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Going in for my CPAP next week...what should I know?
I was diagnosed with moderate sleep apnea and have an appointment scheduled on the 10th with a sleep specialist to get setup for my CPAP machine. I was wondering if anyone would like to share any advice on what I should expect and perhaps any questions I should ask? I dont like going in unprepared and then getting home later only to realize I should have asked something that I just didnt think about at the time. Thanks!
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Replies to This Discussion
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Permalink Reply by Mary Z on
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Nicole, I think the most important thing to is get a data capable machine- one that can give your leak and AHI (the newer machines give much more data). You do not want a machine such as the ResMed Escape that only gives compliance hours (hours you used the machine) The reason for this is that should you want to follow the effectiveness of your therapy AHI is the best number we have at present to show if your therapy is working, and leak information is always helpful. AHI should be less than five. You also want to be fitted as much as possible with a comfortable mask. The tech who gives you the machine is not going to show you (in all probability) how to get to the data. For you to access the clinical data it must be enabled, at least on my S8, on the clinical menu which I had to learn to do myself.
You also want to know the pressure prescribed. If seeing the doc ask for copies of your report. I was satisfied with the docs written report, some people want more. I feel like this can be taken care of later.
Write down your questions so you don't forget anything.
If you're seeing the doc before you actually get your machine, tell him/her that you want a data capable machine and have the prescription written that way.
You are always going to have new questions, hopefully your equipment provider will be available to you. Try to cultivate a relationship with one person and emphasize that you want to be involved in your therapy and learn as much as possible. We are always here and can answer many questions.
Read the FAQ and as many articles from the main page as you can, Nicole. It will help if you become familiar with the glossary of terms.
Good luck, keep us posted.
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Permalink Reply by Chris H on
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Hi Nicole, Their are many different masks. You can swap out the first 30 days till you find the best fit for you. A heated humidifier is also helpfull. Good Sleep,Chris
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Knowing what I do now here's what I woud have asked "back then":
1] Call my insurance (if Medicare, call secondary insurance) to ask what local DME CPAP providers there are contracted with (the more options the better bargaining/negotiating position)
2] Request not just the doctor's dictated results but also the full data summary report w/condensed graphs (the longer you wait to request the more difficult to get) ffrom each in-lab PSG and my equipment order (prescripton) or copy of my equipment order.
3] Ask that the phrases "access to Leak, AHI and AI data" and "full face, nasal cushion, nasal pillows or oro-nasal mask of patient's choice" be included on my equipment order (script).
4] Ask what my titrated pressure is and the name of the mask I used during the PSG
Keep in mind that YOU are paying for this equipment; whether thru insurance or out of pocket is immaterial, YOU are paying for it. Most all insurances, including Medicare, reimburse for CPAP by HCPCS (insurance) code NOT by brand and model. Both CPAPs and auto-tItrating PAPs (APAPs) are the exact same HCPCS code: e0601. You should have your choice of either despite the APAPs cost the local DME providers more than the CPAPs.
You should feel comfortable w/the local DME provider staff you will be working with and they should offer a lenient mask exchange policy. The three major mask manufactures will replace FREE to the local DME providers any of their masks patients have tried and been unsuccessful w/IF the local DME provider fills out a form and return the form and mask W/IN 30 DAYS.
DO NOT BE BASHFUL about shopping your various local DME provider options to find one you like and are comfortable with. This will most likely be a long term relationship (unless you opt to buy some accessories online out of pocket as you gain more experience).
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Well heres my update...
I went and picked up my machine yesterday. I had called my insurance company beforehand and was informed that the machine that I was getting was the only one they were covering me for at this time. Of course I was free to purchase any machine I wanted if I paid for it in full myself. Gotta love insurance companies right? I was given ResMed Escape S9 and wasn't surprised. I didn't get to see a doctor because his next available appointment isn't until January 11th. Wasn't surprised there either. The tech did fit me with the smallest size full mask since I suffer from chronic sinus infections and breathe through my mouth some of the time. I was shown a video, given a quick overview of how everything works, paid my $140 dollars for the first three months and sent on my way. When I got home I called back my insurance company to see if there was a different doctor that I could actually see before January and there isn't. This one is it.
As for the first night of use...I did everything I was supposed too. But it wasn't easy or restful. I wasn't surprised there either. I finally feel asleep after 1am sometime. I did spend quite a bit of time adjusting my mask becasue one I laid down it kept feeling like it was squeezing my nose down and closed. And of course the one thing I forgot to ask about was what to do for a bathroom break. Might sound silly but I seriously had no clue. So when 5 am rolled around and I woke up I debated for about 10 mins on what to do. I gave up took off the mask and knew I was not going to be able to fall back asleep. I know all this will take some time to adjust too. And I'm not going to give up. But it is very frustrating. Thankfully my husband was pretty understanding about the whole night.
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Nicole, what I do for a bathroom break is to disconnect the hose from the mask and leave the mask on. Wearing the mask and getting it adjusted correctly takes some practice, so I'm not surprised you had some trouble with that last night. It should get easier as you go along. One of the main things to remember is that tighter is not better when it comes to stopping leaks. I wear my Total FM fairly loose.
Sorry about the Escape- you won't have data capablities, but if the insurance company stonewalled you there's not much you can do. It's a fine machine, just lacks that feedback data. The price was right! My 20% of my S8 is over $100.00/month.
I'm glad the husband is supportive. We hear about some that are not, but it's your health at stake and if you snore it should be nice for him not to have to listen to that.
Keep posting and keep us posted. I hope it goes smoother every night from now on.
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Nicole, Mary is right about he toilet break, I also put my mask on first, then plug it into the hose, then turn it on. If you get leaks two suggestions are use mask liners and get you hose above your head, you could be one of the lucky ones that get it working after a couple of nights. Good Luck.
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Hmmmm. Did your insurance company actually say that particular brand and model ? Did the insurance person you talked to understand that several different brands and models fit the one HCPCS (insurance) code? Is your insurance an HMO? Outside of an HMO insurance I've not heard of any insurances that only pay for one particular brand and model CPAP.
Which full face mask do you have? Hanging your hose above your head an eliminate that pulling the mask down your nose. You are aware that you should be laying down w/your CPAP turned on to your set pressure or 10 cms which ever is higher when fitting your ask, aren't you. Our facial tissue is subject to the laws of gravity juast as everything else. The "shape" changes when we lay down from where it was when we were sititng up. Assuming you are like most of us you don't sleep sitting up.
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My insurance company is TRICARE through the military. I spoke to two different claim people and they are the ones that gave me the info for which model I had been approved for.
The mask I have is the Quattro FX. The tech who showed me everything never said anything abouy laying down first to fit the mask on but after reading some tips on this site yesterday I did try that last night.
It was a slightly better night but I still struggled to get comfortable enough to fall asleep. Once I did I woke up about 4:30 am because my mask was leaking. I move around so much at night and Im a side sleeper and I just seem to keep knocking the mask around to much. But if I tighten it anymore it starts to hurt. It just doesnt feel like it fits well enough around my nose.
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Drop in an join the apneasupport.com forum. Check for a "Sticky" for the military. There are quite a few posts by those dealing w/the military and CPAP, active duty, retired, etc. Some are routinely provided w/fully data capable CPAPs from the get go w/o asking thru those like you being provided w/just an entry level, compliance data only CPAP. It seems to vary greatly w/the area you are receiving VA or TriCare benefits.
There should have been some literature that came w/your Quattro FX, including a CD if I remember right. Read the literature, watch the CD. There is a trick to getting a leak-free fit at the bridge of the nose w/these really thin mask cushion "covers" and if I remember correctly the Quattro FX is one mask that they advise fitting sitting up and THEN re-fitting whilst laying down w/pressure turned on. Its been so long and I've been thru so many masks I don't really remember for sure.
It just so happens that the Quattro FX has become my favorite full face mask - but - that doesn't necessarily mean it will be the best one for you. Because it is so light weight and doesn't have a forehead brace its quite a popular mask.
The full face I had tried before the Quattro and been quite happy w/was the ProBasics Zzz-Mask. It was lightweight, no forehead brace, but a simple cushion mask which, for me at least, seem easier to fit, especially around the eyes and bridge of the nose.
I have found that the Quattro FX works MUCH better for me if I hang my hose above my head. That reduces the tugging on the mask when I move in my sleep AND when and if there is a tug it is upward instead of downward. The mask moving down on the nose it what causes the mask cushions to slice into the bridge of the nose as it tends to turn the edges of the cushion up and outward to slice the nose bridge. Sliding the mask up a skosh tends to turn the edges under so that they don't irritate the skin at the bridge of the nose.
And I have a nose that just loves to start dripping w/the least little bit of pressure at just the right spot up near the bridge. If I misplace my mask just a little bit its like it is milking my sinuses and just getting my snozz to drip like a water faucet. Just take your time fussing w/your mask to get a good fit before giving up on it - BUT - dont go over 30 days when trying one out so you can exchange it if necessary.
If a leak is a minor one, just run your fingertip gently along the seamline between mask cushion and facial/nose skin. That will often turn the edges of the mask cushion UNDER enough to complete a good seal.
Good luck!!
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