Snoring / Sleep Apnea / CPAP

[Loco 3752]

On 5/9/2018 at 2:34 PM, MoJames said:

Worst I've seen is like 118.

 

Pulm I work with has seen it in the 300 he states, but I call bullshit.

Hold my beer...

Dr. pulled all kinds of strings to get me the CPAP the night immediately after my test.  Said I was the Babe Ruth of apnea and he could never forgive himself if something happened to me that night.  At the test they woke me up after 1 hour to fit a mask.  The technician apologized and said they intended to do the testing for 4 hours or so, but said I qualified in the first 20 mins.

After getting fitted with the mask, I woke up at 8am not 6am.  The tech said I went so hard into REM sleep and just kept REM Rebounding, he figured I really needed it so he let me sleep while he got other shit done.  I felt SOOOOO fucking awesome that morning.  I don't care if I look like an idiot or sound like darth vader, CPAP makes an incredible difference for me.

Edited May 10, 2018 by Loco

[MoJames 8244]

It's awesome when it works that way.

[vox 70]

On 5/10/2018 at 2:19 PM, Loco said:

At the test they woke me up after 1 hour to fit a mask.  The technician apologized and said they intended to do the testing for 4 hours or so, but said I qualified in the first 20 mins.

1

Took 45 minutes for me but yeah...same.

 

[vox 70]

Looking at new CPAP supplies vendor. 

Just changed insurance carriers and my current supplier (instamed/rotech) hasn't been bad but I want to take this opportunity to do price/service comparisons.

Preferably someone that takes BCBS.

I want the automatic refresh program - where your supplies just show up at the front door every month.

Where does everyone go?  Who do you use? 

Thanks, I'll hang up and listen now...

(ousucks)

[Not that Bob 735]

I use Monitor Medical. You will have to ask them about insurance. I think all DME's are thieves, but they do provide refills by mail. 

[MoJames 8244]

14 hours ago, Not that Bob said:

I use Monitor Medical. You will have to ask them about insurance. I think all DME's are thieves, but they do provide refills by mail. 

Why do you think they are thieves? Curious as my patient's work with them quite often and I'd like to help them if there is something inappropriate going on.

[Not that Bob 735]

Glad you asked. Everything seems within "the law", but they bill the absolute maximum allowed. For example, my CPAP machine was billed in monthly installments to my insurance. The total cost of the machine was, and I don't remember exactly, about 2-3 times what the cost was on a CPAP webpage bought outright. I'm sure the DME and insurance (or Medicare/Medicaid) have an agreement, but It just rubbed me the wrong way that they were charging way over "retail". It's like paying window sticker price for a car, plus a significant mark up. They email me asking if I want mask replacements every quarter. That is what "the law allows", but I don't need replacements that often. With a minimum of care the masks should last much longer than the replacement schedule "recommended" by the DME. 

Again, I am sure it's all within the insurance/DME agreement, but this is part of the reason that insurance and medical expenses are so high. Most people don't pay attention, and/or "do whatever they are told by a medical professional", so up go the expenses. Just my 2 cents. Don't want to get too cloak roomish.

[Loco 3752]

I have found that I can buy supplies off Amazon for about the same as my co-pay with insurance.   I don't go though the supply houses...  fyi

[Noah Fence 480]

The DME my doctor sent me to was trying fuck me around so I just paid cash for a new machine from CPAP.com.  I submitted a claim through my insurance and got about half back from them.  I saved about $250 from what the DME was trying to gouge me for with copay and deductible.  The cash price and copay through the DME are a wash for supplies.

[vox 70]

1 hour ago, Noah Fence said:

The DME my doctor sent me to was trying fuck me around so I just paid cash for a new machine from CPAP.com.  I submitted a claim through my insurance and got about half back from them.  I saved about $250 from what the DME was trying to gouge me for with copay and deductible.  The cash price and copay through the DME are a wash for supplies.

Appreciate'ya...

[vox 70]

On 10/9/2018 at 12:01 PM, Loco said:

I have found that I can buy supplies off Amazon for about the same as my co-pay with insurance.   I don't go though the supply houses...  fyi

Yup...appreciate'ya...

[Lat22 4010]

On 10/9/2018 at 12:01 PM, Loco said:

I have found that I can buy supplies off Amazon for about the same as my co-pay with insurance.   I don't go though the supply houses...  fyi

This. I never even considered going through insurance to buy new nasal pillows. 

[Tonesky 932]

Anyone know how to take a deep dive into an Resmed S10 Autoset? 

I had a sleep study and started using a CPAP about 8 years ago.  It was originally set to a fixed pressure based on the study.  Some years later, when it seemed I needed higher pressure, the doctor set it to an autoset range for a few months and then, based on data he pulled from the machine, he reset it to a new (higher) fixed pressure setting.  I am certain he said at the time that he was able to get a detailed report of the pressure levels pulled while sleeping.  So, fast forward to now and I have new machine - S10 Autoset.  The DME supplier set it to a range.  In the morning when I get up, the machine displays the current pressure.  And, I can log on to an account and download data, which is pretty extensive, but which does not include any pressure levels.  I'd like to, if I am in fact settling into a pretty consistent pressure level while sleeping, set the machine to that fixed level, which the doctor has told me a number of times is preferable to autoset.  So, anyone know if the S10 records the pressure data and, if so, how to access it (without paying the doctor a $50 copay)? 

[MoJames 8244]

24 minutes ago, Tonesky said:

Anyone know how to take a deep dive into an Resmed S10 Autoset? 

I had a sleep study and started using a CPAP about 8 years ago.  It was originally set to a fixed pressure based on the study.  Some years later, when it seemed I needed higher pressure, the doctor set it to an autoset range for a few months and then, based on data he pulled from the machine, he reset it to a new (higher) fixed pressure setting.  I am certain he said at the time that he was able to get a detailed report of the pressure levels pulled while sleeping.  So, fast forward to now and I have new machine - S10 Autoset.  The DME supplier set it to a range.  In the morning when I get up, the machine displays the current pressure.  And, I can log on to an account and download data, which is pretty extensive, but which does not include any pressure levels.  I'd like to, if I am in fact settling into a pretty consistent pressure level while sleeping, set the machine to that fixed level, which the doctor has told me a number of times is preferable to autoset.  So, anyone know if the S10 records the pressure data and, if so, how to access it (without paying the doctor a $50 copay)? 

Provider in sleep. There is no advantage to putting it to a static pressure setting anymore. The devices have programming that is advanced enough I put most of my patient's on an auto-titrating setting. Often position and stage of sleep can determine pressure needs. As well having an auto-setting allows the CPAP to work where ever you travel to a point (might not work perfectly in Silverton). If I was you, I'd leave it alone.

In the past, the auto-set would not respond appropriately to sleep. At this point, the machines are advanced enough and the nuances of programming avoid the machines ramping up unnecessarily. 

[Tonesky 932]

1 minute ago, MoJames said:

Provider in sleep. There is no advantage to putting it to a static pressure setting anymore. The devices have programming that is advanced enough I put most of my patient's on an auto-titrating setting. Often position and stage of sleep can determine pressure needs. As well having an auto-setting allows the CPAP to work where ever you travel to a point (might not work perfectly in Silverton). If I was you, I'd leave it alone.

In the past, the auto-set would not respond appropriately to sleep. At this point, the machines are advanced enough and the nuances of programming avoid the machines ramping up unnecessarily. 

Thanks!

[Irish Wrist Watch 1359]

On 4/20/2018 at 11:27 AM, lateshow said:

I went to Walgreen's and bought a Mute. It's an insert that goes into your nose and expands the nostrils. Seems to have helped mine quite a bit. I feel better and my wife says that she's not bothered or awakened by my snoring any longer. 

You should try this first. Who the fuck wants some machine attached to their head that needs regular cleaning to get rid of bacteria?

[HoustonHorn 1062]

Anybody try Inspire?

[MoJames 8244]

On 2/8/2021 at 12:24 AM, Irish Wrist Watch said:

You should try this first. Who the fuck wants some machine attached to their head that needs regular cleaning to get rid of bacteria?

Yeah much worse than having a stroke.

[MoJames 8244]

7 minutes ago, HoustonHorn said:

Anybody try Inspire?

Have about a dozen patient's on it. Only one patient up to this point has been unable to tolerate it. I do have one patient that it isn't helping decrease the apneas as well as we had hoped. No huge issues up to this point.

[HoustonHorn 1062]

16 minutes ago, MoJames said:

Have about a dozen patient's on it. Only one patient up to this point has been unable to tolerate it. I do have one patient that it isn't helping decrease the apneas as well as we had hoped. No huge issues up to this point.

I have a CPAP machine that's a few years old but has the full mask which I can't and don't use. Can I just order and try a different kind of mask out?

I think I might give Inspire a try. What do you mean by not "tolerate" it, as in the signals it sends?

Thanks for the info.

[MoJames 8244]

The one guy that didn't tolerate it was probably a bad patient to consider. He had all sorts of pain issues previously and stated "the wire hurts" discussing the wire from the battery to the sensor over the chest. I've never had a patient complain about it or note it at all since or prior.

If you are synced in with a DME, call them and ask about mask change options. Sometimes it requires an order from the provider. I would certainly try a different mask and make sure to replace the gasket as often as recommended by insurance.

[HoustonHorn 1062]

28 minutes ago, MoJames said:

The one guy that didn't tolerate it was probably a bad patient to consider. He had all sorts of pain issues previously and stated "the wire hurts" discussing the wire from the battery to the sensor over the chest. I've never had a patient complain about it or note it at all since or prior.

If you are synced in with a DME, call them and ask about mask change options. Sometimes it requires an order from the provider. I would certainly try a different mask and make sure to replace the gasket as often as recommended by insurance.

Not synced in with one, haven't done anything about it in several years after I determined I couldn't sleep with it.

The one I have doesn't get a good seal (I have a beard), moves around when I move or turn, I have to sleep on my back which I don't and can't do (side sleeper), and I wake up feeling clausterphobic sometimes and have to pull it off.

I'd try a new mask if I can just get one to try out but considering my experience I don't feel like having to go back and do more studies or whatever in order to make that happen.

[HoustonHorn 1062]

Looks like to buy a mask you need a prescription. I'm not even sure I can find the guy I went to before. If I can find him, is it likely that I would be able to get a different mask without going in? If not, any recommendations for someone near the Beltway (west)/I-10 in Houston?

[MoJames 8244]

Just now, HoustonHorn said:

Looks like to buy a mask you need a prescription. I'm not even sure I can find the guy I went to before. If I can find him, is it likely that I would be able to get a different mask without going in? If not, any recommendations for someone near the Beltway (west)/I-10 in Houston?

Check your DMs

[Noah Fence 480]

On 2/10/2021 at 3:10 PM, HoustonHorn said:

Not synced in with one, haven't done anything about it in several years after I determined I couldn't sleep with it.

The one I have doesn't get a good seal (I have a beard), moves around when I move or turn, I have to sleep on my back which I don't and can't do (side sleeper), and I wake up feeling clausterphobic sometimes and have to pull it off.

I'd try a new mask if I can just get one to try out but considering my experience I don't feel like having to go back and do more studies or whatever in order to make that happen.

Try the nasal pillows.  I couldn't tolerate the mask.  Switching to the nasal pillow was a game changer and work well with a beard.

[MoJames 8244]

2 minutes ago, Noah Fence said:

Try the nasal pillows.  I couldn't tolerate the mask.  Switching to the nasal pillow was a game changer and work well with a beard.

Main trick with anything nasal though is you must keep your mouth closed. Just an fyi.

[Chewbacca 7765]

23 hours ago, HoustonHorn said:

Looks like to buy a mask you need a prescription. I'm not even sure I can find the guy I went to before. If I can find him, is it likely that I would be able to get a different mask without going in? If not, any recommendations for someone near the Beltway (west)/I-10 in Houston?

I can't help you with the prescription, but on the masks, I love this one.  Very comfortable.

 

https://www.thecpapshop.com/respironics-dreamwear-nasal-cpap-mask?utm_source=google&utm_medium=cpc&adpos=&scid=scplp1116700-BUNDLE&sc_intid=1116700-BUNDLE&gclid=Cj0KCQiAyJOBBhDCARIsAJG2h5e59yqtuNkK8MCXoOHFQ_2bqI3vfs6EjvEqRjxxA0V622qpbwJCu1saArMLEALw_wcB

[HRSchenker 2268]

What's the best mask for a mouth breather? I just got my cpap machine but I only have a nasal mask. Not sure if this is going to work but I'll give it a shot

[UnivTex34 1763]

3 hours ago, Chewbacca said:

I can't help you with the prescription, but on the masks, I love this one.  Very comfortable.

 

https://www.thecpapshop.com/respironics-dreamwear-nasal-cpap-mask?utm_source=google&utm_medium=cpc&adpos=&scid=scplp1116700-BUNDLE&sc_intid=1116700-BUNDLE&gclid=Cj0KCQiAyJOBBhDCARIsAJG2h5e59yqtuNkK8MCXoOHFQ_2bqI3vfs6EjvEqRjxxA0V622qpbwJCu1saArMLEALw_wcB

This is good to hear, as I ordered it yesterday.

 

also, nice little hack for y’all, if your order the three parts that constitute the mask separately on Amazon, you can save about half the cost of any cpap supply website. 

[MoJames 8244]

13 hours ago, HRSchenker said:

What's the best mask for a mouth breather? I just got my cpap machine but I only have a nasal mask. Not sure if this is going to work but I'll give it a shot

Most of my patient's prefer this one. Dreamwear full face

Edited February 12, 2021 by MoJames

[Bosco 56]

I’ve been wearing that Dreamwear full face mask for almost 3 years and it works great.  I’m a stomach sleeper and mouth breather and I have no issues wearing it.

And you don’t need a prescription to buy a mask.  You can buy on Amazon.  I buy all of my components on Amazon.

[MoJames 8244]

I’ve been wearing that Dreamwear full face mask for almost 3 years and it works great.  I’m a stomach sleeper and mouth breather and I have no issues wearing it.
And you don’t need a prescription to buy a mask.  You can buy on Amazon.  I buy all of my components on Amazon.

Correct, but with a prescription, insurance will pay for your equipment.

[HRSchenker 2268]

3 weeks with the cpap and my mornings are great! I'm not yawning every 10 seconds and actually feel like I have energy. I'm also noticing what I guess is my metabolism cranking back up because I'm at the last notch on my belt this morning. Did 200 COVID shots yesterday and had to adjust myself because my ass was almost showing.

[BigDHornfan 6545]

Well Team Cpap as of today.
Got the dream ware mask as well.
Looking forward to sleeping better!

[Chewbacca 7765]

Well Team Cpap as of today.
Got the dream ware mask as well.
Looking forward to sleeping better!

Stick with it. Took me a week or two to get used to it.

[Jiggy-Z 3432]

At a cross roads and on the horns of a dilemma:

Hoping some of you have had similar issues and experiences and can chime in.

Medical background:  Age 54, wt 190lbs, 5'-11".  Could stand to lose about 15lbs, but for some reason that seems to be harder now than it used to be and by used to be 3 years ago. Not a mouth breather by day. My insurance blows.

I went in for a sleep study back in 2006 and I was diagnosed with mild sleep apnea and the doc said CPAP was probably not necessary, which was kind of confusing, since although on occasion, I drank too much or ate too late, or had some kind of cold or mild allergy type of thing going on, apnea seemed to be occurring to a lesser degree every night.  Also did not have any weight issues.  Did not get CPAP.

Since the sleep study, my condition has gotten worse but only slightly more so.  Some of that I attribute to transitioning to more back sleeping, which has become my preferred position, but I am often awakened by my wife when I sleep on my back, so I move to either side which helps but does not eliminate snoring /apnea.   

I got a mouthpiece from my dentist a couple of years ago, which helps, but it is not anything too special.  I wear it every night but it does not eliminate the s/a, just lessens it a bit.

I was gifted a smart watch and have been tracking my sleep.  In general, I get the recommended amount of sleep time, but ~70% of the time the smart watch says I do not sleep well (70-75% sleep quality).  I sleep especially poorly, according the watch, when I drink too much which is a six pack or more (15% -70% sleep quality).  Also, I sleep poorly when I exercise late in the day, which is usually a 3.5 mile walk around 6PM, which seems unusual.  I tend to sleep exceptionally well one or two days after drinking too much.  My best sleep quality is on these post hangover nights (80% to 93% sleep quality).  Even without drinking and exercise, the best sleep quality I can get is around 83%, but it is not consistent. 

From this thread, it seems like CPAP or its derivations are the only treatment that seems to be effective.

So with that in mind, last week I made an appointment with Snoring and Sleep Specialist, thinking I would go in, get an at home sleep study, get diagnosed with apnea, get a CPAP and be on my way eventually.

First thing that did not go as planned: I am recovering from a cold from about 10 days ago and have some residual effects lingering in the form of inflamed/infected nasal passages, for which Dr. Slaughter prescribed mild antibiotics, mild steroid, and another special homemade Rx nasal spray.  I understand the thinking, and the doc said this might be a possible cure, but even if it was not, at least it would clear things up so that possible sleep study could be more illustrative.

2nd thing that did not go as planned: I was also diagnosed with a slight deviated septum.  Had no idea.

3rd thing: CPAP was only briefly mentioned with the flowchart explanation of allergies and treatment and all kind of mild surgical procedures etc. coupled with CPAP and allergy treatment would probably be effective.

Intuitively, I just don't think I need all of that stuff, nor do I think an apparent condition I have had for years can be cleared up with a few weeks of pretty common medicine.  This feels like a sales pitch, and after my follow up visit in 30 days after going through this round of medications, I am seriously considering another Dr.

I don't want to be on CPAP the rest of my life, but seems like it is the only alternative based on this thread, if I don't want to go in for a what seems like a never ending parade of procedures, medications, and cash outflow.

Help.

 

 

 

 

[MoJames 8244]

51 minutes ago, Jiggy-Z said:

At a cross roads and on the horns of a dilemma:

Hoping some of you have had similar issues and experiences and can chime in.

Medical background:  Age 54, wt 190lbs, 5'-11".  Could stand to lose about 15lbs, but for some reason that seems to be harder now than it used to be and by used to be 3 years ago. Not a mouth breather by day. My insurance blows. 

I went in for a sleep study back in 2006 and I was diagnosed with mild sleep apnea and the doc said CPAP was probably not necessary, which was kind of confusing, since although on occasion, I drank too much or ate too late, or had some kind of cold or mild allergy type of thing going on, apnea seemed to be occurring to a lesser degree every night.  Also did not have any weight issues.  Did not get CPAP.

Since the sleep study, my condition has gotten worse but only slightly more so.  Some of that I attribute to transitioning to more back sleeping, which has become my preferred position, but I am often awakened by my wife when I sleep on my back, so I move to either side which helps but does not eliminate snoring /apnea.   

I got a mouthpiece from my dentist a couple of years ago, which helps, but it is not anything too special.  I wear it every night but it does not eliminate the s/a, just lessens it a bit.

I was gifted a smart watch and have been tracking my sleep.  In general, I get the recommended amount of sleep time, but ~70% of the time the smart watch says I do not sleep well (70-75% sleep quality).  I sleep especially poorly, according the watch, when I drink too much which is a six pack or more (15% -70% sleep quality).  Also, I sleep poorly when I exercise late in the day, which is usually a 3.5 mile walk around 6PM, which seems unusual.  I tend to sleep exceptionally well one or two days after drinking too much.  My best sleep quality is on these post hangover nights (80% to 93% sleep quality).  Even without drinking and exercise, the best sleep quality I can get is around 83%, but it is not consistent. 

From this thread, it seems like CPAP or its derivations are the only treatment that seems to be effective.

So with that in mind, last week I made an appointment with Snoring and Sleep Specialist, thinking I would go in, get an at home sleep study, get diagnosed with apnea, get a CPAP and be on my way eventually.

First thing that did not go as planned: I am recovering from a cold from about 10 days ago and have some residual effects lingering in the form of inflamed/infected nasal passages, for which Dr. Slaughter prescribed mild antibiotics, mild steroid, and another special homemade Rx nasal spray.  I understand the thinking, and the doc said this might be a possible cure, but even if it was not, at least it would clear things up so that possible sleep study could be more illustrative.

2nd thing that did not go as planned: I was also diagnosed with a slight deviated septum.  Had no idea.

3rd thing: CPAP was only briefly mentioned with the flowchart explanation of allergies and treatment and all kind of mild surgical procedures etc. coupled with CPAP and allergy treatment would probably be effective.

Intuitively, I just don't think I need all of that stuff, nor do I think an apparent condition I have had for years can be cleared up with a few weeks of pretty common medicine.  This feels like a sales pitch, and after my follow up visit in 30 days after going through this round of medications, I am seriously considering another Dr.

I don't want to be on CPAP the rest of my life, but seems like it is the only alternative based on this thread, if I don't want to go in for a what seems like a never ending parade of procedures, medications, and cash outflow.

Help.

Your Sinus infection has no effect on sleep apnea.

Nasal deviation rarely has any effect on sleep apnea and if it does it is mild and repair rarely fixes it.

How are you determining that the MAD (mandibular advancement device) isn't improving the sleep apnea?

Your watch, although interesting, does not do a good job of quantifying sleep efficacy - it simply determines movement and if you are still for a bit, you are considered asleep, if you are in a deep sleep theoretically your bp drops about 10 bpm, so it considers that deep sleep.

Mild OSA is becoming more and more of a grey area with the risk factors really not showing up like we thought they would. Risks do in worsen when you get 20+ apnea/hr.

What degree/specialty is this sleep/snore specialist. Sounds like they are trying to sell you on a procedure.

I'd get home sleep study. 

CPAP is definitely the first step in treatment of moderate to severe sleep apnea, but there is a new device called Inspire (hypoglossal stimulator) that can be considered in the right patient.

[Jiggy-Z 3432]

1 hour ago, MoJames said:

Your Sinus infection has no effect on sleep apnea.

Nasal deviation rarely has any effect on sleep apnea and if it does it is mild and repair rarely fixes it.

How are you determining that the MAD (mandibular advancement device) isn't improving the sleep apnea?

Your watch, although interesting, does not do a good job of quantifying sleep efficacy - it simply determines movement and if you are still for a bit, you are considered asleep, if you are in a deep sleep theoretically your bp drops about 10 bpm, so it considers that deep sleep.

Mild OSA is becoming more and more of a grey area with the risk factors really not showing up like we thought they would. Risks do in worsen when you get 20+ apnea/hr.

What degree/specialty is this sleep/snore specialist. Sounds like they are trying to sell you on a procedure.

I'd get home sleep study. 

CPAP is definitely the first step in treatment of moderate to severe sleep apnea, but there is a new device called Inspire (hypoglossal stimulator) that can be considered in the right patient.

Thanks so much.

Clarifications: The MAD device is working. Since I have been using it the snoring is better, just not enough for my wife's liking.

Dr. Is Daniel Slaughter ENT. This stuff is all he does, seems qualified, just got a slick sales pitch vibe, although there was no pressure. Just seemed like it was going to be a series of things that were not going to be CPAP. Definitely not getting warm and fuzzies based on your sinus infection comment.

I included the smart watch info for general background, but yeah it has been way off a few times and I'm pretty sure I am getting more than 20-30 minutes or Rem sleep per night.

In fact, except when I drink, I feel pretty good about my sleep. The only other thing that disturbs my sleep is some soreness/stiffness in my back on occasion and of course my wife waking me up to tell me to turn over.

[Chewbacca 7765]

1 hour ago, Jiggy-Z said:

Thanks so much.

Clarifications: The MAD device is working. Since I have been using it the snoring is better, just not enough for my wife's liking.

Dr. Is Daniel Slaughter ENT. This stuff is all he does, seems qualified, just got a slick sales pitch vibe, although there was no pressure. Just seemed like it was going to be a series of things that were not going to be CPAP. Definitely not getting warm and fuzzies based on your sinus infection comment.

I included the smart watch info for general background, but yeah it has been way off a few times and I'm pretty sure I am getting more than 20-30 minutes or Rem sleep per night.

In fact, except when I drink, I feel pretty good about my sleep. The only other thing that disturbs my sleep is some soreness/stiffness in my back on occasion and of course my wife waking me up to tell me to turn over.

Just do the sleep study and get the CPAP.  You likely need it and once you get used to it, you won't be able to sleep without it.  Your wife will approve as well.

[milkman 428]

Does anyone know if you need a prescription to buy a CPAP machine? The one I have now is involved in a recall.

[Apep 645]

Technically yes, but you can get them online from reputable gray market dealers without one.

[MoJames 8244]

Does anyone know if you need a prescription to buy a CPAP machine? The one I have now is involved in a recall.

Register the machine, Philips is replacing them for free although it isn't happening quickly bc of the manufacturing delays.

[HRSchenker 2268]

14 hours ago, milkman said:

Does anyone know if you need a prescription to buy a CPAP machine? The one I have now is involved in a recall.

Yep. I used cpap.com for my dreamstation (now under recall too). All I did was upload a copy of the prescription and they sent it to me. 

[Felix 607]

Kind of glad this popped up again.  My CPAP (2nd one) is pretty old.  Maybe 8-9 years.  I feel like maybe it's not doing the job any more or my stuff has changed.  Should I have another sleep study?  I understand the newer machines can report back to the provider.  I think mine has a smart card that I can send it but not sure.  Just wondering if I need a new one and if I'll have to do another sleep study as my last one was like 15 years ago.

[milkman 428]

Kind of glad this popped up again.  My CPAP (2nd one) is pretty old.  Maybe 8-9 years.  I feel like maybe it's not doing the job any more or my stuff has changed.  Should I have another sleep study?  I understand the newer machines can report back to the provider.  I think mine has a smart card that I can send it but not sure.  Just wondering if I need a new one and if I'll have to do another sleep study as my last one was like 15 years ago.

I'm in the same boat. Just need someone to sell me a machine or Philips to hurry up and get my recalled machine exchanged.

[MoJames 8244]

Insurance will pay for a new machine every 5 years. The newer machines have modems in them making the SD card a backup anymore. The information from the CPAPs can let the provider know if it is effective.

[Jiggy-Z 3432]

On 10/11/2021 at 3:23 PM, MoJames said:

Your Sinus infection has no effect on sleep apnea.

Nasal deviation rarely has any effect on sleep apnea and if it does it is mild and repair rarely fixes it.

How are you determining that the MAD (mandibular advancement device) isn't improving the sleep apnea?

Your watch, although interesting, does not do a good job of quantifying sleep efficacy - it simply determines movement and if you are still for a bit, you are considered asleep, if you are in a deep sleep theoretically your bp drops about 10 bpm, so it considers that deep sleep.

Mild OSA is becoming more and more of a grey area with the risk factors really not showing up like we thought they would. Risks do in worsen when you get 20+ apnea/hr.

What degree/specialty is this sleep/snore specialist. Sounds like they are trying to sell you on a procedure.

I'd get home sleep study. 

CPAP is definitely the first step in treatment of moderate to severe sleep apnea, but there is a new device called Inspire (hypoglossal stimulator) that can be considered in the right patient.

OK.

Did the home sleep study and the result are in:

But first a little refresher.  Me 5'-11" 195lbs, 54.  Dock says neck is a bit thick as is my tongue. Slightly deviated septum which doc says is too slight to make much of a difference.  I have a MAD that helps but according to the wife, not nearly enough.  I get almost 8 hrs of sleep/night and do not feel tired during the day or yawn a lot.  Did a sleep study 15 years ago and was diagnosed with mild apnea and Dr. did not push CPAP.  Wife was concerned about CPAP noise at the time so decided to try weight management (although I was not overweight at the time) and...

I am about the same.

REI: 10.5

OAI: 2.7

CAI: 0.9

Desat Index: 11.5

Average Desat %: 92%

High Desat %: 97%

Low Desat %: 83%

Mean HR: 54.5BPM

Lowest HR: 45 BPM (unusual, normally I get into the mid to upper 30's)

Highest HR: 86 BPM

217 snoring episodes

 

 

[MoJames 8244]

On 11/23/2021 at 12:21 PM, Jiggy-Z said:

REI: 10.5

This is the most important metric.

5-15 is Mild sleep apnea. It is certainly up to you, but if your wife is being effected, the newer CPAPS are fairly quiet and you could give it a shot. From a risk factor standpoint the majority of new data suggests an mild OSA patient actually has very little risk when compared to moderate to severe patients.

[HRSchenker 2268]

My wife had the same concern but it's no louder than having a fan next to you on the low setting. If she can sleep with another fan on, she can tolerate your cpap 

[Jiggy-Z 3432]

On 11/29/2021 at 9:27 AM, MoJames said:

This is the most important metric.

5-15 is Mild sleep apnea. It is certainly up to you, but if your wife is being effected, the newer CPAPS are fairly quiet and you could give it a shot. From a risk factor standpoint the majority of new data suggests an mild OSA patient actually has very little risk when compared to moderate to severe patients.

Medical Update:

I got my CPAP last Friday and have been using it every night.

The good news: Programming and set up was a breeze, wife has not complained about snoring at all, machine is quiet enough also, and I am getting usage scores of 100 out of 100 every night (5 nights) with about .5 events per hour. So all of the external factors are great.

The not so good news: My sleep is not so good, both by how I feel and as measured by my smart watch.  Not a huge drop, but noticeable.  I think some of it is getting used to the treatment, but I feel like I am waking up or in light sleep too much.  I wake at night sometimes and mess with breathing, allowing pressure to build up, releasing through my mouth etc., and go back to sleep.  I think one possibility is that I try to mouth breath once I try to begin snoring, and then go back to nasal breathing, but it kind of startles me so I come out of sleep at least 3-5 times per night.  I have tried sleeping without my MAD and that makes the mouth breathing worse.  I am not generally a mouth breather, but am interested in what a full mask might do.  I will give it some more time, but given the proper working of the treatment side, I think I might need some kind of adjustments. Any thoughts?