So I guess I have OSA - what happens next?

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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RyN
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So I guess I have OSA - what happens next?

Post by RyN » Sun Aug 14, 2022 9:30 pm

Hello everyone! I’m Ryan. I’m 43 and live in Las Vegas.

I’m new to the world of sleep apnea and CPAP machines. I don’t even have any equipment or anything yet.

But I have taken an at-home sleep study through Lofta. I had one done in more of a hospital setting maybe 10 years ago, but that one came back fine. This time around, they diagnosed me with mild OSA, which is what I would have guessed based on my subjective sleep experiences and overall health and energy. I have my prescription and have just started trying to research what happens next!

I am trying to figure out how best to get started in trying an APAP. Any tips (or general direction pointing) on how to figure out which machine, mask, and accessories would be a good starting point?

Also, I’m still trying to figure out if my insurance will help it all (it sounds like not too much since there is a $1k deductible),

I’m a mouth breather, especially while I sleep, due to a ton of allergies and chronic sinus issues. So it sounds like that has me looking for a full face mask.

I’ve also trained myself to mostly be a side sleeper over the years, though I’m sure I still end up on my back 1/4 of the time.

For now, I’m reading the stickies and wikis to try to get a grasp of the basics. If there is any info or data that would help you help me, let me know. Thanks for having me. You all seem like a very helpful and friendly bunch!

lynninnj
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Re: So I guess I have OSA - what happens next?

Post by lynninnj » Mon Aug 15, 2022 8:25 am

RyN wrote:
Sun Aug 14, 2022 9:30 pm
Hello everyone! I’m Ryan. I’m 43 and live in Las Vegas.

I’m new to the world of sleep apnea and CPAP machines. I don’t even have any equipment or anything yet.

But I have taken an at-home sleep study through Lofta. I had one done in more of a hospital setting maybe 10 years ago, but that one came back fine. This time around, they diagnosed me with mild OSA, which is what I would have guessed based on my subjective sleep experiences and overall health and energy. I have my prescription and have just started trying to research what happens next!

I am trying to figure out how best to get started in trying an APAP. Any tips (or general direction pointing) on how to figure out which machine, mask, and accessories would be a good starting point?

Also, I’m still trying to figure out if my insurance will help it all (it sounds like not too much since there is a $1k deductible),

I’m a mouth breather, especially while I sleep, due to a ton of allergies and chronic sinus issues. So it sounds like that has me looking for a full face mask.

I’ve also trained myself to mostly be a side sleeper over the years, though I’m sure I still end up on my back 1/4 of the time.

For now, I’m reading the stickies and wikis to try to get a grasp of the basics. If there is any info or data that would help you help me, let me know. Thanks for having me. You all seem like a very helpful and friendly bunch!
All I can tell you is my personal experience. Cardio referred me to sleep doc/pulmonologist who ordered a home sleep study that came back positive. I was told that due to supply chain issues it could be 2 months or more to get a machine. They said they only deal in Resmed machines because they are of the best quality. Fast forward and they sent the paperwork to my insurance company and it took 2 weeks to approve. I now have the machine and am supposedly "leasing it for a period of three months and then purchase after that". I have no clue if that means my insurance co is leasing and buying or what. All i know is that I need this machine and will pay whatever it takes to get one. So it may not cost you the full 1K right off the bat. I don't know more because insurance is diff everywhere and everyones policy is different.

I had a pleasant experience at the sleep doc office. The gal let me try on as many masks as I wanted. She had around 12 styles including full face, nasal, pillows, cushions, etc. It was helpful to find something comfy and I started with what I thought was the least invasive first. I am lucky that I dont have sinus issues and use a nasal cushion. I am sure every office is different but according to one of our dear leaders Pugsy (who is on vaca this week in your area) you can try a full set of gear with certain companies and do the 30 day guarantee return if it doesn't work.

That said, I am hopeful my insurance is covering those costs because it isnt cheap. I have managed to find replacement cushions and straps for mine on ebay and here for a decent out of pocket ($20 or less) but the frame would cost me $80 to replace so I just wait for insurance to provide me wiht the next one and hope to reserve it as a backup.

Pugsy also has a donation bin of diff masks if someone is stuck.

HTH and gl!

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chunkyfrog
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Re: So I guess I have OSA - what happens next?

Post by chunkyfrog » Mon Aug 15, 2022 9:25 am

With that big deductible, I would stay away from the local clip joints--they will "hose" you.
Cpap.com has the best prices for new equipment.

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ChicagoGranny
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Re: So I guess I have OSA - what happens next?

Post by ChicagoGranny » Mon Aug 15, 2022 10:25 am

Welcome!
RyN wrote:
Sun Aug 14, 2022 9:30 pm
I am trying to figure out how best to get started in trying an APAP. Any tips (or general direction pointing) on how to figure out which machine, mask, and accessories would be a good starting point?
ResMed AirSense 10 AutoSet or AirSense 11 AutoSet. Accept nothing else. Make sure the machine is AutoSet.

Go to cpap.com to view those machines and full face masks. Regarding masks, look at the specs, ratings, reviews, photos and popularity. For starters, go with one of the more popular masks.
RyN wrote:
Sun Aug 14, 2022 9:30 pm
(it sounds like not too much since there is a $1k deductible),
Have you verified with your insurance company that this applies to DME?

Please stick to this one thread so that people helping you can easily see the history.

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earlvillestu
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Re: So I guess I have OSA - what happens next?

Post by earlvillestu » Mon Aug 15, 2022 11:44 am

Re sleeping on your side. There are devices that wrap around your chest and back and encourage you to stay off your back. I use one named Sleep Noodle, available on Amazon, and it keeps me on my side.

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RyN
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Re: So I guess I have OSA - what happens next?

Post by RyN » Mon Aug 15, 2022 12:20 pm

Thanks for all the info! Sounds like I have been on the right track at least. It sounds like the mask is the biggest thing to figure out as long as you get one of the recommended machines. I'm sure I'll stick with the Resmed 10 or 11 (and I'll make sure it's the Autoset version!).

And I'm a big stats nerd. So I'm glad to see all the info on using OSCAR with all their data. Although it's for a different issue, I've been tracking my heart rate and HRV with a chest strap and/or wristwatch nearly 24 hours a day for the past few months. I'm hoping I've grown accustomed to things taking a while to figure out so I can put in the work to help improve my sleep on some level. I'm sick and tired of being so sick and tired for sure!

D.H.
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Re: So I guess I have OSA - what happens next?

Post by D.H. » Mon Aug 15, 2022 12:58 pm

Two things I will point out.

1) Since you live in Las Vegas, which is a particularly dry place, you'll probably want to use the humidifier on a high setting.
2) Don't assume that you have to use a full face mask. For some people, the pressure is enough to allow you to breathe through the nose. That was the case for me.

Also, as a footnote, I was 43 years old when I was diagnosed, back in 1999. Without CPAP, I don't think I'd still be here!

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RyN
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Re: So I guess I have OSA - what happens next?

Post by RyN » Mon Aug 15, 2022 2:43 pm

D.H. wrote:
Mon Aug 15, 2022 12:58 pm
Two things I will point out.

1) Since you live in Las Vegas, which is a particularly dry place, you'll probably want to use the humidifier on a high setting.
2) Don't assume that you have to use a full face mask. For some people, the pressure is enough to allow you to breathe through the nose. That was the case for me.

Also, as a footnote, I was 43 years old when I was diagnosed, back in 1999. Without CPAP, I don't think I'd still be here!
Interesting notes, thank you! As far as the full-face mask versus one just for your nose, is that basically trial and error on our end in purchasing a mask, checking the stats for a while, and then buying something else if the original isn't working well for you?

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Brad S
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Re: So I guess I have OSA - what happens next?

Post by Brad S » Mon Aug 15, 2022 3:16 pm

RyN wrote:
Mon Aug 15, 2022 2:43 pm

Interesting notes, thank you! As far as the full-face mask versus one just for your nose, is that basically trial and error on our end in purchasing a mask, checking the stats for a while, and then buying something else if the original isn't working well for you?
Hello and welcome.
One of the things I am really struggling with is mask selection.
I found a great youtube channel yesterday that has tons of great info and advice for all levels of users.
https://www.youtube.com/watch?v=TK58N4BqxwQ
Check out this video and Nicks channel.
I am just about 1 month into this journey and the one thing I learned today is that it is better to start with lower pressure and get used to it and then raise the pressure. I really like the nose pillow masks and Nick explains this principle well. There is a lot more to it, but the videos explain it in great detail and I am excited to try it tonight.
OSCAR is a great tool. There are good OSCAR instructional threads in the sticky's.
Call your insurance company and ask what your DME (durable medical equipment) deductible is. I have Kaiser I only have a 10% co-pay. I paid $76 for my AirSense 11 Autoset and all of the supplies. (This is a purchase, not a rental)
Good luck and I look forward to following your journey.

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clownbell
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Re: So I guess I have OSA - what happens next?

Post by clownbell » Mon Aug 15, 2022 4:10 pm

To RyN - Mask selection is the biggest issue in getting started. Different masks seem to fit different face shapes: long oval shaped faces, short wide faces, flat faces, etc. In my experience, there is a lot of trial and error. Many mask sellers (including cpap.com) offer 30-day return insurance. If you try a mask that doesn't work for you, you can return it within 30 days for credit toward another mask. This is worth looking for. Some sellers seem to make a small charge for the "insurance" while other sellers do not. Try a mask for several days before deciding whether to return; it often takes a few days to adjust to new things. Take other people's reviews with a big grain of salt. What works for one user may not work for another. What constitutes a problem for one user may not be a problem for another user.
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Re: So I guess I have OSA - what happens next?

Post by Janknitz » Mon Aug 15, 2022 5:57 pm

I'm going to respectfully disagree with some of the things said above:

1) Humidity is a very personal issue. Some people do best with more humidity, some with less. Assuming that because you live in a desert you will necessarily need more humidity is not always the case. You may be very adapted to low humidity conditions, and too much humidity may be irritating to your sinuses. It's a good idea to start with moderate humidity and adjust up or down from there. How warm or cool your bedroom is at night will also be a factor in how much humidification you may need for comfort. And during "Monsoon season" in Las Vegas, it may be even different from the rest of the year. Expect to need to adjust it incrementally if you find you are having discomfort/congestion. We suggest changing only ONE thing at a time and giving yourself a few nights to adjust to that change before changing it again, unless the change makes you more miserable.

2) IMHO, the biggest factor in people failing to adapt to CPAP is not too much air blowing in their face (most people get used to that pretty quickly), but the feeling of suffocation. Sleep clinics and sleep doctors often start people on the lowest possible CPAP pressure (4 cm/H2O) or they start them on a ramp setting at that low pressure with the idea that you are supposed to be asleep when the pressure starts increasing. Most people who come here stating they are having trouble tolerating CPAP complain about the feeling of suffocation when the pressure is set so low. It MAY help the first night or two, but after that, it feels like you may not be getting enough air to breathe (you are getting plenty of air, but it FEELS that way). So starting at a very low pressure often sabotages a person's efforts to adjust. I get the theory, but the reality is something different. Most people do best with the minimum pressure set somewhere between 6 - 8 cm/H2O with NO ramp by the second or third night.

I don't mean to confuse you, as you are getting mostly good advice here, but I've been here many years and those are my observations over a long period of time.
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Re: So I guess I have OSA - what happens next?

Post by TropicalDiver » Tue Aug 16, 2022 9:23 pm

RyN wrote:
Mon Aug 15, 2022 2:43 pm

Interesting notes, thank you! As far as the full-face mask versus one just for your nose, is that basically trial and error on our end in purchasing a mask, checking the stats for a while, and then buying something else if the original isn't working well for you?
Masks are a bit of a journey. For me, it was trial and error. After trying two types during my split study, I knew that I would want to go full face. In a follow up session, I was able to try numerous ff masks. Some were an instant no based on fit. Some were a maybe and one or two was a yes. Things got better when the foam cushioned resmed became available. Things got even better with an anti-leak strap. Things got near perfect with tweaking a few settings. Now I am just staying the course (ahi reliability under 0.5) and everything is great.

The data can help spot things like leaks while sleeping.
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RyN
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Re: So I guess I have OSA - what happens next?

Post by RyN » Sat Aug 20, 2022 11:59 am

I finally nipped my overthinking in the bud and placed an order last week for some equipment as a starting point. It looks like it's set to arrive Monday!
  • ResMed AirSense 11 Autoset
  • ResMed AirTouch F20 full face mask with headgear
  • ClimateLineAir 11 Heated Tube
Is there anything I missed to get me started in some fashion this coming week?

Also, any tips or how-to's for a first-time rookie on what to do or try early on to get started and acclimated are much appreciated as well. Even if they contradict with others 😉 I'm the type of person that loves to hear multiple sides to things so I can have options to pick from to find what works best for me. Especially when we're talking about sleep!! I looooooovvvvve my sleep time 🥰

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Pugsy
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Re: So I guess I have OSA - what happens next?

Post by Pugsy » Sat Aug 20, 2022 12:17 pm

You may or may not end up needing or wanting additional accessories. What you are starting with is sufficient for now.

One little hint……practice during the day using everything while awake and under no pressure to get to sleep.
Another hint….don’t use the ramp and don’t use the default starting minimum of 4 cm.
Instead try these settings
Mode……auto
Minimum pressure….7 cm
Max pressure….20 cm
EPR. Exhale pressure relief…..set to full time and at the setting of 3.

See how those settings feel to you.

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Re: So I guess I have OSA - what happens next?

Post by chunkyfrog » Sat Aug 20, 2022 12:22 pm

While you are waiting, you might enjoy an unboxing video for airsense 10 autoset.
YouTube has several.
I did not see one for the Airsense 11, but it should be similar.
Also, get some distilled water for the humidifier tank.

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