want to monitor sleep activity

[archangle]

At the same time, I've learned that the medical pecking order (in the U.S.) is that the DME's marching orders must come from the doctor. In your case, Ugly, when your DME told you the limits of what you are eligible for, I understand that to mean that so far your doctor has only written a Rx for the type of machine you recently got. That "eligible for" phrase means what's on the Rx they received. So, it's unproductive to ask the DME for something like a machine model switch; they can't do it without that Rx from the doc. This has been my own experience in finally getting switched from a straight CPAP to an auto.

The usual situation in the US is exactly the opposite.

The doctor usually specifies something like "CPAP at 8 cmH2O." The DME can fill this prescription with a manual brick CPAP, a manual full data CPAP, or a full data APAP. It has to be set at 8 cmH2O pressure as dispensed, but the DME can give you whatever machine he wants to. If you have the choice of multiple in-network DMEs, you can shop around for one that will give you a good machine in return for your business.

It's a shame that more doctors don't realize that they are crippling their ability to monitor their patient's treatment by not requiring full data CPAP machines, and APAP machines as well.

For that matter, the cost to buy a top-notch APAP machine online out of pocket is trivial compared to the long term cost of poorly monitored CPAP treatment. Without a data capable CPAP machine, you may have to do another sleep study and many doctor visits and other unnecessary tests to figure out apnea problems that a data capable CPAP will figure out with no extra cost on the part of the patient.

[Ugly]

Ugly, you're not alone in the series of events that led you here. Six years ago after my first sleep study, the doc told me about the specific Respironics M Series (brick) I was going to get at a pressure of 7cm. I knew nothing about any of this at that time. I used it at that setting for 5 years.

Of course my Healthdyne unit was more of a cinder block than a brick. I was blown away by how SMALL they are now in comparison. And reading the user manual the claim that they are "quiet" I didn't know just how quiet until bedtime. My Healthdyne unit generated a steady stream of "white" noise at a SUPPOSEDLY steady pressure.

Then, my wife told me of my apneas each night. When I tried to get a different mask, I learned the DME needed a Rx.

Oh yeah. Oops. It's like a standard medication, you need a prescription. Part of me wonders why. I mean, unless you pump something through the air stream, it's not going to get you high or anything.

That got me back to a doc, then sleep study and finally to this board.

I figured all you guys were out there somewhere. But I never went looking until recently.

Regarding the variations you're seeing in your pressures and AHI from night to night, I can tell you that I see similar swings in my own numbers. Each night is (or can be) a different situation as far as how we sleep for a variety of reasons. I would not be concerned with the night-to-night data changes you're seeing. The main thing is to see what your pressure is for most of the nights (95th percentile) to have input for you and your doctor about where your pressure should be set when you must go back to a machine with a set pressure.

At least I am setting a range that I seem to be at so I can pick my own target pressure if by chance I have to live with the S9 Escape ("brick").

Like yours, my AHI also varies from night to night. Again, it's the range that counts, and as you know, the goal is to have it below 5 for most nights.

I had that one night out of three so far and I guess the 2.3 AHI goes hand in hand with the 11.0 pressure listed when I woke up.

Another thing I've learned is that a persons pressure requirements can change quite a bit over time.

And since the doctor doesn't keep tabs on me, I have to do it myself.
Until recently I didn't have the means to do that. And I found that if I don't see the specialist for more than a year I'm off his patient list and I have to get referred again. That's where I'm at. Even though he apparently got me the sleep study, for whatever weird reason I still have to get a referral to see him.

Finally, I've learned that mask leakage can have a lot to do with getting the AHI down there and keeping it in that range. At least it has for me.

Actually that's where I'm a pro. I can tell if there's a leak by both how it feels and how it sounds. It's just a not-so-comfortable sensation and the S8 AutoSet II confirms this as my S9 Escape doesn't verify if my mask leaks. This one does and apparently I'm doing OK in its opinion. Gee. Here I am talking as if it's alive.