Hi CommunicativeGoldFox. There are patients who use CPAP or BiPAP along with oxygen, and there are attachments designed to allow oxygen to flow into the breathing circuit. Oxygen should only be required if the CPAP or BiPAP alone does not keep blood oxygen levels within an appropriate range. I have worked with many patients over the years who were placed on oxygen for sleeping but who no longer needed the oxygen while using PAP treatment. Unless medically necessary, Medicare and other insurance providers will usually not cover both treatments. As for adjusting to high pressures, this can be difficult. Many patients find that practicing while awake and not in bed helpful. Try using the machine during the day or in the evening while watching TV, reading, etc. This might also help prevent the anxiety of being exposed to treatment right at bedtime when you are tired and ready to fall asleep. Now that you and your physician know you have difficulty with the higher pressures, it might be worth asking whether he can start you at a lower pressure and increase you over the course of a few days or a couple of weeks as you become adjusted to treatment. Many modern machines can have their settings remotely adjusted. Best wishes, and please keep us posted on your progress!
Hi RestlessRichard. I tried the Liberty when it was introduced by ResMed just for the experience. Quite a few patients I have worked with over the years report very positive experiences with this mask. It seems to work well for people who need a full face mask but prefer the feel of nasal pillows vs. a mask that sits over the nose. Keep in mind that you might require a slightly higher humidity setting on your humidifier, but you should be able to tell pretty quickly whether you need to make an adjustment. Let us know what you think!
Hi FriendlyOrchidDeer6349. Medicare's requirements are very specific, but your physician should be able to help you address their requirements. I encourage you to make an appointment and go into the office to see him. When I worked in a sleep clinic, it was very common for Medicare to require a copy of the clinic notes that contained specific information (documentation of excessive daytime sleepiness, other health conditions, etc.) and a copy of the sleep study. You might find this link helpful for your physician. It was published by Medicare in October 2016 and outlines the requirements for CPAP coverage. Hope this helps, and please let us know how it works out!
Great recommendation, wiredgeorge. Treatment of sleep apnea in patients with neuromuscular disease sometimes requires machines with more sophisticated treatment modes (like VPAP, ASV, AutoSV). The changes to the machine are very specific and must be closely monitored. I'm sorry to hear you are feeling lousy, but you have a good plan with the visit to your respiratory therapist. Please keep us posted on your progress!
I agree with wiredgeorge. Your machine should use at least a little water if the water is evaporating at night. When you remove the water tank in the mornings (or when you stop your treatment), do you notice that the plate on the bottom of the reservoir or inside the machine is warm? If not, the humidifier might not be properly connected. Some models also allow the humidifier to be turned completely off. Many ResMed machines that separate from their humidifiers have lights or power indicators on both the flow generator and the humidifier. Do you see any lights or displays on your humidifier? It might be that the connection between the two is not firm. Please let us know what you find, and glad to have you here on the Forum!
Hi ModestOrangeRedFlamingo1397. Since you have only been on treatment for a few days and are not sleeping as well or in the same position as you normally would, I think giving it a little time is fine. If you are taking any medications after your surgery, some medications that cause relaxation (pain meds and such) can often worsen sleep apnea symptoms. I encourage you to continue using your treatment and monitor your number of events over time. Hopefully, you will continue to adjust and see some improvement as you both adjust to treatment and heal from your surgery. Please let us know how things progress!
Hi AffableIndigoFox. I'm sorry to read that you never feel rested. I felt this way for years and eventually realized I was driving while drowsy. Fortunately, nobody was hurt. Living with constant fatigue and sleepiness was exhausting and frustrating. This led to my sleep study and eventual treatment, and my treatment has resolved the problem. Unfortunately, CPAP does not fix the problem for everyone. Especially when there are other health problems that might contribute to the fatigue. I don't know your full medical history or what kinds of physicians you have seen, but there are so many more things that can contribute to fatigue than sleep issues. I hope you are able to find some answers and truly wish you all the best.
Hi Susan. StraighforwardSilver makes a good point about talking to your doctor. Some patients experience "air hunger" when their starting or ramp pressure is set too low, and a slight increase in the pressure can help resolve that problem. For others, the force of higher pressures causes difficulty exhaling. In this case, a change in treatment might work. Sometimes this means a change from a fixed pressure to an automatically adjusting pressure, a change from CPAP to BiPAP, or a change in a machine setting that temporarily decreases pressure during exhalation. Some machines use the term EPR or flex for this feature (CFlex, Aflex). I encourage you to talk to your sleep physician or equipment provider to see if there are any suggestions or adjustments that might help. Best wishes!
Hi Therapist1. Sinusitis can contribute to sleep apnea symptoms. People with sinus issues often have nasal blockage or obstruction from fluid in the sinus cavity, swelling or irritation of sinus tissue, etc. Patients with sinus problems or allergies often report snoring, or worsened snoring, when they have significant flare-ups. Most often, in the case of obstructive sleep apnea, the problem is caused by some kind of blockage of the airway by tissue (tonsils, adenoids) or by a small airway that collapses when the muscles relax. Hope this helps!
Hi Tommy. You mentioned trying sprays and a chin strap. Have you tried a full face mask that covers your nose and mouth? Sometimes using a nasal mask allows the humidified air to enter your airway, but the opening of the mouth and the air rushing out causes the dryness in your mouth and throat. With a full face mask, you can breath through either your nose or mouth. I only ask because I did not see you mention your mask type, and I have worked with many patients where the full face mask (along with humidification) has solved this problem. Best wishes!