Hello,
So I have been a snorer all of my adult life to the best of my knowledge. This was not much of a concern to me until recently I have been waking up a couple times throughout the night and have not been feeling rested in the morning even though I believe I am getting about 7 hours of sleep.
I looked into this a bit online and sleep apnea kept popping up as a possible diagnosis. I was wondering if anybody could give me some advice on how to proceed? Are there ways I can self diagnosis myself? Do I go right to a doctor? Primary doctor or other? Just wanted some guidance on what to do next to try to address this issue.
Thanks in advance for your help.
Cheers, Ben
Hi Ben, and welcome to MyApnea.Org! The majority of patients seek a referral to a sleep physician from their primary doctor. Exactly how you proceed with your next step will somewhat depend on whether you are a self-pay patient or on the type of insurance you have. Some insurance plans allow patients to schedule directly with a specialist, while other require the referral. Either way, your ultimate goal should be to see a physician who can order a sleep study. Some sleep studies are performed in a sleep lab while others can be performed in the home using a small device you wear overnight. There really is not a reliable way to self-diagnose, and you should be evaluated by a physician to see what type of study and/or treatment is best for you. Good luck, and please keep us posted on your progress!
Thanks Dan for the helpful response. I am in a bit of a unique situation because I don't have insurance (besides medical) as I just started my own venture and I am living in Colombia (South America). I was hoping I would be able to self diagnose myself but I guess that isn't an option. I will search for a sleep physician in the area to see what I can do. Hopefully its not too pricey.
Have you found that the sleep studies in the lab versus at home differ significantly in price?
Just want to know what I should be pushing for.
Cheers, Ben
Hi Ben. Whether you need a sleep study in a lab or in the home will depend on the assessment of the physician. However, sleep studies in the home are generally much less expensive for obtaining a straightforward OSA diagnosis. If there are other health conditions to be considered that may have an impact on the sleep study, the physician may recommend an in-lab study. Most medical insurance plans pay for sleep studies, and your provider should be able to tell you if they provide that coverage and exactly what kind of testing they will pay for. Best wishes!
First of all, want to give an update that I got a sleep test performed in a sleep lab and I was positively diagnosed with moderate sleep apnea. Oddly enough, I am actually relieved to have received a positive diagnosis as at least now I know the cause of my chronic drowsiness and I can get started on operating at my full potential again.
Obviously the next step is to get a CPAP machine and mask. I really would appreciate some guidance on how to go about finding the right one for me.
My prescription is: 11 CM/H2O
I don't know if my prescription matters or whether the fact that I am newly diagnosed matters in terms of determining which CPAP machine and mask to get. In the meantime, I'll also do some research of my own and see what I find out.
Any guidance is much appreciated.
I have a Resmed machine and it can be set into the CPAP, BIPAP or APAP modes. It is an Airsense 10 and works well enough. I am not promoting this machine as I haven't had any experience with any other but mine works for me. You will note that when looking at masks, there are MANY types by many manufacturers. Masks are a prescription item and one thing that drives which type mask is appropriate is the amount of pressure. Again, I am not a med pro so the only thing I know is that I HAVE to use a full face mask as my pressure is 25 cm/H2O which is the max for my machine. When you look at masks, look at the specs to see what pressures are accommodated. You also have to take into consideration if you breathe through your mouth. If you do, you will need some some of strap to keep your mouth shut if your mouth isn't covered. If you can work with a supply place with trained fitting personnel, that would be your best bet. Last, many folks were given a mask they changed out from due to it not working so it is sort of a trial and error process based on the professional tech's recommendations. Don't be surprised if you look for alternatives once you have had a chance to use your initial mask but hopefully it will be a good first choice.
Hi brose005. I'm sorry to hear you received a positive diagnosis of sleep apnea, but I am happy that you now have some answers and can be treated! Wiredgeorge provided some good input. Masks are very specific to each person, and a mask that fits well is potentially the most important thing to consider. Many patients like nasal pillows because they are relatively small and lightweight. If you are primarily a mouth-breather, then a mask that covers your nose and mouth may be a better option. Working with a supplier that will allow you to try on various masks and actually try them while in your usual sleep position is helpful. As for machines, there are many good brands out there. What you receive may depend on what manufacturers the equipment provider works with. I have used ResMed, Respironics (Philips), Fisher & Paykel and DeVilbiss over the years. All have worked really well. Good luck, and please keep us posted!
If you can get a mask that fits you well and is reasonably comfortable that should help you tremendously with getting accustomed to the treatment. Many times the doctor will prescribe the mask you that wore during the sleep lab study. I would agree with the others, try to find a supplier that will diligently work with to help you find the mask that feels most comfortable for you and covers your needs (nose breather, mouth breather). You can ask them on the phone before they provide you with equipment if they will let you try on different masks. If they won't, see if you can find another supplier that will do so. I agree with wiredgeorge that unfortunately even if you are allowed to try on different masks sometimes it is trial and error and you may have to switch masks or mask types down the road. The type of machine you receive is usually based off the doctor's prescription, your insurance coverage, and the suppliers manufacturer brands. Many of the CPAP machines have programs were you can keep track of your progress online. Good Luck!
Sleep, Wish I had seen your last comments prior to choosing an equipment provider. My insurance is an HMO and the ones available were limited but I picked one out of the hat without finding out about whether they would allow me to try on a mask. They tossed one at me that was prescribed by the sleep study doc (I never met) and was told I would be able to figure out how to make it work. It didn't and I more or less insisted I be fit with a mask that actually might work for me (I spoke to my insurance company first). I was also prepared to buy one on my dime if that didn't work out after getting a prescription from my PCP. The second mask was actually fit to me a bit. At first the med supply place fussed that they couldn't let people try them on as it would make them useless and then relented and brought out a number of sample masks to do trial fitment. I am forced into a full face because of my extreme pressure prescription and the mask I wear now, A Simplus by Fisher & Paykel works decently; can't say if there are better or more suitable as the med supply place wasn't conducive to trial and error. It would be great if most PCP's had training to fill in patients on these issues prior to having to figure out how to pick out a mask or choose a med supply company for that matter. The insurance company was absolutely no help either as they can't suggest one med supply place over the other; I asked.
Thanks guys for all of the advice. I do like the Airsense 10, I have heard good things. I am pretty much in between the Airsense 10 and the Dreamstation Auto. They both seem to be the top of line from the main manufacturers (ResMed and Philips Respironics).
The mask seems to be a trickier deal as like you guys said, very personalized. I guess I will have to just start testing them out to see which mask is best for me. As I am a mouth breather and assume I will need a full face mask. I have been seeing a lot of good reviews about the Mirage Quattro, so maybe I will try that first and see if that works. I hear they have reasonable return policies so if I don't like it, I can try another one.
I will be sure to keep you guys in the loop on the results. Thanks again!
Most people with sleep apnea are mouth breathers but i have found that the BIPAP (or CPAP in your case) more or less allows breathing through the nose on a scale that wasn't possible before you began treatment. I used to snore and breath through my mouth but find the free flow of air through my nose a very pleasant change and now never open my mouth at night. I am a reformed mouth breather I guess you could say.
Good plan, brose005. And wiredgeorge makes a good point. Some patients who breath through their mouths prior to therapy are often able to use nasal masks or nasal pillows with treatment. However, if you feel you would do better with a full face mask, I have heard good things about the Quattro. As for the 2 machines you are looking at, both are very good. I happen to have and Airsense 10, but I have also used Philips machines. Both are considered top of the line. Thanks for keeping us posted!