A few questions

Diag portion: obstructive 2, Central 2, hypopnea 42.
Treatment: 1, 1, and 17 respectively.

Missed a reply, do have insurance. Aetna, and I love them.

Thanks. That helps.

Yeah. Pugsy's posts above are absolutely golden. Spot on, in my opinion.

I would add that meds and similar substances can sabotage attempts to improve sleep, since they can mess with time in REM, etc. I fight the allergy battle a lot myself, though. So I get it. Some variation in AHI night-to-night is fine, especially for the first several weeks. It is the overall average over time that matters most. It may be that you are in REM on your back more one night than another, or something, but getting REM is important, so the nights you get the most REM may be the nights with the highest AHI--but it is still better to get that REM than to get a low AHI from less REM. That is just an example, one of many possible examples, of how one night's AHI doesn't always tell the entire relevant story.

So don't let the numbers reported to you each morning become self-fulfilling prophecies. Pay more attention to how you feel long-term over time while firming up your "sleep hygiene." (Good term to Google the heck out of.) Getting up at the same time every morning, for example, is a goal that really pays off for some. When your brain is used to getting up at the same hour, it starts to consolidate your REM and time it out better. Long term goal. And nobody gets that perfect. But it can pay off.

From my perspective as a person with no medical training whatsoever, your OSA diagnosis is great in that it earned you the right to try PAP therapy to see if that will address all those hypopneas. But as you yourself mentioned, and as Pugsy mentioned, other changes may need to come into play for you to get your breathing and sleep where they will do you the most good.

I like your attitude about it. I'm sure you'll get there. Hopefully your air time will soon improve your air time.

Go to your DME (big pharma as you called them) whomever you got the machine from and ask them to swap out your half assed brick for a full data machine....at least the AirSense 10 Elite machine...AutoSet would be even better but at this stage of things getting them to swap might be a bit difficult and while the Elite might not be ideal...it's better than the half assed brick.

Tell them you need/want more details than just the hours of use and generic AHI....they might just do it because you asked.
If you don't ask the answer is always 'no'.

Your insurance pays the same no matter which machine you get...the half assed brick or the Elite or the AutoSet....they all are HCPCS billing code machines E0601. The DME gave you the half assed brick because they make more money on those models because that cost less than the Elites or AutoSets. Don't let them tell you that your insurance only pays for the half assed brick....Aetna uses HCPCS billing codes and not brand or model in determining what they pay for and if you don't believe me call up Aetna and ask them. If you have the Aetna plan that most Aetna people have you have a perpetual rental anyway.

Thanks, yeah, Air Time is hard to get sometimes. I discovered the evils of mucinex. I’ve done some extensive testing and discovered that anworghted majority of my allergies are food histamine intolerance due to genetically low DAO production. Taking DAO enzyme supplements helps but it’s not a silver bullet. Best answer for my situation is loratadine.

The source of the insomnia has been dogging me for a while, am taking a few things to help but have a hunch it’ll get better when I get rid of some “mitigating obnoxious tickborne crud” I won’t even dignify with a name at this point.. but it not only starts with L, it came from ‘L and it can go straight back to ‘L. . Actually part of the reccomendation to get the study done was because it’s possible that lack of energy etc was hampering treatment.

Thanks for all the help so far. I’m really at this point glad that places like this exist, and that it’s possibel and encouraged to be an active participant in my own treatment with a primary and a tickborne specialist that let me find my own balance.

Pugsy wrote:Go to your DME (big pharma as you called them) whomever you got the machine from and ask them to swap out your half assed brick for a full data machine....at least the AirSense 10 Elite machine...AutoSet would be even better but at this stage of things getting them to swap might be a bit difficult and while the Elite might not be ideal...it's better than the half assed brick.

Tell them you need/want more details than just the hours of use and generic AHI....they might just do it because you asked.
If you don't ask the answer is always 'no'.

Your insurance pays the same no matter which machine you get...the half assed brick or the Elite or the AutoSet....they all are HCPCS billing code machines E0601. The DME gave you the half assed brick because they make more money on those models because that cost less than the Elites or AutoSets. Don't let them tell you that your insurance only pays for the half assed brick....Aetna uses HCPCS billing codes and not brand or model in determining what they pay for and if you don't believe me call up Aetna and ask them. If you have the Aetna plan that most Aetna people have you have a perpetual rental anyway.

I’ll call them up in a few. Autoset > Elite?. I have made minor adjustments trying to get the pressure right. Maybe they will.

Best case scenario...the AutoSet...it's like 2 machines in one because it has 2 modes of operation...cpap fixed mode (which is what you have now) and apap auto adjusting mode and while not everyone needs or wants apap mode...kinda nice to have in some situations.

But the AutoSet costs more than the Elite...and DMEs are notorious for being cheap and wanting more profit.

The Elite is like your current machine in that it only has cpap fixed pressure mode but it has all the data available that the AutoSet has and your half assed brick doesn't have.

With your half assed brick if you used SleepyHead you would see this minus the event categories..you get AHI and leak numbers only.
This one is from a night I forgot and left the SD card in the computer so I missed all the detailed stuff.



With a full data machine you see this and more (there's more than what I have shown here).

Quite a difference that... well, I’ll call when they get back from lunch and tally to them. I seem tonrekbee somebting about a swap possibility.

That was a worthwhile phone call. The RT can’t swap them without an updated script from my primary, however did recommend trying the autoset and asked me to give them a call and have one faxed over. Once that’s in I just pay a flat fee for the difference and exchange machines

Airwolf wrote:Once that’s in I just pay a flat fee for the difference and exchange machines

Actually this is called balanced billing and most of the time it isn't allowed. It's totally not allowed with Medicare.
You need to check with Aetna yourself and find out for sure what your policy does or doesn't do. Confirm if balanced billing is allowed or not and if they pay by HCPCS billing code.
Though if it isn't much money...it might be worth it to avoid a long drawn out hassle and fight.

Your DME just wants more profit...plain and simple.

Oh...the old "you need a new RX" that's hogwash too. Even with a fixed cpap pressure RX the AutoSet can be supplied...all they need to do is set it to fixed cpap mode. So they could do it if they would just do it....but they want to keep those profit margins high.

I’ll double check my paperwork, but equipment and mask changes in the first 30 days I don’t recall being a problem. They’re really good about things like that. Of course, I also pay high option PPO, so maybe that helps....

Primary is just sending a note over for the update, I’ll pick up the new machine after work tomorrow.

Whatever profit they make is going to WVU medicine. Given how they’ve transformed care around here and got it out of the dark ages, I’m okay with it. Seriously. OMG it used to be so hot and miss.

As long as you are happy with what you get and what you pay or don't pay...that's all that matters.

Well, and LadyWolf not rolling me over 15 times a night saying “you’re snoring roll over”

Yeah...gotta keep the wife happy. If she doesn't sleep so great and ends up poking you to get you to roll over to stop the snoring...no one sleeps good.

Alllright! I got my first night's statistics with the new machine and and sleepyhead.... cool! As soon as I get the screenshot uploaded, I'll post it on up!