Its not Apnea but.....

[bexiesbruv]

If you don't have apnea and your oxygen is so low, I don't understand why you weren't referred to a specialist to identify why the oxygen shortage?

The cynic in me says its because they want to sell me a machine.
Another part of me says its just part of the process the drill down to the issue.
The cynic is winning. The sleep place for sure were less than impressed that I said I would not buy new equipment, and kind of switched off after I said this.
I will call them this morning and ask for their report or at the very least to send it to my Doctor for this afternoons appointment with him.

One thing that I did notice, to add to a question posed above regarding daytime SP02 was that when taking several deeper breaths my 02 goes up to 98%, but will crash down to as low as 85% before heading back to around 91%
Is that relevant?

[Hydrangea]

As an aside... I had the same thought about my sleep dr, and even his Yelp reviews said he was basically just a CPAP factory. I decided that while that may be true... IF I am actually seeking help from a sleep dr, it's probably because I need it. And hey, if cpap ended up not helping me, I'd figure it out pretty quickly.

Despite the fact that my sleep dr is many names that are perhaps inappropriate to say in a respectful forum such as this one... at least he gave me the Rx I needed, so now my life has changed for the better!

[Beej]

...One thing that I did notice, to add to a question posed above regarding daytime SP02 was that when taking several deeper breaths my 02 goes up to 98%, but will crash down to as low as 85% before heading back to around 91%
Is that relevant?

It could be. There are some conditions where breathing may be impaired which are not apnea. A good pulmonologist and/or cardiologist might be good consults.

[bexiesbruv]

I wonder if I should now start a separate thread for the next question? I will post here first and see what comes back to me.
Budget is tight.
To get the benefit of the advice from the respiratory place I need to spend $200
They will provide a dreamstation, monitoring and make changes and also offer mask selection.
I am under no obligation to buy from them and have said they will set up any used equipment I purchase and I have indicated that my insurance will pay out enough to purchase masks/tubes.
When asked what machine I SHOULD look for in the used market, they offered no advice.
When I asked why they will trial me on the Dreamstation they said because it has a gentler algorithm.

So my question
When looking in the used market, what machine should I look for.
Its already been mentioned to look for a S9 Autoset, which I have found, within my budget, but need to buy mask.
But I also have been offered a Remstar Auto C-Flex refurbished, two new masks/tubes, under my budget.

Would either of these work for me?
I ask on the basis of the comment that they will set any machine up for me that I bring to them so would the Algorithm in the Dreamstation be that important?

I am also minded to just buy the equipment and utilise the wealth of knowledge here and "do it myself", however, if it does not help me
1. I am out the cost of the equipment (I am pretty sure I can make a proportion of the cost back)
2. I might not be able to get the refer to a pulmonologist/cardiologist because I think the data needs to come from the sleep place.

Actually, I think I just got my answer. I have to go the $200 route because I need that referral if I am to proceed.
So we come back to

Does the machine type ultimately matter?

[Sleeprider]

I'm not sure what you are getting for $200, or what referral that entails. You need a prescription for most options. I assume you looked into Supplier #2 for the Resmed S9 Autoset. The trial on a Dreamstation Auto should be fine, but what does this lead to? I really don't care that much for the "gentler" algorithm. It mostly means you need higher minimum pressure for it to work correctly, and I'm not a big fan of the Respironics algorithm that increases pressure by 2 cm every 20 minutes or so just to test a higher pressure, and I think the Flex pressure relief is a kludge compared to EPR in Resmed. JMHO.

When you say Remstar Auto CFlex, what model? Is this the PRS1 60 series auto or some earlier model? PRS1 DS560 or 561 is a very capable auto CPAP with data. Hopefully you're not talking about a legacy machine like the M-Series. As far as what machines I would consider in the used market, here they are in order of preference:
Resmed Airsense 10 Autoset
Resmed S9 Autoset
Philips Respironics Dreamstation auto
Philips Respironics System One 60 Series auto

Don't worry about setup, we can get you there.

[holden4th]

I'm assuming that you know about optimum heart rate training zones and how to calculate them. If you're within the range for your age you're OK. Your max HR drops with age.

[bexiesbruv]

I'm not sure what you are getting for $200, or what referral that entails.   You need a prescription for most options.  I assume you looked into Supplier #2 for the Resmed S9 Autoset.  The trial on a Dreamstation Auto should be fine, but what does this lead to?  I really don't care that much for the "gentler" algorithm.  It mostly means you need higher minimum pressure for it to work correctly, and I'm not a big fan of the Respironics algorithm that increases pressure by 2 cm every 20 minutes or so just to test a higher pressure, and I think the Flex pressure relief is a kludge compared to EPR in Resmed.  JMHO.

When you say Remstar Auto CFlex, what model?  Is this the PRS1 60 series auto or some earlier model?  PRS1 DS560 or 561 is a very capable auto CPAP with data.  Hopefully you're not talking about a legacy machine like the M-Series.  As far as what machines I would consider in the used market, here they are in order of preference:
Resmed Airsense 10 Autoset
Resmed S9 Autoset
Philips Respironics Dreamstation auto
Philips Respironics System One 60 Series auto

Don't worry about setup, we can get you there.

The $200 gets me the loan of a Dreamstation (model unknown) and their "expertise" in set up and ongoing tweaks and evaluations over the coming month. Additionally, if my spo2 does not improve, the ongoing referal to a cardiologist or pulmonary specialist if more appropriate. Thats the route thats got to be taken according to my Doctor.
The algorithm makes little sense to me as such, I am understanding a little more about such things, when put into the context of them agreeing to set up ANY equipment I bring to them from the used market.
I dont know which version Remstar right now.
Looks like I can get a used RESmed S9 Autoset EPR for $425CAD which, when exchange and shipping is factored in, will be similar cost as the seller 2 option. Or brand new from an online seller with a Calgary (Alberta) base for $500 out of pocket when the Insurance kicks in their small part.
I should be able to go back to my Doctor and present with symptoms and get a referral to a specialist without gong the $200.
On the other hand why not just part with the $200 and live with it. Principle.
The prescription is already printed according to the Doc. I just dont have it, the sleep folks do.

[bexiesbruv]

I'm assuming that you know about optimum heart rate training zones and how to calculate them. If you're within the range for your age you're OK. Your max HR drops with age.

Yeah, you assume correctly. I have been doing MAF and MMAF (Maffetone and modified maffetone) aerobic training  since October last year, at which time my Max HR was 171. Its now dropped to 161. I have asked an expert in this for his thoughts but has not come back to me yet.
I wondered if it might be diet based as I have been low carb for some time and reintroduced a higher amount of carbohydrate in the last couple months.
Thanks for the suggestion, I appreciate it.

[Sleeprider]

You could always blow their minds and pick up the Dreamstation Auto BiPAP DX700T11 on Amazon for $700. Not much you couldn't do with that, including much better ventilation and oxygenation with pressure support, as well as a CPAP and APAP mode.

I guess I'd want to verify the Dreamstation on loan is an Auto or at least has data, otherwise their expertise won't be very useful. Also if they are going to monitor your SpO2, are they kicking in a recording oximeter? I'd get my hands on the Rx, and get the details on what is being proposed.

[bexiesbruv]

You could always blow their minds and pick up the Dreamstation Auto BiPAP DX700T11 on Amazon for $700.  Not much you couldn't do with that, including much better ventilation and oxygenation with pressure support, as well as a CPAP and APAP mode.

I guess I'd want to verify the Dreamstation on loan is an Auto or at least has data, otherwise their expertise won't be very useful. Also if they are going to monitor your SpO2, are they kicking in a recording oximeter?  I'd get my hands on the Rx, and get the details on what is being proposed.

It was my intention to call them again tomorrow and ask about the prescription. Did they write or my Doctor?
Is there anything else relevant to this that I need to ask them? Frankly, it never occurred to me.