Sierra

As SleepMommy has suggested mask liners should help. I've heard of those who make them out of old t-shirt material to save on the costs. Here is a link to one brand of commercial ones. They have a sizing chart so you can determine what size you need for your mask. I have no experience with them as I use a nasal pillow mask and the liner is not necessary for that type of mask.

RemZzzs Mask Liner

There are some drug and supplement interaction checkers on line. One at the link below on a quick check. Your pharmacist should also be a good resource.

Drug Interaction Checker

One more question to ask your doctor is if the overnight study is actually a titration study. They are done to determine the set pressure of a fixed pressure CPAP. If you buy a fixed pressure CPAP it may only be about $80 cheaper than an auto version. A titration study to determine pressure is not necessary with an autoset machine. Doesn't make much sense to spend $5000 to save $80!

No experience. All I can suggest is trying a nasal pillow mask like the ResMed AirFit P10 which may be more comfortable. The other choice is just to wait until the pain and swelling subsides.

Unless you have other health conditions such as heart conditions a home sleep study should be quite sufficient to do a diagnosis. You should first ask for a copy of the sleep study report. It should have been prepared and reviewed by a sleep specialist doctor. It should give you an overall AHI number, as well as a breakdown of the central apnea events, obstructive events, and hypopnea events. Based on the AHI there is a rating system of the severity of the apnea.

None/Minimal: AHI < 5 per hour

Mild: AHI ≥ 5, but < 15 per hour

Moderate: AHI ≥ 15, but < 30 per hour

Severe: AHI ≥ 30 per hour

There should also be an oxygen desaturation measurement. 95% or higher is normal. 90% is good. Less than that starts to be a concern. It sounds like oxygen desaturation is not a problem for you, which in turn suggest your apnea is not likely severe. However, there should be an AHI number to determine where you stand with apnea.

If you are in the Mild category you could use a CPAP or try a dental device. The dental devices are typically more expensive than a CPAP though. If you are in the Moderate or Severe category you should use a CPAP.

I was diagnosed with an AHI of 33 based on a home sleep study only. My general practice doctor used it to prescribe a CPAP and I bought a complete package including a mask on line for about $900 Canadian. If you go that route I would suggest the ResMed AirSense 10 AutoSet for Her. It automatically adjusts the pressure and there really is no need for an overnight titration test to determine your optimum pressure. The machine will find the pressure you need. The For Her version of the machine includes an extra program that may be helpful to a female or male.

So, unless there are some other complicating medical conditions it would seem to me that if you do have apnea (and you need the AHI number to confirm that) you would be better off spending your money on an auto CPAP machine. Assuming you are in the US you will need a prescription to get one though, unless you can find a used machine. Here is one I found on line in the US. The price seems high to me, so you should look around and see if you can get a better price. If you are in Canada I can give you a link with better prices, but I don't think they will ship to the US.

ResMed AirSense™ 10 AutoSet™ For Her

But your next step should be to call your doctor and ask for more information such as a written copy of the sleep report. You need the AHI number and you need to know if the primary component is obstructive apnea and hypopnea. They can be reduced with a CPAP. If it is central apnea then it is more complex and you may need more than the basic auto CPAP. If it is just basic apnea then ask him why you would need another study, and if he will just write a prescription for an auto CPAP now. To me it doesn't seem to make a lot of sense to do a $5000 study to determine if you need a machine that will cost under $1000.

Hope that helps some. Just post again with any questions.

From the ResMed Battery Guide (page 22) it seems that the current draw for a ClimateLine set to 30 C, and humidifier setting of 8, draws 1.02 amps more than the Slimline hose and the humidifier set at 8 (both for same pressure setting). From the V=IR or R=V/I formula this suggests a resistance of about 24 ohms assuming they are using the full 24 volts that the machine power supply delivers.

As I understand it they measure temperature at the end of the ClimatLine so there must be a thermocouple there. The three wires of the hose would then probably be a common ground, plus one with the heating current, plus one that goes to the thermocouple.

The lesson I learned is to get your hearing checked, and your sleep study done before you end your Cadillac insurance. I had that until I was 65 and it would have paid for everything too. But, I was avoiding the CPAP stuff for as long as I could. Did the same with hearing, and still holding out on that. Having an excuse to say "I did not hear that" is not all that bad...

SnuzyQ may be referring to my comments about how sleep apnea diagnosis and treatment happens in Alberta. It is frankly a bit dodgy in some ways. Yes, everyone gets a sleep study, diagnosis, and initial prescription at no cost through the provincial health care system. The study is typically done at home, and the prescription is for an APAP without any titration study. I have no problem with that as an APAP is virtually the same cost here as a CPAP. I would dread the US DME system where you have to get an in clinic sleep study, then an in clinic titration study, and then it seems a battle with the DME to avoid getting a CPAP instead of an APAP. And if the CPAP doesn't work, then a rinse and repeat with the in clinic studies to move to an APAP. In Canada, or at least in Alberta, we cut to the chase and go straight to an APAP typically of your choice, right from the home sleep study. BUT, and it is a big BUT, in Alberta at least, you or your insurance company has to pay for the APAP and mask. I believe in Ontario the provincial health care system pays up to 75% if you buy from an approved vendor, but in Alberta the health care system pays nothing. This said, it is not all that bad, as I have found Cadillac insurance is very expensive, and if you pay your own way, it can be much less expensive in the long run. Plus you can buy what you want. The only thing is that you have to go it alone for support for your machine. For those that can use SleepyHead and do it, it is fine. You can buy the whole initial package for about $850 CDN on line, and SleepyHead is free. For someone who wants the sleep clinic to look after them, the same equipment package costs $2400. So yes, to some degree we are left to our own choices. Pay the $2400, or do the support yourself -- at least in Alberta.

As far as medical records go I have no concerns at all. Alberta has an electronic record system, and I think were first out of the gate with that. Ontario tried to copy it, but bungled it big time and ran up a huge cost (debt). Don't know if they have it fully working yet. It is too bad that our medical system was not federal instead of provincial. I think there could be huge cost savings. But things are looking pretty good in Alberta. I believe they are close ( a year of so) to giving patients on line access to their own medical records. Now it is restricted to doctors, pharmacists, and other health care providers. I'm sure my current medical records show I have been prescribed an APAP and am using one, but that is it. It certainly does not contain detail like pressure settings and compliance. The compliance thing seems to be a US concern. Big brother watches to see if you are using your CPAP, and if not cuts you off. I am not aware of any such big brother process in Canada, but some province may do it.

I am not all that familiar with DreamMapper, but I think it is just giving you summary data. SleepyHead does that too, but the real value is the minute by minute graphical plots of a number of variables during the whole sleep session. These are displayed with the Daily Detail chart. See this example for a Dreamstation, which is actually a BiPAP machine, but an Auto CPAP will be quite similar. Notice the red pressure trace and see how the DreamStation keep peaking it up during the night and back down again. The results this individual is getting are quite good, but they potentially could be improved with some pressure adjustments to reduce the pressure variation during the night. It also looks like hypopnea events are primarily occurring when the pressure is lower. In any case this is the kind of detail you can see with SleepyHead. It can be very helpful in determining what may be causing your arousal events, and what adjustments could be made to reduce them.

DreamStation SleepyHead Screen Shot

Your pressure range of 5 cm to 20 cm is very wide, but not unusual for an initial guess for setup. Most will find that 5 cm is too low and when you start there each night, some feel short of air, or a claustraphobic feeling. More often 7-9 cm is a better start point. And narrowing up the minimum and maximum pressures can make the experience more comfortable, and at the same time improve AHI.

SleepyHead will run on Windows or Apple, and all you need to do is remove your SD card from you machine and plug it into a card reader to get the data into SleepyHead. Not all that hard. Your sleep provider or doctor should have software from Phillips similar to this, and can view the data as well. However, what they can do, and what they actually do are often different things...

It does sound like you may have a defective machine. Some thoughts on the issues:

1. You mentioned that prior to the incident the machine stopped shutting off when you took your nasal pillow mask off. In the Clinical Guide troubleshooting section (see page 32) they mention that if you use a nasal pillow mask and your set pressure is less than 7 cm the automatic shutoff will not work. This would seem to suggest for some time you may be getting less than 7 cm pressure. Do you know if it should be higher than that, or if it has been changed?
2. Do you use SleepyHead to monitor what the machine is doing? If so you could look back through the history which should all be on the SD card to see if the machine was slowly failing, or if it was an intermittent thing.
3. A few weeks ago we went camping and tried out our new 12 volt to 24 volt power adapters. Mine which is on an A10 worked fine for all nights. On my wife's S9 machine it initially worked, but then one night it started to act up. In her case it would shut down and then start up again in ramp mode. When I looked at what happened in SleepyHead the next day, I think it shut off and restarted about 15 times. I am amazed that she got any sleep at all. She was going fairly long periods with the machine not running at all. At about 5:00 in the morning she changed to the normal AC adapter as we did have AC on that night. It then worked fine. After some troubleshooting I figured out that the plug on the adapter where it goes into the S9 must have had a broken wire or solder joint to the connection inside the molded plug. If you wiggled it just the right way the power would go off and on at will. I did a screen shot of the SleepyHead chart and sent it to the vendor that I bought the adapter in the spring. They immediately sent me a new one. The warranty on the adapter and the machine is 2 years. That said it sounds like your machine is not shutting right off, or if it is, then it may be immediately restarting without you knowing. I would try wigging the plugs and wires to see if you can make it shut off and on.

In any case I would look at the data on SleepyHead before giving up on it. It might just be the adapter.