NEW TO CPAP AND FORUM

[KijabeKid]

Hi Guys/ Gals.

This is great forum and I have learnt a lot in a short amount of time since getting my sleep studies done.  My initial sleep study showed that I had an AHI of 94.  They classified me as "very severe".  After my 2nd study with the CPAP my dr has given me a script for a machine with a pressure setting of 6.  I picked up a rental machine last week for a month of testing before purchasing.  I have been given the Resmed Airsense 10 with a F&P Eson nasal mask.  I have now used this for 3 nights, 8 hrs each night, and the AHI the machine reported is 24, 27, and 54 consecutively.  I assume this is very poor, however am not sure how much reliance you can put on what the machine tells you on the display?  Anyone have an idea on this?  I am going back to tomorrow for further investigation with the supplier I have got the rental from.   I assume they will suggest to increase the pressure, I am also finding the mask headgear too prominent and the straps that hook to the mask in front are dislodging when I turn from my back to my side.  Any suggestions on a good alternate mask/headgear??

Thanks!

[Melman]

I'm sure others will support me in the recommendation that you download SleepyHead software and post data on this forum. see the links below for instructions  on how to obtain the software, configure the data charts, and post them in the forum. You will need at least four posts before you can post any data but I'm sure you will have followup questions plus just respond with a "thanks for the info' say hello again etc.

A couple of things jump out at me. First, you have a machine that can be configured to operate in a pressure range to respond as required to prevent apneas by increasing pressure when necessary, but it is not configured to operate as such. Based on my experience and those with expertise on this forum a constant CPAP pressure is not usually effective.

Secondly, your pressure of 6 is very low. I, for example operate my machine in the range of 8-14 and it often goes close to 14 to prevent apneas. When I was on constant pressure of 10 my AHIs were almost always above 5 and often in the teens. since going to auto pressure control my AHIs are almost always below 2 and often below 1.

Mask issues can be a hassle. A very knowledgeable forum member has written a mask primer that can be found here: http://www.apneaboard.com/wiki/index.php...ask_Primer

I have tried a number of full face mask and have found the Airfit F20 to be the best but others have different preferences. It's a very individual thing.

I believe the AHI values reported on the machine are reliable but am not 1oo% sure. But anything above 5 is not good.

You have come to the right place. There are members of this forum with impressive expertise who are ready and anxious to assist.

I note that you are temporarily renting the Airtsense 10 autoset. You will find the consensus of the forum that that is the best machine to go with.

Get some data posted and you will get help.

[KijabeKid]

Hi Melman, thanks for the reply.  I am downloading sleepyhead now.  When I was in discussing with my DME they stated that I did not need a automatic machine and a constant should be fine.   I was of the thought that an automatic would be the best option as it allows more flexibility.  Not sure why they would say that, maybe they are trying to clear stock.  Anyway, I am happy with the machine so will probably go for this when it comes to purchasing but will do some further research into its capabilities.

I will check with the links you have provided, thanks for taking the time!

Cheers.

[holden4th]

Hi Melman, thanks for the reply.  I am downloading sleepyhead now.  When I was in discussing with my DME they stated that I did not need a automatic machine and a constant should be fine.   I was of the thought that an automatic would be the best option as it allows more flexibility.  Not sure why they would say that, maybe they are trying to clear stock.  Anyway, I am happy with the machine so will probably go for this when it comes to purchasing but will do some further research into its capabilities.

I will check with the links you have provided, thanks for taking the time!

Cheers.

Hello Kijabe Kid and welcome from a fellow Aussie.

Was you sleep study done with SNORE Australia?

Who is your DME?

[KijabeKid]

Hi Holden4th,

I am in Gladstone, there is only one DME here which is Gladstone Surgical, I believe 1 pharmacy also has some for sale but there is not a lot of options here.  My doctor gave me a direct prescription for this DME  I did by sleep studies through Genesis and both studies were done the at the local private hospital.  Do you know if the prescriptions states CPAP if you can get an APAP instead and have no issues with the health fund?  Not sure if I will purchase locally or buy via internet from those that are provided on the supplier list.  Generally everything here is more expensive than elsewhere in Oz.

Cheers

[DeepBreathing]

G'day KijabeKid. Welcome to Apnea Board.

It seems a lot of docs like to prescribe a single pressure rather than an autoset machine. While recognising that some few patients do better on a fixed pressure, I don't think the docs are thinking this through properly. Your pressure needs will vary over time and even over the course of a night. Typically, you will need a higher pressure when sleeping on your back, compared with sleeping on your side. Add in variables such as coughs and colds, sinus conditions or hay fever etc, then different pressures will be required in each case. Moreover as you get older your physiology will change. To try and cover all this on the basis of a single night in a strange bed in a hospital when you're hooked up to 20 or more sensors and electrodes is just plain crazy.

As far as what type of machine you're able to buy, there are no limitations in Australia. You don't need a prescription to buy a machine. Most of the health funds only provide a pittance and don't have any regard to the type of machine. (You'd be better off getting homeopathy and essential oils - they pay more for that!) If you buy outside Australia (eg from one of the suppliers on our list) you may or may not need a prescription. If buying online you should be aware of a few key issues:

1. You are on your own as far as warranty is concerned. If you have a problem you'll have to ship the machine back to the states for repair as nobody will touch it here even if it is a Resmed made in Australia. Likewise your friendly local DME may be disinclined to help you if you have a problem.

2. With the AUD currently around US$0.75 it's harder to get the bargains we could a few years ago

3. You need to factor in the cost of postage

4. Customs may try to charge you GST. However CPAP machines are on the list of medical devices which are specifically exempt. They are within their rights to charge a handling fee which seems to average around $50, depending on who you talk to.

Good luck!

[Sleeprider]

What model Airsense 10 is this? You will see the word CPAP, Elite or Autoset on the lower right under the word Resmed. The CPAP does not provide Efficacy data.

A CPAP pressure of 6.0 is very low, but your event rate is exceptional. The question is whether these events are obstructive or central.

[trish6hundred]

Hi KijabeKid,
WELCOME! to the forum.!
Good luck to you with your CPAP therapy, Hang in there for more responses to your post.

[KijabeKid]

G'day KijabeKid. Welcome to Apnea Board.

It seems a lot of docs like to prescribe a single pressure rather than an autoset machine. While recognising that some few patients do better on a fixed pressure, I don't think the docs are thinking this through properly. Your pressure needs will vary over time and even over the course of a night. Typically, you will need a higher pressure when sleeping on your back, compared with sleeping on your side. Add in variables such as coughs and colds, sinus conditions or hay fever etc, then different pressures will be required in each case. Moreover as you get older your physiology will change. To try and cover all this on the basis of a single night in a strange bed in a hospital when you're hooked up to 20 or more sensors and electrodes is just plain crazy.

As far as what type of machine you're able to buy, there are no limitations in Australia. You don't need a prescription to buy a machine. Most of the health funds only provide a pittance and don't have any regard to the type of machine. (You'd be better off getting homeopathy and essential oils - they pay more for that!) If you buy outside Australia (eg from one of the suppliers on our list) you may or may not need a prescription. If buying online you should be aware of a few key issues:

1. You are on your own as far as warranty is concerned. If you have a problem you'll have to ship the machine back to the states for repair as nobody will touch it here even if it is a Resmed made in Australia. Likewise your friendly local DME may be disinclined to help you if you have a problem.

2. With the AUD currently around US$0.75 it's harder to get the bargains we could a few years ago

3. You need to factor in the cost of postage

4. Customs may try to charge you GST. However CPAP machines are on the list of medical devices which are specifically exempt. They are within their rights to charge a handling fee which seems to average around $50, depending on who you talk to.

Good luck!

Thanks DeepBreathing, I am quite shocked at what out of pocket expenses I will incur despite having private health insurance!  Anyway, should not be too surprised as ti seems to be the way with the industry....  I will investigate buying online in Australia after getting some quotes from my local supplier first.  I see some package in a mask etc.  I now realise that the machine I have on rental is the Autoset model, so it looks like they have set this up to be on a constant pressure rather than adjusting to my requirements.  I 100% agree that the 1 night evaluation is not going to give a great analysis.
Your detailed response and support is most appreciated.

Cheers.

[KijabeKid]

What model Airsense 10 is this?  You will see the word CPAP, Elite or Autoset on the lower right under the word Resmed.  The CPAP does not provide Efficacy data.

A CPAP pressure of 6.0 is very low, but your event rate is exceptional.  You should go to the doctor that did this and demand your money back.  An Auto machine is far superior.  As long as your machine produces data (Elite?) then we can get you sorted out.  Otherwise , we just have to assume your events are obstructive and suggest a pressure increase.  I would go to 8.0 cm with no hesitation.

thanks Sleeprider, my rental modes is the Autoset.  I have an appointment again this afternoon and will see what I can get done to increase the pressure and a mask change.  Last night was a big dissapointment but hope tonight will be better.

Many thanks!