[Treatment] Seeking advice on treating sleep apnea

[LG18]

Hello everyone, 

I've been advised that this forum along with CPAP Talk are great places for those new to this disorder to ask questions, so I was hoping for some advice on my specific issue. 

I'm due to have jaw surgery in November, and although this was originally for aesthetic concerns, I have been alerted by my surgeon to the functional consideration -- namely that my airway is small which puts me at risk for sleep apnea. 

I can't say I have any notable severe symptoms currently other than perhaps some daytime tiredness sometimes, but the surgeon said that if I don't have OSA now, it'll definitely become a problem when I'm older (I'm 27 right now) due to soft tissue laxity. From what I've read, people can also be experiencing symptoms but just not realize because it's their 'normal'.

The narrowing of my airway is caused by receded jaws which will be fixed with the surgery, so while I'm not considering long-term management of sleep apnea with a CPAP machine, I'm wondering whether I should get tested and potentially be using one in the six month run up now that I'm aware of all this. I've been reading about the damaging cognitive effects of sleep apnea if left untreated, and while my risk factors are soon to be treated, I feel anxious about the damage it may do from now until my surgery.

However, I've discovered that pursuing this, particularly in my country (UK), opens up a whole other can of worms. I can see polysomnography is the standard for diagnosis, but there seem to be barely any places in the UK that do it and those that do cost like £2000, so I can't afford that. Therefore, I've been looking to the home tests, but have also heard they can be vert inaccurate.

I've also seen people disregard the testing altogether, and simply just buy a CPAP machine and figure out the settings on their own. I'm not sure how I'd go about doing that with no benchmark to go off of, but given the high cost of a proper in-lab test I can't afford and the apparent inaccuracies of the at-home tests, this is at least something to consider (if it's safe/advisable).

Overall, I'm conflicted about any route because even if I just bought the machine, it's a lot of money for a risk that I'm hopefully eliminating this year anyway. That said, having talked to my sister -- who has the same jaw profile but doesn't want to pursue surgery -- I could give the machine to her afterward so that someone else can benefit from it. 

Would love to hear your thoughts and opinions. Thanks!!

[Narcil]

while the home tests aren't perfect they give a good idea. lofta is pretty good but it can't detect everything since no EEG sensors. Most places require a script to get a machine unless you go to fb marketplace, so it's good to get a study even a home one. you'll need another study after the surgery and recovery to determine if you still need a machine. 

maybe you can put yourself on some nhs waiting list to have a psg study after recovery in 1y+? if not just stick to lofta and maybe do a home one before surgery too if you're anxious about it.

settings are the easy part, but it's not easy for most people to get used to the machine. something like 1/3 of patients stop using it when they have a diagnosis, if you don't even know if you actually need it, i think it's even less likely you'll stick with it.

[PeaceLoveAndPizza]

Cheers mate, sounds like you have found a good doctor. 

As Narcil said, an in-home study is a good directional indicator. There are a number of sites in the UK that will do an in-home test for less than 200 quid. 

You can usually find a used machine for around 200-300£, or 500-700£ new. Only get a ResMed or Löwenstein, avoid Philips or Luna. If it turns out after surgery you do not need it, then you can sell or donate it.

[LG18]

while the home tests aren't perfect they give a good idea. lofta is pretty good but it can't detect everything since no EEG sensors. Most places require a script to get a machine unless you go to fb marketplace, so it's good to get a study even a home one. you'll need another study after the surgery and recovery to determine if you still need a machine. 

maybe you can put yourself on some nhs waiting list to have a psg study after recovery in 1y+? if not just stick to lofta and maybe do a home one before surgery too if you're anxious about it.

settings are the easy part, but it's not easy for most people to get used to the machine. something like 1/3 of patients stop using it when they have a diagnosis, if you don't even know if you actually need it, i think it's even less likely you'll stick with it.

Lofta...thank you, I'll look into this. 

And yes, getting the ball rolling with the NHS is probably a good idea, good suggestion. 

I've heard it can be very difficult to get used to, sure.

---

Cheers mate, sounds like you have found a good doctor. 

As Narcil said, an in-home study is a good directional indicator. There are a number of sites in the UK that will do an in-home test for less than 200 quid. 

You can usually find a used machine for around 200-300£, or 500-700£ new. Only get a ResMed or Löwenstein, avoid Philips or Luna. If it turns out after surgery you do not need it, then you can sell or donate it.

Thanks for the post!

Good to hear the home tests are a good idea. I'll look into that, then. 

And yeah, I've seen a fair few on Gumtree for around that price. ResMed seem to be the most common -- is there any specific model you'd recommend?

[PeaceLoveAndPizza]

If you can find a good used ResMed AirCurve 10 Vauto at a price you can afford with less than 2000 hours used, get it. Otherwise find a similarly used ResMed Airsense 10 Autoset.

Be sure to check the hours used. It is not crazy expensive to put a new blower motor into them, so getting 10 years or more is not unrealistic.

[LG18]

If you can find a good used ResMed AirCurve 10 Vauto at a price you can afford with less than 2000 hours used, get it. Otherwise find a similarly used ResMed Airsense 10 Autoset.

Be sure to check the hours used. It is not crazy expensive to put a new blower motor into them, so getting 10 years or more is not unrealistic.

Thanks for the tips! 

From what I can tell, the main difference between the AirCurve 10 Vauto and the Airsense 10 Autoset is that the former provides two pressure levels (IPAP and EPAP), while the AirSense 10 AutoSet adjusts a single pressure level automatically.

So the AirCurve is what is referred to as BiPAP, right? Is this type of machine only used for specific disorders that demand more precision in that case? There seem to be a lot of AirSense 10s on the market here but not many AirCurve 10s.

[Crimson Nape]

The AirCurve 10 VAuto Bi-Level (BiPAP is a registered trademark of Philips) is the epitome of CPAPs for OA type of apneas.  It allows a finer resolution of pressure adjustments and a greater range in bi-level support.
- Red

[Deborah K.]

Crimson Nape, I think you mean ResMed, not Philips.

[Crimson Nape]

No, the term, "BiPAP" is a Philips registered trademark. This trademark was inherited when Philips bought Respironics.
- Red

[LG18]

The AirCurve 10 VAuto Bi-Level (BiPAP is a registered trademark of Philips) is the epitome of CPAPs for OA type of apneas.  It allows a finer resolution of pressure adjustments and a greater range in bi-level support.
- Red

When you say OA, you're referring to OSA, right? I thought most people with OSA were on CPAP. Thanks.