out of compliance because of not getting much sleep

[narual]

My wife’s DME is telling her she needs to pay $3000 for her aircurve 10 of return it because she’s out of compliance. 

She’s only getting 5-6 hours of sleep per night most days. Obviously that’s not ideal, but that’s what’s happening. She usually wears the mask for at least 3/4 of the night. 

After getting help with the settings here, her AHI is almost zero, but I guess that’s not a consideration when they expect her to wear it 6 hours per night and she’s not. 

She has an appointment with her sleep doctor next week, so she can probably get another trial period, but aside from the obvious “sleep more” is there any advice you can offer here? 

Thanks!

[cmpman1974]

I believe compliance usually means 21 out of 30 days wearing it with a minimum of exactly 4+ hours per night.  If she was doing what you said, she would meet compliance requirements.  it must be less than this.  What is making her not wear it the remaining 25% of the night? That kind of defeats the purpose of treatment.

[narual]

Yeah, I thought it was 4 hours, too, but according to OSCAR, her average hours since the compliance period started comes to 4:07. She's wearing it for some amount of time roughly 6 days per week. At first it wasn't every day, and even in January she had 3 nights without it, but this month so far she's used it every night. If her compliance period started the day she got it rather than the day she met with the MSC person (after they stopped all the back and forth nonsense about her prescription being wrong and needing an ASV because someone at the DME got confused by a doctor's extra note on her script), then it comes to 3:57 average, since there was a nearly 3 week period in there where she stopped using it even though I showed her the reports proving that it was helping -- because "you're not a doctor" and she was "not going to wear it when the DME says it's the wrong one". /facepalm

She says she takes it off because at some point in the night she turns to sleep on her side and it leaks and annoys her and she's not awake enough to deal with it. This is the first I've heard that it leaks and she's going to try the p30i instead of the n30i tonight to see if that helps.

[staceyburke]

The hour are hours on. Put it on and read a book or at watch TV 3 hours a night. They will all count towards complacency.

[OpalRose]

narual,

Here is the official compliance requirement used by Medicare and most insurances (unless it's changed).

Compliance:
Medicare requires that a patient use CPAP for a minimum of 4 hours per night on 70% of nights (21 nights) during a 30-day consecutive period any time in the first three months of use.

Patient must also have a face to face appointment with their doctor any time after the first 30 days, but before the 90 days expires.

As stated prior, have your wife use it an hour or so before bed sitting up reading or watching TV.

[Sleeprider]

Yeah, I thought it was 4 hours, too, but according to OSCAR, her average hours since the compliance period started comes to 4:07. 

Each day is a day of compliance and the average means she is very likely above or below half the time.  You need 70% of a 30 day period (21 days) to be greater than 4 hours.  It's not hard to get by using the machine while reading or watching TV as well as sleep.  That is a really nice machine to lose over noncompliance!!

MAYBE you can post an Oscar chart of her therapy, and we could identify the problem, make the therapy more comfortable and get her back on track?