CPAP

[Mos Eisley]

I haven't done it too many times but...If you use water and roll over to the extent you pull the machine off the nightstand it's a real bummer. Water up the hose, in the tray, and on the floor. Sucks getting woke up by that and having to clean all that up. Luckily it's probably only happened 3 or 4 times in the 4 years I've had it.

 

[_CY_]

for those new to cpap and/or thinking about trying cpap .. do it .. go take that sleep study. for some it can be life changing and/or save your life.

the dirty little secret for cpap is compliance or the lack of .. for cpap to work you've got to actually use it .. everyone is different but generally one needs to use cpap for about 5 hours each night to be effective. you've got to deal with a foreign object attached to your face all night. then when you roll over, mask could become unsealed. air could be forced into your stomach, etc. etc. etc.

hopefully you can find solutions to all of above .. but it takes a bit of work to find it and you may not get the support needed before one gets so frustrated .. cpap mask gets ripped off your face because you just can't stand it. hence why lots of like new cpap/bipap machines on Craigslist.

1. commit .. get a sleep study .. preferably at a sleep lab that is willing to follow up with support
2. you can find loads of support at Apnea Board forum
3. go with an autoset cpap machine with data capabilities .. free sleephead software available so folks at Apnea board can help with solutions.
4. an autoset bipap can be easier to tolerate and could make a huge difference in compliance.
5. full face mask, nasal and pillows are the three options available .. don't give up .. you may have to try all three before finding one you can tolerate.
6. knowing how to control your cpap machine's settings can make a huge difference in compliance

reason an autoset cpap/bipap machine is preferred is simple .. a sleep lab can only provide a snap-shot in time for one night .. lots of factors can effect your pressure needs .. sleep positions .. clogged nose, etc. etc. an autoset cpap/bipap will change pressures on the fly.

a cpap machine provides a continuous flow of air at xx cm pressures to create the splint that keeps your airways open. when you exhale that positive pressure is still there. if you have trouble exhaling against that continuous positive air pressure (cpap) then your partial pressure of carbon dioxide (Pco2) in the blood can raise too high.

a bipap or bilevel machine detects when you exhale, then lowers pressures during exhale cycle. some newer autoset bipap machine can be set to mimic your natural intake and exhale cycles .. without question will be more comfortable to use and help with compliance. but due to higher costs your insurance company will not pay extra without a pretty darn good reason.

technology marches on and that's a good thing .. one of the newer data capable cpap machines has a bipap like function but limits drop to 3 cm during exhale. resmed airsense 10 autoset behave like a bipap limited to 3 cm pressure difference.

resmed aircurve 10 vauto is the auto bipap version if you can swing it .. it's got additional features that allows delivery of airflow to more closely mimic your natural breathing cycle for a more comfortable use.

 

[ConstitutionCowboy]

Don't know if this has been asked yet - - -Is it possible to get one without a prescription?

Woody

 

[DavidMcmillan]

How did you come to realize you might need this device or to do the sleep study? Surely y'all didnt do a sleep study for the fun of it. Did a doc recommend it? the wife? the dog?

My wife has told me for several years that she would hear me stop breathing for extended periods of time. I figured that if I started breathing again each time, I was good to go. Then after knee replacement surgery earlier this year, surgeon indicated the issue was serious.

 

[stick4]

You need a Rx for the sleep study. Based on results showing Apnea the Rx is not reqd to get the machine through a DME. You could buy your own CPAP machine off Ebay, Amazone, etc w/o a Rx.

Don't know if this has been asked yet - - -Is it possible to get one without a prescription?

Woody

I don't think you could get the sleep study w/o an Rx Woody. Machines are readily available but insurance won't pay w/o an Rx.

 

[_CY_]

Don't know if this has been asked yet - - -Is it possible to get one without a prescription?

Woody

that's a yes and no question .. a DME normally would require a prescription before selling a new cpap machine to you. but there are other options like craigslist but you'd better have done your research before buying. like know which specific machine to purchase and how to verify actual hours on machine. the safest is a current model auto bipap with low hours (under say 200 hours) like .. Resmed Aircurve 10 Vauto (autoset bipap)

it's always best to purchase new masks/nasal/pillow/hose which doesn't require prescription.
but procedure to sanitize masks/hoses, etc. are to place in 195f hot water for about 10 min.

you really need a sleep study to determine how bad your apnea problems is .. they will determine proper titration settings for your new cpap machine. even if you go with an autoset machine, the doctor at sleep lab will determine min/max parameters, etc. they will also determine if you've got central sleep apnea which is when your body forgets to breathe vs obstructive sleep apnea where say soft tissue collapses blocking your airway.

it's really best to start with following what a sleep doctor recommends!

 

[Old rookie]

The importance of the full neurological workup and history that is documented is vital. I would never, ever, recommend skipping the sleep study. There is just too much at stake. Sleep apnea technically is "cessation of respirations"....not a good thing to have less than full documentation about. IMHO.

 

[ConstitutionCowboy]

Thanks to all for the info.

I had a "sleep study" about 15 years ago but didn't 'qualify' for a CPAP. I could not fall asleep long enough or deep enough for what I would call an effective study.

Sometimes I would wake myself with a gigantic gasp for air with a snort that would scatter the cattle, so I decided to get a snore guard fitted at the dentist and I did notice a marked improvement in my sleep quality and quantity. My snoring stopped. I no longer felt the need for an afternoon nap, and didn't have to fight to stay awake.

Older now, and heavier, and with the snore guard wearing out and not holding my lower jaw out where it belongs, I'm slipping backward with sleep and beginning to have difficulty staying awake in the afternoon.

The cost of a good snore guard is now more than quadruple what I originally paid, and most of the prices on a CPAP machine are compatible with what I originally spent for that snore guard. This has prompted me to look into a CPAP machine.

I don't believe I have a neurological - CLICK - neurological - CLICK - neurological - CLICK - neurological - CLICK - neurological - CLICK - problem, though, so I'm willing to try out a CPAP machine.

Woody

 

[_CY_]

The importance of the full neurological workup and history that is documented is vital. I would never, ever, recommend skipping the sleep study. There is just too much at stake. Sleep apnea technically is "cessation of respirations"....not a good thing to have less than full documentation about. IMHO.

as a clarification about differences between central sleep apnea vs obstructive sleep apnea .. both reduces and/or stops airflow .. difference is how apnea occurs.

a sleep lab will use an air flow sensor to determine when air flow reduces/stops .. a chest senor monitors expansion when lungs are trying to move. if say air flow sensor indicates air flow has stopped without chest movement .. this indicates central sleep apnea or a lack of signal from brain to breathe.

if say air flow stops with chest movement indicating lungs are trying to fill but cannot. this indicates obstructive sleep apnea
a Pulse Oximeter or Blood Oxygen Monitor will track O2 levels. the sleep technician titrates air pressure levels until number of apneas hopefully goes close to zero. under 6 apnea events per hour is considered normal range.

bipap or bilevel machines that treats central sleep apnea acts like a ventilator, takes over breathing cycles and are very different from normal cpap and bipap machines. advanced ASV (central sleep apnea) machines are much more expensive and are NOT needed or desired to treat obstructive sleep apnea. this definitely a case where the more expensive machine is NOT better.

latest autoset cpap/bipap with auto titration and data tracking are hands down superior vs straight cpap/bipap where pressure(s) are set and doesn't change. note sleep lab will determine parameters autoset cpap/bipap will operate at.

confused ... don't feel like the lone ranger ... there's a slew of different model/mfg for cpap/bipap out there .. with trademarks keeping everyone from using same terms. for instance bipap is a registered trademark, bilevel is the actual technical term.

below are highly recommended models from Resmed for three different types of machines. I'm only showing autoset models which should be a first choice if budget allows. note Airsense 10 acts like a bipap limited to 3 cm pressure difference between inhale and exhale even thought it's considered a cpap. all three operate so quiet you can barely hear them (26 db)

Resmed Airsense 10 Autoset (CPAP)
Resmed Aircurve 10 Vauto (BIPAP)
Resmed Aircurve 10 ASV (BIPAP for Central Sleep Apnea)