Anyone looking sleep apnea / CPAP / BiPAP / ASV advice?

I found that if I visited my APNEA doctor yearly, when he wrote a script at the five year mark, insurance would approve without issue. Might help for next time?

 

concur my Dr. said 5yrs per machine for full coverage.

 

Thanks, I'll definitely check that group out.

I'm currently stuck in a high deductible plan so I'm trying to avoid using insurance whenever I can.

 

@rhaliuk I did a study a few weeks ago and these were the results I was sent.

The HST showed us that you stop breathing 31.3 times every hour that you are asleep.
Each of those events are 10 seconds long and have oxygen desaturations.
Your O2 levels are dropping from 99% down to 84% with each of the respiratory events.
It also calculated that you snore 1291 times throughout the night.

My wife says I snore, she does a little as well.
There are times trying to go to sleep, I'll catch myself snoring and gasping, not all the time, but it happens.
Although I've never woken up that I know of.

Tomorrow I have an appointment with a vendor for an APAP, whatever that is.
I'm really not even sure if I'll use it, but my insurance is paying 100%.
I can't see myself sleeping with a full face mask, maybe something just covering my nose would work.
Are the masks different for APAP and CPAP?

Can you tell me in plain English what to expect from my visit and the equipment I may get?
I've watched a few videos so I know more than I did this morning..
Thank you..

 

You have a severe case of sleep apnea. Your airway relaxes (snoring) and narrows at night which reduces the amount of air that goes in and out of the lungs per breath. This in turn causes the oxygen to decrease. You won't remember every event because the brain wakes up only for a few seconds at a time. It is enough to spike all body functions up, but not enough for you to become aware of the awakening. Usually, people remember the episodes of gasping at the beginning of the night when they are not fully asleep.

APAP is an automatic air compressor that will calibrate itself to find the amount of pressure needed to keep your airway from narrowing. It will start at a low pressure setting - 5 cmH2O and increase up to 20 cmH2O (if needed).
The vendor will offer you a variety of masks - from FFM to nasal. They generally ask if you "breathe through the mouth at night" which is often the case when you have sleep apnea. I always tell my patients that the right way to ask is "can you breathe through your nose while you are awake". If you choose to start with a nasal mask, ask for a chin strap. A chin strap will help you keep your mouth closed. It is a good training tool. Also, stay away from your back on the first night because it will keep your pressures low and there is a better chance of tolerating nasal breathing.

I recommend DreamWear Nasal Cushion or Gell Pillows for a nasal mask. ResMed AirFit P10 nasal pillows are good too.

Personally, I have a DreamWear FFM. It is a full face mask, but it goes under the nose instead of over the nose. It works well if you have no facial hair, have enough teeth structure to support the mask, and have no deep wrinkles.

Good luck! It took me a while to get used to mine, but I love it.

 

Thanks for the input.
Of course, I put off looking into it for several years because I really didn't think it was a problem.
But I had back surgery in September, I'm off work until the first of the year, and all my insurance deductibles have been met, so I figured this would be a great time to look into it.
As well as doing whatever other medical/dental stuff I need to be done while I'm off work.
I'm also exhausted when I get up in the mornings and I'll only sleep 5 or 6 hours a night and then just wake up.

I pretty much have to sleep on my back.
My shoulders are bone on bone so I don't sleep on my side very often.
I pretty much sleep like Dracula in his coffin, on my back, hands together on the top of my chest.
Most mornings I wake up in the same position, the sheets haven't even moved, but sometimes I wake up on my stomach.

I think my son-in-law is using a setup as you described, a nose mask with a chin strap.
I think I could do that.
The chin strap alone seems like it would help with the snoring.

I appreciate your help.
I'd like to be somewhat educated when I go for my office visit tomorrow.
I did learn today by watching videos about the differences between CPAC, APAP, and BiPAP.

If I have any more questions as this process goes on I'll be sure to ask you.
You describe things very well..
Thank you so much..1LL

 

It's not easy to get used to, but after a while it gets to be the norm. It'll change your life, stick with it. APAP is Auto Positive airway Pressure, as opposed to CPAP Continuous PAP

 

@rhaliuk
I ended up with a Luna G3 APAP LG3600 and a Resmed AirFit F30.
I'm going to give it a shot tonight.
I did notice now I'm home they had all the masks that you suggested.

I couldn't decide between the full or nose mask, they suggested I try this one.
I have 30 days to exchange the mask.

Now I'm setting it up and figuring it out, seems like a nasal mask would be easier to keep clean.
But what do I know..

Any tips on the specific equipment they gave me?
Thanks again..

 

There are surgical interventions now that can work for mild cases. Which are particularly helpful for the “can’t wear a mask or oral appliance” due to ptsd etc crowd. It’s essentially an outpatient procedure where electrodes are attached to your hypoglossal nerve (for the tongue) and based on your sleep study a device will “thrust” your tongue forward enough to open an airway but not wake you syncing up with what should be your normal sleep/ breathing schedule/rhythm. It’s pretty cool. Battery pack/receiver sits inside the chest (surgical placement). And control module lays on your chest as you sleep.

If this is too wild or your case too severe for this, ask your dentist about an oral appliance, particularly a somnomed fusion. They’re great. Patients have great success with them.

Pricey, so I have patients buy 2 athletic mouthguards. Top and bottom. See if you can wear those first, then I’ll make you the appliance.

 

Those Inspire commercials are what got me to finally do a sleep test.
Inspire Sleep Apnea Innovation - Obstructive Sleep Apnea Treatment

I have no idea if my insurance would cover it but it's roughly a $20K surgery from what I've read with no guarantee of results.

I'm missing some lower left back teeth from a mountain bike accident several years ago.
I looked into an oral appliance years ago and they said it wouldn't work for me because of the tooth loss.
Getting teeth back there is another 'project' I've been working on since I've been off work this year.
I got my preauthorization insurance EOBs this week and need to make an appointment with the dentist to go over them.
I have unlimited dental (no annual cap) so I'm a fool for not using it.

My insurance paid for everything today.
The place I got it from made it clear that the unit wasn't a rental, it now belonged to me.
BUT, in order for them to give me replacement parts when needed (masks, hoses, etc) I have to have a 70% usage rate.
The unit keeps track of how long per day and how many days I use it.
From what they said the unit reports it to them thru wifi somehow..

I just set it up and lay in bed for a few minutes.
It's not that bad.
I can't even hear the unit running next to me on the nightstand.
The hose comes off the mask easily so I don't have to take the whole thing off to piss in the middle of the night.
I don't watch TV in bed, although it wouldn't be a problem.
I can still put my reading glasses on to read in bed.

The dog was giving me the side eye, he sleeps with us and doesn't like change..
My wife doesn't even know I have the unit yet..

I guess my biggest concern now is the full face or nasal mask.
I'm not a mouth breather, but I have no idea what I do when I sleep.
Seems the biggest PITA is going to be cleaning the mask daily and everything else weekly.
That is going to take some getting used to..

 

@1lowlife There are 2 different types of obstructive sleep apnea. And they differ on the way your airway closes (centrifugal/circumferential or from the ventral side only). These devices/surgeries only work from a ventral collapse perspective. This information is obtained with a scope/scan. If you fit the criteria, lifting / thrusting your tongue lifts/removes the collapse from your airway and you’re essentially cured.

I don’t know much about “inspire” but I wouldn’t sign up for anything that doesn’t perform this scan as part of the diagnosis to see if this is right for you.

edit:
And yes, use your dental insurance. You’ve either earned it (military) or are paying for it in some shape or form. That said, insurances, particularly dental, are scumbags.

 

I have been using a CPAP for 2 years, I fought for 5 MONTHs and after I got over using the machine now I could not do with out it!

 

In all my research (I overthink everything ) I've yet to find one person that said CPAP didn't work for them.
Even the posts in this thread from users are all positive, as well as my family members.

I'll start it tonight and see what happens in the next few weeks.
I'm off work until the first of the year so there couldn't be a better time for me to try it..

Thank you all for your input.

 

Well, that sucked I got about 5 hours of interrupted sleep last night.
I fell asleep at 11, and woke up at 1 with a dry mouth and cheeks full of air.
Increased the humidifier and tried it again only to wake up again 2 hours later in the same situation.
Took it off and lay in bed until 8 this morning wide awake.

It seems when I go to sleep, my tongue is pressed to the roof of my mouth.
As I fall asleep and relax, my tongue relaxes and my mouth gets full of air and dries out.
My mouth never opens during all this.
I called the vendor today, she wasn't very helpful.
She said she can't see my reports until the day after the events which will now be Monday with the holidays.

I'll give it another shot tonight, but I don't see anything being different.

Does anyone have any tips?

 

I would echo this recommendation, especially if you are like me and feel like the Full face mask is suffocating.

 

Looking for a 12 volt power supply for my Resmed 10 or 11. Is this something you can help with. Thanks

 

I trued the full face mask and it was horrible, I switched to the nose pillows and am very happy with the machine now. Again I fought using it for 5 months! Now that I'm used to it, I could not live without it!

 

i had to lower the exhale resistance on mine. made it all the better.

youtube can show you the key sequence to get into clinic mode.

 

Resmed 10 power supply is 24V @ 3.75A.

You can use something like this 12V powered adapter (it's a DC to DC boost converter):

$30 Resmed Airsense 10 Supplies, CPAP Power Cord for ResMed Airsense 10 Power Supply AirStart 10 CPAP BiPAP Machines & AirCurve 10, Lumis VPAP BiLevel Series 90W ResMed S10 370001 DC Converter/Adapter

https://www.amazon.com/TAIFU-Vehicle-Airsense-AirCurve-Machines/dp/B07VV231SJ

The best bet is a Jackery 500 or something like that. In dry desert air, the humidifier is running, and it needs about 60W per hour (Jackery 500 is good for eight hours in those conditions). If I am camping on a humid night, it only needs 10W per hour, which is good for multiple days.

I have a ResMed AirMini for bike camping. Uses a funky "moisture capture device" for humidity control.
https://www.amazon.com/Pilot-24-Battery-AirMini-AirSense-Devices

Expensive 95W battery, so I would only use it with the AirMini. I have a fold-out solar panel, which can charge it in a few hours or sunlight.

 

I thought they made a 12v adapter which could be plugged into a cigarette lighter.

 

Been on CPAP for 15 years or so (using Phillips equipment). My question is technical (I'm a retired Mechanical Engineer), how does the system work and be completely quiet and vibration-free? There is absolutely no noise during operation and no felt vibration at all. Never seen anything like this in any other air pumping system.

Dan

 

I'll update this;
I gave the machine 2 months, on and off.
Every time I used it, I would wake up 1 to 2 hours later with a dry throat and nonstop air running into my nose and out my mouth.
I tried 5 masks, 2 nose pillows and 3 full face, air in the nose and out the mouth with all of them.

I even tried a sling to keep my mouth closed.
Worked great when I went to sleep, but as my face relaxed my mouth would open.
Tightened it one time so tight my teeth were clenched together, woke up 2 hours later with the airflow and my teeth hurting.

I never went back to the doctor.
I don't have any sick days left to take off work.
Might go back after the first of the year when I gain some more sick days..

Maybe this thing just isn't for me..
Glad it worked for some of you.

 

Yeah I have an airsense 11 resmed and use the f30 nasal masks. Works great but I use it only 3-4 times a week. Have a few months left till I own it. Phillips is under an active recall not sure I would want to use them.

 

Let me look through your posts and give you some answers. I wasnt getting notifications on this thread until a few days ago when someone messaged me.

 

You have a severe case of sleep apnea and sleeping on your back is the worst-case scenario. Supine sleep requires the most amount of air to keep the airway open. You got the APAP, and the machine automatically adjusts the pressure up whenever it senses that you need more pressure. I am guessing your doctor set the machine up the usual 5-20 cmH2O.
What is your age and BMI? Higher BMI = higher pressures. Age affects your airway dynamics and muscle tone = more pressure. Since you have tried the nasal masks and your mouth opens even with the chin strap on, you should stick to a FFM.
When you fall asleep, the machine increases the pressure and when it gets high it wakes you up either from a momentary leak or dry mouth. At high pressure, the humidifier can sometimes fail to provide an adequate amount of moisture or it can use up the water very quickly.
1.Try to elevate yourself in bed with pillows as much as you can but without making it uncomfortable. This way you will reduce the amount of pressure required to keep your airway open.
2. I can help you adjust the APAP range - limit it to 6-13. This way the machine will never go higher than 13. APAP sometimes goes crazy and increases the pressure too high and you wont be able to tolerate it. You can also try to increase the pressure to 13 while you are awake and see if you can tolerate it at all. If you can't, decrease it to 12, but if your BMI is over 35, 12 might be too little. We can do trial and error.
3. I need to see your face (you can send it via private chat) to be able to make a mask recommendation. AirTouch F20 is an excellent mask - its soft foam and its a pressure seal so it makes an excellent air tight seal. Will your cheeks keep getting full of air? After some time it will stop unless your pressures are very high.
4. If you keep waking up every 2 hours, but the pressure is not crazy high - trust the process. Without the machine your brain wakes up after every single episodes yet you wont remember it. 2 hours is about the time it takes you to finish the first sleep cycle - NREM and REM sleep. Either your machine goes crazy high during REM sleep, or the normal brief arousal after REM sleep is prolonged by you being unused to wearing the mask.
5. The machine itself should offer many answers to all of my questions. Do you have an app or a chip that you insert into the machine?

I reached out to you via private chat! Looking forward to helping you out!

 

My response is about a year late! Sorry! I wasn't receiving notifications.
I tried reading about PAP tech, but I am not able to digest any of it.
https://www.alibaba.com/product-det...html?spm=a2700.7724857.0.0.272c92d0d1Xdg5&s=p
Here is an example of what is used as PAP blowers. None of the machines I used in my life had any vibration or noise. You do hear the initial ramp-up or sudden pressure changes (in the case of BiPAP), but otherwise, it is super quiet.