[Treatment] PurpleOx Therapy: Diagnosed with Moderately Severe OSA

[PurpleOx]

Study types: 3-night at-home sleep studies due to insurance

• 1-night WatchPAT study results attached
  
• 2-night EEG results not included. EEG showed I slept 5.4% and 3.6% of the time in supine position in two separate night studies. My sleep is very disrupted; I am getting zero N3 sleep. The sleep architecture shown on WatchPAT is thoroughly off from the EEG, and I know to trust the EEG more on the sleep architecture.
  

Stats:

• Age: 28
  
• Sex: Female
  
• BMI: 18.8
  
• Neck circumference: 12.5 inches (31.8 cm)
  
• Overall AHI: 22.3
  

My overall AHI indicates moderate SA but my doctor diagnosed with "moderately severe obstructive sleep apnea" -- likely because I slept only 10% of the time in supine position, where my AHI was 33.9. May I say that I slept quite spectacularly during the sleep study, and I feel the sleep apnea has gotten worse since then...

My thoughts/plans/what I have done:

• I've been lurking on this board for a few weeks now....  
  
• He prescribed me an Auto CPAP, which I am 100% on board with. I want to make it work. Once I get the CPAP and have data, I'll post OSCAR results.
  
• Speaking of getting a CPAP machine, the CPAP machine shortage!!! I really, really need the CPAP yesterday.  I have good insurance (I will only pay 10% of CPAP) so I would really prefer to go through them. I will be picking up a copy of my prescription this evening -- I don't know what it says exactly, except that it's Auto CPAP. The DME supplier my doc sent the script to said everything is on backorder. So I called my insurance to get a list of DMEs (7), and I know that there are ones that are not on the list too that will accept my insurance. Tomorrow morning (when I have the script) I will call them all and check their stock. If I don't hear what I want to hear, I will check out the suppliers mentioned on this board to see if they accept my insurance and have what I ened.
  
• My body seems to know not to sleep on my back, so I'm guessing I don't have to worry about backpacks and all that. Maybe this will change with CPAP therapy. 
  
• I can't believe I snore during my sleep...   But the EEG and WatchPAT does not lie.
  

My questions:

• Do you see anything notable on my results that I didn't pick up on? What do you think of the "moderately severe" vs "moderate" OSA?
  
• I need to order an SD card, less than 32 GB, right?
  
• Knowing my sleep breathing patterns, I believe I have mixed SA, not plain OSA. I didn't say anything to the doctor when he gave me the OSA diagnosis because I'm assuming that if I have mixed SA, it will come through during CPAP treatment and I will fail CPAP?
  
• I thought about seeing an ENT, because at my age, BMI, and neck size, something must be structurally wrong?? But I need relief right away which is why I'm getting the CPAP regardless.
  

Thank you, thank you, thank you for reading this far.

Edit: Got attachments working!

[SarcasticDave94]

Welcome to the Apnea Board,

Some things to consider:

Look for either the ResMed AirSense 10 or 11 AutoSet. The 10 has either AutoSet or AutoSet For Her while the 11 has both in one. The form factor will be a bit different but therapy will be comparable. Look for the name ResMed.

Mask, consider first a pillow type mask as they're lightest and the smallest format. Next would be a nasal mask. Then last is either a full face or hybrid full lower and nasal upper.

You'll want a heated hose so that you can avoid rainout, the condensation that collects inside the hose and mask. Consider a hose cover and hanger to add comfort.

You'll want to get your copy of the clinical manual after deciding what machine you want. It's available above. You want to know how to set your PAP yourself.

You'll want a free report tool OSCAR. You need to know what your therapy looked like. Doc isn't going to devote a lot of time to help. Doc will be interested in after you using PAP 4 hours a night, did AHI go down to 5.0, is patient feeling any better, any better meaning even slightly. But on the forum, we can do lots better than slightly.

[PurpleOx]

Thanks for the welcome, Dave. I'll keep an eye out for Resmed 10/11.

I finally got my hands on the prescription... It has all the info that a typical CPAP prescription would have (machine type, humidifier, heated hose, 99 months, prescriber ID, etc) but is addressed to a specific company/vendor. Can I use this for other vendors?

[Sleeprider]

The prescription can be used by anyone you send it to. They will probably contact the doctor's office for confirmation. Are you buying out-of-pocket or is this insurance?

[PurpleOx]

The company he sent it to is covered by my insurance. I would really prefer to use insurance (they cover 90%), but I called the supplier for this medical equipment company and Resmed AirSense 10/11 (as well as Luna) are backordered.   I'm trying to determine what price I'm willing to pay to have the machine sooner, e.g. get it in 3 weeks for $600 (if anyone even has the machines) vs get it in 2 months for $150. I have the funds to cover it, it's a question of "what level of health emergency is this?"   My job is really suffering from my symptoms, I am unable to work full time. I set up an appointment with an ENT specialist for next week, so I think I will call around about CPAPs to know my options but hold off on making orders until the ENT specialist looks at what's going on.

Prescription: AUTO CPAP

Duration: 12

• hmmmmmm.... Sneaky.
  

Pressure (cm H2O): 4-16

• I'm a small lady but not child size and my fingers will itch to change the min from 4 to 6 lol... I've give default settings a chance though.
  

Other: heating tubing, filters, water chamber, headgear (if needed), chinstrap (if needed), heated humidifier and fit with dreamwear PAP mask

• So, so glad he pointed out the humidifier because I am sensitive to humidity.
  
• Dreamwear PAP masks will fit ResMed machines? I was eyeing the Resmed N30i and I suppose from a user's POV the Dreamwear PAP mask is pretty close.
  

[SarcasticDave94]

Most CPAP masks will fit the hose end. Some masks to require a short connection hose which are included in those cases. Take a look at the Fisher and Paykel masks, on their website for homecare. I use a F&P Vitera which seals very well on minimal strap tension. It has a RollFit bellows. I am not saying you need full face, but look at the other models first: Evora, Brevida, Eson & Eson 2, Pilairo Q.

Me personally, I would just stick with a ResMed PAP. We have a supplier list you can call. Supplier #2 sells lightly used machines that can be a great alternative. DOTmed sells used machines as well as sometimes there's some to be found via Search Tempest.

[PurpleOx]

Dave: Thanks for the mask recs as well as pointing me out to Search Tempest. Didn't know there was such a thing!

[SarcasticDave94]

You're welcome, hope the info helps find what you need

[Gideon]

Call your insurance comp and state that every DME you called has a very significant backlog for these devices.
And you are confident you can purchase one, likely for significantly less, from an online source in less than a week. So will you reimburse me for that purchase? The likely answer is no. Then ask why not? My health is at stake as is my job. Ask, no Push for an exception due to these backlog times. Ask how much they would reimburse to you if they followed that route.

We recently a member who was successful on doing this.

[PurpleOx]

After being quoted a 2+ month wait from my insurance for an APAP, I've gotten my hands on an AirSense 10 Auto for Her myself. (Bonus: 4 GB Resmed SD card came with it!) My mask is arriving on Monday, so my first usage will be Monday night.

Here are the settings I will try the first night. Could I have feedback please?

• 4-16 cm H2O: This was in my prescription. I know 4 is low but I tend to breathe low and slow, so I'm going to give it a try for a night. Like most everyone else I will probably need higher so I'll adjust according to feedback on my OSCAR charts.
  
• EPR: Off? For first night use, would you rather see no EPR at all, or EPR set to 3 which will kick on once the pressure gets to 7cm?
  
• Ramp: Off (Since min is 4)
  
• Humidity: Auto
  
• AutoStart: Off
  

Thanks!