In the UK...Pod153’s Big Mild OSA/UARS Adventure - ready to give up

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Pod153
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In the UK...Pod153’s Big Mild OSA/UARS Adventure - ready to give up

Post by Pod153 » Tue Nov 01, 2022 11:02 am

Hello. I am a woman in my early 30s in the UK. I have had symptoms of sleep disordered breathing for years, did an NHS PSG several years ago which was scored using AASM 1B without RERAs, showed AHI of 0 but 60 unexplained arousals per hour, and was sent away with no treatment.

Fast forward to 2022 - I found out that UARS exists, saw a consultant privately for a second opinion, and did a repeat study scored using AASM 1A which showed AHI 5.8, RDI 10.3, so mild apnoea (though he described my sleep interruptions as 'UARS-like', presumably because I have as many RERAs as apnoeas). It also showed severe and constant nasal flow limitation.

I was prescribed an oxymetazoline nasal spray to use for three days just to see if it made a clear difference to my nasal breathing, and...yeah. Turns out I've never really been able to breathe through my nose very well, and only now do I recognise the difference (though my sleep was no less fragmented while I was on the spray). I kind of wish I'd never tried it because now I am super aware of how congested/inflamed my nose is at baseline. I've been on steroid drops and an antihistamine spray for three weeks, but am not seeing much change in my nasal breathing yet. Breathe Right strips help a little, but no miracles. I'm awaiting an ENT appointment in a month's time.

Meanwhile, the OSA remains untreated and I am miserable and exhausted, and still wake up so often and so full of adrenaline that I am only managing to squeeze in about 5 hours of sleep a night. My consultant will only refer me directly to ResMed to get a machine, but my preference would be to try the AutoSet For Her 10 since the algorithm is supposedly better-attuned to more subtle breathing interruptions, and it turns out that ResMed in the UK is out of stock of the AutoSet For Her indefinitely.

So I am now considering just importing a refurb machine. But that also means I can't try on masks, and just have to pick one. I have absolutely no idea where to start with this. There are so many. Where do you even begin?

My consultant has also warned me that I should try to unblock my nose before even trying a CPAP since it will likely make my nasal inflammation worse. I'm unclear as to whether this would also be the case if I were to use a full face mask (he seemed to think they were too uncomfortable to be worth considering, but you know what else is uncomfortable, only getting 5 hours of sleep a night).

Is my consultant right, and I need to just tough out the OSA until the steroid drops start to work? If not, where do I start with masks? Nasal mask? Nasal pillows? Full face? What brand/type should I start with? How do you even begin to narrow it down?

Any advice anyone here can offer would be hugely appreciated. I am pretty desperate for sleep at this point.
Last edited by Pod153 on Tue Dec 06, 2022 10:58 pm, edited 3 times in total.
I live in the UK, so my access to various aspects of healthcare may not be quite the same as yours.

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ChicagoGranny
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Re: In the UK...Mild OSA/UARS, awful nasal congestion at baseline, don't know where to begin with masks

Post by ChicagoGranny » Tue Nov 01, 2022 12:07 pm

Not in any particular order,

1. Until you get a good therapy working, avoid back-sleeping (easier said than done). Sleep-disordered breathing is typically more severe when sleeping on the back. Sleep on your sides or stomach. You may get some relief, but not likely to be a cure.

2.
Pod153 wrote:
Tue Nov 01, 2022 11:02 am
I was prescribed an oxymetazoline nasal spray to use for three days just to see if it made a clear difference to my nasal breathing, and...yeah.
The oxymet spray can be used much longer than this. When discontinued, it's likely to cause rebound congestion. It can be discontinued one nostril at a time. After two to four days, any rebound congestion will go away. Then, the second nostril can be discontinued. Given your condition, I would not hesitate to use the oxymet until your ENT appointment next month.

3.
Pod153 wrote:
Tue Nov 01, 2022 11:02 am
So I am now considering just importing a refurb machine. But that also means I can't try on masks, and just have to pick one.
You could buy both a full face mask and a nasal mask. I recommend starting with one of the more popular masks. For a nasal mask, here is the AirFit™ P30i Nasal Pillow CPAP Mask with Headgear Starter Pack - https://www.cpap.com/productpage/resmed ... illow-mask

For a full face mask (FFM), here is the ResMed AirFit F30i Full Face CPAP Mask with Headgear - https://www.cpap.com/productpage/resmed ... -face-mask

4.
Pod153 wrote:
Tue Nov 01, 2022 11:02 am
I'm awaiting an ENT appointment in a month's time.
This seems to be a very important event and could lead to a major improvement.

5.
Pod153 wrote:
Tue Nov 01, 2022 11:02 am
My consultant will only refer me directly to ResMed to get a machine, but my preference would be to try the AutoSet For Her 10 since the algorithm is supposedly better-attuned to more subtle breathing interruptions, and it turns out that ResMed in the UK is out of stock of the AutoSet For Her indefinitely.
Are you aware that the AirSense 11 AutoSet includes the For Her algorithm?

Pod153
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Re: In the UK...Mild OSA/UARS, awful nasal congestion at baseline, don't know where to begin with masks

Post by Pod153 » Tue Nov 01, 2022 4:29 pm

ChicagoGranny wrote:
Tue Nov 01, 2022 12:07 pm
1. Until you get a good therapy working, avoid back-sleeping (easier said than done). Sleep-disordered breathing is typically more severe when sleeping on the back. Sleep on your sides or stomach. You may get some relief, but not likely to be a cure.
Side-sleeping is the one thing I've already implemented based on my sleep study results (which were slightly worse supine) and subjectively I do feel it helps a little bit, thankfully.
ChicagoGranny wrote:
Tue Nov 01, 2022 12:07 pm
2. The oxymet spray can be used much longer than this. When discontinued, it's likely to cause rebound congestion. It can be discontinued one nostril at a time. After two to four days, any rebound congestion will go away. Then, the second nostril can be discontinued. Given your condition, I would not hesitate to use the oxymet until your ENT appointment next month.
I will consider this, but was expressly asked not to continue using it by the consultant I saw, and to be honest the rebound was so horrible even after three days that I'm a bit scared to use it again anyway. My sleep quality wasn't hugely improved while I was on it, but was far worse for several days after I came off it.
ChicagoGranny wrote:
Tue Nov 01, 2022 12:07 pm
3. You could buy both a full face mask and a nasal mask. I recommend starting with one of the more popular masks. For a nasal mask, here is the AirFit™ P30i Nasal Pillow CPAP Mask with Headgear Starter Pack - https://www.cpap.com/productpage/resmed ... illow-mask

For a full face mask (FFM), here is the ResMed AirFit F30i Full Face CPAP Mask with Headgear - https://www.cpap.com/productpage/resmed ... -face-mask
Thank you, this is so helpful - I just had no idea where to even begin. These look like a very reasonable place to start.
ChicagoGranny wrote:
Tue Nov 01, 2022 12:07 pm
4. This seems to be a very important event and could lead to a major improvement.
I really hope so. I've been told that if the steroids don't resolve things by then I will likely be looking at surgery, which even if I self-fund I may be waiting months for, so I feel like I need to at least try and work around it in the meantime because everything in combination is sending me a bit loopy.
ChicagoGranny wrote:
Tue Nov 01, 2022 12:07 pm
5. Are you aware that the AirSense 11 AutoSet includes the For Her algorithm?
I am, and was really hoping that that might be a viable alternative - but have since discovered it doesn't seem to be available directly from ResMed in the UK at the moment either, which I forgot to mention in my original post. My location seems to have been a surprisingly significant limiting factor in both diagnosis and treatment so far. I can get either one of the two AutoSets with the For Her algorithm from resellers in either the USA or the EU, but was leaning towards the 10 simply because it's less expensive.

Thank you so much for all of this, it gives me the starting point I desperately needed. I'll reconsider the oxymet spray.
I live in the UK, so my access to various aspects of healthcare may not be quite the same as yours.

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ChicagoGranny
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Re: In the UK...Mild OSA/UARS, awful nasal congestion at baseline, don't know where to begin with masks

Post by ChicagoGranny » Tue Nov 01, 2022 4:46 pm

This may not be necessary because you seem forum savvy, but when posting an update stick to this one thread. For members helping you, it makes it easy for them to see the history.

Good luck in the meantime.

rick blaine
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Re: In the UK...Mild OSA/UARS, awful nasal congestion at baseline, don't know where to begin with masks

Post by rick blaine » Tue Nov 01, 2022 5:10 pm

Hi Pod153,

I'm in the UK too, and I have moderate-to-severe sleep apnea (AHI 16-30). And I'm a retired medical journalist so I have some familiarity with navigating health options in the UK. Perhaps I can be of assistance.

The NHS – with its 150 foundation trust hospitals, most with their sleep medicine clinic – does not respond well to UARS. They are primarily geared up to straightforward presentations of sleep apnea. And even then, they only treat at an AHI of 15 and above.

Any patient with an AHI of, say, 13 goes without – even tho that can be quite disruptive to their sleep. The alternative for 'below 15 but still a problem' is for the patient to fund their treatment themselves. Fortunately, both Philips Respironics UK and ResMed UK are willing to sell directly to such UK patients – provided the patient has a prescription or 'scrip'.

I note that you are already past the initial investigation stage, and that you have 'gone private', and that your consultant 'will only refer you directly to get a machine'. From this – and the fact that you mention getting a refurb – I conclude that you haven't got a machine at home as yet.

If so, I would recommend that you get a 'scrip' completed and signed now anyway. And ask whoever you get to fill it in – your GP or the consultant – to write it so that it covers both a suitable machine and a mask (or masks). Then that will cover you if you import from an American second-user source, and if you buy masks direct from either PR UK or ResMed UK, even if they don't sell you a machine.

If you ask ResMed UK (see number below) they will send you a blank electronic scrip form, and it can be filled and signed 'on screen'.

As to getting a good fit – before the Covid pandemic, ResMed UK used to hold 'clinics', either in Abingdon or Bristol, and at least twice a year, where you could go along and try out masks – on your face and with a machine running – and with the help of a trained and experienced ResMed operative.

Of course, it was a sales context, and they offered only ResMed masks. But they were the only supplier in the UK to offer such a try-on facility. I don't know if they have started doing that again. My local GP has just given up the 'mask required' condition for consultations. Perhaps ResMed UK is treating the pandemic/ epidemic as sufficiently passed too. You could give them a ring on 0800 907 7071.

For completeness, I will add that there is a third-party dealer called Intus Healthcare now in Woking which lets you try out a few masks at a distance – ie, by post. But do note that there's an 'insurance charge' for that facility, and that that try-on offer was also before the pandemic. You would need to check if it's still on offer. Their new number is 0800 024 8050.

This is getting a bit long, and if I may, I'll post this now and come back later. For now the Columbo – or 'one more thing' – is that, of all the masks I have tried, the one that worked best was, and is, the ResMed F20 Air Touch with memory foam. It really did the business. The only drawback is that the memory-foam cushion part only lasts 4 to 6 weeks, and then needs to be replaced.

You can buy a 'bumper bundle' pack of nine foam cushions, and that is some saving. But it's still quite expensive for some people – certainly for me. So these days, I use rhe F20 Air Fit with a silicon cushion. Not quite the same super seal, but otherwise effective.
Last edited by rick blaine on Tue Nov 01, 2022 6:01 pm, edited 4 times in total.

Pod153
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Re: In the UK...Mild OSA/UARS, awful nasal congestion at baseline, don't know where to begin with masks

Post by Pod153 » Tue Nov 01, 2022 5:48 pm

rick blaine wrote:
Tue Nov 01, 2022 5:10 pm
If so, I would recommend that you get a 'scrip' filled out and completed now anyway. And ask whoever you get to fill it in – your GP or the consultant to write it so it covers both a suitable machine and a mask (or masks). Then that will cover you if you import from an American second-user source, and if you buy masks direct from either PR UK or ResMed UK without them supplying a machine.
Hello! I have tried this, since it seemed the obvious solution (and in all honesty I thought it would be the default approach to prescribing a CPAP), but have been hit with 'we can only refer you directly to ResMed and cannot fill out a prescription for you to take elsewhere'. I'm not convinced this is actually true, I don't see why it would be, but I have rephrased the question every which way and that's all I can get out of his secretary. I have a strong suspicion that if I can ask the consultant directly he would be happy to do it, but until I can get in front of him during an appointment again, I'm stuck with whatever his secretary is willing to gatekeep. She has also said that it would be up to ResMed to help me select a suitable machine which surprised me.

I think Eu-pap is now Intus, and as far as I can tell they don't do try-on any more per se, but they do let you pay an insurance fee on top of the cost of a mask which allows you to return it if it doesn't fit. I likely will use them for obtaining masks just because otherwise i can see things getting very expensive very quickly.
rick blaine wrote:
Tue Nov 01, 2022 5:10 pm
This is getting a bit long, and I'll post this now and come back later if I may. For now the Columbo – or 'one more thing' – is that, of all the masks I have tried, the one that worked best was, and is, the ResMed F20 Air Touch with memory foam. It really did the business. The only drawback is that the memory foam part only lasts 4 to 6 weeks, and then needs to be replaced.
Thank you! It's been added to the shortlist.

I have been informed that I am actually sufficiently symptomatic for an NHS CPAP despite the mildness of my apnoea (I also have gradually worsening POTS which the consultant who diagnosed me suspects is secondary to my sleep issues), so it does seem to be more complex than 'no treatment at all below AHI 15' - but I've also been told that the waiting time might be as long as two years, and that this is the case even for more severe apnoea (which is pretty frightening). I have already had to move back in with family in order to be able to keep working, because I no longer have sufficient surplus energy to both do my job and look after myself without assistance. I simply can't wait two years. At this point I'd happily bankrupt myself if it meant getting some semblance of a life back. Hopefully I won't have to!
I live in the UK, so my access to various aspects of healthcare may not be quite the same as yours.

lynninnj
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Re: In the UK...Mild OSA/UARS, awful nasal congestion at baseline, don't know where to begin with masks

Post by lynninnj » Tue Nov 01, 2022 6:57 pm

Is it possible they don’t want to get you a philips machine because of the recall and because resmed is a more reliable machine?

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Pod153
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Re: In the UK...Mild OSA/UARS, awful nasal congestion at baseline, don't know where to begin with masks

Post by Pod153 » Tue Nov 01, 2022 7:56 pm

lynninnj wrote:
Tue Nov 01, 2022 6:57 pm
Is it possible they don’t want to get you a philips machine because of the recall and because resmed is a more reliable machine?
I would have thought if that was the case they’d just write me a prescription for an appropriate ResMed machine that I could fill with any supplier though (which indeed was what I expected/hoped would happen).
I live in the UK, so my access to various aspects of healthcare may not be quite the same as yours.

lynninnj
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Re: In the UK...Mild OSA/UARS, awful nasal congestion at baseline, don't know where to begin with masks

Post by lynninnj » Tue Nov 01, 2022 8:22 pm

Pod153 wrote:
Tue Nov 01, 2022 7:56 pm
lynninnj wrote:
Tue Nov 01, 2022 6:57 pm
Is it possible they don’t want to get you a philips machine because of the recall and because resmed is a more reliable machine?
I would have thought if that was the case they’d just write me a prescription for an appropriate ResMed machine that I could fill with any supplier though (which indeed was what I expected/hoped would happen).
I hope you get answers soon.

I don’t know if anyone mentioned this but when doing cpr you extend the head/chin up to get the tissues at the back of the throat to move out of the way. I find I have fewer events if I can keep my chin up after dozing off.

might help if you can pull it off.

some folks sleep better with chin down but with UARS you might get benefit.

hth

_________________
Machine: AirSense 11 Autoset
Mask: ResMed AirFit N30 Nasal CPAP Mask with Headgear
Additional Comments: Newbie who loves her machine!
Beware the schoolyard bullies, mean girls, and fragile male egos. Move along if you can’t be kind.

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ozij
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Re: In the UK...Mild OSA/UARS, awful nasal congestion at baseline, don't know where to begin with masks

Post by ozij » Tue Nov 01, 2022 11:53 pm

I love CPAP.com, sponsors of this forum for the way they set it up and let it run and for their online shop. BUT - when you want to order a mask or a machine and have it delivered outside the US the shipping prices are very very very high - because of the price of insurance.

For masks - I have had them delivered to friends or relatives who happen to be on a trip to the US. Have never ordered a machine.

You'll need a script - I suggest you get yours in writing, whatever it says, upload it to cpap.com and see if they accept it.

You will need a plug adapter (not a transformer) to change from the American type plug to the British type. https://www.worldstandards.eu/electrici ... d-sockets/

When you order a machine, makes sure you order a supply of hypoallergenic filters because they will give you a few hours of filtered air while you sleep, which may give you relief too. How frequently you change them depends on your living conditions - mine and get changed every 2 weeks because they're gray by then - hence "a supply".
Pod153 wrote:
Tue Nov 01, 2022 11:02 am
My consultant has also warned me that I should try to unblock my nose before even trying a CPAP since it will likely make my nasal inflammation worse.
Are you aware of nasal rinses? They can give great relief. I find this one very convenient, and helpful: https://nmshop.neilmed.com/collections/sinus-rinse
You can get it through Amazon and through https://uk.iherb.com/.

Read the following message about using nasal rinses nttps://www.cpaptalk.com/viewtopic.php?f=1&t=18 ... o#p1412438 then the whole thread, and the references also.
I'm unclear as to whether this would also be the case if I were to use a full face mask (he seemed to think they were too uncomfortable to be worth considering, but you know what else is uncomfortable, only getting 5 hours of sleep a night).
It's true that air blowing into your nose can make inflammation worse - and the nasal irritation is at its worst with nasal pillows masks.
There are many types of full face masks - while "rick blaine" does best with the AF20 I could not manage any FFM that came to the bridge of my nose (though granted this was some years ago) and I do better with those that come to your nose from below - e.g. the AirFit F30. The i version, which i haven't tried is apparently more noisy and that bothers some people.

Another important fact in this context of irritation: Modern machines have heated hoses, with sophisticated temperature and humidity control of the air that blows in. How warm and how humid is something only your nose knows - you'll have to try patiently. But it too makes a big difference.

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ChicagoGranny
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Re: In the UK...Mild OSA/UARS, awful nasal congestion at baseline, don't know where to begin with masks

Post by ChicagoGranny » Wed Nov 02, 2022 4:53 am

ozij wrote:
Tue Nov 01, 2022 11:53 pm
a supply of hypoallergenic filters because they will give you a few hours of filtered air while you sleep, which may give you relief too. How frequently you change them depends on your living conditions - mine and get changed every 2 weeks because they're gray by then - hence "a supply".
You are in dusty conditions? As a matter of routine, my filters get changed every six months. It's probably a waste because the old one coming out is no different in color than the new one going in.

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ozij
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Re: In the UK...Mild OSA/UARS, awful nasal congestion at baseline, don't know where to begin with masks

Post by ozij » Wed Nov 02, 2022 5:23 am

ChicagoGranny wrote:
Wed Nov 02, 2022 4:53 am
ozij wrote:
Tue Nov 01, 2022 11:53 pm
a supply of hypoallergenic filters because they will give you a few hours of filtered air while you sleep, which may give you relief too. How frequently you change them depends on your living conditions - mine and get changed every 2 weeks because they're gray by then - hence "a supply".
You are in dusty conditions? As a matter of routine, my filters get changed every six months. It's probably a waste because the old one coming out is no different in color than the new one going in.
I am. And you're talking of hypoallergenic filters, not the regular more spongelike one?

_________________
Machine: ResMed AirSense™ 10 AutoSet™ CPAP Machine with HumidAir™ Heated Humidifier
Mask: Bleep DreamPort CPAP Mask Solution
Additional Comments: Machine: AirSense??? 10 AutoSet??? For Her CPAP Machine with HumidAir??? Heated HumidifierSoftware: Oscar; alternating masks
And now here is my secret, a very simple secret; it is only with the heart that one can see rightly, what is essential is invisible to the eye.

Antoine de Saint-Exupery

Thumper1947
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Re: In the UK...Mild OSA/UARS, awful nasal congestion at baseline, don't know where to begin with masks

Post by Thumper1947 » Wed Nov 02, 2022 10:20 am

Pod,
I concur on seeing an ENT. I've been on CPAP for7 years and it took me about six years to figure out that my whole problem was UARs. I had two broken noses from my sports days and one operation for a deviated septum while I was in the military. In addition I do not have a big nose. Combine all that with a mild to moderate allergy problem, and it doesn't take much to block my air ducts, especially on the right side. I have virtually no obstructive and almost no central apneas. Years ago my sleep doctor recommended trying a netti pot. I didn't like the sound of it and when I saw what it was I like it even liked it less, so I never tried it. Eventually, I saw a video of a thing called Nasopure. It's not as gross looking as a netti pot and costs about $15. At nighttime, just before going to bed,I use it 3-4 times to get my sinuses cleaned out. I have found combining that with a product called Xlear(about $15), a spray that I use after the first shot of Nasopure, works amazingly to totally clear out your sinuses. I take about 15 minutes to do this, and most times I can breathe completely free. I haven't had an AHI above .5 for the past six months, but more importantly, I sleep a whole lot better with clear sinuses. Both products can be used as often as you like with no addiction or rebound effect. This works for me. Here's links to the products on Amazon. Good luck.

Nasopure:
https://www.amazon.com/Nasopure-Buffere ... 85&sr=8-11

Xlear:
https://www.amazon.com/s?k=xlear+nasal+ ... -doa-p_4_5

Thumper
Mask: Dreamware FF
Machine: Resmed Autosense 10 APAP

rick blaine
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Re: In the UK...Mild OSA/UARS, awful nasal congestion at baseline, don't know where to begin with masks

Post by rick blaine » Wed Nov 02, 2022 11:10 am

Hello again Pod153,

A couple of items to add to your useful info folder: :D

1. To the Q: where in the UK can I buy a machine if not directly from ResMed UK in Abingdon*?

To keep themselves in good standing with the DoE, Intus Healthcare quite strenously suggest that you do their sleep study – to the extent that the message which is conveyed is that: they can't and won't sell you a machine without you doing their sleep study. At the cost of – last time I checked – £250+.

But you already have done not one but two sleep studies, so that 'hurdle' does not, IMHO, apply to you. If a doctor – could be your GP – or a consultant – you are formally in the care of one – writes a scrip, then that should be enough for Intus. They would be legally covered.

2. To tidy up from ozij above: almost all CPAP and APAP machines come with a voltage transformer which is external to the main unit. That is, a cable (US, cord) runs from the wall socket to a little black box – the transformer – and then a thinner cable (US, cord) runs from that to the machine.

If you were to buy from an American supplier of lightly-used and second-owner machines, and they were to send a cable with a US plug on it, you don't need a bulky, multi-nation, runs-the-risk-of-becoming-unstable travel adapter. You just need this 13 amp cable, available from Amazon UK:

https://www.amazon.com/InstallerParts-P ... 2TMHPAF685

3. As for rinses, the easiest and cheapest – and usually least reactive – rinse for any throat or nose condition is a flat teaspoon of ordinary table salt dissolved in a 200cc cup of lukewarm water. Followed by rinsing with clear lukewarm water.

4. I have some other thoughts. Keep coming back to this thread for them. 8)

* Long story short, It's to do with the warranty. Buying direct from the manufacturer is better. And there's less fuss about ''return for repair', if that becomes necessary.

Pod153
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Re: In the UK...Mild OSA/UARS, awful nasal congestion at baseline, don't know where to begin with masks

Post by Pod153 » Thu Nov 03, 2022 8:23 am

New development: my consultant apparently prefers to refer to ResMed rather than writing prescriptions himself because he doesn't feel he is sufficiently au fait with the differences between different devices to prescribe a specific one, beyond recommending fixed pressure/auto/bilevel. I am currently trying to find out on what basis ResMed get to decide exactly what to offer me, and how follow-up works if the prescription is through them and not him.

I am in general slightly perplexed by all of this, but am now trying to work out whether to accept the referral just to stay in the system and to be able to try on masks, and to see what they offer me in the context of the UK's seemingly very limited device availability, or whether to just go off-grid and sort it myself.
lynninnj wrote:
Tue Nov 01, 2022 8:22 pm

I don’t know if anyone mentioned this but when doing cpr you extend the head/chin up to get the tissues at the back of the throat to move out of the way. I find I have fewer events if I can keep my chin up after dozing off.

might help if you can pull it off.

some folks sleep better with chin down but with UARS you might get benefit.

hth
Thank you for this, good call - I actually do feel like I can breathe better with chin up, though my consultant suspected my tongue falling back was part of what's causing the apnoeas so you'd think it would make that worse, but who knows. I might see if I can manage to sleep on some sort of yoga roll thing instead of a normal pillow just to see how I get on.

ozij wrote:
Tue Nov 01, 2022 11:53 pm
I love CPAP.com, sponsors of this forum for the way they set it up and let it run and for their online shop. BUT - when you want to order a mask or a machine and have it delivered outside the US the shipping prices are very very very high - because of the price of insurance.

For masks - I have had them delivered to friends or relatives who happen to be on a trip to the US. Have never ordered a machine.

You'll need a script - I suggest you get yours in writing, whatever it says, upload it to cpap.com and see if they accept it.

I was wondering about Second Wind for a refurb machine in part because they don't require a prescription for overseas orders (and, as above, I seem to have hit a brick wall as far as getting a supplier-agnostic prescription goes). Not sure about shipping though. I have lots of friends and family who are resident in the USA and am also trying to figure out if I can usefully enlist them somehow.

Back when I had a life I had a side job as a professional synth player, so I already own pretty much every kind of adapter and converter known to man. Good to know an adapter is all that is needed, at least that part is easy :)

ozij wrote:
Tue Nov 01, 2022 11:53 pm
Are you aware of nasal rinses? They can give great relief. I find this one very convenient, and helpful: https://nmshop.neilmed.com/collections/sinus-rinse
You can get it through Amazon and through https://uk.iherb.com/.

Read the following message about using nasal rinses nttps://www.cpaptalk.com/viewtopic.php?f=1&t=18 ... o#p1412438 then the whole thread, and the references also.
I haven't tried a nasal rinse yet! I'll give it a shot and will read the thread through, thank you.

ozij wrote:
Tue Nov 01, 2022 11:53 pm
It's true that air blowing into your nose can make inflammation worse - and the nasal irritation is at its worst with nasal pillows masks.
There are many types of full face masks - while "rick blaine" does best with the AF20 I could not manage any FFM that came to the bridge of my nose (though granted this was some years ago) and I do better with those that come to your nose from below - e.g. the AirFit F30. The i version, which i haven't tried is apparently more noisy and that bothers some people.

Another important fact in this context of irritation: Modern machines have heated hoses, with sophisticated temperature and humidity control of the air that blows in. How warm and how humid is something only your nose knows - you'll have to try patiently. But it too makes a big difference.

Anything on the bridge of my nose seems to make it harder to breathe, so it's great to know there are full face options that don't sit on the bridge. I also didn't know that nasal pillows are worst for irritation, so maybe I should shunt those to the bottom of the shortlist.

I notice that heat and humidity make a massive, massive difference to my nose even pre-CPAP - I have become a bit of an air quality nerd over the last few weeks, so it's good to know there are options there.

rick blaine wrote:
Wed Nov 02, 2022 11:10 am
A couple of items to add to your useful info folder: :D

1. To the Q: where in the UK can I buy a machine if not directly from ResMed UK in Abingdon*?

To keep themselves in good standing with the DoE, Intus Healthcare quite strenously suggest that you do their sleep study – to the extent that the message which is conveyed is that: they can't and won't sell you a machine without you doing their sleep study. At the cost of – last time I checked – £250+.

But you already have done not one but two sleep studies, so that 'hurdle' does not, IMHO, apply to you. If a doctor – could be your GP – or a consultant – you are formally in the care of one – writes a scrip, then that should be enough for Intus. They would be legally covered.

2. To tidy up from ozij above: almost all CPAP and APAP machines come with a voltage transformer which is external to the main unit. That is, a cable (US, cord) runs from the wall socket to a little black box – the transformer – and then a thinner cable (US, cord) runs from that to the machine.

If you were to buy from an American supplier of lightly-used and second-owner machines, and they were to send a cable with a US plug on it, you don't need a bulky, multi-nation, runs-the-risk-of-becoming-unstable travel adapter. You just need this 13 amp cable, available from Amazon UK:

https://www.amazon.com/InstallerParts-P ... 2TMHPAF685

3. As for rinses, the easiest and cheapest – and usually least reactive – rinse for any throat or nose condition is a flat teaspoon of ordinary table salt dissolved in a 200cc cup of lukewarm water. Followed by rinsing with clear lukewarm water.

4. I have some other thoughts. Keep coming back to this thread for them. 8)

* Long story short, It's to do with the warranty. Buying direct from the manufacturer is better. And there's less fuss about ''return for repair', if that becomes necessary.
This is a goldmine! My useful info folder runneth over.

1. From poking around their FAQ, I think Intus might actually be willing to sell me a machine with the paperwork I've already got - a sleep study showing OSA, and a letter from the consultant to my GP saying he would support CPAP therapy if I choose to go that route. Intus, however, also don't have the AirSense 10 For Her in stock - I've already asked them if they have a restock date and got a resounding 'dunno'. It seems like the only readily available ResMed APAP anywhere in the UK is the standard AirSense AutoSet 10. Which would quite possibly be fine! But I'd like to have the option of the more sensitive algorithm, given how hideous my flow limitations are compared to my AHI.

2. Even better! And pretty sure I already have one of those cables knocking around somewhere, see above. I'll hunt it down in preparation.

3. Also even better! My consultant told me only to use saline and never clear water since the latter is irritative...but perhaps I need to read the nasal rinse thread first.


Lots of great info here. Thank you all so much, it's really wonderful to have this level of support when I've been feeling so adrift with it all!
I live in the UK, so my access to various aspects of healthcare may not be quite the same as yours.