Heaven and Hell!

Got my machine about 10 days ago. It is a RemStar M Series DS100 (no C-Flex or A-Flex, etc.), and since I have nasal congestion issues, I have a Mirage mask. The first night I fitted the mask carefully, turned on the machine, used the ramp feature..... Woke up 7 hours later!! Awesome!! This was the magic sleep of lore! I had my best night sleep in 3-4 years. I was so happy I could barely stand it. Then the next night.... HELL!!!! I woke up after an hour feeling like I was suffocating. Since that time, I have not been able to use the machine at all, no matter what I try, I rip the mask off after a short time. Apnea is better than no sleep at all, so I have stopped using the machine all together. The main problem is that the pressure is set very high (17) and I can't exhale against the pressure. I know getting a APAP, C-Flex, A-Flex machine would probably help. I don't know how to go about doing this. Do I call my Dr., Insurance, Sleep Center, don't know. Just very frustrated, and tired!

You call you doctor, and comlain. At your pressure, a bi-level machine can be a great help, but some insurance companies need "proof of failure" at a single level machine. Complaind tilll they give you a machine you can sleep with.

O.

In the meantime, see viewtopic.php?f=1&t=41946&p=368893#p368893

My first night was the same and on my 2nd & 3rd I also woke up in a panic thinking I was suffocating. But I just did my relaxation techniques and now it is gone. My doctor warned me about this - we have trained our brains to wake up and warn us and it takes a while to get it across to it that we are really ok.
You KNOW intellectually that you are actually getting more air then you need. The fact that you slept all the first night tells you your body needs this machine desperately and that the feeling of suffocation is all "just" in your imagination. I am finding the nights right now, 3 weeks in, harder because I think I have caught up on some of the sleep deprivation and my issues are being allowed to come to the surface as I drift off. The first 2 weeks I was out like a light as soon as I put the mask on, not now, I get all these little issues coming up as I am drifting off, including "Oh no you have something on your face!" as I am just drifting off.

Guess the first night the sheer exhaustion won out over the discomfort. I just want to say that if your machine indeed does not have any exhalation relief and your pressure is 17, I think I'd ask whose decision that was and why they felt that was acceptable, and why your liklihood of success with this setup wasn't taken into consideration. At least you know where you stand with them.

If they give you a hassle about changing machines, whatever doctor originally referred you for a sleep study should be made aware, as they may have more sway, being a referral source. Also, if a sleep doctor ordered your machine, were they aware of what you were given? I'm not trying to make you discontent, just want you to be aware so that you don't assume everyone is working in your best interest and that any difficulties are your fault. Sounds like you are already doing your homework, so that will be helpful as you go forward.

As far as steps to take, it depends on who referred you, who ordered your machine, who is managing your care, and how knowledgeable these different players are. Seems to me a good starting place would be the provider of your machine, by asking them what they require to swap machines. After that, contact the ordering physician with your concerns and be explicit about the machine you believe will give you the best opportunity for success and see where that takes you. Hopefully someone in the circle will be in your corner. If not, you could compare your costs at the DME with insurance to the cost of an online purchase.

Let us know how this pans out, hopefully you'll get an appropriate machine right away with no hassle and get on with your treatment. The squeaky wheel gets the grease, so tell them right away about your problems. Best wishes.
Kathy

Kathy

Tman, it's not your fault that you're having difficulty. A straight pressure of 17 would be difficult for most people to exhale against.


I agree with ozij:

ozij wrote:You call you doctor, and comlain. At your pressure, a bi-level machine can be a great help, but some insurance companies need "proof of failure" at a single level machine. Complaind tilll they give you a machine you can sleep with.

O.

and with Kathy:

kteague wrote:If they give you a hassle about changing machines, whatever doctor originally referred you for a sleep study should be made aware, as they may have more sway, being a referral source.
---
As far as steps to take, it depends on who referred you, who ordered your machine, who is managing your care, and how knowledgeable these different players are. Seems to me a good starting place would be the provider of your machine, by asking them what they require to swap machines. After that, contact the ordering physician with your concerns and be explicit about the machine you believe will give you the best opportunity for success and see where that takes you.

If it were me prescribed that kind of pressure, I'd definitely want a bilevel machine. BiPAP is Respironics' trademark name for their bilevel machine; VPAP is ResMed's trademark name for their bilevel machine.

These are the specific bilevel machines I'd want -- because these can be set to work as plain bilevel or can be set for autotitrating bilevel operation:

Respironics BiPAP Auto M series
or
ResMed VPAP Auto