Night Watch vs Resmed Auto

[jmjm28]

Just received results from my home sleep study. In short, my overall score for six hours of recorded sleep was 9 events
per hour which I was told is mild sleep apnea. However, when I'm on my back (1.5 hours) I have 29 events per hour which
I was told was moderate/severe. If I'm reading the report correctly I only have 1.2 events per hour on my left side and
2.6 events per hour on my right side. I have the complete report here and can post other stats if helpful.

Based on this, the sleep doctor recommended the Resmed Auto. My thinking is that I only seem to have issues on my back
which I sleep on 25% of the time so why should my first recourse be to a CPAP machine that will treat the whole night when
most of the time I'm only having under 3 events per hour?

An alternative I came up with is the Night Watch positional therapy device. Commercial Link Removed.  Do a search for Night Shift Therapy.

Sort of like a high tech version of sewing a tennis ball into the back of your shirt.

In short it emits increasingly stronger vibrations when you roll over on your back and they don't stop until you roll back on your side.
It also monitors its own progress by recording how much time you actually spend on your back each night plus monitors snoring and awake time.
But I think the main thing is that it tries to keep you off your back and unlike a tennis ball it tells you in the morning if it was
successful.

The question is does trying the Night Watch first make sense, or am I missing something and should I go straight to the ResMed Auto
as the sleep doctor suggested?  I'd also be interested if anyone has tried or heard about the Night Watch and has any comments they would like to share.

I'm very new at this so any help would be appreciated.

Jim

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[Walla Walla]

Just my opinion. I'd rather sleep all night with a machine than to keep getting woke up because I roll onto my back. We all sleep different but I know I might roll onto my back two or three times a night at least. When your sleeping you don't think about it. But getting buzzed will wake you up.

[jmjm28]

Related, the sleep doctor said I would be contacted by some service and that I would be receiving the ResMed Auto by mail. My understanding is that the machine is usually titrated in a sleep lab setting by a technician, so how will they find the right settings by just mailing it to me? I did have a split/night study
several months ago, but because I didn't have the required number of events, all they did was fit me with a mask before the study but no titration was
done that night. When the study was repeated at home, of course no cpap machine was involved. If they were going to titrate me on a split night study, I assumed they would have me back in the lab for titration based on the results of the home study.

Jim

[jmjm28]

Thanks. Yes, I think the sleep study showed that I turned to sleep on my back three times during the night with total time on the back pretty evenly divided. That means that at least initially the Night Watch would alert me at least three times to turn over. Hopefully it won't be too disruptive but I get your point.

[Walla Walla]

Normally they will have it set in Auto at the default pressures 4cm-20cm. Before you get that call about a machine you should read this link. http://www.apneaboard.com/wiki/index.php...with_a_DME

[jmjm28]

Thanks. Initially, the doc just said I will get a call and a CPAP machine will be mailed to me. When I asked, which machine (after reading the reviews and suggestions here) he said that he ordered the Resmed Auto because that's what I need and that is what I will get. lol. Fortunately he picked one of the recommended machines but apparently he is not studied on the concept of shared medical decision making! He expertly ended the conversation with "I have go get off the phone now" so that was that. 

So other than confirming that they are sending me a new ResMed Auto, anything else to ask the DME when they call? Will I have a choice of mask or heated and/or humidified tubes? Or will they just follow the doctor's Rx which i doubt very much he will change.  I suppose if it doesn't work out with this doc I will just find another but at least I appear to be getting a good machine and I do have the resources here. I don't know what up with so many docs these days as they treat you like something on a conveyor belt. I'm old enough to remember a different world when they even made house calls and seemed to care. 


Jim

[Mosquitobait]

I think they have stopped encouraging people to sleep on their sides because if you sleep on your side all the time, as you get older, it will effect your spine. I just had imaging done and found out that this has happened to me.

I would ask for heated tubing primarily because it's the best way to treat rainout. All is not lost however - if you get regular hoses (nearly always, it will be unbranded), you can add a hose cozy or keep the tubing under the blankets.

Doctors DO care, but much of their time is reserved for sicker and sicker patients, so the rest of us mugs are factory processed. You ARE getting a good machine. You just want to make sure that the lower setting is at least 6 before you go to bed - this is because 4 and 5 are pediatric settings and most adults struggle to breathe with those.

I have zero apnea except during REM and near REM. However, I have a lack of oxygen due to a slow heart. So my machine is on the lowest setting for about 70% of the night, only climbing up as I fall into deeper sleep. Were it not for my heart, I wouldn't have even qualified for a machine.

The best thing you can do is get your DME to give you the policy for exchanging masks IN WRITING. I say this because too many people have been told that they can switch out within so many days and then when they go to the DME's office, find out that the policy is completely different. You want a WRITTEN policy. My first DME was really clear - no free exchanges. You get what you got. My current DME allows a change within 30 days until you find a mask that works. They get reimbursed by the manufacturer for used, swapped masks.

[Walla Walla]

I better mention a couple of other things. Make sure you get a copy of your prescription and sleep study from your Doctor. You'll need it in future years and they're required to give it to you on request.

Also you can request the clinic manual for the Resmed Airsense 10 Auto in the members private files section. It shows you how to adjust pressures and other settings. You'll need that also as time goes on.

[jmjm28]

Thanks for the advice. I assume then that I will have to pay extra for the heated hose if the doctor didn't prescribe it? Do you know how much the cost. What if I want to change DME's? Do I have to go through my doctor on that. He never sent me an Rx, just said I would be getting a call. As one of those not too sick "mugs" you're talking about, not sure how much of the doctor's time I will get. His next office appointment is in September. Not saying sleep apnea isn't serious by a long shot, but I've got some more serious medical issues going on now also with doctor issues, so I need to choose my battles carefully.

Jim

[Walla Walla]

Check the link I posted. There's a section on changing DME's.