Moderate sleep apnea, want to wait...

Michelle.......

The way I see it, the situation boils out to this:

The problem is you aren't getting enough oxygen in your bloodstream while you're asleep. But, since you aren't hooked up to a recording device that tells you how deficient you are, you don't yet know how critical the problem really is.

When your blood oxygen saturation gets really low while you're asleep, your body goes into crisis mode......dumps a bunch of "I'm gonna die if I don't get some oxygen" hormones into your system....and that causes all sorts of difficulty. Your health is wrecked because you're dying....slowly.

If you're content with depriving your body of needed oxygen, then, don't bother to measure anything, put off using a CPCP machine, and ignore all the danger signals your body is giving you. This is kinda like the commuter/freight train wreck in California a little while back. It's thought that the freight train ran a bunch of warning signals....while its engineer was merrily text messaging.

The first thing you can do is.....get your hands on a good recording oximeter.....and measure your blood oxygen saturation levels all night....for a whole bunch of nights....a couple of weeks or so. Gather a lot of data that shows how far below 93% your oxygen saturation level drops.....and for how long.

Then, if you see that you're actually in deep trouble, follow "Georgio's" lead......and get yourself an Auto CPAP machine with AFLEX......plus Viewer Software so that you can manage your therapy with the greatest amount of comfort and the maximum effectiveness.....and read everything you can get your hands on about your condition. Don't depend on the medical establishment (doctors + insurance) to tell you what to do......take charge of your therapy....and use experimentation to determine what works best.

Gerald

With respect Gerald, an Oximeter is a good thing to have BUT, in my opinion, a data capable (preferably an auto) cpap machine is first.

Your first sleep study measured your oxygen levels along with a lot of other things. You are entitled, by US law, to have a copy of that. Contact the sleep lab and get it. When you have your titration (hopefully very soon) that information will again be there. Get a copy of that too.

If you have trouble interpreting your sleep study which has your oxygen level and other data, come here and ask!

The order in which to proceed, in my opinion, is to (1) Get your titration done. (2) Get the printed results from both studies. See what is happening in your sleep. Get help here to interpret if needed. (3) Get a data capable machine (hopefully an auto). (4) Get the software and reader (the smart card will come with your machine if it's data capable). (5)Get an Oximeter later if you want one.

All through these steps - come here with questions and information and ask for the help that the people here are able and willing to give you! I say that from personal experience.

In addition, you have to check out the situation as far as the arthritis and the diabetes is concerned as soon as you can as well.

Hawthorne.....

I respect the fact that you've been on this forum 2-years longer than I have.....however, I respectfully disagree with your position.

"Lack of oxygen" is the root problem.....the bottom line. When we try to "reduce snores", "prevent apneas", or "head-off hypopneas", we are actually trying to breathe correctly.....and get enough oxygen while we sleep.

Our CPAP machines don't give us the full picture....only "clues" (AHI) as to how we're doing. More data is needed.

What I was trying to do with Michelle was to help her get enough data so that she would convince herself of the need for therapy.

My nights at the sleep center were miserable, poor quality experiences.......not representative of my normal sleep at home. Once I got my Rx.....and was able to distance myself from the shoddy "sleep centers" in my area......I quickly learned how to manage my own therapy. Michelle may have better "sleep industry" people in her area, but sleep study data might not be enough to convince her of her need for therapy. If she runs an O2 saturation study on herself, she learns....she takes an active part in the analysis of her condition.

When I suspected that my SO had the same problem I have.....mild sleep apnea.....I purchased an oximeter so that she could test herself......in the comfort of our home. She ran tests on her O2 levels for a couple of weeks.....and discovered....for herself.....what was going on. I never would have convinced her to have a sleep test.......but I was able to let her view the problem....her oxygen deficiency. We now have (3) auto CPAP machines....mine, hers, and a spare.

Gerald

Gerald - I respect your opinion, as I said.

Bottom line is, we are all trying to help Michelle in the ways that worked for us from our own experience. We are all attemping to get her to get treated.

Her financial situation is unknown to us. If she buys a good Oximeter and knows her oxygen stats are down, will she then be able to spend money on an auto machine, especially if a good portion of the cost has to come out of her own pocket.

She'll have a great oximeter and know her oxygen stats are not good but may not be able to afford a machine to do something about that.

I guess it's the "chicken and egg" thing here.

By all means, if she has the money, go for it all right away! If not, I still think an oximeter can come later.

Reading her replies on this thread, I think we have convinced her to go for the titration. She said - a few posts ago- "I will see what my sleep study has available and go for the titration this week if they can do it".

Beyond this you and I can agree to disagree. I'm good with that!

I too wasn't too happy about having to wear a "nose hose", as I'm a pretty big diva But once you see how much better you feel, you will get over it quickly. Oh, for curiosity's sake, I didn't wear my mask for a couple of nights and found my "all" symptoms coming back - most troubling is that at night I can't stay out of the fridge

To have a better shot at getting an auto CPAP machine ask the doc to prescribe you a make/model specific machine with a prescribed range of pressures. (I won't recommend a make/model as I only know about one and there are a few to choose from -- Mine is a Respironics M-Series - but check them all out and see which one will suit you best!!!)

It worked for me and many others here -- after I got my initial CPAP machine set at 5cm (which is the pressure I was titrated)....I can't breathe at 5cm, so we adjusted to 7cm.....that worked a bit better, but after reading a bunch of stuff here and consulting with the doc I asked her to write me for an Auto CPAP with pressure range of 8-16 -- she had no problem doing that. (with a pressure range prescribed, they have to give you a Auto!!!! ) The DME whined because they weren't going to make quite as much $$$ off of me as they would have if I'd kept the regular CPAP (the billing codes are the same, so their profits will be lower) -- but you know what -- I really don't care about their profits -- I'm worried about my health!!!!

You've made a good choice -- continue on, follow through (also see a Rheumatologist as birdshell suggests!!!).
Please come back and let us know how you're doing!!! If you have problems, issues, depressions or whatever, pass 'em along. I'm sure there are a lot of us who have felt the same!!!!

Good luck!!
cheers
goose

Thank you so much to everyone! I see how you each care about helping others out an it is so appreciated to new ones like me.. {{HUGS}}

My financial situation is terrible and we almost just lost our home. Thank god finally in the end it worked out. We live paycheck to paycheck with both my husband and I working full-time and not getting anywhere fast. But I did find this in my copy of sleep center data.

Oximetry Data

Average 02 while awake 97
Average 02 while in REM 95
% Non-Rem time <90% 0.00
Average 02 while in Non-REM 95
Approximate lowest 02 value 86

I was surprised to also read that I had a total of 153 leg movements. To me I awake in the same position as I fall asleep and it seems as if nothing happened during that time. What an eye opener this is.

Thank you so much for the recommendations of a machine! I hope and pray my insurance will pay for it, an auto one as I think I would feel most comfortable with that type. I cannot afford to pay for one myself at this time and will have to rely on the insurance totally as to what I receive.

Which doctor writes the prescription for the cpap? The one who evaluates my study or my home doctor? If I do not get what I want, I will NOT fill the prescription and whine like a baby for the one I want! hehehe

Which doc sent you for the study?

The first time around with mine... my GP sent me, some unknown doc scored the test, and my GP wrote the script.

The second time around with mine... the sleep doc sent me for the study, scored the test and changed the script.

MY GP sent an order over to the sleep study, then they called me in a few days and we set up the study. As you said some unknown doctor who works for the study scored me and sent the results back to my doctor who then signed off for a cpap.

This machine, the...

Respironics Remstar M Series auto with A-Flex or the C-Flex

Do they have humidifiers in them or is that sold separately too?

I believe a prescription made out to the exact model machine/humidifier/mask you want from either Dr. would work if you were buying a machine. I can't say what your insurance may do. Some have found it advantageous to purchase their own machine at a reasonable online cost....compared to the inflated numbers the DME's charge insurance co's, when considering deductables, etc. Hopefully your insurance will cover the equipment you want. You're on your way.

A humidifier almost always comes with machines now so you will in all likelihood get one. Usually you get a mask and a hose as well as a smart card (with any auto) so you will have everything ready to go.

It would be good if you could get the Respironics Remstar M Series Auto with A-Flex.
It gives 2 options in terms of exhalation relief. (A-Flex and C-Flex in the auto mode - C-Flex in the cpap mode).

The Respironics Remstar M Series Auto with C-Flex is just about as good for most people. It gives 1 option for exhalation relief (C- Flex for both the auto and cpap mode).

It would be good to really push for one of these machines ( AUTO A-Flex first) - if they balk go for the AUTO C-Flex. A point to make is that the doctor or DME can set in in cpap mode if that makes them happier. If they let you have an auto and don't want you to use it in auto mode they won't tell you how.

If you want to try autopap mode, come here. We can help you do that.

If your GP sent you and he/she writes the prescription, you may have a better chance of getting an auto, since they often will write a prescription for what the patient wants.

I sure hope your insurance will cover an auto. You may have to pay some yourself. I know that may be difficult but it will save you the cost of sleep studies in the future.

The doc may need to include a HH in the script - mine did so there was not argument.

My GP sent me to a neurologist who sent me to the sleep study -- the neurologist wrote the script and then "modified" the script per my request.....She did include a HH, supplies and "Mask of patients choice".....
I had her modify the mask part to a specific mask at one point because the DME was whining they didn't carry the mask I was asking for (and really didn't want to special order one --- profits again). So I had the doc send over a mask specific script, which she did, and then I got the mask I requested. Then she re-wrote it again for "Mask of patients choice", so I still have that option. I don't know if I'll have a problem with the "new doc" or not as I haven't seen him/her yet......

Hawthorne is right -- the doc should write it for the auto option (Respironics would be the Remstar M-Series Auto with A-Flex, but again check all the manufacturers -- if your DME allows you to test drive different machines -- do it!!!)......If the doc specifies a pressure range in the script they pretty much have to issue you an auto machine!!!! Straight CPAP machines won't do a range.....

Good luck
cheers
goose

I did have a choice whether to take the HH or not.....
I didn't think I'd need it, but took it anyway. I didn't turn it on for the first few weeks then put some distilled water in it to use in passover mode for a time. I use it now at a setting of 2 and generally don't take it on the road with me (a lot of my road trips take me to the coast where I really don't need it)......
I have purchased an HC150 out of pocket and have it in the box until I have room on my table to install both the machine and the Tank HH instead of the integrated HH......Even at a setting of 2 I have to fill it nightly, which is a PIA even though it's a small issue.....
But all that said, Karen is correct -- it should be noted in the prescription -- along with all supplies (hoses, filters etc.). If it's not included the insurance company may balk at paying for it....

Good luck!!
cheers
goose