Just diagnosed

[bwexler]

Everyone knows the Resmed S9 Autoset with H5i Humidifier and heated hose is the best machine you can get, except the folks who think the Phillips Resperoncs PRS1 DS560TS with heated Humidifier and heated hose is the best. They are about equivalent.

A call to the provider to ask what machine they are planing to provide is a good place to start. If they suggest either of the above machines you will be fine, but you must be VERRRRY SPECIFIC about the model designations. Some aredeceptively similar.

If they suggest anything less talk to who ever is writting the precription and insist that they writ it for exactly one of the machines I mentioned plus your mask of choice and then write on the prescription "dispense exactly as written." Also when you pick up your machine have them turn it on in front of you and look at the display for total machine hours. This will tell you if you are receiving a NEW machine or a preciously used machine. You want NEW, less than 10 hours.

The mask is not so simple. Have you ever gone shopping for shoes with a woman? There are hundreds of masks from dozens of manufacturers, in many styles. In a room with 100 peaople you are unlikely to get a majority agreement on the best mask.
In a room with one person, me, I can't get agreement on the best mask. I can't tolerate nasal pillows. Some days I like my SleepWeaver Elan nasal mask, some days I prefer my SleepWeaver Anew full face mask, some days it is my Fisher and Paykel full face mask. Some days I don't like any of them and look for something new. I am also a side sleeper and I am younger than you only 68.

To recap, you must be very fussy about the machine it will be with for 5 years based on Medicare guidlines. The mask can be replaced every 3 to 6 months and most DMEs will alow 1 or several returns when you are first getting started.

[Bama Rambler]

The best way to have the prescription written is to have it say "Full Efficacy Data, Auto-Titrating Unit". To get an Auto-titrating unit, the Doc must also specify a range in the pressure setting. Since your apneas are relieved at 5 to 7 cmH20, he could write it for 4 to 10 cmH2O and that'd satisfy the requirement. However, most Auto machines are usually set 4 to 20 cmH2O for some reason.

To get the mask you want, you can either have it written specifying the exact mask or have them write it "Patients Choice".

[jb1176]

Hi everyone,
Update. Three nights with my ResMed S9 with humidifier and the P10 pillows and everything is going smoothly. I am very thankful to those who wrote about the P10 nose pillows for they are much more comfortable than the full face mask I had to wear in the sleep clinic.

Any advice about how to deal with slight irritation at base of nose from the pillows? It is not bad but I can tell it may develop into a bigger problem if I don't seek a solution.

The S9 is so QUIET!

[retired_guy]

Hi everyone,
Update. Three nights with my ResMed S9 with humidifier and the P10 pillows and everything is going smoothly. I am very thankful to those who wrote about the P10 nose pillows for they are much more comfortable than the full face mask I had to wear in the sleep clinic.

Any advice about how to deal with slight irritation at base of nose from the pillows? It is not bad but I can tell it may develop into a bigger problem if I don't seek a solution.

The S9 is so QUIET!

There's a product called HPA Lanolin that is highly recommended around here. You get it in the baby supplies department at your favorite store. When I got mine, I used it according to the directions on the tube and it didn't work very well. After a couple of days I tried putting a tiny bit on my nose and it worked great!

Also, if you're using the "medium" pillows, give the "large" a try. Amazingly you can kind of go back and forth with these pillow things and they always seem to work.

[SleepyDreamCatcher]

Hi everyone,
Update. Three nights with my ResMed S9 with humidifier and the P10 pillows and everything is going smoothly. I am very thankful to those who wrote about the P10 nose pillows for they are much more comfortable than the full face mask I had to wear in the sleep clinic.

Any advice about how to deal with slight irritation at base of nose from the pillows? It is not bad but I can tell it may develop into a bigger problem if I don't seek a solution.

The S9 is so QUIET!

You are doing a great job taking control of your therapy. Be sure you are not tightening the straps on your P10 mask too tightly. I just started my therapy too and if I used as much pressure on the straps as the therapist at the DME used to show me how to put it on I would have trouble getting through the night. Use just enough pressure to hold the pillows to your nose. They should actually seal better that way. If you hear or feel air leaking try gently lifting the mask slightly away and then repositioning it. Sometimes I need to do this a couple of times to get the pillows situated correctly. You need to find a balance point between the tension needed to keep the mask on your face and the space needed to generate the seal.

The other help I learned about here is to put a little HPA Lanolin lotion just inside your nostrils. You can use a Q-tip to do that. We are supposed to do that until the nose has toughened up to this new tactile input. I used some last night (my second night) and there was already less discomfort for me. This lotion is found in the baby aisle of the store.

Good luck again tonight.

[jb1176]

Thanks for the suggestions for the HPA Lanolin lotion. Went out right away to buy it.

[Gabby]

Hi everyone,
Update. Three nights with my ResMed S9 with humidifier and the P10 pillows and everything is going smoothly. I am very thankful to those who wrote about the P10 nose pillows for they are much more comfortable than the full face mask I had to wear in the sleep clinic.

Any advice about how to deal with slight irritation at base of nose from the pillows? It is not bad but I can tell it may develop into a bigger problem if I don't seek a solution.

The S9 is so QUIET!

Hi jb1176,

I hope the lanolin has fixed your problem but in case it hasn't I had this problem from the Large Airfit P10 pillow, which gives me the best fit. It gave me a small sore at the outside of one of my nostrils, I tried the lanolin but the pillow was still annoying the sore so it needed covering to heal, so I have been putting some cotton wool in to completely cover corner of my nose every night. My sore has healed and I think it makes the seal even tighter.
Hopefully the lanolin will do the trick but just thought I would throw in this tip just in case.
All the best.

[WSHenry]

Hello everyone,
I just was called by the sleep clinic telling me the results of test. Confirmed apnea with average of 35.8 episodes per hour over two hours. With full face mask and pressure range 5-7 episodes eliminated. I am male age 71 and this is my first sleep study. Have not met yet for machine and mask selection. Medicare eligible. Side sleeper. Felt claustrophobic with the full face mask and was difficult to use as a side sleeper. I need some help knowing what is ahead for me when I meet to select machinery.

1. With Medicare will I have a choice of full face or nose mask?
2. We travel out of the country frequently. Will they allow me a travel machine?
3. Continuous flow, bi level flow, or automatic? What should I get?
4. Heated, humidity ?
5. Remember I'm a side sleeper. What mask should I look for? Will Medicare allow an upgrade for machine, mask, etc?

Thanks for advice. This is going to be an adventure and hope I can go with the flow. Many of my friends gave up.

Choice of mask is a personal preference. I alternate between a full face mask and a nasal pillows mask. Scripts will need to be written for each style of mask requested. These must be separate from the machine script, as Medicare treats each as a separate hardware item.

No issue with travel. If flying, the airport security folks have seen these machines before. They'll either wave you through or do a cursory exam for explosive residue. I have a letter from my Dr. stating the equipment is medically necessary.

The machine type specified by your Dr. will be somewhat dependent on the types of sleep disorders found during the overnight study. I agree with other posters that you want to request a data-capable machine. the easiest way to do this is to have your Dr. write a script for an auto-titrating machine, even to include the specific brand and features. As mention, there is only one equipment code for billing purposes. The folks at Medicare don't care if you have a "brick" or a data-capable APAP machine.

I wish you the best in your decision to improve your sleep. I know its working for me.

[trish6hundred]

Thanks for the suggestions for the HPA Lanolin lotion. Went out right away to buy it.

Hi jb1176,
It's good to hear that you are doing well with your CPAP therapy, keep up the good work.
You have probably found this out but,, use the HPA Lanolin sparingly, a little goes a long way.

[jb1176]

I think I have discovered the cause of the irritation from the P10 nasal mask - at least what I think is causing my problem. There is a tiny ridge or edge around the frame of the nasal mask where the pillows snap into the frame. At night that ridge pushes into the skin at the base of my nose above the lip area. The lanolin ointment helps the discomfort during the day but the process repeats itself again at night. The curious thing is that the irritation is only on my right side. I'll try the cotton wool idea, but really there is a fault in the construction of the mask itself probably coming from the molding process such that a sharp edge is left as the mask frame is formed. I can feel the sharp edge around the whole face frame with my finger. Wonder if ResMed could be told about this fault?