Going for CPAP setup on Thursday - have some questions

Was diagnosed with mild sleep apnea a few weeks ago. Last night, I spent my 2nd night in the sleep clinic. On this trip, the techs attached the CPAP machine to monitor what the pressure was to be.

It felt like that I didn't sleep even though the tech said that I had. The funny thing is that I did actually feel a lot more rested than the first night in the lab. The tech insisted that I try a full face mask due to the size of my face and the risk that I might breath through my mouth. The first mask that he tried created a nasty wooshing noise rather like the sound of a force 9 gale. Withing 10 minutes, he had changed the mask to a much better one. I noticed that during the night, the mask leaked a little when I slept on my side. That was with my contour pillow from home. Is that normal and what is the best way to stop it? I am not a person who can sleep on ones back preferring to be on my side.

On Thursday, I go to the doctor for the CPAP setup. The did tell me that I have a choice between two machines. One made by Fischer Paykal and the other by a manufacturer like resmed or something similar. What should I consider when picking a machine? Also, they did say that I will have a selection of masks. How do I select the best mask? My insurance company pays 80% so am not worried about paying the extra 20%. Just want to make sure that I get the bext most comfortable machine/mask.

Any advice would be apperciated. I look forward to using this forum on a regualr basis as I venture into the new realm of CPAP. I have had sleep problems for years and always seem to wake-up very early at about 12.30 without being bale to get back to sleep. On occasion, I have awoken feeling like thebed was moving. That is what caused my family doctor to refer me to the local sleep lab. Also, my blood pressure has been steadily increasing which might be sleep related.

Welcome to the forum.

Go up to the top of the page and click on the yellow lightbulb icon "Our Wisdom" and start reading.

From what you wrote (that you only have a choice between two machines), you're going to need to be an informed user before they try to push off some bottom-of-the-line machine on you. Your insurance provider will pay the exact same amount for ANY CPAP or APAP (Auto-adjusting CPAP) because they all have the same insurance code......and they shouldn't be able to try to charge you extra for a higher-end machine (data-capable or Auto).


Den

Thanks for the information. It looks like I have some reading to do before tomorrow. This is going to be a very useful and informative website in helping me get started with CPAP.

fsmitty, here's a link you might find useful. So many machine names and model names are similiar -- gotta reallllllly be sure which are which:

My list of machines that record "full data" (AHI and leak info) and those that don't -- updated through Sept. 2009:
viewtopic.php?p=307168#p307168

DME might not understand what "Full data" is.
viewtopic.php?p=344265#p344265

Definitely start reading all that info that RestedGal recommended.

Just remember, regardless of the brand, you want a fully data-capable machine; meaning it records all apnea/hypopnea events, leaks, etc., rather than just how many hours you use it (compliance data).

Again, thanks for all the information. I will print out the list of machines and take it to the doctor tomorrow. The CPAP setup will be at the sleep doctors office. Can't wait to start using the CPAP as my tiredness has come back very badly after my CPAP sleep test on Monday night. I felt a lot rested on Tuesday which I attributed to the CPAP machine in the sleep lab. Last night, I went to bed wishing for the mask with thast air as I had a hard time breathing last night without.

I have had sleep issues for years and always keep waking up every 2 hours or so. My body will keep waking me up at around 12.30am or so with me not being able to get back to sleep again. At about 3pm, my body starts trying to shutdown with me feeling very tired and groggy. Hopefully the CPAP will help me get my life back.

fsmitty wrote:I have had sleep issues for years and always keep waking up every 2 hours or so. My body will keep waking me up at around 12.30am or so with me not being able to get back to sleep again. At about 3pm, my body starts trying to shutdown with me feeling very tired and groggy. Hopefully the CPAP will help me get my life back.

Smitty,

That sounds familiar. I was getting up every 60 to 90 minutes thinking I had to go to the bathroom. My neighbors would pound on the wall about the snoring (I live in a townhome). And I would fall asleep anytime I stopped moving during the day. I got an instant positive benefit from CPAP, almost like a switch had been flipped. I am hopeful that you will have the same experience. Please do post back on how it goes. From there, we can help you figure out how to read your data so you can play an active part in your treatment.

-john-

jweeks,

I will try to get the doctor to give me a written copy of my sleep lab test results. The last time in his office he asked me if I had any questions, being new to this diagnosis I did not know what to ask. Last night was a terrible nights sleep. Again woke up very early at about midnight and not able to get back to sleep. Only had 4 1/2 hours sleep and feeling like crap. Will let you know what happens in the CPAP setup appt today. I am hoping that the CPAP will help me as these short sleep patterns are killing me. The only way that I function in the early morning is by drinking coffee and going to the gym at 5am. The gym does give me the energy to get through the morning. However, my body starts to crash in the last afternoon. I only drink coffee in the early morning and try to avoid it after 6am so as not to affect sleep at night. The really only way that I can currently stay asleep longer that 4 1/2 hours is by taking something like Tylenol PM along with Benadryl. I am not in favor of taking pills as don't know what the long term affects will be and I also hate that groggy feeling in the morning. Hopefully, the CPAP will provide the non-chemical relief I need.

Not too sure if sleep apnea can be in your genes as my father has it also.

Well went to the sleep doctors office this morning. The equipment that they recommended for me is listed below:

Machine: SleepStyle 234 CPAP Machine with Built In Heated Humidifier
Mask: Mirage Quattro Full Face CPAP Mask with Headgear

The machine appears to have some good reviews. The face mask is the same one that I had good luck with in the sleep lab. Tonight will be my first night with the device. They have told me that it is on loan/rent for 30 days. After that the insurance company will be billed and I have to pay the 20%. I am hoping that it works since I only got 4 1/2 hours sleep last night.

Remember, it's not just sleeping that matters, it's the quality of the sleep! Read your machine's data every morning and track it to determine if your sleep is good or fragmented as you go along, that's why data is essential to determining efficacy of CPAP therapy. Pre-CPAP, I could sleep 14 hours and be more tired when I woke up than I was when I went to sleep -- that's what apnea does, destroys the restfulness of sleep...that in addition to the oxygen deprivation that occurs during events which for many of us is a bigger health threat. So, number of hours asleep is not the only thing to track.

http://www.fphcare.com/osa/cpapi.asp

Someone please correct me if I am wrong but it appears to me that this 234 model is not fully data compatible and is compliance only. Hours of usage. No other useful data available???

Listen to Muse... the Muse knows...

*For example, last night I woke up (fully) four times but otherwise had pleasant sleep with dreams. Coincidentally, I had an AI 0.4 (apneas/per hour average) this morning. With the number of hours I sleep, as long as my AI stays under 1.0, the AI correlates with how many apneas I've had the whole night. I can feel the difference today with the fragmented sleep; not bad, but not as good as usual.

*NOTE: I am dealing with a cough, most likely a URI that seems to be resolving on its own.

When I sleep through the night, even if I have a couple of apneas (AI = 0.2), I feel really good the next day. When I sleep through the night with no apneas (AI = 0.0), man do I feel great the next day!

It is lunchtime and after doing some research it does appear that the Sleep Style 234 that they gave me is not full data. My sleep doctor, who is attached to the Alabama Sleep Clinic, only gave me one choice of machine. They said that it is on loan for 30 days and then my insurance company will get billed to full purchase price.

Is the Sleep Style 234 a bad CPAP machine to have? Reviews on the internet seem to show that people like it mainly due to it's low noise and integrated humidifier. My doctor is also the DME so I don't really know if I have any choice in the matter. I will give this unit a try and see how it goes.

Also, they said that the unit will ramp up to my sleep level which is 9. Is that a high number? I am new to this and still don't understand the terminolgy.

fsmitty wrote:Also, they said that the unit will ramp up to my sleep level which is 9. Is that a high number? I am new to this and still don't understand the terminolgy.

Not a particularly high number in the grand scheme of things. Probably about average. There are people that have to use 17-20 cm of pressure.

Regarding the doctor being the DME and the machine. Check with your insurance company to see who else is on their DME approved list. They cannot force you to use the doctor/DME. You actually have the right to get a copy of your prescription and take it anywhere to get filled. How badly do you want data capable machine? Sometimes it takes a fight..

fsmitty wrote:Also, they said that the unit will ramp up to my sleep level which is 9. Is that a high number? I am new to this and still don't understand the terminolgy.

Smitty,

A pressure of 9 is on the low side of middle. Anything less than about 6 or 7 isn't really enough air for most people to breathe. About 14, and it gets hard to exhale, so folks often go to a Bi-Level machine. Most of the entry level machines max out at 20, but the mid-grade machines and Bi-Level machines typically go to 25. If you are above 25, then you are into the upper tier of very expensive machines.

CPAP doesn't work on a sliding scale. For example, someone with a pressure of 18 doesn't have twice as bad of OSA as someone with a pressure of 9. Rather, what the air does is "stent" open your airway. Once there is enough pressure to keep your airway open, you can then magically breathe. Someone can have very bad OSA and only need a pressure of 9, and others can have a comparatively mild case but need a pressure of 20. That was the deal with your titration study--to find that magic pressure level that works for you.

-john-