CPAPtalk.com

I have been having very loud snoring during sleep and other signs such as depression, daytime fatique, memory and concentration issues.
Recently, I have been prescribed a sleep test at hospital but due to stress, I could not fall asleep and the results and money went to waste. Insurance was just willing to pay half of it. Then I was recommended by doctor to go for a home test but this time I have to pay in full. And I am much worried that I will screw up the test again.

So I am basically hopeless now until I phoned a vendor who can sell me an auto cpap without a prescription. He told me that I could try for 2 weeks and see the data if my pressure blockage indeed indicates a problem. I gladly accepted and arranged it.

In my mind, the risk of using the auto cpap for a real patient and normal patient is equal. Besides there is not much risk involving using a machine. If there is, it is also a risk for the patient who has obtained a doctor's prescription. So getting a sleep test in my mind is just determining if you need a treatment not about whether or not worth the risks. From my point of view, I could not see anything bad from trying the machine for 2 weeks and deduct from my own feeling and data to see if I have sleep apnea.

There isn't much risk if you're healthy other than the sleep apnea, although some serious medical conditions can be troublesome. Sorry I can't give more info but I'm not a doctor.

There are two main types of sleep apnea: obstructive (the airway closes up) and central (the brain decides it doesn't need to breathe). A CPAP or auto CPAP machine can only treat obstructive sleep apnea. If you have centrals or a mixture of both, you may need a more advanced machine. The risk here is that the CPAP machine won't do much good, not that it will be harmful.

You will want to make sure you get a machine with full data capability so you can download your data to see how well the machine is working for you. The discontinued ResMed machine known as the Escape Auto is worthless because it provides only limited data. (We call them "bricks.") There are also a number of fixed pressure machines with the same problem including current models. After you download your data, you can use it to make informed changes to your settings.

The risk is that you will start out at a pressure much too high and give yourself central apnea when you don't otherwise have it... so make sure the machine's low pressure is no higher than 7-10 cms and the high setting can be left at 15 or even 20 (that's not the one that matters). It's likely however that the low setting will have been dialed in only at 4, as too many doctors (and DMEs) believe an Apap at that low setting will find its appropriate level (not necessarily so), but it's so hard to inhale there that most need to be up at least a couple more (e.g. 6, 7 etc) for a valid test.

Using a machine set at 5cm was enough to treat my sleep apnea. So if you have OSA that is treated at the lower setting, you can not diagnose yourself that way.
And most people need their low setting to be around 6-7 so that they feel like they are getting enough air to be comfortable. So even at 6-7 you will be getting therapy.
BUT- it will show if you have OSA that is untreated at the lowest setting you can use.

I would set it at the lowest setting you can tolerate to avoid treating any apneas. Do that for 2-3 nights and see what your AHI is. I'd put it in CPAP mode at a setting of 5. You are not trying to treat yourself, but diagnose how many events you have untreated. If 5 leaves you feeling starved for air, move it up to 6.
After you determine that, then people can help you get the correct settings.

cctv wrote: I phoned a vendor who can sell me an auto cpap without a prescription. He told me that I could try for 2 weeks and see the data if my pressure blockage indeed indicates a problem.

I like that supplier. Go for it.

And download the free Sleepyhead software so you know exactly what is going on.

The biggest problem with just using an apap without a sleep test/lab test is that if apnea isn't your only problem and it won't be identified. I think you have a good deal going with the vendor to try out the machine to see if it identifies apnea issues.

One other thing. Sometimes letting the apap have free reign actually increases your apnea episodes. Mine is normally set at 9-11, but when I set it to say 13, it will go into the 12 range and my AHI actually increases, yet I usually feel better. Not sure why that is. It's on my list of questions when I go in for my appointment later this month.

It would be great if you could get a machine that has a trial mode. See my post titled "Remstar Trial Mode - Thoughts?"

Snoozeless wrote:It would be great if you could get a machine that has a trial mode. See my post titled "Remstar Trial Mode - Thoughts?"

While I'm sure you found your trial mode useful, It is my understanding that in these machines with "trial modes" the trials are only available for a limited time. I would recommend, instead, a full auto machine. All modern autos that I am aware of can be run in either the CPAP or Auto mode without limitation.

It isn't bad at all, if you take control and educate yourself.

You don't have to depend on a sleep doc to write the Rx. CPAP.com accepts prescriptions from the following:

The CPAP.COM dudes wrote: The prescription can be written by any of the following care providers:
•Medical Doctor
•Doctor of Osteopathy
•Psychiatrist (MD Only)
•Physicians Assistant
•Nurse Practitioners
•Dentist
•Naturopathic Physicians

https://www.cpap.com/cpap-faq/Prescriptions.html

Tell one of the above-listed medical professionals that you are going to buy out of pocket so that they don't have to worry about insurance issues. Hopefully you know one of the above well enough that they will write the Rx for free. CPAP.com will even collect the Rx for you, as explained in the link.

Just tell one of them to write a CPAP Rx for 10 cm. Then use the Rx to buy a full-data APAP to find out what pressure(s) you need. People do it all the time.

Jay Aitchsee wrote:While I'm sure you found your trial mode useful, It is my understanding that in these machines with "trial modes" the trials are only available for a limited time.

I have also read that unlimited trial modes are available by erasing all the machine's history and starting a new trial.

Clarification on this point and noting of which models have this feature will be appreciated.

ChicagoGranny wrote:I have also read that unlimited trial modes are available by erasing all the machine's history and starting a new trial.

Clarification on this point and noting of which models have this feature will be appreciated.

I think that the original Auto IQ Respironics machines had unlimited trial modes but that was rather quickly abandoned in favor of 5 resets which ultimately gives 180 days of trial apap mode.
I haven't seen the number 5 first hand though...just what someone told me that they saw in some paperwork.
I have had the occasion to try to help someone with the PR S1 Pro model that would have had apap trial mode but apparently it was used up and became a grayed out area in the menu no matter if we did the reset trick or not.
Upon further inspection it was determined that the "new" machine the user had been given wasn't really new at all and had nearly 1 K hours on it.

As far as I know there is the ability to get 5 resets of apap trial mode for 30 days after first initial one is used up.
Also....the days don't necessarily have to be consecutive. A person could use apap mode randomly if they wish and the 30 days are cumulative.

I have not myself seen documentation as to the 5 resets though...just heard about it from someone who said they saw it....as "up to 5 times".

Pugsy wrote: 5 resets which ultimately gives 180 days of trial apap mode.

I dislike bureaucrats, whether they be in government or in private manufacturing, who think they know better what is good for the user and lock them out of certain possibilities. Didn't it take some extra lines of computer code to kill the function after 5 trials? Ridiculous.

Thanks for the answer, Pugsy.

If the manufacturer made it, it is because their primary customers in big business (large DME cartels) asked for it. The customer is always right. We are not the customers. We are the victims.

Big business wants to increase income for itself by keeping itself in the loop for how the product is used in the future, instead of giving patients what patients need to cut the greedy members in the sleep industry out of the loop once a patient is diagnosed.

Jay Aitchsee wrote:

Snoozeless wrote:It would be great if you could get a machine that has a trial mode. See my post titled "Remstar Trial Mode - Thoughts?"

While I'm sure you found your trial mode useful, It is my understanding that in these machines with "trial modes" the trials are only available for a limited time. I would recommend, instead, a full auto machine. All modern autos that I am aware of can be run in either the CPAP or Auto mode without limitation.

Perhaps I should have been more clear. I was suggesting that getting a machine that has a trial mode would help with getting a good initial setting for the poster. And the machine that I have certainly can be set to auto or cpap after the trial. In fact mine did not set me to auto. It upped my pressure and set it to cpap. I'm going to leave it like that before I tweek anything, because my AHI is averaging .39.

On 1800CPAP's site it says the trial can be run as many times as you like on the PR System One 60 Series REMstar Pro CPAP Machine. It aslo has CPAP-Check mode. This mode "continuously verifies pressure requirements and makes adjustments after every 30 hours of use providing the user with more effective pressure levels over time."