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Permalink Reply by Monica on April 2, 2009 at 12:06pm

ok - call me ignorant but - what is the difference between "simple obstructive" and "central" sleep apnea? I assume complex is a mix between the two?

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Permalink Reply by Mike on April 2, 2009 at 12:20pm

Monica -- we're all learning here, so no worries. Here's an FAQ page that contains a glossary of all the terms

Monica said:

ok - call me ignorant but - what is the difference between "simple obstructive" and "central" sleep apnea? I assume complex is a mix between the two?

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Permalink Reply by Monica on April 2, 2009 at 12:34pm

OK - thank you so much! That helps sooo much!
I didn't realize that tooth grinding was a part of this too? I do that alot. I have a missing tooth and have a tendency to put my tongue against the gap at night, which makes me wake up in the morning with a sore mouth sometimes because of the pressure. But if I don't do that, my teeth hurt in the morning because I have clamped my mouth shut so tight that my teeth grind together. Is there anything available out there that can help stop this? I find myself doing it sometimes during the day when I am awake too.

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Permalink Reply by Mike on April 2, 2009 at 1:18pm

dentists can talk to you about night guards. i got one, because i grind my teeth too, but i gave up on it because of my apnea, oddly enough --- i have such a crowded airway as it is (big tongue/big tonsils/etc), that the last thing i want to throw in there is a foreign object (night guard) to make it even more crowded.

Monica said:

OK - thank you so much! That helps sooo much!
I didn't realize that tooth grinding was a part of this too? I do that alot. I have a missing tooth and have a tendency to put my tongue against the gap at night, which makes me wake up in the morning with a sore mouth sometimes because of the pressure. But if I don't do that, my teeth hurt in the morning because I have clamped my mouth shut so tight that my teeth grind together. Is there anything available out there that can help stop this? I find myself doing it sometimes during the day when I am awake too.

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Permalink Reply by Chuck Hughes on April 2, 2009 at 3:22pm

As a CPAP provider, I prefer the Respironics BiPAP ASV. It i a bit cumberson, much like the older Pro 2 series CPAP. However, it does have a card port and the down load provides the data needed to determine treatment efficacy.

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Permalink Reply by Mike on April 2, 2009 at 4:08pm

Thanks for the MAD suggestion. Would be great to kill 2 birds with one stone and solve mouth leak too. I'll investigate.

j n k said:

Mike, If you haven't already, you may want to look at getting a mandibular advancement device (MAD) that will also protect your teeth. I use one every night to help my PAP therapy. I find that wearing it allows me to use a few cm less pressure on my autobilevel. The idea of a MAD is moving your jaw forward to make more room for your airway. The nice thing is that the MAD also holds my mouth shut as I use my nasal-pillows mask, since the dentist formed it well to my teeth. So wearing it helps eliminate mouth leak for me. (I also run a stretchy headband diagonally from the crown of my head to the front of my chin to keep my lips closed. I wear the headband under the straps of my LT, so that cuts down on strap marks too. But I go off point. . . ) My main point is that a MAD may solve the grinding and help your PAP therapy at the same time.

jeff

Mike said:

dentists can talk to you about night guards. i got one, because i grind my teeth too, but i gave up on it because of my apnea, oddly enough --- i have such a crowded airway as it is (big tongue/big tonsils/etc), that the last thing i want to throw in there is a foreign object (night guard) to make it even more crowded.

Monica said:

OK - thank you so much! That helps sooo much!
I didn't realize that tooth grinding was a part of this too? I do that alot. I have a missing tooth and have a tendency to put my tongue against the gap at night, which makes me wake up in the morning with a sore mouth sometimes because of the pressure. But if I don't do that, my teeth hurt in the morning because I have clamped my mouth shut so tight that my teeth grind together. Is there anything available out there that can help stop this? I find myself doing it sometimes during the day when I am awake too.

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Permalink Reply by White Beard on April 2, 2009 at 9:59pm

Chuck Hughes said
("As a CPAP provider, I prefer the Respironics BiPAP ASV. It i a bit cumberson, much like the older Pro 2 series CPAP. However, it does have a card port and the down load provides the data needed to determine treatment efficacy".)

ResMed VPAP ASV also has that capability with the ResLink I know in my area allot of DME's don't like to handle ResMed because they are expensive and cut into their profit margin, and they find ResMed difficult to deal with! I know the owner of my DME told me that. I had my Doctor write the script for the ResMed ASV and my DME insisted they were going to give me the Repironics, I said NOPE and if they would not give me the machine I wanted, I would go else where! They got me the ResMed machine! I also got my ResLink and nonnin Pulse-Ox and everything thru them, ResMed told them they could not sell me the Card reader or ResScan software, so the boss said he wouldn't he told them he would give it to me! He showed me exactly how much it cost him and how much profit he was making, This DME has alway been fair with me and they came thru with everything I wanted, So I purchased the the extras through them! My DME has also been really good about working with me on finding a good mask.

I know I have seen on line how,.. so many people have problems with their DME's, pushing off equipment on them that they don't want and even lying to them about what they can get!, There are allot of DME's in my area that do that! My little small privately owned DME takes care of it's cliental, and in turn their customers are loyal and bring in other customers to them! There have been others that post on other SA forums that have used both the Respironics and ResMed ASV's and most like the ResMed ASV enhanced the best! I had a Repironics CPAP and I still have the Respironics BiPAP Auto M with Bi-Flex, I went thru three BiPAP before I got one that worked right! Admittedly the first two were not the BiPAP Auto M but they were Respironics! But I was not happy with the Respironics, and I hate their "Brick" power supply! I am not fond of their humidifier either! So I done my research and I decided on the ResMed VPAP Adapt SV enhanced! I have never been sorry for my decision either!

Thanks to these Sleep Apnea forums more and more people are getting educated about not only their sleep apnea but also the types of equipement used to treat it, and how to monitor their own treatment, and also about what to look for in a sleep apnea doctor and the DME's and how the insurance works in covering and paying for the equipement! The smarter the consumer and patient the better! After all diabetics monitor their own treatment, why should the sleep apnea patient be any different? It sure isn't as complicated as having diabetes! I used to work in the medical field before I went on disability and I am very much a patient advocate, I firmly believe the more involved a patient is in their own treatment the more likely they will be successful with it!

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Permalink Reply by sherry on April 3, 2009 at 10:09pm

Hi again, and again, what great information from all you guys..I just talked with a friend who complained about being tired all the time, and not sleeping, and I gave her this web address as it sure sounds like she has OSA, she was amazed that her snoring and possible sleep apnea could be causing her symptoms, and is going to her doctor to see about being tested.

As an update, yesterday I talked to a fill-in doctor as mine is on vacation, he gave me to the lady at the sleep clinic who did my mask fitting and is 'the one that knows all about the machines', she was great at helping me find a mask and also documenting my need for an ASV. She told me the ResMed Adapt SV was the state of the art (I notice you keep referring to 'enhanced'--it this another model? As mine does not say that anywhere and I don't see it on the web references, but again, my web surfing is not optimal, lol), and the best I could get. She also indicated that I was not happy because I wanted a 'little, cute one', which I did not appreciate. As I told her, it is the data issues that concern me. Anyway, she said she would re-write the script for the RemStar (didn't I see that these were morphed into the M-series or something after Jan 2007?? Am I on the same path I thought I was on with the Adapt SV??).
Not sure now if I will trade it in or not, although the lack of the data card, as well as not having any software to see how I am doing if I keep the ResMed, is still my big roadblock. Is the card-reader a peripheral that I can purchase? No one has told me that was an option. If so, I will keep the Adapt.

I feel like I am becoming the CPAP witch, but I just want to know what I need and be sure I get it, as well as looking out for my financial interests. I will try to find a better DME, I think that is the major problem, after reading some other posts.

I have given this site address to several of my friends, I would have been much better prepared if I had found this first!!

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Permalink Reply by White Beard on April 4, 2009 at 2:25pm

Sherry I am confused why would she rewrite the script for the Remstar M serries. If you are having central apneas then the ResMed VPAP Adapt SV is definitely the machine for you! The enhanced is the newest version of the ResMed VPAP Adapt SV if your machine is a new one then it is that machine, You know you can get your daily averages AHI, AI, VT. Average Pressure, MV, Respiration Rate, Leak Rate, all on the screen on top of the machine, all it has to be is enabled, and if it isn't already I can help you to do that! Unless they are switching you to the Respironic version of the ASV, I would not switch, and even then I would probably not switch because you have the best machine right now, One way to check if you have the newest machine, is do you have the users guide for the VPAP Adapt SV? Go to page 33 Technical Specifications go down th list to Performance if it says ( operating pressure rang: 4-25 cm H2O) then you have the new model version, the old one only went to 20cmH2O Also I might note that the enhanced version I think came out in March or April of last year, and it replaced the the old one so they might not list it as being the enhanced any more! Anyway sherry I would sure hate to see you give up a superior machine like that for something that might not work for you as well, but that is only my opinion! If later on you want to get the ResLink card and card reader you can and then you would have the capapbilities to down load data to your computer! If I can be of any help to you just let me know! Good Luck to You

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Permalink Reply by sherry on April 4, 2009 at 3:33pm

The reason I was given a rewrite was because I wanted a machine with the data card on it (not because it was cute, lol)...but since you say above, that a data card reader is available for the Adapt, it just comes separately-- I will keep what I have, and hopefully will be able to avoid carting it all back to the sleep lab for a checkup.

I just checked my users manual and it says 4-25 cm, so yeeha, I have the machine you have been talking about. I will set it up today and get started!

I now have a question about the face mask, as well.. my first night with the cpap, I had a mask that covered my nose and no matter what size etc still had air leaks around my eyes, due to my nose configuration. As I am on Restasis for dry eyes, the tech suggested the nasal pillows, which I used on the next sleep with the SV, and they worked much better. When I picked up the machine, it had a nasal cover mask with it, but I told her that was not what the tech had told me to use, so she gave me an OPUS nasal pillow mask.

However now I see on the ResMed site that the nasal pillows are not to be used with the Adapt?

Is this a big no-no, to use the nasal pillows on the Adapt, or is it just not optimal? It said there was some Adapt feature that may not work properly with this mask, but maybe that would not be as important to me as a comfortable mask? Maybe after I get used to using the machine for a while, I will be able to better tolerate the other mask if I need to switch?

Once again, y'all have been so helpful. I have gotten so much valuable info from you that would have just been trial and error on my own. Several people have told me they got a CPAP and took it back after a few days as they had so many problems with it. I can see why. Had I not come here, I would have been very likeley to have done the same thing.

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Permalink Reply by White Beard on April 4, 2009 at 5:13pm

sherry I use the ResMed Mirage Liberty mask it has nasal pillows and it also covers your mouth it, I am a mouth breather of sorts, when I sleep my facial muscles relax so much that even with a chin strap air escapes out my mouth, so I found the Liberty a good answer to tha! I also can't stand anything pressing on the bridge of my nose and I can't stand air blowing into my eyes! Anyway I have found the Liberty mask passes the learning circuit just fine! you just set it on full face mask and yourt all set! You might ask your DME about checking that mask out if you think you would be interested.

Also do you have the humidifier with your machine? If not I would ask your Doctor to write the script for it, I have the HumidAire 2I it fits right onto the front of the machine. Anyway if if I can help you in anyway just let me know!
Good Luck to You!

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Permalink Reply by sherry on April 5, 2009 at 8:32pm

Good to hear, I will try the nasal pillows, 10-4 good buddy on the air in the eyes!

They did have a 2i humidifier ready to go with the machine, but because I was not too confident that was the machine I should have, as well as the humidifer being a non returnable purchase of $365, I decided not to purchase at that time.
I have since seen them for $150 at online suppliers, so I plan to either get one there and save my insurance company $200, or find a local DME, in any event I won't return to the one where I picked the machine up, as my experience there was not a good one.

I'm glad you mentioned the humidifier, as I saw there is a 2i, 3i and 4i, and couldn't really tell the difference except apparently the 4i has a larger capacity?

Thanks
Sherry

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