Help for new-ish user.

[solo]

Is it best to have a nearby DME in case we need advice? We live about as close to the university based sleep clinic as to the DME we had been using. If we buy online, do we just get advice from the sleep clinic if needed? If buying online is a good option, can you recommend good vendors? The Airsense 11 was purchased from LocalCPAP, but they don't take insurance.

[Sleeprider]

The main priority for someone with good insurance is to use a DME that is in-network or an approved provider for their insurance. Proximity is of little or no consequence. Most consultations are done remotely by phone, and it is rare to have useful in-person interaction with a DME for anything other than mask fit. Even with a local DME, most people will receive their machine configured for their use and any supplies by a parcel carrier. The monitoring for insurance compliance is also performed remotely.

[solo]

Thank you again!

[solo]

We did find a new DME that is a portal for cpap supplies by mail from Lincare. We are told that we have to (by law) pay 20% of all supplies. Luckily that is not a problem, but I find it odd that our former supplier didn't require that. Is that common?

[acruisertoo]

I'm was in a beef with Lincare. They prebill 20% and then credit back the next month what the insurance covers. I have received nastygrams from them but I refuse to pay up front when they are the local provider via insurance. I wait until my insurance has paid and tells me what my responsibility is and I pay that. After 3 months of back and forth, they realized I was correct and issued a boat load of credits and I now owe nothing. I don't like the way they bill and am currently researching Aeroflow to handle my recurring supplies since they are in my network.

[solo]

Thanks for that. I thought it was strange.

[solo]

Can extended release melatonin increase AHI? Average went from @3-4 up to 7+. Started taking Sertraline 25 mg a month or so ago due to anxiety. Was increased to 50 mg after a trial. Mood is better now, but incidence of REM sleep disorder returned. Sleep clinic advised slow release Melatonin. Started on 2.5 mg and quickly increased to 5 mg gummies. AHI jumped, seemingly after starting that supplement. Did not take it last night but still has an AHI of 7+ last night. Can this increase be due to the Melatonin?

[Sleepy Quixote]

@solo

For me personally, any sort of medicine or herbal that promotes relaxation or deeper sleep seems to bump up the flow limitations and AHI a bit due to greater relaxation of the throat muscle group during sleep. I've had to compensate by titrating up the pressure in response. I usually only increase by .2, monitor for a couple and see where things settle. For months I was successfully running a minimum pressure of 7.2, that was before trials of meds for PLMD came along, Melatonin was one of those trialed and I did have to bump up, now four trials down the road, most geared toward relaxation or depressing the symptoms I am up to a minimum of 7.6 and contemplating going to 7.8

Your increase is a bit more than I experienced and it could be there are other contributing factors.

[solo]

Thanks for that. Are you continuing to take the melatonin or other relaxant and just upping the upper pressure by .2 until your numbers are better?

[Sleepy Quixote]

@solo

Yes I am continuing my medications and melatonin and yes I bump up the pressure gradually over several days and observe the numbers. If they improve I continue until I get into a situation of diminishing returns or increase in sleep disturbance due to discomfort I then start bumping down slowly till I find a happy medium.