Hi guys,
I am so excited to finally get my machine.  I took the day off to go the class on how to use the machine and I couldn't wait so I took a nap today for an hour and knocked out hard using my machine.  They didn't give me the top of the line machine but I can't really complain because it was free.  I got a standard machine with built in humidifier.  Its in the other room all set up and my hubby is sleeping so I don't want to disturb him but I believe it is a Respronics or something like that.  Its new not used.  It is set at 11 and there is a ramp so that makes it easier for me to get used to at the beginning.  It isn't data compatible and won't give me any info about what happens each time I use it except for the hours I slept but that is ok with me for now.  I can always trade up right?  The mask is the one that I used at the sleep study and it must be ok because I slept like a baby at naptime.  If it starts to bug me I have an exchange policy so that is good.  
Overall, I feel so glad to finally get the party started.  Thanks to all of those hoseheads out there that gave me advice while I was ready to flip out at a moments notice because I had to wait so long and the doctor kept me in the dark.  I never did find out how bad I have it because I am still getting flack about getting the results of the sleep studies.  It seems like it is going to be a long process.  The lady at Apria said that she didn't have my results but my doctor wrote that I had an apnea episode 20 times per hour.  That isn't so bad is it?  I was thinking it was worse.  Anyway, that is all I know for now.  Thanks again for everything.  I will post tomorrow about how my first night went.  Hopefully more good news.
Michelle

am  happy for you, it may help to soak mask and airhoise in warm water and detergent to get rid of any chemicals left over from making them

the number of apneas per hour isnt all that important, Ive never been shown much data either

a common problem is breathing thru mouth with a nose only mask, this needs to be checked for as it stops all benefits, usually causes very dry mouth and tonuge, regardless of humidifier


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resmed S6 lightweight, respironics comfort gell mask using CPAP since 1995, no humidifier
during my many years of severe fatigue, no doctor ever asked me if I snored

Ah, CONGRATULATIONS, Michelle! I hope you slept really well last night!

As far as getting a print out of the data from your sleep evaluation and titration, just send a written request and tactfully remind them you have a legal right to those copies under HIPAA (if you are in the USA - I am assuming you are since you mention Apria). You want not just the doctor's dictated results (1-2 pages each) but also the full scored data summary report w/condensed graphs (5+ pages each). Keep a copy of your written request includng the date on it.

An AHI (apnea/hypopnea index) of 20 would indicate you endured a combination of 20 apneas and hypopneas per hour durng your sleep and that is considered moderate OSA. 5-15 would be considered mild OSA, 15 to 30 moderate OSA and >30 would be considered severe OSA.


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Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

Hi all,
It didn't go as smooth as I had hoped but I am keeping a positive attitude.  After reading many of the newbie posts over the last few weeks I think I did pretty good last night.  I slept for six hours with the CPAP running.  I hit that ramp button quite a few times but thats ok.  I pulled it off at 5am for my last hour of sleep because the sides of my face and ears were sore and so was my nose, chin and forehead.  I think I need a new mask.  I was able to get on my stomach which I thought would take some practice but once in a while it would leak.  
Anyway, we shall see.  I feel pretty good this morning.  
Yippeee.
Michelle

Crohnie has taken my words out of my mouth....congrats.

What mask did you get?  it should not be hurting..it may be on too tight.  As for the machine..not to pry..but does your insurance cover your machine 100%...if so it is not free...you pay for the insurance one way or another.  If you mean free because you are getting financial assitance to get it then I can understand.  Keep in mind..a machine can NOT be traded up...once it is yours it is yours.  The data is very important.  I have the same DME...my local place is greeat..but they tried their darndest to get me to take a basic.  Used every excuse in the book..but I got the one I wanted in the end.  As said before..the price of the machine has nothing to do with it..it is the capabilities.  The machine you have will deliver you good therapy...just that you have no way in knowing if all your effort and wearing the machine everynight is making any difference..the only way you can gauge it is how your feeling..nothing that you can llok at and say..."geekers, I thought I had the mask on right and getting no leaks but the machine has told me that I have a 60% leak rate..no wonder my AHI was soo high last night."

You still have time to try and get a data machine...if you have insurance..the billing code is all the same and insurance will cover it.

with all that said...again..CONGRATS!  I have been wondering how it went for you


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CLICK HERE FOR MORE INFO~ http://tinyurl.com/69q52a

BiPAP Auto M 13/8 Mirage Nasal Swift. 20 years+ undx'd. RLS/PLMD, Hypersomnia & more.

Hi there Mrs. Rip Van Winkle,
When I said I got it for free what I meant was that I didn't have to pay any out of pocket costs.  I am a teacher and get free insurance (nothing is deducted from my check) and my husband is a Teamster and has the same HMO so I am double covered.  
I asked them about the data capable machine and they said that this machine was what my doctor ordered.  There was a room full of people at the same class who looked at me like I was a kow it all asking for the moon.  Whatever... at least I have one.  I have waited so long to get one I am happy.  I guess I won't miss out on what I never had.  Haha.
As far as the mask goes it was really uncomfortable last night.  Maybe I did have it on too tight.  My ears were getting numb and my forhead and nose hurt.  I finally pulled it off at 5am and whats funny is after that I heard myself snoring.  The plastic is so hard and its a full face mask.  The mask says ResMed on it and the CPAP is a Remstar Plus M Series with the built in humidifier.  I am happy that I got a ramp and hit it several times last night.  Oh, I made sure that I got one that stops blowing when I exhale.  
I don't know if what I got is ok or not.  I do know that I felt a bit more energy today than usual.  I hope to get a better night sleep tonight and since I don't have to work tomorrow I am going to try and sleep in with my machine.  I will fight the urge to throw it across the room.  haha.
Thanks so much for your help.  I will check into a better machine and mask if you think I should.
Michelle

You will get as good therapy w/the Plus as you would a fully data capable CPCP, but, I would think that as a teacher sooner or later curiosity would get the best of you and you would regret not having a fully data capable CPAP.

As far as the mask: give it a week and try adjusting the fitting for comfort as well as no or few leaks. If you can't get comfortable and relatively leak free then you might want to consider trying another.

Are you and your husband in that HMO because you have no choice of other insurance coverage or did you both choose to go w/that HMO? Are they family or individual coverages? I would think that if they are both employer provided family coverages you might be better off w/two difference insurances. Just guessing 'cause my health insurance has always been thru my parents or my husband. I never had any on my own.

And, by the way, your insurance coverage is NOT free, even if it is totally employer paid. You gave up wages per hour to get that "free" insurance coverage. "Wages" you didn't have to pay income tax on.

My husband was an Electrician for General Motors and my best friend's husband was an Electrician for the IBEW (International Brotherhood of Electrical Workers). They used to get into friendly discussions all the time about the "disparity" in their wages. IBEW elections made mucho more $$$ per hour than the GM electricians - BUT - they paid toward their own insurance, retirement, etc. whereas the GM electricians got "free" insurance and retirement, etc. They always figured that it evened out and that they made about the same per hour when everything was taken into account.

Now, of course, w/GM renegging on that "promise" (union negotiated benefit) of paid health insurance and even retirements ... and starting new hires at drastically reduced wages and benefits ..... the IBEW was the smarter of the two Unions! I have a daughter who is a salaried Engineer for GM and salaried employees' health benefits have been DRASTICALLY cut. We've never discussed her retirement benefits.

You don't get nuttin' fer nuttin'. Santa Claus is dead. You are better off in the long run if you get the higher wages and develop the discipline of providing your own health insurance and retirement benefits. You can NOT rely on your employer, your union OR our government, you can ONLY rely on and provide for yourself. No one else has a more vested interest in you and your welfare than you!


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

  People probably looked at you like a know it all because they had no clue..and you DID in fact know more than them.  I have a neighbor on CPAP..had it a long time..had no clue that there were different machines out there..including APAP and BiPAP's...Many people do not know that there are choices in masks either..if they are shown only one mask then they figure that's it.  I know in the beginning I thought there was only one machine and one mask...I have now learned better.

You may want to search and see which of the Resperonics M series machines is data capable with an LCD screen to read your AHI amd Leak rates.  You probably still have time to call the DME and tell them that you want to buy that machine verses the one they chose for you.

Yep..you pay for your insurance one way or another...Benefits are part of the pay package.  Your insurance does not pay the DME for a machine by Name Make and Model.  It is doen through a billing code..all CPAP's/APAP's are under one billing code therefore the price paid out by your insurance is the same.  SOme insurance plans allow the DME to charge you OP above and beyond the basic pricing.  I know my insurance does not allow a provider to charge a patient above the contracted price.

Curious to know the exact mask you have..once known, others who have the same mask may be able to help you with it.


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CLICK HERE FOR MORE INFO~ http://tinyurl.com/69q52a

BiPAP Auto M 13/8 Mirage Nasal Swift. 20 years+ undx'd. RLS/PLMD, Hypersomnia & more.

Hi all,
I started out a few days ago with a ResMed mask.  I don't know what kind I got because when I went to the class they had us pull everything out of the boxes and bags and leave the trash there because they gave us a nifty carrying case.  Whatever kind of Resmed mask it was it was really hurting me and my eyes are burning.  I was getting leaks all night long and when I tightened the velcro my head started to get numb and my nose and forhead hurt.  
Its funny what lack of sleep can do to a person along with the crazy notion that I was going to wake up this morning with so much energy that I could run a marathon.  I drove over to Apria walked in and cried.  haha.
The nice lady took pity on me and gave me a new mask which felt better sitting in the chair but who knows what will happen tonight when I sleep.  At least I have two now to work with.  She gave me the Respronics comfortgel full mask with SST flap whatever that is.  It seemed to fit better around my nose and it didn't seem to stick out so far and I am a side/stomach sleeper.  
Gosh, I feel like such a bitchy complainer lately..... I keep crying and eating.  Haha
Thanks to all of you that have patiently guided me through this lately.  I will hang in there.
Michelle

Michelle, CrohnieToo and Mrs.RVW are very experienced and know whereof they speak.  I don't have sleep apnea but I get to see my husband's experiences and I know that adjusting a mask is a slow process.  You may need to make small adjustments and try them out before you get it right.  Don't get discouraged!

One thing I do know from my husband's experiences.  It sometimes helps to change the tilt of the mask by loosening the top and tightening the bottom - but just a little at a time.

Michelle, have you seen Crohnie's fitting tips in the sticky on Machines and Masks in the Mask section?  Very comprehensive!

Guys... I need help.  I put it on the sleep study board but I am wondering if you guys can take a look at my sleep study results that I finally got last night?  I pestered my doctor for so long for it and now I have no idea what it all means.
Im a little scared because it says that I have more central apnea than obstructive.  Then I looked up central and it says that it usually happens in very ill people or people on drugs which I am not.  Can anyone take a look and tell me what it all means especially the central apea part.  Is this common?
Thanks again,
Michelle
FINDINGS: Diagnostic Polysomnogram (PSG)
Stage 1 4%
Stage 2 73%
Stage 3 / 4 14%
REM 10%

Central Apneas 49
Obstructive Apneas 41
Mixed Apneas 5
Hypopneas 36
Total Respiratory Events 131

Total Recording Time (minutes) 485.9 min. (8.1 hrs.)
Total Sleep Time (minutes) 388.0 min. (6.5 hrs.)
Total REM Periods 2
REM Latency (minutes) 194.0 min. (3.2 hrs.)

Sleep Efficiency Index 90%
Sleep Maintenance Index 89%
Apnea Index 14.7
Apnea / Hypopnea Index 20.3
Apnea / Hypopnea Arousal Index 20.1
Longest Apneic Event (seconds) 28.0 sec.

Snoring Level (1 = Mild : 5 = Severe) 1 - Mild
Relative to Body Position No
Relative to Respiratory Events Yes
Myoclonic Index 0.8
Myoclinic Arousal Index 0.3

Baseline SaO2 94%
Lowest SaO2 89%, Stage 1

Cardiac Minimum (bpm) 54 bpm-NREM, 76 bpm-REM
Cardiac Maximum (bpm) 114 bpm-NREM, 103 bpm-REM
Cardiac Average (bpm) 80.8 bpm-NREM, 89.7 bpm-REM



This nocturnal polysomnographic sleep study showed evidence of
mild snoring. It also showed evidence of mild to moderate
obstructive sleep apnea with desaturations and arousals.
The patient will be rescheduled for auto -CPAP-titration.
The EKG recording showed no abnormal rhythm .
Also of note was a myoclonic index of <10 on CPAP. Clinical
correlation for possible PLMS is not indicated. If there are any
questions regarding this patient, please contact us at the Sleep
Lab.

I am in a hurry right now and will come back to this..but I needed to say:  How can they say it is Obstructive Apnea when it clearly shows centrals and a few mixed in there!  I know off a few that the Dr automatically put them on regular CPAP or APAP when they should of had a better machine.  Granted..one has to fail CPAP sometimes to get a better BiLevel for the centrals..and if the centrals do not show up during the titration then it can prove on paper at the time of the titration that they were being treated..but IMHO down the road they may be problematic.

Do not freak out over the centrals and what you have read as being very ill or on drugs...it is not a s grave as that.  It is concerning but think of it this way...you have lived this long without any treatment for the SA.

I will try to come back to this later on..if someone else does not go over it.  I am not as good at reading the studies as many others are.  But will take a stab at it if needed.  (basically I need to remember what the normal time in the  sleep stages are and figure out the BPM) I can tell you now..your O2 was good.  Dipped a little but still good..xPAP will bring your lowest right up...the baseline is pretty normal..nice to be over 95...mine stays around 92 for the baseline.


_________________

CLICK HERE FOR MORE INFO~ http://tinyurl.com/69q52a

BiPAP Auto M 13/8 Mirage Nasal Swift. 20 years+ undx'd. RLS/PLMD, Hypersomnia & more.

I have been worried all day at work.   When I got home the first thing I did was check the site to see if anyone commented on my post.  THANK YOU very much.  I am really scared.  Looking forward to hearing what else you might think and what anyone else might have to add.  


Michelle
Chronie and Daniel....... you out there?????  HELP...haha

Quote:

Stage 1 4%
Stage 2 73%
Stage 3 / 4 14%
REM 10%

Stage 2: This stage occupies 45 to 55% of total sleep..yours is high...

REM: Ttypically is about 20% of sleep time for the non Apneiac Person and take a person about 70 to 90 minutes from sleep onset to enter REM.  Yours is only half of the time needed....

Stage 3/4: Is very low...

So, it looks like you have a hard time staying in REM and Stage 3/4..This is what is considered arousals and are usually brought on by apneas, hypopneas or leg movements.

Quote:

Central Apneas 49
Obstructive Apneas 41
Mixed Apneas 5
Hypopneas 36
Total Respiratory Events 131

Pretty much self explanatory...  As you said..you do have a few more Centrals than Obstructive..plus you have a few Mixed/Complex.

Quote:

Total Recording Time (minutes) 485.9 min. (8.1 hrs.)
Total Sleep Time (minutes) 388.0 min. (6.5 hrs.)
Total REM Periods 2
REM Latency (minutes) 194.0 min. (3.2 hrs.)

You entered REM  twice..normal is 3 to 5 times

Took you over 3 hours to reach REM..most take 70 to 90 minutes to reach REM...

Quote:

Sleep Efficiency Index 90%
Sleep Maintenance Index 89%
Apnea Index 14.7
Apnea / Hypopnea Index 20.3
Apnea / Hypopnea Arousal Index 20.1
Longest Apneic Event (seconds) 28.0 sec.

AHI 20.3..of which 20.1 times the event took you out of a sleep stage into a lighter one..or woke you.
The longest time you stopped breathing was for 28 seconds.

Quote:

Myoclonic Index 0.8
Myoclinic Arousal Index 0.3

These are jerks in the body...sometimes called Periodic Leg Movement Dissorder (Syndrome)  AKA.. PLMD/PLMS.  This often happens in Stage 1 sleep.  They are not too concerned with it...yours was mild and most likely will go away once on xPAP.  If it was worse then you would need meds for it.

Your O2 dipped below 90 but that is not bad ccompared to many with untreated SA...some have gone into the 50's..mine went as low as 83.  This is usally during your longest event (the 28 seconds)

As for the Cardiac stuff...I am not sure on it.  They would have mentioned it if it were a problem...hopefully others will go over this stuff too...I am pretty confident in what I came up with..however, If I am misguided I welcome others to correct it.

I would really talk to the Dr about the Centrals and Mixed...  I would be most concerned if they scripted a CPAP or APAP...I would want a VPAP or BiLevel...similar to what WhiteBeard has and a few others.

SO you have Moderate SA...I hate to say Obstructive...I can see if you had only a few Central events..that would be probably due to an obstructive event playing games with your brain.

Many things can cause Centrals..meds, other conditions, neurological problems, neck injury..or you could have been born with it....I have also heard that Obstructive Apnea that has gone for a long time untreated can cause it...don't know the accuracy of that though.

Best of luck..probably by the time I finished typing this you have tons of replies ...LOL.


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CLICK HERE FOR MORE INFO~ http://tinyurl.com/69q52a

BiPAP Auto M 13/8 Mirage Nasal Swift. 20 years+ undx'd. RLS/PLMD, Hypersomnia & more.