Diagnosed - what now?

[Route67]

Hi again all....

I was diagnosed in early july; after almost a year of severe nocturia and visits to 3 urologists, a nephrologist [kidney specialist] and a couple GP's, I finally nailed it when I visited a sleep clinic and did the overnight test and was told I have severe sleep apnea, with a number of 29.5. They loaned me a CPAP for a week but I never really got used to it.

Now back in the states {I live part-time in Mexico}, I need to get started again but would certainly like to skip the overnight sleep trial and move right on to the purchasing and getting-used-to-it phase. The machines and masks are much cheaper here, based on what I have seen on the Supplier list of this forum.

So...... can I just buy the machine {A Fisher-Paykel Icon w/ humidifier was the one they loaned me} and a mask and get started? Or do I *have* to visit a sleep clinic here in New Hampshire? My worry being that they would want to start from square one, sell me the device and masks, do an overnight trial, monitor my progress, etc....when I already have written proof [in English] from a trusted sleep clinic in Mexico City. I think I have read here that a "DME" has to set the machine properly and monitor me over time, and they would probably also like to get me to buy from them, no?

Bear in mind my insurance deductible is high, so anything I am spending will be out of pocket. I will also do a consultation with a local dentist who swears by the OAT device, but in all reality I am quite sure I need a CPAP machine and asap; I haven't felt good in months and months.

Thanks one and all!

[PaulaO2]

I answered this question in your other thread.

An AHI of 29 is just under the threshold for 'severe' sleep apnea. As if that makes a difference, right?

There's a few threads here on the Icon. Do a forum search for either Fisher-Paykel or Icon and see what comes up. Memory is telling me it is low end. If you are paying out of pocket, Resmed S9 Autoset or the equivalent Respironics (DS510?) Auto is the way to go. Supplier #2 sells used and open box machines for really good prices.

An Auto would allow you to basically self-titrate. You get the sleep study results and look to see what pressure was recommended. If the pressure was, say, 8, then you'd set the auto to 6 to 10. Then you'd use it a week and look at the data. If you are regularly hitting the upper number, raise it a point or two. If you never get up there but stay around 7, leave it alone and enjoy the sleep.

The hard part is going to be the mask. There's a lot of them out there and it can take a LOT until you find the one you like. I have an odd nose (and odd everything else, actually) and a nasal mask didn't work for me so I use the nasal pillows. I tried one of the hybrids (nasal pillow and part that covers the mouth) but hated it. I do not breathe through my mouth at night so I didn't need it anyway.

Ask this dentist fellow if you can try one without buying it. But, like Zimlich said in the other thread, there's no way to tell if it is working or not. An oximeter would help but it is very limited. You'd have to first use one every night for a week or so to see what your oxygen saturation gets to each night. That would set the base line. Then you'd have to use it and the oral device for a week or more then again look at the data. If it is significantly better than without it, consider it done. But if there's little change or if the O2 still does not get into the safe zones, then you will have to use a CPAP.

[Route67]

Thanks again, Paula.....looking over the list on supplier number 2 right now, and also just spoke with a local friend who has sleep apnea.

Same as I have read here, he says since using his machine the difference in sleeping is amazing and feeling better the next day as well. He also reminded me that NOT using a machine is a perfect setup for some serious health problems down the road- or right now.

[PaulaO2]

Exactly. It isn't "just" a sleep issue. It is a life issue.

Some people take a long time to adjust. Many give up far too soon. Yet some put on the mask and it works for them immediately.

[Sleepster]

Supplier #1 has the PRS1 APAP Model 550P on sale right now. (Item #DS550P-DS550S). You will need a prescription, though, to purchase it.

[zonk]

So...... can I just buy the machine {A Fisher-Paykel Icon w/ humidifier was the one they loaned me} and a mask and get started?

If your apnea is worse at some sleep positions ... than autoPAP would be the best therapy choice.
If buying the Icon stay away from the Novo which is not data capable machine
My first choice would be S9 AutoSet bc it offer better data reporting on the screen, supported by ResScan and SleepyHead software..

[archangle]

In my opinion, anything other than CPAP borders on quackery. They don't work as well, if at all, often cost more, and delay getting real treatment, CPAP.

You do need a prescription to get a CPAP machine through normal channels. Insurance usually requires a sleep study before they'll pay. Local DMEs (CPAP sellers) will rob you blind if you don't buy it with insurance. Online suppliers are cheaper, but getting the right mask may be more difficult, and you usually can't get them paid by insurance.

Some buy used machines on craigslist.

Get the ResMed S9 AutoSet or the PRS1 Philips Respironics Model 60 Auto. Get a heated humidifier to go with it. These are Auto CPAP and will do everything a manual CPAP will do, and usually won't cost anything more to you. If you have a pig headed doctor who won't prescribe APAP, the S9 Elite or PRS1 PRO models are good manual CPAPs. Do NOT accept an S9 Escape or Escape Auto, or a PRS1 PLUS. These do not collect the data you need to manage your therapy.

Don't bother with any of the other CPAP machines unless you get a really good deal. Including older machines from the same manufacturer. The other machines all have limitations for data collection.

[Route67]

Thanks a lot, everybody. I went with the advice from Paula and called secondwindCpap today.......nice people, took my order very effectively and got it out today; a 2nd-hand Gently Used ResMed S9 AutoSet and Accessories [including hose]for $549; the nasal mask was 89 more.

I am happy with the purchase and seriously can't wait to use it. I fully understand that it will be difficult to get used to, I had a very hard time with my trial period last month. But I also know that my brain is not working the way it should be because I am over-tired in the daytime and feel lethargic and lousy most of the time.

Will be here early next week, can't wait!!

cheers one and all.......

[trish6hundred]

Hi again Route67, Glad to hear that you found a new, (to you,) machine and accessories. Best of luck and continue to keep up posted on how you do with your CPAP therapy.

[zimlich]

Route67, how are things going? Please keep us posted.