er' a try:

I did not do a home study, but my daughter did and she said it was not problem.... so don't worry.

I suspect you'll get a data capable machine for the test. If you keep your mouth open at night, you'll need a FULL FACE MASK. If you can, pick get a Resmed F20 or a Resmed F10. There are so many masks, brands and styles.... just recommending some popular ones.

The machine you want to end up with needs to be a data capable machine and should be an autoset machine. Do not accept a cpap (only) machine. Insist on a autoset… data capable machine. If they ask why, say "I want the lower pressure levels that the autoset provides". Look at my Resmed S10 Autoset machine below, in my profile. Best machine on the market.

Read all you can here and educated yourself. Especially the threads at the top of this forum's home page. The ones for newbies. Keep asking questions, we'll help you thru this.

Sheriff

Welcome to the forum.

It seems like more and more insurance companies are opting for the home titration via an auto adjusting machine (commonly referred to as an apap machine). Most are fully data capable and will record the data needed to evaluated pressure needs.
Actually pretty simple. Kaiser has been doing it for years this way and saving the in lab studies for special needs cases when a problem pops up. Most of the time no problems pop up. Insurance companies know they will be paying for a machine anyway and might as well use the machine to figure out the optimal pressures. Saves them the cost of an in lab sleep study and to be honest sometimes those in lab studies don't always get it right anyway. I had one and it didn't. Let's face it...not easy to sleep normally in such a foreign environment with all the wires and stuff.

And yes....most likely the machine dispensed for the home titration will be your permanent machine.
Most likely either a ResMed AirSense 10 AutoSet or the Respironics DreamStation Auto CPAP. Those are the two main heavy players in the auto adjusting market and they offer the most comprehensive data.

Don't worry about your preferred sleeping position. With most masks we can still sleep in any position we want and in terms of data the machine collects sleep position affects nothing.
The hardest part to all this cpap therapy IMHO is getting the right mask that suits our own personal needs the best and lets us sleep comfortably.
I sleep on my stomach and side a lot. It can be done...sometimes there are a few challenges but nothing that can't be overcome with a little bit of work.

Ask your doctor to write the RX for the home titration machine being the ResMed AirSense 10 AutoSet or the AutoSet for Her (it has 3 modes of operation whereas the regular AutoSet only has 2 modes and sometimes that extra mode will come in handy and it doesn't matter if you are male or female).
It is probably the best machine...it's quieter and has a better exhale relief available should you happen to need exhale relief.
Respironics DreamStation machines come in a close second place but if you end up needing pressures in the teens....ResMed's exhale relief is sooooooo much better and since we don't know your pressure needs....get a machine that will cover all potential bumps in therapy.

I’m a Kaiser patient, and they gave me a PR machine for one week of home titration and then a ResMed as my permanent machine. I really hated the PR machine— always felt as though it was trying to rush my breaths. What a relief to find that the ResMed machine followed my breaths completely unnoticeably.

Thanks to all of you for the responses. I received my test results today, and attached them if anyone is interested.

The sleep study results I received also had a prescription sheet, attached below. I assume this is simply a generic prescription that the sleep study company sent over for my doctor to use if she wants (the nurse scanned and sent these, I don't think this was meant for me to try and use). I've read on here (I am actually trying to read as much as I can before asking questions) that sometimes you need a doctor to write specific models and features to force the DME to provide a model you want. Is that something I need to try and get upfront or would it only be necessary if the DME tries to play games? When my doctor was discussing the results at my followup she did mention that she really liked the new Resmed models and that they were a lot quieter than older machines, so that was encouraging after seeing how much you guys recommend them. I'm going to try for the Airsense for her model.