I suspect that I probably have some form of sleep apnea and may end up on a machine. If I had to guess how many times I woke up over 8 hours last night, it would probably be 100+ times. Still unknown what exactly is waking me up, but I'll know soon enough and I get SPO2 sensor today to start testing myself tonight and comparing readouts on the computer. I have been thinking ahead of time about what I would need, which setup might be best for me, etc.
I'm trying to figure out how much this will cost in general. I know that many people state that the machines can last anywhere from 3-5 years and up to 6-8 years in some cases if you take care of it. What about the other equipment like the hoses, connectors, etc.? Do you have to buy a new mask/nostril pillows/hoses often?
How do you keep the machine "clean" like it should be kept? This seems to vary wildly. I've browsed around the forum for a while and I see where some people say that they "don't worry about" cleaning the hose and just lightly clean the mask and pillows. Others indicate that they use various mild and unscented soaps to flush through the hoses and clean the mask. Yet I have known of a couple of people who were said to have gotten sick because they didn't clean their machine properly. What's the deal with that? How do you "clean" the inside of the machine and what are they referring to, stuff like mold on the lungs or something?
If I end up having to get one, I would want a smaller machine. If I need to travel sometimes, I would want to take it with me, of course. I would want to get a computer readout on how I'm breathing and such. I'm sure that both of those is probably a common thing nowadays. Do they make smaller hoses the size of an oxygen line (diameter of pen/sharpie) instead of those huge hoses that I see with the diameter of a quarter? They look ridiculously big.
Finally...how did you figure out if you needed a mask or the nasal pillows? The mask seems like it would make people a bit claustrophobic and also cause indentations on the face and mess up the hair on the back/top of the head. The nasal pillows, on the other hand...do those stretch the nostrils to make them permanently large? One can't help but wonder that.
I had a good $8,000 in payments for medical bills for this year and ran about $45,000 total through my previous employer's insurance chasing down a fix for the sleep troubles. I haven't started my new job yet, but it will likely be next Monday. 12-hour shifts, 48-50 hours per week and I'll likely be working 4 days each week. That will, no doubt, be tiring for someone with sleep issues and I'm trying to hurry and get all of this sleep stuff together so that within coming weeks I can have a solution for it. I won't have health insurance yet and the end of the year is a little over a month away. Should I wait to get another sleep study and/or CPAP machine? Are they that expensive?
My wife has been into the CPAP for nearly 4 years now. I'm only 6 months into it. None of it has been covered by insurance other than the initial at home sleep study.
Costs in Canadian dollars. Prices seem to be higher in the US so these probably translate pretty closely to $US.
Auto machine: ResMed AirSense 10 Auto including mask and heated hose: $900 - probably needs to be replaced every 5 years or so. My wife's S9 ResMed is 4 years old and is running fine. She averages about 9 hours a night.
Hose: A heated hose is the Cadillac way to go and they cost about $30-40. My wife is on the original, and has the standard hose as a spare. Perhaps every 5 years for replacement? You do not want a smaller hose as it increases pressure drop and air velocity and likely will be more noisy and disturb your sleep.
Mask: They run from about $100 to $150 depending on the type and model. The replaceable inserts on my wife's original mask lasted about 18 months each and cost about $35 to replace. I'm still using my original after 6 months.
Filters: Not sure what they cost. Those that were included in my original package will last me a long time. I made the first replacement after 6 months.
Cleaning Machine: My opinion is that these are not at all necessary -- a solution in search of a problem. Yes, I'm sure they do a good job of sterilizing your machine. However after you take two or three breaths through it, the mask and hose is just as contaminated as it ever will be. Exhaled air does not go back through the machine. It exits from a vent in the mask. The machine only ever sees clean filtered air from your room. All you need to do is rinse out the mask and hose with household vinegar, follow that with a wash with water and a little bit of dish washing liquid soap, and then rinse with clean water and hang up to dry. Probably not necessary any more than once ever two or three weeks.
Yes, you can buy smaller machines for travel, but my opinion is that they are not necessary. Our son who is a bit younger than you, got both an AirSense 10 machine and a travel Z-1 Auto machine. He gave away the Z-1 to us to keep as a spare. He found it too noisy. We don't use it either. ResMed makes an AirMini travel machine, but it is a bit of a pain. First it needs a special mask or adapter to fit it. It does not use a water humidifier, but instead a replaceable gizmo that I gather sucks water in from the air. And, I don't think it talks to SleepyHead which is the common software used to monitor results. The standard ResMed AirSense 10 AutoSet with the ClimateLine heated hose is very portable, uses a standard water humidifier which is built in, and talks to SleepyHead. I just went on a 4 day trip and packed the whole travel case inside my carry on luggage. You can also carry it separately and it has velcro straps to secure it to a wheeled travel bag. You are allowed to carry it on at no cost as required medical equipment. In short I see no reason to get a travel sized CPAP. The ResMed standard machine travels very well.
Masks are a problem. However, you would appear to have a mild apnea at most based on your reported sleep study results. Most likely you will not be using a very high pressure. The pressure is what drives you to tighten the straps to keep the mask from leaking. In general the nasal pillow masks are the most comfortable and least claustrophobic, standard nasal next, and the full face masks the least comfortable. For that reason most try the nasal pillow like the ResMed P10 first and only move to the other ones if the nasal pillow is not tolerable.
On machines I think there are two good ones; the ResMed AirSense 10 AutoSet, and the Phillips Respironics DreamStation Auto. The DreamStation is typically a little cheaper but in my opinion not as good as the ResMed. They both will share data with the SleepyHead software application, which in my view is a necessity to monitor your treatment.
The way things work in this part of Canada is that a positive diagnosis of sleep apnea is followed by a free trial of a CPAP. If that is available to you, I would go that way. It will give you a chance to see what mask works for you, whether or not the treatment works, and if you like the machine they give you. Both my wife and I did that. We did not buy the machine they gave us to try, and just bought our machine on line at 1/3 of what they were going to charge us. But that all depends on your health coverage as to what works for you.
Hope that helps some,
I suggest, if possible, hold out for an in-lab sleep study followed by a titration study so that whatever mode of machine you are prescribed will be set for optimal therapy. If you have to pay for the machine on your dime, there is a company called "Second Wind Cpap" that offers checked-out used machines that come with a warranty I believe. The manufacturer doesn't seem to make a great deal of difference but I think a major player would offer the best chance of a reliable machine. Respironics or ResMed come to mind. Since you are not really able to tell if you need CPAP, APAP or BiPap at this stage, best to get that settled first. I have a ResMed S9 BiPap that is useful for travel; especially without the water container. You might also look at Craigslist as machines pop up but you run the mistake of buying a lemon (don't ask how I know). It really isn't bad to haul a ResMed series 10 machine as it comes with a nice case that is space economical for the accessories. I have traveled with my ResMed Aircurve 10. If you are going to be on insurance fairly soon, then the mask will be the biggest expense out of pocket outside the PAP machine. As far as clean goes, I wash the cushion from my mask daily. I clean/dry the tank every week or so. That is it. Others feel more involved cleaning and more frequency is good. I just know I have not been sick since I went on therapy a number of years ago. I did start out washing the cushion with anti-bacterial wipes which contained bleach or something and ruined my first cushion in no time; plus those things are kind of stinky.
I understand you are between health care plans. Is your plan to wait until you have another health care plan in effect before you go ahead with a CPAP? The reason I ask is that based on the study you have had you may or may not need a basic CPAP. I can't imagine how you would ever need a BiPAP type machine. There is not much point in spending a bunch of your own money to determine exactly what type of machine you need and what pressure it should be set at. Those tests will cost two or three times more than the machine itself would cost. The difference between a basic CPAP and an Auto CPAP is about $80. The Auto machine essentially eliminates the need for a titration test to determine your set pressure. It finds the right pressure for you.
I guess what I am suggesting is that there are different routes to take depending on who is paying...
I understand you are between health care plans. Is your plan to wait until you have another health care plan in effect before you go ahead with a CPAP?
Not sure yet. The new job is one of those temp-to-hire deals, but the unique thing about the new employer is that they have hired people directly after a month and the time period is solely based on how well you do the job. In that case, I might get instant benefits upon direct hire, depending on the company. It is also a union and I have never worked for one of those (orientation is tomorrow, actually). If it is within a month, I'll basically be into the new year anyway and just wait to throw all of that at my new deductible for next year. On the other hand, once I get hired on directly with the company, money won't be a problem. The issue is getting enough sleep to pull 50 hours a week.
Right now I don't have anything to go on but the crazy amount of times that I seem to wake up and the single sleep study that I've had for only 2.75 hours. A lot of that could have been skewed. I moved around a lot during the study, my breathing may have increased out of frustration from their crazy tall pillows that were extremely uncomfortably and then I was the last one that they put the sensors on. Some of those hypopneas/apneas could have even been related to my neck positioning on those very tall pillows. Someone was snoring massively in the room next to mine and a machine in another room kept letting out a loud beep all throughout the night.
Got my SPO2 monitor today and going to see how many times (if any) my actual oxygen level drops throughout the night for tonight, Friday and Saturday. The monitor takes a measurement every second, so it should catch it. It checks the pulse rate, too...so I can compare the two and see if there are any relations around the same time period.
If my oxygen level can't be found to drop any and I'm having these odd "jumps/jerks" that wake me up whether I'm on my back, side or stomach, then it may not be sleep apnea. A machine would be useless to me if I've got something else going on that just wakes me up. That may or may not be "better" than needing a machine because it would probably mean that I have something else alarming going on. But we'll see. I'm planning to do an SPO2 test Thursday, Friday and Saturday night to see if I can pick up anything.
If I absolutely can't find anything at all, I may end up finding another sleep doctor so that I can have a sleep study at another location. The two people doing the sleep studies at the previous clinic that I went to seemed to be rather unprofessional. I did not care for the facility. It was in a questionable area of the city and they just seemed to have a don't-care attitude and couldn't wait to hurry me out of the door. I think she actually woke me up a bit earlier than the time I was supposed to get up, as well. The whole time that she was putting the electrodes on, she complained to me about her sleep problems, that she was allergic to a couple of pages of things and such.
OK, I understand better. I have to say that based on your one sleep test results that is not real likely that apnea is a major cause of your waking up. And I also have to caution you that there is always some discomfort with wearing an apnea mask. The therapy has to reduce apnea enough that it offsets the increase in discomfort with the mask.
I would also say that doing a sleep study is not a fun event. I did mine at home and had control of a lot of things that you did not. I would say I got almost no sleep, but they told me I got probably 3 hours. All of that considered I think my assessment with an AHI of 34 or so was probably accurate.
My thoughts are that unless you have other serious issues like heart disease or lung issues, an at home sleep study is probably just as good as an in lab test. You have control of much more of the event, and are likely to get more sleep in that can be used to make an assessment.
This all said don't underestimate the value of an in home sleep trial with a CPAP. Just make sure it is an automatic one that collects data on everything that happens.
Just my thoughts as having gone through the process. Not a medical professional!
So here are my results from 10/16. I started it earlier than that, but something must have happened and I restarted it again when I got up for the bathroom at 2:00am. This was for the 3 hour period from 2:00am to 5:30am. Looks like my heart rate started going up and down about halfway through and at one point my SPO2 level went down to 88%. A number of others in the low 90's.
https://image.ibb.co/jtL9dA/1.jpg https://image.ibb.co/jORhyA/2.jpg https://image.ibb.co/jvtjBV/3.jpg
