New Member/A Little Worried

[JustMac]

Glad I found this forum and have been reading peoples stories. It quells some of the anxiety, but not all of it. I'm a 35 year old guy recently diagnosed with moderate OSA after my girlfriend nagged me enough to see a specialist due to snoring.

I had a take home study a couple weeks back (I feel like I barely slept, but they seemed to be able to diagnose me with moderate OSA). My flow evaluation was from 11:29pm - 6:23am. I know for a fact I didn't sleep until at least 1am, so all of the following numbers may need to be adjusted for that...

AHI: 16.9
Total Apneas: 6
Hypopneas: 109
Oxygen Saturation: base 97, avg 92, low 73
Avg breaths/min: 18.1
Snores: 3334
Pulse: min 48 avg 60 max 122

Is there anything interesting in these numbers? I haven't spoken to a doctor since my diagnosis, only a respiratory therapist who is now explaining to me all the equipment I need to buy on Friday. My doctor faxed approval to the respiratory therapist for an Auto PAP machine. I'm able to choose any equipment I want, and from talk in here, it seems I'll want the ResMed 10 Elite or the Respironics auto PAP as the top choices. I'm also a classic mouth breather, and from what I've read, I'll need to go with a full face mask as a result.

My prescribed pressure is 10-20 cm of water. How forceful will this be?

My insurance is forcing me to rent equipment for 3 months at a rate of $130/month, with machine paid off fully after 10 months of rental (I'll pay $39/mo out of pocket). After 3 months, I can buy the rest of the machine (but of course at that point, it will be January, and I'll be on a new deductible and responsible for the full remaining cost up to $3000).

Does this seem like an outlandish rate to anyone? Or standard?

Any tips on first week use? I'm worried it will be very hard to get used to, and i'll be even more tired during the day than I already am.

Thank you all very much for any input. I'm pretty overwhelmed right now, as poor health hasn't been a part of my life until very recently.

[Sleeprider]

Hey Mac, welcome to the forum. It looks like you're being prescribed an auto CPAP with a wild guess as to what the pressure should be in the absence of a titration study, to treat your borderline mild/moderate obstructive sleep apnea. In addition, you've been referred to a DME that has told you you will be renting.

For a machine, I think hands down the Resmed Airsense 10 Autoset. First, it has the auto CPAP capability your doctor's range implies, and the Elite is not much cheaper, but is a fixed pressure machine. It's good to have a choice. Don't be surprised if you think you're a mouth breather because breathing has been difficult up to now. Me too. Whether it's chronic congestion, or deviated septum, CPAP pressure makes breathing through your nose easy. The only way to find out is to try it. I encourage you to get a minimal nasal pillows mask like the AirFit P10 an give it a try before you settle on a full face. Most suppliers allow up to 30 days for you to decide if the mask is right, and let you exchange it. Take advantage of that opportunity. A nasal pillows mask is less scary to kids, spouses and dogs, and gives you a lot of freedom and comfort if it works.

Let's talk insurance. First time users often have a rental deal, until they demonstrate compliance. You want to press for some details here. Most suppliers (DMEs) bill separately for the mask, headgear, cushion, hose, filter, humidifier, water chamber and CPAP. It's true, even though those are all packaged together, that is how billing works. You need to know what is being rented, and what the end cost will be. If the humidifier is sold (not rented), then the cost of that will be on this year's insurance. If you have 10 months of rental at $130, that is $1300. Not awful if that is the whole price. Much of that will apply to deductible and that has some value for other health care needs. You need to compare that against the cost of outright purchase from an online seller that will bill insurance, like Supplier #30. Go with the bet deal. They sell that unit for $939 complete with a heated hose option. If they can bill it for you, then you win. Can't hurt to try.

Don't worry about the pressure. We can help you dial it in a little better, and most users with your history do great with a minimum pressure of 8 and you will never see the max. Don't worry, one day at a time, one problem at a time. You'll do great.

[justMongo]

10 to 20 cm-water is in the upper range of pressures. Not uncommon.

The Resmed Airsense 10 Autoset will also fill the bill.

If your going to get stuck paying full retail for the machine; and insurance, because of the end of the year, will stick you with most of the cost, then you should check out Supplier #2 on the list. They have new, and open box specials machines for far under retail. You will need a copy of your Rx to buy from them.

You can get the Resmed Airsense 10 Autoset for less than $800.

[JustMac]

Thank you for the response, Sleeprider.

For a machine, I think hands down the Resmed Airsense 10 Autoset.

I think I was confused on the machines. Is the Airsense 10 Autoset the only APAP in the ResMed 10 lineup? I was under the impression Airsense 10 elite was a top of the line APAP, but it seems you're saying it is not an auto machine?

AirFit P10 an give it a try before you settle on a full face. Most suppliers allow up to 30 days for you to decide if the mask is right, and let you exchange it. Take advantage of that opportunity. A nasal pillows mask is less scary to kids, spouses and dogs, and gives you a lot of freedom and comfort if it works.

This is great advice, had no idea on the 30 day exchange. I definitely will try the nasal pillows first, and move to the full face if necessary.

Let's talk insurance. First time users often have a rental deal, until they demonstrate compliance. You want to press for some details here. Most suppliers (DMEs) bill separately for the mask, headgear, cushion, hose, filter, humidifier, water chamber and CPAP. It's true, even though those are all packaged together, that is how billing works. You need to know what is being rented, and what the end cost will be. If the humidifier is sold (not rented), then the cost of that will be on this year's insurance. If you have 10 months of rental at $130, that is $1300. Not awful if that is the whole price.

Over the phone, the therapist stated that the rental/final sales price would include everything I need (APAP, hoses, filters, mask, etc.). So i'm under the impression for the final 3 months of this year, I'll pay only $39/mo since I've met my deductible for this calendar year. But a total of $390 will go toward the 1300 total. Then I would be responsible for the full $910 remainding next year, bringing my total out of pocket for everything to ~$1040. This looks pretty competitive with the prices on Supplier #30's website when you consider mask, plus comes with any necessary "servicing" (whatever that is) from the DME.

Don't worry about the pressure. We can help you dial it in a little better, and most users with your history do great with a minimum pressure of 8 and you will never see the max. Don't worry, one day at a time, one problem at a time. You'll do great.

Thanks for the positivity. Something I definitely need.

[Sleeprider]

The Autoset is your only choice in the current Resmed line for auto CPAP and full data.

Ask your DME about mask exchanges. This part of the service is a big plus to going local.

The costs seem fair for what you're getting, and there will be better service and assistance if you need it.

We're here to help. For most of us, there is nothing new or unusual about dealing with air pressure and the lifestyle issue that go with it. Like any support group, we've been there.

[PoolQ]

Never assume anything with product naming, that Is pure marketing.

My pressure has gone to 15 and it is noticeably higher than 10, mask fitting became an issue to stop blow outs. Some go to 25 and still manage to make it.

Read up on EPR and you may like that with the higher pressures.
Some of this you are just going to need to check out and see how you do. This is one of the reasons for the rental, you can take it back and get a different type of machine (BiLevel or ASV if you turn into a complex apnea subject). If this happens you will be glad it was a rental.

I too was concerned about the rental period over lapping into the new year, but totally surprised that my out of pocket(that was met in the starting period) did not start up again in the new year as the triggering event happened in the year my out of pocket had already been met, talk with your insurance and see how they will treat the rental.

Your O2 sat did get quite low so for you AHI may not be all that important, you will need to see how long the apneas lasted, minimum required is 10 seconds, but I have heard of some going for 2 minutes. Your O2 went low enough that you really do need CPAP regardless of AHI. You are in a good range for CPAP but not the most I have seen, 200+ and hour and below 60% O2

Good you found out about this, you are on the right track, you should feel much better once it's dialed in and you get used to it.

Oh and your mouth breathing might be because of your apnea. I snored a lot and use a full face mask but not because of mouth breathing.

[trish6hundred]

Hi JustMac,
WELCOME! to the forum.!
I know this is overwhelming, but you can do this. Just keep coming back with any questions you have, we are hear to help.
I wish you good luck as you start your CPAP journey.

[robysue]

Thank you for the response, Sleeprider.

For a machine, I think hands down the Resmed Airsense 10 Autoset.

I think I was confused on the machines. Is the Airsense 10 Autoset the only APAP in the ResMed 10 lineup? I was under the impression Airsense 10 elite was a top of the line APAP, but it seems you're saying it is not an auto machine?

Just to clarify:

The Resmed Airsense 10 AutoSet is the only APAP in the Resmedx 10 line up. It does record full efficacy data.

The Resmed Airsense 10 Elite is a fixed pressure CPAP that records full efficacy data.

[cate1898]

Hi JustMac and welcome to the forum! Sounds like you are on top of things and will be well informed and able to make your decision on which machine etc more easily due to the advice you have received via this wonderful forum. Good luck and keep us posted!

[JustMac]

Hey all, thanks again for all the advice. Just gonna take this one day at a time.

I ended up choosing the ResMed AirSense 10 Autoset (10-20 cm) along with the Airfit P10 mask. They also sent me home with an AirFit F10 mask to see which I preferred. After testing I have the following conclusions:

Ideally, I'll learn to close my mouth and be able to use the P10 mask. Having less on my face works alot better for me. But in the event i need to switch it up, I think it will be nice having the F10 for when my nose isn't working properly. I breathe much more naturally in the F10 at the current time.

One thing I noticed is, every time I exhale, my ears fill up quite a bit and get just to the verge of popping...and then don't pop. Neither is preferential, but I'd almost prefer they just pop to relieve the pressure. Anyone have any tips on soothing this? Thanks.