Sleep apnea

[bolverk 29655]

I think this has been an ongoing problem for a while, but I finally got confirmation. Last month, I had to get an emergency appendectomy and the nurses who saw me over-night informed me I needed to get my PCP to authorize a sleep test.

So Monday night I did the take-home test, and my PCP called me yesterday with the results. He said I stopped breathing 571 times in six hours and my oxygen was below safe levels 63% of the time. Clearly, I need a cpap.

Do any of you guys use one? If so, do you have any recommendations? I got a call today from some medical supply outfit letting me know they were going to check with my insurance on where to get one. They also mentioned that there were six different types that I'd likely choose from.

I'm starting from zero knowledge at this point, so any advice would be greatly appreciated.

TIA

[TwiceHorn 31438]

I have no personal experience with them, but some knowledge of the subject as a result of having done some patent work in the field. 

As you are probably aware, the devices work by placing a mask over your nose and mouth and pumping air into your airways.  This does a couple of things:  it inflates your airways so that they are open and unobstructed, and insures that your lungs are getting filled, regardless of your respiration effort.  The side effect is that the pressure opposes your exhalation, which can be uncomfortable.

The more sophisticated and expensive machines use various algorithms and mechanisms to try to match the application of pressure to your airways to your breathing, so there is less opposition to exhalation.

You may find that you dislike the noise, the mask, or the opposition to exhalation, or all three to varying degrees.  If you dislike the side effect strongly (many seem to), a more expensive (yay) or possibly just a different machine may help.  You can probably get used to all of the drawbacks over time, but it may suck at first.

[Chico_SA 521]

Started with full mask earlier this summer. I’m still a little inconsistent with it as I’m used to tolling over to my stomach and I tend to remove it. When I keep it on, my wife says that I’m almost completely silent. 

[Chewbacca 7767]

I have an auto CPAP that I use every night (your test results will dictate what kind of machine you get).  My sleep is worlds better now than it was before getting it, but it took me probably 2-3 weeks until I was used to sleeping with it.  Sleep apnea is no joke.  Use your machine every night.

 

Find a mask that is comfortable for you.  I initially had a mask like this and I hated it.

 

 

Switched to this one and it is much better.  They will let you try a couple new masks at first to find one that works for you.

 

 

 

[Felix 607]

To echo Chewy, your test should be a good indicator of which machine you need.  Even then there are options.  I've had 3 over the years and I'll just suggest getting the quietest one possible.  Also consider portability as you'll want to take it with you when you travel and the easier it is to haul and set up, the better.

Mask is key.  When you go for your fitting, try on as many as you need to find one that's as comfortable as possible.  How you sleep will be a big factor.  I use a nose only mask like the first one on Chewy's post.  It works for me as i'm primarily a side (80%) and back (20%) sleeper, but lot's of people don't like them.  Take your time when you do your fitting and try each kind.  You can get a new mask fairly inexpensively if you need to, but insurance generally only pays for 1 per year.  

I does take a week or two to get used to it, but stick to it.  It really makes a bid difference in your quality of life it you use it every night and will benefit your heart greatly over time.

[Tailgate Jeff 3]

I have been using a CPAP for 11 years now. I'm on my third machine and they have all been almost silent when they in operation.  I have a new automatic machine that I really like and use a full face mask after initially  trying a variety of different types.  You machine is going to be dependent on what your insurance company is going to pay for.  I had to go out of pocket for $300 for my new automatic machine. A ramp feature that gradually increases pressure over 30 to 45 minutes is pretty important. Allows you to get to sleep with a minimal amount of pressure and then ramp up to a higher pressure.   Also, get a model that has a humidification chamber and heated air hose. My new machine also is able to connect with a App on my iPhone via Bluetooth that gives me a daily report of how many hours a night I use my machine and the duration of the various pressures.

Investigate other medical supply companies other than what your insurance company or doctor steers you to.  I'd been using the same company that was a "preferred provider" to my insurance company for years and they were sold and their service went to hell.  Ended up using a smaller local company that had better pricing on my supplies and the ability to walk in and pick up my supplies and not have to pay shipping and the transition from old company to new was seamless with my insurance company. 

Finally, the insurance company and your doctor are going to monitor your usage. If you aren't using it, the insurance company is going to make you pay for it or return it.  Older machines had a SD card that I had to take out and mail to the insurance company a couple of times a year. I also had to take the card to my annual appointment with my sleep doc to make sure I was using the machine.  New machine can send the report via the App.

 

[bolverk 29655]

Thanks for all the solid advice @Felix and @Tailgate Jeff. I'm all out of rep at the moment, but I want y'all to know I really appreciate it. 

[Bat Guano 359]

Anyone tried those mouthpieces that advance the lower jaw to open up the airway? They are significantly less expensive and seem like they'd be less annoying to use. They are for mild to moderate apnea, so they may not work for more severe cases. I don't know if OP's case is considered severe or not.

[Chewbacca 7767]

Anyone tried those mouthpieces that advance the lower jaw to open up the airway? They are significantly less expensive and seem like they'd be less annoying to use. They are for mild to moderate apnea, so they may not work for more severe cases. I don't know if OP's case is considered severe or not.

Mine was too severe for that but i have heard they can work well for mild apnea.

[Onboard 2.0 9083]

I know several people that use the C-PAP machines. They definitely work, but I'd try a mouth guard/snore guard first.  Get one that you boil/soften up like a football mouth guard.

I use a mouth guard and it works like a charm.

[Chewbacca 7767]

19 minutes ago, Onboard 2.0 said:

I know several people that use the C-PAP machines. They definitely work, but I'd try a mouth guard/snore guard first.  Get one that you boil/soften up like a football mouth guard.

I use a mouth guard and it works like a charm.

I have been told by 2 Drs that those are only effective on mild to moderate apnea.  What bolverk is describing is nowhere near mild or moderate.  He stops breathing almost 100 times per hour.  My number was somewhere around 40 and I was told that was too severe for the mouthpiece.  He needs the machine.

[Onboard 2.0 9083]

5 minutes ago, Chewbacca said:

I have been told by 2 Drs that those are only effective on mild to moderate apnea.  What bolverk is describing is nowhere near mild or moderate.  He stops breathing almost 100 times per hour.  My number was somewhere around 40 and I was told that was too severe for the mouthpiece.  He needs the machine.

Yeah, it's definitely not a solution for all situations. If he's in the stop breathing  mode then yeah apnea is probably the culprit.

[DaysOff 7947]

As I recall bolverk is a skinny guy, so that severe of apnea is surprising.

[Onboard 2.0 9083]

4 minutes ago, DaysOff said:

As I recall bolverk is a skinny guy, so that severe of apnea is surprising.

Yep, usually it's weight that seems to be the culprit.  

[Call 393]

Plus whatever on trying multiple masks.

The first couple nights will suck as you adjust to trying to sleep with the mask.  The first time you make it through the night or most of the night with the Cpap you’ll be amazed at how rested you truly feel.  I’ve been using a Cpap over 5 years and it has been a game changer. 

[Onboard 2.0 9083]

51 minutes ago, Call said:

Plus whatever on trying multiple masks.

The first couple nights will suck as you adjust to trying to sleep with the mask.  The first time you make it through the night or most of the night with the Cpap you’ll be amazed at how rested you truly feel.  I’ve been using a Cpap over 5 years and it has been a game changer. 

What they need are Darth Vader CPap masks.......

[stupidgringo 66]

Due to history of mild apnea, I did a take home sleep study with my age 50 checkup. Don't recall the exact numbers, but they were bad. PCP wanted me to start on a CPAP asap. I have a friend who's an ENT doc, so I had the results sent to him and we decided to do another take home test. Should get the results by Monday. FWIW, I'm 5'8", 170 lbs, which is about 10 lbs less than 10 years ago when my apnea was deemed mild.

The point is that it looks like I have a CPAP in my immediate future. How does getting the CPAP work? Doc prescribes, then you go to the CPAP store? Order online? If you're in Austin, where did you buy yours?

[immamac 42835]

Get the resmed autoset 10 + Philips respironics mask. I've used it most nights for the last 3 years, took like 2 weeks to get used to and now I can't sleep without it. 

[texasjacket 289]

On 9/12/2018 at 10:20 PM, bolverk said:

I think this has been an ongoing problem for a while, but I finally got confirmation. Last month, I had to get an emergency appendectomy and the nurses who saw me over-night informed me I needed to get my PCP to authorize a sleep test.

So Monday night I did the take-home test, and my PCP called me yesterday with the results. He said I stopped breathing 571 times in six hours and my oxygen was below safe levels 63% of the time. Clearly, I need a cpap.

Do any of you guys use one? If so, do you have any recommendations? I got a call today from some medical supply outfit letting me know they were going to check with my insurance on where to get one. They also mentioned that there were six different types that I'd likely choose from.

I'm starting from zero knowledge at this point, so any advice would be greatly appreciated.

TIA

Not everyone can get use to those machines, especially if you travel, depending on your situation, there are some surgeries you can look into to help immensely reduce these metrics to normal levels. Plus, you won't sound like a grizzly bear when sleeping too. I had a family member go this route and changed his life for the better after it.

What ever you do, the first thing any PCP will ask you to address honestly is your weight when it comes to sleep apnea. Not sure how much of a 'dad bod' you are rocking, but the easy way to tackle this problem is dropping some lbs. 

[Tailgate Jeff 3]

On 9/15/2018 at 2:12 PM, Call said:

Plus whatever on trying multiple masks.

The first couple nights will suck as you adjust to trying to sleep with the mask.  The first time you make it through the night or most of the night with the Cpap you’ll be amazed at how rested you truly feel.  I’ve been using a Cpap over 5 years and it has been a game changer. 

While weight is a definite factor in obstructive sleep apnea,  the physical make up of your neck and throat are also factors.  I know 2 women who have sleep apnea and both are physically fit, active and definitely not overweight.

 

At my initial exam, my sleep doc took a look at my throat and neck and pretty much told me that I had sleep apnea but needed the sleep study to find out the severity.  I have a short, thick neck with a lot of tissue at the back of my throat.

Last year, my sleep doc really got on my ass about losing weight and that was enough motivation to start my weight loss and exercise plan.  I've lost 70 pounds in the last 16 months (325 to 255) with 20 more pounds to lose.  No matter how much weight I lose, I'll always have sleep apnea because of the physical construction of my neck and throat. 

[Felix 607]

That's the boat I'm in.  Neck and throat are the culprits.  Surgery is an option but I've known three people who had the surgery and all told me it was a mixed bag and if they could have just used a CPAP they would rather do that.

[Onboard 2.0 9083]

Just now, Felix said:

That's the boat I'm in.  Neck and throat are the culprits.  Surgery is an option but I've known three people who had the surgery and all told me it was a mixed bag and if they could have just used a CPAP they would rather do that.

Never heard of anyone happy with the surgical route.

[texasjacket 289]

17 hours ago, Onboard 2.0 said:

Never heard of anyone happy with the surgical route.

I know several