Positional OSA?

[SarcasticDave94]

Stuffiness or congestion might be due to dry air and could benefit from the humidifier on the PAP being turned on. Secondly, if your settings on the PAP aren't optimized to your needs, it may enhance feeling like you're not benefitting. And you'll find that the doctor and supplier typically get the settings off a bit as they don't have enough time to adjust them. So to fix that, you self advocate and self titrate, which is what we do here on Apnea Board.

[Zoe Lee]

Stuffiness or congestion might be due to dry air and could benefit from the humidifier on the PAP being turned on. Secondly, if your settings on the PAP aren't optimized to your needs, it may enhance feeling like you're not benefitting. And you'll find that the doctor and supplier typically get the settings off a bit as they don't have enough time to adjust them. So to fix that, you self advocate and self titrate, which is what we do here on Apnea Board.

I did always make sure the humidifier was on. 

Yeah, I hear you, self help is what we ultimately have to do.

Well, my insurance told me they only cover a CPAP in 10 years. Since I returned the machine last year, I have to wait till 2031 to have one covered by them   ???

Did anyone buy on their own?

[Jeff8356]

Did anyone buy on their own?

Yes, there are some users here that pay out of pocket for their machine and supplies.  My wife and I both paid out of pocket because we didn't want to deal with insurance, compliance issues, and DME's.

You will need a prescription of course, but you can use the suppliers list here as a starting point
http://www.apneaboard.com/forums/Thread-...plier-List

Machines are in short supply right now so it may be a while before you can get one.

[SarcasticDave94]

One in ten years? Most get a new CPAP every 5 years. I'd call insurance again, ask again. Sometimes they give an uninformed, incorrect answer the first time.

[desaturator]

This sucks. Looks like there is no way out of a clumsy cpap!

Yeah. I've been using CPAP for a couple of months now, and I can't say I hate it any less as time goes by. And, like you, I don't have any obvious, textbook symptoms of sleep-disordered breathing, so I'm unclear whether the CPAP is even necessary.

But...

If you're prone to OSA, my understanding is that it usually gets worse over time. Also, I think that the your body and mind do adapt to a gradual worsening of sleep quality. So you might think that you feel fine, but perhaps that's because you've gotten used to poor sleep. If that's the case, it might take weeks or months on CPAP before things improve and, even then, you might not notice because the improvement is so gradual.

I don't like CPAP but, for the moment, I'm inclined to persevere with it, because it improves my overall oxygen saturation, which might help with the cardiac problems with which I won't bore everyone again. But it's difficult, because I don't feel any different. I feel absolutely fine, with it or without it.

In your situation, I think I would probably not continue with CPAP, if I could control the problem just by forcing my sleeping position (assuming I were able to do that). However, I would repeat the sleep study every year or so, in the expectation that there probably would come a time when I would need treatment. I suspect my view would be different if I didn't find CPAP so objectionable.

Incidentally, in answer to your other question, I bought my CPAP myself. It's fortunate that over here in the wonderful UK this equipment is not regulated, so I just ordered one from the supplier. My understanding is that even in the USA, where these things are subject to more regulation, you can still buy and sell used devices. I understand also that the prices hold up well, so you won't lose all that much if you buy one and find you don't need/want it.

BW, DS

[Zoe Lee]

 I think that the your body and mind do adapt to a gradual worsening of sleep quality. So you might think that you feel fine, but perhaps that's because you've gotten used to poor sleep. If that's the case, it might take weeks or months on CPAP before things improve and, even then, you might not notice because the improvement is so gradual. --- very good point, well taken.

I don't like CPAP but, for the moment, I'm inclined to persevere with it, because it improves my overall oxygen saturation, which might help with the cardiac problems with which I won't bore everyone again. --- I started having memory issues and uneven heart beats for a while but since I'm going through menopause so even doctors I saw couldn't be sure. But this is why I'm revisiting my sleep issues, and reconsidering CPAP

In your situation, I think I would probably not continue with CPAP, if I could control the problem just by forcing my sleeping position (assuming I were able to do that). --- I used to be a side sleeper until I got vertigo and stopped sleeping on my left side about 10 years ago. Back then I had to trained myself to sleep on my back, so it's not hard to return to old habits. 

However, I would repeat the sleep study every year or so, --- very sensible actionable advice

Incidentally, in answer to your other question, I bought my CPAP myself. --- how did you decide on the settings? Just curious. 

Thanks D, I really appreciate your help!

[SarcasticDave94]

What you can do for the setting decision is first decide what PAP you're getting. I recommend the ResMed over any other right now. You don't have special requirements, so a ResMed AirSense 10 AutoSet or AutoSet For Her will be great. ResMed AirSense 11 AutoSet is out there as well, the main differences are looks, different hoses and humidifier tub, the hose has 90°angle on 10s and straight on the 11. All 11 AutoSet has For Her mode built-in while 10s are separate models. Both 10 & 11 treat Apnea by virtually identical control algorithms.

Either of these 3 well be fine. After selecting one, request your clinical manual at the top of the Apnea Board page, using your exact model name. There's descriptions of all control settings. From there, you need OSCAR, a free report tool to view your sleep data that you post here. You'll need an SD card in the PAP each night to capture detailed data, then put that SD card in your computer during the day to upload that info to create the chart. Posting it here members can view and suggest tweaking pressure or pointing out other things like leaks.

No doc will get this involved, they may help a bit but it'll never be free. Posting here asking advice on charts is always free and will yield better results.

[desaturator]

As for settings -- I just started with mine on the factory defaults. I fiddled with the settings gradually over a month, until I found the values that seemed to work best for me -- they weren't very far from the defaults, in the end. I ended up with the minimum pressure up a couple of cm from the default 4cm, and the EPR setting at 2cm (factory setting is 3cm, I think). I looked at the machine's recording every morning using OSCAR, fiddled with a setting, and saw what difference it made the next night, if any. I fiddled about with the heat and humidity a bit, but these were just for comfort. It was easy, in a way, because my machine (ResMed S9) has very few settings to tweak, compared to some.

Having said that, I think my OSA is easy to treat. Even setting the machine to minimum pressure significantly reduced my AHI. I think this is unusual -- most people have a response to settings which is more marked than mine, and need more careful tweaking. There are plenty of people around here who have experience doing that.

BW, DS

[Zoe Lee]

What you can do for the setting decision is first decide what PAP you're getting. I recommend the ResMed over any other right now. You don't have special requirements, so a ResMed AirSense 10 AutoSet or AutoSet For Her will be great. ResMed AirSense 11 AutoSet is out there as well, the main differences are looks, different hoses and humidifier tub, the hose has 90°angle on 10s and straight on the 11. All 11 AutoSet has For Her mode built-in while 10s are separate models. Both 10 & 11 treat Apnea by virtually identical control algorithms.

Either of these 3 well be fine. After selecting one, request your clinical manual at the top of the Apnea Board page, using your exact model name. There's descriptions of all control settings. From there, you need oscar, a free report tool to view your sleep data that you post here. You'll need an SD card in the PAP each night to capture detailed data, then put that SD card in your computer during the day to upload that info to create the chart. Posting it here members can view and suggest tweaking pressure or pointing out other things like leaks.

No doc will get this involved, they may help a bit but it'll never be free. Posting here asking advice on charts is always free and will yield better results.

Wow, thanks very much! I truly appreciate it! 

I plan on doing another test like Desaturate suggested sometime this year, to see if only sleeping on my sides will still produce any OSA results. If that was the case, I can find out the model and settings from last year from the doctor I suppose, and go from there! Thanks again, definitely feel better now...

[SarcasticDave94]

Welcome. Note this action please. Any sleep test you take, request your copy of the detailed report. HIPAA law permits you to request and receive it. You could consider posting it here redacted of personal info. Knowledgeable Board members can't help you decipher it. Besides you'll want a copy for your personal health file on case anything happens to the ones at doc's office. This may save you from taking another test later.