Hi Judy. Maybe your family in Germany liked Opera. Madam Melba was very famous in Europe????? Or maybe they just liked the name.

I was diagnosed with sleep apnea about a month ago....so am still adjusting. I tried the nose cup mask for a while and thought it would be better than a full face mask. However, it seems to slip and I do not feel as if I am getting as much adjusted air flow. It seemed more annoying as my breathing sounds were more pronounced. I am seeing my doctor again in two weeks. I like her very much. I am 62. This diagnosis is amazing as I have struggled with lack of alertness and focus, depression....psychotherapy, antidepressive and the like for many years. She said my best medicine is air....and she is so right. I feel really good and am able to function ....don't need naps etc. I have cut my Ambien in half to 6.25 but have not been able to completely get off of it yet. I work as a Teaching Artist a couple of weeks out of the month with a federal grant in Beaufort SC....I now live in NC. so I travel back and forth. I hope to wean myself off of it when I return as I will have six weeks of "retire" life and do not have to get up at the crack of dawn to go to schools.

I am very interested in others experience. and tips. Thanks for responding. Melba

You read it right - AHI of 15. Most insurance companies will only pay if you have moderate sleep apnea or worse. To get a CPAP when your AHI is between 5 and 15, you need additional documentation. As I wrote in the discussion on the validity of AHI,

In cases where AHI is less than 15, Medicare has specified certain instances wherein beneficiaries may still qualify. The provider must have documentation on file from the prescribing physician stating one or more of the following:
- Excessive Daytime Sleepiness
- Impaired Cognition
- Insomnia
- Mood Disorders
- Hypertension
- Ischemic Heart Disease
- History of Stroke

Most private insurance companies also adhere to these guidellines, although it can be an arduous appeal process to get approved. It's pretty easy for a doctor to qualify any low AHI patient under the Excessive Daytime Sleepiness or Insomnia conditions, if they truly want to get a CPAP.

To provide you with the equipment, all I need is a prescription that specifies how the device is to be set. In order for insurance to pay for it, I am required to have the medical justification for the prescription. In most cases, this means the results of the diagnostic sleep study that shows that the patient has sleep apnea. Usually, a one-page summary that shows an AHI over 15 is enough, but there are lots of variables. Private insurance company requirements vary tremendously and capriciously, depending on which claims examiner is reading the claim. It is my belief that they sometimes reject a claim or hold it up by asking for additional information merely to hold on to their money longer than the 45 days that the law requires them to resolve a claim. Sometimes they ask for complete chart notes and a complete PSG, but that's pretty rare. I usually send whatever I have, and if they ask for more, I try to get it. If I hit a brick wall with the sleep lab, I have no choice but to enlist the aid of the patient. This is done by sending a bill to the patient, explaining to the best of my abilities the reason that their insurance won't pay, and then leave it for them to resolve. I don't believe the equipment provider should be denied payment when someone's insurance company is refusing to pay.

I don't have the Respironics part numbers all memorized. You are correct about the one I was thinking about. I can see that the Respironics Basic would be kind of incompatible with the OptiLife. If I were you, I'd try removing the Optilife strap and see what happens.

SomniHealth doesn't carry your chinstrap. I've found that the thin straps at the top of the head wind up slipping and sliding for most people. Some get lucky. I think it has to do with the shape of your head.

I was looking at the price differentials on CPAP.com. I previously mentioned that I take a loss when I give a patient the Respironics Deluxe. As a Medicare provider, there is only one price I can bill for a chinstrap. I abhor the idea of charging patients upgrade fees for the model that works best for them. Most providers solve this dilemma by only stocking inexpensive chinstraps and then telling patients that there are no other choices. The other option is to fill out extra paperwork and then charge the patient an upgrade fee. Are they bad providers, or is the system horribly broken?

Good old 302175, aka the Respironics Deluxe, not to be confused with the Respironics Premium, which is black, but has a cup, not a hole, at the chin. I like that one because (thanks to it's width) it provides the most vertical support for your jaw, rather than pulling backwards, which most others do. The fabric is a cotton/poly blend, which breathes a whole lot better than the neoprene ones.

With the Deluxe, I would imagine that you could use it with the Optilife chin support as long as you put the chinstrap on first. I haven't tried that combination personally. With chinstraps, it's often the case that the supplies given to you by the DME are the raw materials for you to come up with the best solution for you. That's especially true regarding the white Velcro braces that come with the deluxe. Some people don't use them at all; others use just one. Don't think of yourself as a lab rat if you don't use it exactly as shown in the diagrams.

Here's what I don't like about the Respironics Deluxe:
- After a few weeks the velcro causes the chinstrap to look pretty ratty
- It's definitely not the most attractive thing out there. When I see one on a patient, it always reminds me either of a 1940's cartoon character with a toothache who has a diaper on his head, or a WWI soldier with a head wound.
- You call it chintzy, but I think the reason they call it the Deluxe is that they charge the DME more for it than other chinstraps. It costs me more to give that chinstrap to someone than Medicare is willing to pay me. I lose money whenever I give someone the Respironics Deluxe.

I just stumbled across your comment about the OptiLife under the picture of the Activa.

You're right about the shin support on the OptiLife. It doesn't come close to functioning like a chinstrap to control mouth-breathing, and depending on the chinstrap you use, it could get in the way.

Funny timing. Last night, I was going to put on my OptiLife and I found that my puppy had chewed the frame where the chin support loops through. The fabric was dangling and there was no way to re-attch it. I should have learned by now to keep a spare mask at home (this is the second time the puppy has chewed a CPAP mask), so I had no choice other than to try the OptiLife with no chin support. For me at least, it was fine. Made no difference whatsoever.

If the OptiLife strap prevents you from using your chinstrap, I suggest you try removing the OptiLife strap and see how you do. By the way, what type of chinstrap do you use, and do you like it?

no to all those tests.......the only extreme test was an emergency chest cat scan to r/o a clot..and i'd refuse a blood gas......you see, i've been an RN for 25 years.....no way. no how....

last night only lasted about 30 mins..started the "cough" can that was it.......no more mask. Hopefully DR emails me back today....maybe it's the maching making me cough, and not the med.

Lisinopril was the med........today I started on Diovan

ok.....I feel not so bad......but here is another issue....I initially got he sleep study because i was going to gastric lapbanding. During the cardiac w/u, i was found to have pulmonary hypertension, Md won't clear me, put me on meds....and the side effects is freq cough. So on top of the mask issues..i pull it off because I cough so much. So ......today my meds were switched, to elliviate the cough......tonight's another night. We'll see.......i think if not for the cough, i'd be ok.....it's one of the reasons i take the damn thing off....try coughing with the mask and pressures......the noise is hysterical.....lol

Hi...I've had it about 3-4 weeks....of course I'd love to throw it out the window....but I guess it''s better than the alternative. I am having some issues and just emailed my MD. I just, also read about the freq. urination. I thought it was in my head.....I don't feel rested either.....every morning I wake up and it's never on my face......i only can tell how long I wore it by how much water is left in the recepticle.

I have had it for a couple of years but still don't like it. I am having them send me a different mask that is smaller and they are going to check my card to make sure everything is working right. I have not used it faithfully but for the past couple of months I have and do not feel rested like a lot of people tell me they do.

Doing good can't imagine livivg without it know

Welcome to the forum!!

Your knowledge should be helpful to other forum members.