Sierra

I am in Alberta, and the sleep clinics here will do a free (probably Alberta health pays) 2 week trial. Their prices for a machine are similar like $2400 for an APAP. The benefit of a trial is to find a mask that works for you, and to confirm your apnea can be treated with pressure. You should ask for a written copy of your sleep test, and pay particular attention to the % of the AHI that is central. Central apnea is not improved with a basic APAP.

After I completed my trial I gave them the machine back, and bought my own on line. If you have basic apnea I would recommend the ResMed AirSense 10 AutoSet. They are a bit more than the Dreamstation, but are better in my opinion. I am on vacation now, and do not have a link handy, but if you look at some of my other posts you should find a link to a technical clinician manual for three Rested machine. It explains how to set it up. It is normal to start out wit a minimum pressure of about 7, and a max at 20. After using it for a few nights you can refine that.

I would also recommend you google and download a free software program called Sleepyhead. You can also find a beginners manual for it on line. It let's you view your detailed data on a computer, using the SD card in the machine and a card reader.

In any case if there is a way you can do a trial free or at low cost, that is the safest way. Then buy your own machine on line. Try to get the ResMed AutoSet for the trial too.

Hope that helps some. My wife was diagnosed at 80 or so, and now averages about 1. I was diagnosed at 34 but have trouble staying under 3. She has no centrals, and over half of my AHI is centrals.

On adjusting the pressure, yes your sleep clinic can do it. With no ramp it will start at the minimum treatment pressure. That means the minimum treatment pressure would have to be increased.

Make sure your mask is fitting you properly. The mask pillow size may be too small. 9 cm of presure with no ramp should be giving you lots of air. Are you sure you are getting 9 cm of pressure? It should display the actual pressure when you first turn the machine on.

I am not so convinced that the home test is all that bad a choice. First some are not willing to do the in clinic test, and for them it is the best option. The OP's test was very basic as it did not measure breathing effort. That would only mean air flow, so there is no way to distinguish between central and obstructive. But, if that is followed by a trial with an APAP that does identify the difference, then the whole package, test + APAP gets the job done. The key is to get at the APAP data to see in detail what is happening. At the end of the day the proof in the pudding. The availability of sophisticated APAP machines has changed the whole game.

Some comments. A sleep clinic test is not going to help you decide between CPAP and dental appliance treatment. If your APAP is collecting detailed data an analysis of that is going to tell you a lot. Probably more than an in clinic sleep test. Even without a detailed analysis, what is your reported AHI? Has it improved?

I suspect your heated hose or the machine itself has an electrical defect.

Google "how to mouth tape for a better sleep" under Videos.

I have not dealt with the same thing, but perhaps similar. We like to travel and need travel insurance. Pre-existing conditions become an issue. I am quite careful about reporting issues to my doctor that might require a prescription change or special test as that resets the pre-existing condition time clock. If my health was at immediate risk I would just set travel plans aside. That said, your situation is more difficult to deal with.

I find a nasal pillow mask and tape over my mouth forces me to breathe through my nose, keeping it clear through the night.

My thoughts are that a couple of weeks or more with an auto CPAP tells the most, when you look at the results with Sleepyhead.