Hi Donna,
I will try to answer these questions as you've stated them:
1) CPAP machine--where do you get it? At the hospital at his next (8/29) appt? Is it usually covered by insurances?
If that is the titration study, then no, you won't get the machine there. They only test him with a machine, and theirs is a bit different, for diagnostic purposes. You get the machine after that study. And it all seems to happen a little differently, the process. But the doctor should go over the results with your husband. Then the doctor prescribes the machine at a particular pressure. The machine requires a prescription, just like a drug. Then, how you get your machine varies, depending on your insurance. But you may be instructed to go to a DME (durable medical equipment provider) near you, a store that sells these. If so, he goes and the arrangements are made then. If he goes to a DME, have him ask to see the different types of masks, and if he can try them on (they may not let him try them on). Then, either the equipment is ordered and you pick it up, or it's delivered to you.
2) What if he has leaks at night due to rolling over? Can you keep trying masks until you get the right one for you?
Ask the DME provider for their policy. Also, if you have insurance, they should be able to tell you your insurance's mask replacement policy.
But I would insist on seeing the different types of masks. Getting the right mask is the biggest hurdle, and often it's a trial and error thing. Masks are like shoes, one shoe doesn't fit or suit everyone the same way. There are different types, and there are different brands for each of those types. He can always view the different types by going to
www.froogle.com (a division of Google) and search for cpap masks. Equipment can be purchased online, but for first time purchasers who have insurance, a local DME provider is often preferable because you get to see the masks close up and maybe even try some on. Have him ask if there's a short term exchange policy. Most insurance companies will pay for a new mask after a certain time, most are 6 months, but some are 3 months. Some people prefer specific brands even though they may cost extra. You might want to read the mask forum section here.
3) Hypoventilation-- what is this? Should he call the doctor about this now to make sure it is rectified at the next study?
I don't understand it much. But it's the opposite of hyperventilation (hyperventilating because of too much breathing); the lungs aren't ventilating enough or there is some difficulty. I really don't understand it, but ask your doctor. It shouldn't be necessary to know before the next study, but if he's interested, he could always call and ask.
4) He sleeps a lot on his stomach, should he get a firmer pillow to help with the mask?
That I don't know, but maybe just wait and see. You might search and read posts in our mask forum section to see what has helped those who sleep on their stomachs. Or you might post a question specifically about that, but you might do that in the main Help forum section, most people read that section. He ought to ask or read what types of masks best suit stomach sleepers.
5) I'm not sure what the difference is between BiPap and Auto Pap but I read on this board somewhere that if these are needed it must be written on the perscription. Do you think he will need one of these instead of the CPAP?
For most people, the straight cpap is fine. And yes, if a bipap or auto cpap are needed, it has to be specifically prescribed. What type he needs should be determined from his titration study. But if he meets with the doctor at an appointment after the titration study, he might ask about what type he should be getting. What type depends on how he breathes with the machine during the sleep study.
Some people like myself require a bipap. The cpap machine is prescribed one pressure. But a bipap is prescribed with two pressures; one for inhale and a lesser pressure for exhale. This is often necessary for people who require high pressures or have some other problem. Others, they can't determine a definitive pressure that controls the apneas consistently, and an auto is prescribed to handle that situation. But it all depends on the titration study and the doctor's interpretation of the results. With an auto, the doctor still prescribes a pressure, but has the machine set at a range around that number. The auto will adjust the pressure to the need at the moment. If his prescribed pressure is say 10, the doc may have the range set at about 7 to 13. Some parts of the night a pressure less than 10 is needed; other times a higher pressure is needed. But keep in mind, most people can use the straight cpap.
Oh, I don't know if I said, but most people should get the heated humidifier with their cpap machines. It's not required and some people do not need it. But I say it's necessary. But a heated humidifier has to be written into the prescription along with the cpap, in order for insurance to cover it. If he gets that, be sure that it's a heated humidifier and not a passover kind (no heat). The heated humidifier can be used as both heated and unheated, so he has a choice. And most people find they really need the heated humidifier because the cpap can really dry out the throat and nose.
I hope some of this helps.
Linda
