OSA too mild to treat with CPAP? other sleep issues?

[Sleeprider]

Go to Offerup and search for Resmed Airsense 10 Autoset, or for an even better deal Resmed Vauto. The Vauto is a bilevel machine and absolutely the best device money can buy for sleep apnea. I see one in "unused new condition" for $280. You can't get a better machine. Merry Christmas.

[JoeyWallaby]

12 could be classified as mild without any symptoms or oxygen desaturation. You have multiple symptoms and significant oxygen desaturation. Therefore, this is not mild.

[SaldusMiegas]

Hi SleepyTexasGirl,

If you can use your insurance and get a brand new machine that might be the best way to go.  
* I don't know how long these machines last (insurance seems to cover 5 year replacement), but a used machine is that much closer to end of life.
* and it won't come with a warranty in case it fails shortly after you buy a used one. 

* when I got mine a few years ago, we were also beyond the out of pocket max, and so it was fully paid by insurance. 
  .. We were fortunate that our insurance gave us the option to rent-to-own or buy the machine outright in one payment.  
  .. So we got ours in one payment 100% covered by insurance.  
  .. Note that the DME initially wrote up a 13-month contract but when we pushed back they were happy to change it. 
  .. For this reason you have to know your options or you will get the default preference of the DME. 

* some insurance will require you "rent to own" your CPAP in which case there would be 12-13 monthly rent payments before you own it. 
  .. In that case being over the out of pocket would only help for the first month and you would be paying copay (after new plan year deductible) for the rest.  
  .. On the other hand, paying monthly provides an opportunity to see if it works for you and the monthly hit is a lot smaller than one big payment.

* If you can see your doc before end of plan year s/he might be willing to prescribe the CPAP for you so you can get in under the deadline before the plan year resets.
   .. by the way, (this might also depend on your insurance provider, but) I believe any doctor can prescribe a CPAP. It might not have to be a sleep doctor.  We had a family member get a fully covered prescription for a CPAP, written by our family doctor. With your family history and results of your previous sleep study this might work out for you as well. 
   .. if you can make this work, ask the doc to prescribe an Autoset machine (you can even use this board to help you determine a specific one) so the DME won't give you any grief. And make sure before you take it home that you got the exact model machine you want.  Don't let them give you a fixed if you are buying an auto.   

* So talk to your insurance company to be sure you know your options on lease vs purchase. And armed with that knowledge don't be afraid to push back on the DME with what you know. 
  .. the DME will know what their options are for getting paid, but they might not remember to tell you if you have different options.  
  .. Remember that the DME is just selling you the equipment, they are not an authority. 
  .. If their "company policy" doesn't allow for what you know your insurance will cover, then find another DME.  They might discover that they do make exceptions before you reach the door. 

* if you did have to go the co-pay route, then 30% of a new machine might be close enough to what you can buy a used machine for to make it interesting.  Especially if you decide (or are forced) to do the monthly rent-to-own plan, in which case it's a low cost and if it doesn't work out you simply return the machine and no more payments.
   .. make sure if you do a monthly deal that your contract with the DME allows return without penalty if the CPAP therapy doesn't help you.
   .. make sure the DME gives you a new machine, not a used one that others have rented and returned.  This is the machine you will keep at the end of your contract, don't accept a used one when you or your insurance is paying for new. 

In the meantime, if you are required to do the titration study, maybe you can get that in before your plan year resets. 

* That study might cost a lot more than the CPAP machine you are seeking.  

So whatever comes next, maximize your insurance to minimize your out of pocket costs. 

Well, that's a brain dump of all I can think of at the moment.  Hope this is helpful.  

And hope you feel better soon.

Saldus Miegas

[70sSanO]

12 could be classified as mild without any symptoms or oxygen desaturation. You have multiple symptoms and significant oxygen desaturation. Therefore, this is not mild.

Actually a desat to 88% without treatment is not severe, it is considered either mild or moderate.  88% with CPAP would not be good.

That is not to say that I would ignore treatment, but it is not so alarming that I would be sent into a panic.

My original sleep study had an AHI of 79 and (if I read it correctly) a desat that got below 60%.  Now that is severe.  But with xPAP for the last 19 years I am still alive to write this.  You just have to take care of business.

John

[JoeyWallaby]

It's enough to warrant CPAP treatment, that's all that matters to me.

[SleepyTexasGirl]

The titration study was this weekend. I slept like a baby during the first part of the study, but I also took a sleeping pill. After going to the bathroom, they appeared to be doing two pressures for in and out, which I found really distracting.  I also tried switching from back to side (side is how I usually sleep) and found the mask less comfortable. 

So I think I will ask for a new machine instead of using my dad’s old one. They should be able to get it this calendar year.

[Osiris357]

The titration study was this weekend. I slept like a baby during the first part of the study, but I also took a sleeping pill. After going to the bathroom, they appeared to be doing two pressures for in and out, which I found really distracting.  I also tried switching from back to side (side is how I usually sleep) and found the mask less comfortable. 

So I think I will ask for a new machine instead of using my dad’s old one. They should be able to get it this calendar year.

They turned on pressure relief (EPR) for your exhale to make exhaling easier for you. That’s what the different pressures for inhaling and exhaling is called. You will get used to that especially if you feel great after using it

[Gideon]

OK,
Of the APAPs (CPAPs included) I suggest the ResMed AirSense 10 AutoSet or AutoSet for Her. BiLevels the ResMed AirCurve 10 VAuto. The PR machines can tend to try and lead your breathing rather than following it like the ResMed machines do.  I wouldn't be surprised if that was what you felt.  Call and ask which machine they are providing, ask which specific model, then check here.  Also learn how to check the Total Run Hours for your new machine. it should be zero.

[JoeyWallaby]

Yea EPR/PS feels weird at first but you quickly used to it.

[Sleeprider]

OK,
Of the APAPs (CPAPs included) I suggest the ResMed AirSense 10 AutoSet or AutoSet for Her. BiLevels the ResMed AirCurve 10 VAuto. The PR machines can tend to try and lead your breathing rather than following it like the ResMed machines do.  I wouldn't be surprised if that was what you felt.  Call and ask which machine they are providing, ask which specific model, then check here.  Also learn how to check the Total Run Hours for your new machine. it should be zero.

This is great advise and I agree 100% with the recommendations.  To go further, you should decline to accept any machine not suggested by Bonjour. Don't worry about it, because if insurance is involved, it will pay the DME the same for a cheap CPAP or an expensive CPAP.  Sounds crazy, but true.  Finally, if your machine cost to you exceeds the price of an online supplier cash price, you should buy online.  DMEs have tremendous markups that are passed along to uninsured or poorly insured individuals, while someone with insurance only pays the copay and deductible on a discounted / negotiated price.