Back from the lab....

I've been 'titrated' - it wasn't as bad as I thought although I pulled the mask off a few times. (At one stage the pressure felt so high that I couldn't breathe!)

I've been diagnosed as 'severe' with oxygen saturation falling to a low of 60, and an RPI score of 45 in REM sleep and 11 overall. I suppose I must just stop dreaming.

The lab wasn't particularly good about explaining anything. They gave me some advertising leaflets and that was it. I had to ask about the different types of machine, and got some surprising answers.

Bi-Pap machines - you only need if you've got problems like musclar distrophy.

Automatic machines - often miss episodes and should be avoided They normally just stay on minimum pressure.

Types of mask - just keep trying until you find one that suits you. (What, at about $100 a time?)

Humidifiers - you won't need them because the air is humid anyway.

The prices here are horific - if my medical aid won't pay (I think they will) I'll buy from cpap.com. Examples:

Goodnight 420S - Local R5,100 (say $800) cpap.com $449
Remstar Pro C-CFlex - Locally R5,400 (say $830) cpap.com $409

Even with shipping and import duties it's a lot cheaper in the US than here.

Oh well - back to work.

Hi Mike,

If and when you have your follow-up appointment with your sleep physician, you should get more information about your condition.

From what you described, you have moderate sleep apnea with nocturnal desaturarion. The cpap therapy should do you a lot of good.

Ok.. now onto the machines.

Bipap machines are used for people who cannot tollerate cpap, have extremely high pressure (up close to 20cm), or have COPD or some other illness that makes it impairative to blow off C02. Something that person may not be able to do on a regular cpap. There are many uses for the bipap.

Autopap's have been studied, and I have read quite a bit of articles in Sleep Journal that say that the autopap does not treat OSA any more effective than cpap or bipap. Where the autopap shines is in lowering of overall pressure. Autpaps are also a trial and error type of process. They all react differently to each of our conditions. There are favorites though. The Resmed Autoset Spirit, the Puritan Bennett 420 E and the Respironics Remstar Auto all seem to be really good machines.

Heated humidification is a really good thing. It helps keep your nasal passages open and feeling good. Contrary to popular belief, humidity in the air does not mean that you don't need to use heated humidification. When you blow air that quickly into your nares, they will dry out unl3ess heated with a humidifier.

Masks seem to be the key to overall cpap compliance. Each of us likes something different. I am a Breeze, Swift, Activa kind of guy. Others may like full face or the Profile lite nasal mask. It truely is a search for your perfect mask. Just keep trying.

Your mention of how expensive cpap machines are in South Africa is correct. Cpap.com, where I work, has the best pricing of anyone and will match a lower price, if you can find one. The shipping department at cpap.com second to none. We do loads of business, but always seem to get the orders out same day or in the next day if placed after 4:00pm Central time. My hat is off to our shipping department, they run a tight ship.

Thank you for such a good post. Lots of questions and all good ones.

Regards,

Ted the Titrator