Soon-to-be-xPAP user seeking advice

It is very important that you get good medical and CPAP use advice.

Among equipment choices are these factors:
- user interface of machine (e.g. the RemStar classic’s settings are not visible while lying down and otherwise only on a small display, whereas their M version has a big dial for the humidifier setting you may need to adjust often to match weather changes; some machines are better)
- if your nose is often congested you need a “full face” mask type of interface, otherwise you may later want one for occasional use (but concentrate on your primary need first)
- skin sensitivity may affect choice of interface (rubbing of headgear, pressure of mask)
- nose shape especially up in the bridge area is a big factor in sealing of traditional masks (there are mini-masks and nose-end seal interfaces which avoid the bridge problem, and some traditional mask designs attempt to be variable in the bridge area)
- few interfaces seal well for people who sleep on their side or move around a lot while in bed
- size is critical, nose mask needs to be wide, pillows need to be large enough to seal against the skin around the nostrils, nose masks should be wide. Many interfaces do not come in a range of sizes that suits XL or very petite persons.
With the amount of money being paid to your service provider, whether doctor or that vague “DME” term, either directly or buried in their price for equipment, you should expect knowledge and competency in fitting you for your needs.
You have of course come to a place for advice, but you must integrate it for your needs.

I just encountered a troubling equipment combination in an estate sale situation – apparent lack of a vent for exhaled CO2. The machine had two masks with it, one well used the other looking new, of the limited-life type that requires a vented hose adapter to be added. There were instruction leaflets for the vented swivel meant for that brand of mask, which locks into it, but each mask had only a simple swivel plugged into it.

I appreciate the advice. The challenge I was facing was a provider (the "first DME") had no interest in determining if the user interface was appropriate, they simply wanted to sell me a specific machine that offers very little user feedback and limits the input of the user to the therapy. Were I a user with little interest in participating in my therapy decisions, I could have taken that device and been as happy as a clam. However, I do want to be able to see what my leak rate is, what my AHIs read during the night, etc. IMO, there are things beyond the machine (mask/hose positioning as one example) that can affect therapy.

In my case, I went with another DME so I could benefit from the advice of a 'seasoned professional' in determining the best mask, etc. As a first-timer, I was leery about 'going it alone' (in terms of real, face-to-face advice) regarding equipment and masks, so I stuck with the local DME option--I just went with one who I felt would be more likely to work with me than one who only wanted to sell me the machine they happen to carry. Best decision I've made in a while.

Yes, fisamo, good choice by you to find someone who cares to support you.

Support takes time, selling a machine and shoving you out the door is more profitable in the short term, competition overcomes them in the long term.

I read of very low "compliance" rates with CPAP, no surprise given mask challenges and lack of good support.

("compliance" is a terrible word - the industry needs to think "customer success)

BigNortherner wrote: I read of very low "compliance" rates with CPAP, no surprise given mask challenges and lack of good support.

("compliance" is a terrible word - the industry needs to think "customer success)

Yes, but is 'compliance' an industry term or an insurance term?

I'm coming up on 1 week of therapy, and I seem to be settling into the routine. If I recall correctly, my 'worst' night (in terms of AHI) was Night #1 - not too surprising. But I'll have to pull the data from my machine and see more closely what's going on.

Overall, I have to say I feel better, but not to a 'revolutionary' extent--less heavy-headed, but still yawning more than I'd like. OTOH, I've been finishing up on some projects later in the evening than I'd rather go to bed, so that's probably also a factor. It'll be interesting to see what I can learn from my detailed data.

I hear the word "compliance" from medical people and suppliers of CPAP equipment, not from medical insurers, in my limited experience. Both are in the same inefficient industry.