Sleep Study tonight

DFH65 said:
I mean obviously you need to get a sleep study to satisfy the FAA but I would think the data from the machine could tell you a lot. Or am I wrong?
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It should give you data to discuss with your PCP, for sure.
 
Matthew said:
I think you found the trick. If the DIY study shows no OSA, maybe another sleep study will show the same thing. Then you might be able to drop the SI.
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[edited answer]

What I'm being told is that the take home test is exactly equivalent to the sleep center test for diagnosing OSA. And when you use it to get to talk to a real sleep doctor before and after the test.

If the take home test says you have OSA, you probably would need to go to a sleep center so you can be treated like a lab animal while they determine the CPAP machine settings that you need.
 
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DFH65 said:
Maybe some of the folks here would know. If you had an autoadjusting CPAP with good reporting couldn't it kind of tell you if you didn't need the machine anymore? I understand they have a min and max but if you were constantly at the min I would think you could talk to the sleep doc and have that dropped lower to get an idea of where you were at.

I mean obviously you need to get a sleep study to satisfy the FAA but I would think the data from the machine could tell you a lot. Or am I wrong?
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From day one my CPAP runs at the min pressure setting about 99% of the time. I record a very minimal AHI (OSA event index) level. Many mornings my machine is displaying a happy face (literally) when i wake up, because it recorded no OSA events at all.

As long as I'm using my CPAP, for all practical purposes I don't suffer from OSA.

What I don't know is what is happening when I am not using CPAP. The machine can't tell me that.
 
JimNtexas said:
What I don't know is what is happening when I am not using CPAP. The machine can't tell me that.
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That's easy... just count the bruises from your bed partner poking you to turn over and quit snoring.
 
Well, looks like they got enough info and an SI is likely in my future. Don't have the details yet they talked to my wife but I need to schedule the titration now. I will get that scheduled when they are open tomorrow. I can't say I wasn't expecting this outcome but was holding out a little hope.

In any case I am making progress to a resolution and a healthier life. Thanks for all your help.
 
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After 12 years using a "mask" I switched to the "nasal pillow". (rubber hose up your nose)

It initially seemed odd. But after getting used to it I will never go back to the traditional mask style.
 
Unregistered said:
After 12 years using a "mask" I switched to the "nasal pillow". (rubber hose up your nose)

It initially seemed odd. But after getting used to it I will never go back to the traditional mask style.
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I tried the nasal pillow about 15 years ago, but they irritated my nostrils. I've heard recently that a little Burt's Bees lip balm on the pillow inserts helps prevent that.

I've been using a Resmed Mirage and Mirage FX for prob'ly 5 years. The new "Tap Pap" nasal pillow has piqued my interest. No headgear - uses a form fitting mouthpiece to hold the pillow in place.
 
I suspect I will end up with a full face mask as I am a mouth breather but am open to try whatever.
 
DFH65 said:
I suspect I will end up with a full face mask as I am a mouth breather but am open to try whatever.
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A chin strap works for me. The theory behind the Tap Pap is that the mouth piece causes you to reflexively hold it in your mouth, reducing leakage. The users on OSA forums report that seems to be the case, but I haven't tried it yet.
 
Unregistered said:
After 12 years using a "mask" I switched to the "nasal pillow". (rubber hose up your nose)
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Oh! Oh! Mr. Kotter!!

vinny-up-your-nose_480x360.jpg
 
It took a month or two to adapt to the nasal pillow.... But now no problems "mouth breathing" Essentially, I had to re-train myself to sleep with my tongue at the top of my mouth and against my front teeth.

But they are more comfortable. The OPUS-360 mask is the one I use.
 
JimNtexas said:
Based on research I did , I had my GP add the words 'Resmed S-9 Autoset' to the prescription, because they got me a top of the line machine, not the cheapest POS the insurance company might deign to.
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Resmed S9 auto set is a great machine. That's what I use and have been very happy.
 
I don't have the full report yet my PCP's office wont give it to me until he reviews it. I did talk to the sleep place and on the bright side (if you can call it that) my AHI was 15 points less than when I had the test ten years ago and I moved from the Moderate-Severe category into the Moderate category so maybe the weight loss is working although I don't recall what I weighed then. Of course the AHI isn't the whole story as I guess the O2 level was getting fairly low at times which of course isn't good.

I talked to the insurance company and because I am on a high deductible they don't cover diddly nor do they have any agreements for reduced prices for equipment so I am on my own in that regard. As recommended I will likely try to buy the machine online and go to a DME for a mask. At least now I know what the pricing is like so can keep them honest. I don't mind paying a little more to keep local businesses around and for the personal service so long as it isn't over the top.
 
If we didn't already mention it, cpap-supply.com is one of the better online sources. Another one is cpap.com.

There are lots of blowers to choose from. As you check them out and read reviews, make sure to evaluate how easy it is to get the 90-day report off of the recording chip. Take note that some manufacturers like to "block" you from easy access by charging you for software and attachment cables. This is one reason I'm very happy with my DeVilbiss Intellipap machine. The reporting is FREE (see the report generator at www.intellipap.com click the help section to see some sample codes and report).

Be ready to purchase a few masks until you find the right one for you. The big push here is comfort so you don't brush it off in the middle of the night.
 
Oh, something simple to purchase...

There is a "luggage tag" you can purchase to hang on the carrying case that explains the CPAP is required medical equipment.

When I travel, I chose to have my blower as a carry on. This makes a third item with my roll-on case and backpack. Having the required medical equipment tag keeps the gate agents at the airport and the FA's on the aircraft from having a coniption fit because I have 3 bags.

It also serves as my "If lost, please return to..." tag.
 
AggieMike88 said:
If we didn't already mention it, cpap-supply.com is one of the better online sources. Another one is cpap.com.

There are lots of blowers to choose from. As you check them out and read reviews, make sure to evaluate how easy it is to get the 90-day report off of the recording chip. Take note that some manufacturers like to "block" you from easy access by charging you for software and attachment cables. This is one reason I'm very happy with my DeVilbiss Intellipap machine. The reporting is FREE (see the report generator at www.intellipap.com click the help section to see some sample codes and report).

Be ready to purchase a few masks until you find the right one for you. The big push here is comfort so you don't brush it off in the middle of the night.
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I think I put Mike onto DeVilbiss. I like it, small, quiet, a long warranty, and you don't have to buy anything extra for the reports.

If you go to a DME supplier you might not have to buy multiple masks. They may let you try and switch for no or a minimal charge. Mine did, but that was almost 10 years ago. Don't worry, they are still making money because of their markups.
 
I went on a "travel light" kick about five years ago. Most of my trips are 1-2 day. Picked up a Case Logic 21" Rolling Duffel. CPAP, mask, hose and toiletries go in the top compartment. I can lay the duffel on the TSA conveyor, zip open the top and lay the blower and qt. zip loc in a tray. Easy to repack after screening too. Another thing that I like about the duffle is that it can often squeeze between the over-sized bags that most people are stuffing into the overhead compartments these days.

I'm not sure you still need to take out the CPAP for screening these days. Seems like TSA most places I go don't seem to care.
 
Matthew said:
I think I put Mike onto DeVilbiss. I like it, small, quiet, a long warranty, and you don't have to buy anything extra for the reports.
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Another advantage of the DeVilbiss is the 12V input; uses a fairly simple cable for us campers. The ResMed S9 is 24V; IIRC, the ResMed 12V "adapter" is over 3X the price of the DeVibliss cable.
 
Looking at the reviews and discussions online it seems to come down to the Resmed S9 autoset and the DeVilbiss Intellipap sounds like a lot of experience with the Intellipap anyone using the S9? I do realize it is quite a bit more money?
 
DFH65 said:
Looking at the reviews and discussions online it seems to come down to the Resmed S9 autoset and the DeVilbiss Intellipap sounds like a lot of experience with the Intellipap anyone using the S9? I do realize it is quite a bit more money?
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The Intellipap that I use has a setpoint pressure. The machine will do what it can to keep that pressure constant. It does have the ability to ramp up to that pressure over about 15 minutes to give you a chance to get to sleep before it hits full pressure. This is a nice feature if you have a high setting, i don't use it. It also has a way to go to a lower setting when it senses you exhale. I don't use that either. These are pretty standard functions on most machines.

It looks lik the S9 has more 'features'.

A lot depends on your titration study. If you find out you just need 7cm (like me), pretty much anything will be OK since the lowest setting seems to be 5cm. If you find out you need something like 14cm then something with a more comfortable/smoother pressure transition might be nice.

Some cpaps can auto asdjust your pressure between a min/max. It senses apneas and adjusts pressures to minimize them. This is nice if you need more pressure when sleeping on your back than you do when sleeping on your side. Mine doesn't have that either.
 
I have the S9 and like it. It's cool looking and seems very sophisticated. If you put it into clinician mode you can do a lot of customization. For example, I have the heated hose, which is nice, it keeps my nose from freezing. Using clinician mode you can set the relative humidity separately from the air temperature, which is a nice touch.

I really like the auto-on feature, just put on the mast and blow, and it turns on.

One tip: set a pretty short ramp up time. The supplier set my machine to take 20 minutes to ramp from 4 to 8cm of pressure. I was sufficating for most of that time. I quickly changed it to ramp from 6 to 8 in five minutes, and then just turned the ramp off. My machine is set to go from 8 to 20cm as needed. As I mentioned, it rarely goes much above 8.

The S9 records a lot of data, and works well with the 'Sleepyhead' open source software.

For having such advanced hardware, it's amazing that the Resmed software is one of the most horrible windows applications I've ever seen. It seems to be a Windows 3.1 program.

When you go for your SI the FAA wants to see your usage for the last 31 days. It's almost impossible to generate the report that the FAA wants using this software. It took me and DME guy about an hour to finally get it to report anything but the first 30 days of usage. Words cannot describe the horror that is the ResMed windows software.
 
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JimNtexas said:
.For having such advanced hardware, it's amazing that the Resmed software is one of the most horrible windows applications I've ever seen. It seems to be a Windows 3.1 program.
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My first blower was a Fischer-Paykel, and it's software was also crummy. I got it in 2008 and when I needed the download cable in 2010 for my first FAA Medical, it was only a serial interface (D9? connector). Software was expensiive for the crude thing it was and only just to download the data.

So I agree... for the sophisticated machines many of the CPAPs are, they sure have crummy report generators.

(And yes, Matthew gets the credit for suggesting the DeVillbiss to me.)
 
Sorry for the thread derailment, but I'm curious about something. I understand that when they do a sleep study, they hook a bunch of wires up to you. Well, what happens when you have to get up to go to the bathroom?
 
Unregistered said:
Sorry for the thread derailment, but I'm curious about something. I understand that when they do a sleep study, they hook a bunch of wires up to you. Well, what happens when you have to get up to go to the bathroom?
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You may not be there long enough for that to be necessary. However, there is a multi-pin connector for all the wires. In my experience, they wire you up sitting in a chair and, once you lay down they connect the two cables together. If you must have a break, they can just disconnect the two cables.
 
Papa Foxtrot said:
You may not be there long enough for that to be necessary. However, there is a multi-pin connector for all the wires. In my experience, they wire you up sitting in a chair and, once you lay down they connect the two cables together. If you must have a break, they can just disconnect the two cables.
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Correct. But you usually need the assistance of the technician conducting the study to do the disconnect.
 
My tech told me to remove the pulse oximeter from my finger as a signal that I needed to get up. Getting disconnected from the wall isn't too big a deal.
 
Papa Foxtrot said:
You may not be there long enough for that to be necessary. However, there is a multi-pin connector for all the wires. In my experience, they wire you up sitting in a chair and, once you lay down they connect the two cables together. If you must have a break, they can just disconnect the two cables.
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For me all the wires connect to the box and the box connected to the wall in a cradle. When I needed to use the bathroom they would come in pull the box off the wall and I would just walk to the bathroom. When I was done I would sit on the bed and they would come back in and plug it back in.

Heading in tonight for the titration. I need to find a DME to supply the mask. What a pain that is how do you know who is good?
 
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Matthew said:
My tech told me to remove the pulse oximeter from my finger as a signal that I needed to get up. Getting disconnected from the wall isn't too big a deal.
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My first sleep study, I knocked the pulse oximeter off my finger. They came pretty quick! :D
 
Papa Foxtrot said:
My first sleep study, I knocked the pulse oximeter off my finger. They came pretty quick! :D
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My first, I needed to go to the bathroom and sat up suddenly enough to spook the tech. He thought I was sleep walking.
 
DFH65 said:
Heading in tonight for the titration. I need to find a DME to supply the mask. What a pain that is how do you know who is good?
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Figure out which one wortks with your ins co, ask about cash discounts (depending on deductibles, ...), ask about return/exchange policies, and ask if they have different brands and styles to choose from. My study provided a mask for the test.
 
Matthew said:
Figure out which one wortks with your ins co, ask about cash discounts (depending on deductibles, ...), ask about return/exchange policies, and ask if they have different brands and styles to choose from. My study provided a mask for the test.
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Especially with masks, return policies vary widely. Be sure to ask and understand your options.
 
Pretty much everyone I called had a 30 day return policy. Seems like all the places around here either deal in resperonics or resmed. Because they had the resmed what an s9 cost $1300:yikes:
 
DFH65 said:
Pretty much everyone I called had a 30 day return policy. Seems like all the places around here either deal in resperonics or resmed. Because they had the resmed what an s9 cost $1300:yikes:
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That's why you mail order the machine. You really do need to get a proper fitting on a mask, though, and that means a trip to a DME supplier - preferably one who will let you exchange masks until you find one you like.
 
Matthew said:
Figure out which one wortks with your ins co, ask about cash discounts (depending on deductibles, ...), ask about return/exchange policies, and ask if they have different brands and styles to choose from. My study provided a mask for the test.
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The sleep study place provided masks for the test I asked what they had and she said all kinds. My guess is when people return masks they don't like they probably end up being sold at a big discount to the sleep study places. But that is just a guess on my part.
 
DFH65 said:
Pretty much everyone I called had a 30 day return policy. Seems like all the places around here either deal in resperonics or resmed. Because they had the resmed what an s9 cost $1300:yikes:
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This was similar to my first encounter with the DME's. After totaling what my insurance co paid and my out of pocket, my original machine was price was easily 3x what mail order was.
 
AggieMike88 said:
This was similar to my first encounter with the DME's. After totaling what my insurance co paid and my out of pocket, my original machine was price was easily 3x what mail order was.
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On my last trip to the sleep center(~2 mo's ago), I inquired about a replacement machine - my ResMed S8 only records compliance. The tech told me that all their machines just record compliance and they cost approx. $1,700.:hairraise:

I asked for(and rec'd) a prescription...
 
Papa Foxtrot said:
I asked for(and rec'd) a prescription...
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And that's an easy thing from your PCP.

When I needed the new machine, I stopped by my doc's office. While I was explaining the the counter gal what I was there for, my doc walked out of an exam room to give her something. He greeted me, asked how I was doing, and then immediately wrote out the 'scrip after I told him what I was there for.
 
Well I made it through the second night. Not too bad actually I slept much better(I thought so anyway).

Observations:

I am a mouth breather so getting used to the nose mask was a bit of a pain. The whole not being able to open your mouth and take a breath is a bit frustrating.

I also felt at times like I had to work to exhale against the pressure so that was a little annoying. I understand the newer machines can lower pressure on exhale.

The nasal mask they used gave me a sore on my nose. I tried adjusting it several times but with all the other wires I couldn't get it just right.

For the last half hour or so I tried a full face mask and liked it but it has it's own quirks (cheeks puffing up). Thinking I will need one of each anyway for those times when I am stuffed up.

I had a fairly vivid dream that my mask was filling with water and I was having a hard time getting it off. Shortly after that I woke up to go to the bathroom. Not sure what that means. :dunno:
 
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