[CPAP] Thinking about starting therapy on my own - Thoughts?

[bonum.noctem]

Home screening revealed that I have "mild" OSAS. The determined AHI is 6.7, but I have sleep position based apnea, hitting me when trying to sleep on my back, with hypopnea accompanied by considerable snoring in all other positions. The summary of that screening tells AHI slight / Snoring medium heavy / SpO2 slight.

I simply can not sleep on my back (though I want to), sleeping on either side results in me rolling around all the time and occasional shoulder pain, and my preferred sleeping position on my stomach also does not lead to restful uninterrupted sleep accompanied by neck tension and sometimes headache in the morning. I'm clearly feeling the effect it has on me, I'm exhausted when I wake up, tired and unmotivated throughout the day, always ready for an after-lunch nap.

The problem is now, that my full diagnoses in a local sleep clinic is still 3 months away (it's simply impossible to get an earlier appointment). If the diagnoses in the sleep clinic results in me needing a CPAP machine, my health insurance will cover the costs for a rental machine, but requires 80% use (which shouldn't be a problem, because once I have it, I wanna use it).

Right now I'm tempted to start CPAP therapy on my own right away by ordering a new ResMed AutoSense 10 AutoSet with humidifier + heated hose + ResMed AirFit P10 from an online retailer in the USA (which seems to make the most sense, as it's simply impossible to get a machine at a reasonable price here in Europe), with the idea of selling it again once I get a rental machine from a local DME provider paid by my health insurance (I think there is no point in keeping it as a backup, because if there is something wrong with the rental machine, they are going to replace it anyway). I just don't want to wait any longer.

Any thoughts on that?

When getting a new ResMed AutoSense 10 AutoSet that is not pre-configured (so everything at factory default), which settings are to be adjusted to get started? What are the default minimum and maximum pressure settings and how to determine the best starting values on my own?

How long before the clinical sleep study should I stop using the machine to not influence the examination?

[Walla Walla]

If you decide to buy you might want to buy a used one that costs less. Check out Supplier #2 they carry good slightly used Machines.

[Sleep2Snore]

ResMed AutoSense 10 AutoSet with humidifier

Good choice if you do not do camping as it uses 24vDC.
If it is purely for home use it is the best choice in my opinion.
Mask is a choice you make and hope for the best.
Good luck.

Be aware that if you buy a ResMed from the USA they will not honer the warranty in Europe.
This is their way of controlling the price as far as I am concerned.

[spkrason]

I am currently treating myself with relative success, though my main reason was cost.  I have only been doing CPAP for 3 weeks now so still figuring it out and getting used to it. I did a Home Sleep Test and it came back with moderate sleep apnea with AHI 15.4. Started with a Dreamwear Nasal cushion and works well except I have a problem keeping my mouth closed. Tried the chin strap but I have other sinus issues causing me a lot of congestion as well so now I am trying the Dreamwear full face mask. Last night had AHI of 1.7 with some new settings and the full face mask though I am usually around 4, hoping last night was not a fluke.

Main thoughts is you have to be really dedicated if doing this yourself. I did a lot of research to manage the settings. I also use SleepyHead software to monitor the data. The pressure settings default 4 min to 20 max on the pressure. You may want to adjust the EPR and the Response settings but it is really trial and error to see what works better for you. After a few weeks with the default pressure I bumped up the minimum pressure to 6.6 which was around the median pressure my data reports were showing in SleepyHead. My humidity is currently between 4 to 6 (still tweaking it). I have an insulated tube cover because I was getting a lot of condensation in the tube and that fixed the condensation issue.

If looking for a good price, I went through "Registered Portable Monitoring" and did a home sleep study before purchasing equipment from them. RPM had the best price on the ResMed Airsense A10 Autoset - used a coupon code to bring the price down to $525 with a free nasal mask - message me if you want the coupon code. Very happy with the A10 Autoset and there are YouTube videos for getting into the "Clinical Settings" where you can change all the settings yourself. I did a lot of research on managing the settings and so far it has been going well.

i am still very new to this so this comes from the perspective of someone doing it less than a month without a doctor helping manage therapy. It was challenging at first but getting easier every day and this forum is a great resource.

[DeepBreathing]

G'day spkrason. Welcome to Apnea Board - great to see that you're off to such a good start!

[DeepBreathing]

Hi bonum.noctem.

If you want to get started then I second the recommendation to get a "gently used" machine from Supplier #2 or other reputable source. You will take a big financial hit if you buy a new machine then try to on-sell it after a few months. The AirSense 10 Autoset is the best regarded machine and one that is recommended by many members here. Note that it's not the cheapest machine.

The main settings you'll need to worry about are pressure, pressure relief and humidity.

Pressure will vary as required between the minimum and maximum values you set. The default (wide open) values are 4 - 20 cm H2O. This is as good a place to start as any, though it's highly likely you'll want to increase the minimum and reduce the maximum once you get used to the machine.

Expiratory pressure relief (EPR) reduces the pressure a little as you exhale, making the therapy more comfortable. It can be set to 0, 1, 2 or 3 where each number represents a pressure reduction of 1 cm H2O. It's probably best to start with zero and increase EPR if you need to. One problem is that EPR can promote central apneas in susceptible people.

Humidity I recommend you get the heated hose, which then allows you to use automatic climate control.

In addition to the machine, you'll need a mask. This is the hard bit - everybody's face is different and there's no one mask that will suit everybody. The usual advice is to start with the least invasive pillows type mask and go from there.

Finally, you will need a way to monitor your progress - download and install #SleepyHead, which will give you excellent data reporting. Once you get started, post yur charts here and people will be able to advise you on optimising the therapy.