Has anyone declined getting the C Pap Machine and was still approved for surgery???

In my original consult I told the doc that I have a machine but never use it due to the mask being too uncomfortable and claustrophobic and he said that in order for him to do surgery I have to use the CPAP. I'm not really sure if he meant in general or actually in the hospital after the surgery.

He suggested that I get a different mask and find a way to use it so I did that. I still can't really sleep with it though but I am trying.

Do you mean declined by insurance or declined to use a CPAP yourself? Sorry if that sounds thick, but we don't have (in Australia) the concept of your insurance company declining you care recommended by your dr - although we also don't get much of a rebate for CPAP machines on insurance ; ( - I got about $600 on my insurance, which is considered a good policy. New, good spec machines cost around $2k (with mask). I chose to get an APAP which is more flexible, and this cost me $2600 (including mask and follow ups indefinately).

If you've been diagnosed with sleep apnoea I'd strongly recommend a (properly fitted) CPAP or APAP machine and use it consistently. It makes a huge difference to how I feel, is said to help with weight loss and untreated sleep apnoea is a serious risk to your health. If your sleep apnoea is mild, a "splint" may help, be cheaper and easier to use.

I consider the $2k I'm out of pocket some of the best money I've ever spent on myself.

Edited December 4, 201312 yr by Sydney Susan

In my original consult I told the doc that I have a machine but never use it due to the mask being too uncomfortable and claustrophobic and he said that in order for him to do surgery I have to use the CPAP. I'm not really sure if he meant in general or actually in the hospital after the surgery.

He suggested that I get a different mask and find a way to use it so I did that. I still can't really sleep with it though but I am trying.

Perhaps a sleep technician could help you work out why you are finding the CPAP so hard to adjust to. It has to be set to the right pressures, to ramp up to pressure over time (ideally you will be asleep before it is up to full pressure), and your mask must have no leaks yet allow exhaled co2 to escape, and you must sleep with your mouth closed or use a chin strap to keep it closed. It can be quite a challenge working all that put by yourself.

I have a nasal mask and find that quite comfortable except on hot or humid nights. Because it only covers my nose I don't find it at all claustrophobic.

My dr insisted I take my machine to hospital and use it, which is no chore for me as I find it quite reassuring and restful. My father died young-ish and he had untreated sleep apnoea which was probably a contributing factor. I want to die really really old, and yet leave a great looking corpse.

I was told by my pulmonary specialist that it is recommended for use before and after the surgery he said even people with mild sleep apnea such as mine can have difficulty breathing after surgery and use of your CPAP before and after lowers the risk of problems.

My pulmonary doctor told me that if I didn't wear mine for an entire month for a min of 4 hrs per night he would not clear me for surgery. I argued with him and tried to get him to allow me to use the dental appliance but he refused.

I wore it for an average of 4 hrs per night so I could get my clearance. I was going to stop after the clearance but my insurance company required a modem on my unit so they could monitor my progress. So it looks like I'm wearing it until I get approved for my sleeve.

My pulmonary doctor told me that if I didn't wear mine for an entire month for a min of 4 hrs per night he would not clear me for surgery. I argued with him and tried to get him to allow me to use the dental appliance but he refused.

I wore it for an average of 4 hrs per night so I could get my clearance. I was going to stop after the clearance but my insurance company required a modem on my unit so they could monitor my progress. So it looks like I'm wearing it until I get approved for my sleeve.

Depending on how severe your sleep apnoea is, a splint may meet your needs far better than a CPAP machine used only 4 hours a night. Non-compliance (little, inconsistent or no use of CPAP) is a huge problem in treating sleep apnoea, and (i believe) far better with a properly fitted splint. You should be able to find an article on this and share it with your doctor - perhaps that will convince him?? I've added one below. http://www.ncbi.nlm.nih.gov/m/pubmed/23413266/

And note this was comparing a splint with significantly more hours of CPAP use than you are doing.

Edited December 5, 201312 yr by Sydney Susan

I had to have a print out from the SD card in my c pap to prove compliance and had to have it with me day of surgery.

I was told by my pulmonary specialist that it is recommended for use before and after the surgery he said even people with mild sleep apnea such as mine can have difficulty breathing after surgery and use of your CPAP before and after lowers the risk of problems.

My surgeon said exactly this. It's his requirement, not insurance, so I'm guessing it depends on your doctors. Personally I'm having trouble with the CPAP, because my pressure is pretty high and the masks (I've tried two different ones) make me feel really claustrophobic.

I don't even have sleep apnea (passed the sleep study with no significant apneas) and yet the hospital pulmonologist (sp?) tried to convince me I needed to use one in the hospital post-op. She seems put off that I didn't have one and set about trying to get One for me to use. I was completely caught off guard by her insistence so I didn't argue...luckily my dr came by an hour or so later to check on me and said I didn't need one.

Sydney Susan,

I have switched from the old mask, which was claustrophobic, to nasal pillows so that's not really the issue anymore.

Now I think it's that I can't get back to sleep with it after I wake during the night (which I do multiple times). I have to get up at least once or twice to go to the bathroom. So I have to disentangle from the head gear/nasal prongs and then get it all back on and in once I'm back into bed.

By then the pressure is at full speed and it's a lot going into my nose.

Actually, even when I first go to bed (before the ramp up) I feel so upset, I hate the plastic smell of it and the sound it makes when I exhale and the fact that I am uncomfortable falling asleep on my back. It removes all of the joy I normally feel at bedtime. Ha ha.

I do have the ramp up and humidifier features.

If you have any suggestions I am very open to any and all of them.

Woo woo,

My situation is almost exactly like yours. I wake up multiple times per night for bathroom visits and have trouble getting to sleep and staying asleep with it on (even using the ramp up feature). Like you, I don't like the smell or the sound of the air. In my case it also feels like I can't breathe out through my nose. There's too much air/pressure coming in, even with it set to adjust when breathing out. I don't like that the air is warm either (whether I turn on the humidification or not). I tend to feel suffocated if the air in the room is not cool.

I was interested in the nasal pillows, but when I visited for my month follow-up the tech told me that my pressure is high (14), so the pillows would give me nose bleeds. She gave me the whole face mask (like that's supposed to help with a claustrophobic feeling?) Is your pressure high? If so, I think she might have been full of crap.

The thing that stumped me the most is that the doctor mentioned that I have mild apnea, yet the pressure is high. Seems kinda backwards to me.

I'm also up for any suggestions. I'm supposed to wear this thing four hours per night and I can barely get past two and when I use it, I sleep even worse than I do without it!

~Melody

Hey Melody,

My pressure is 8. My tech did say to me that if it (my pressure) was any higher than that she probably wouldn't recommend nasal pillows to me.

That being said it's not all that great anyway. But -- that full face mask they started me with? OMG FORGET IT there is no way. I got a panic attack even thinking about wearing it and never once wore the thing. The entire machine and mask sat in my closet for 10 months until I decided I wanted to have surgery and called for a new mask.

If I was you I would maybe try the nasal mask, which fits just over the entire nose but not *in* the nostrils and not over your mouth at all.

What I did was call the company and say I needed to find a new mask and I wasn't sure which I wanted. The tech came over to my house with a big bag full of one of every mask that was available that my insurance would pay for.

I tried on the nasal mask and it actually felt pretty comfortable but ended up choosing the pillows instead just because it was smaller and lighter. Now I sort of wish I had gone with the other.

I'm pretty bummed about the whole deal and haven't worn it at all for 2 weeks.

ETA: I think the pressure is just whatever was needed in the sleep study to prop your throat open so that air flows freely. I don't think there is necessarily a correlation between pressure and severity. I could be wrong though!

Edited December 5, 201312 yr by woo woo

My pressure is 15 or 16, so pretty high. I don't use the nasal pillows, just a mask that goes over my nose only. If I wake up in the night and turn off my machine the ramp up restarts - perhaps try to set it for a longer/slower ramp up. I have heaps of trouble going to sleep and try to avoid laying there with my mask on, but my ramp up is set for 40 mins.

I have the Resmed S6 and the temp can be set separately to the humidifier - perhaps that can be sorted out on yours?

Re smell, yes or can be horrible. I am perhaps somewhat "blessed" with a poor sense of smell, so not such an issue for me. However cleaners can really get to me, so I confess I don't clean as much as recommended.

Re noise, a new, high spec machine should be pretty quiet, but somedays the noise just gets to me. I throw a pillow over the machine, just making sure the inlet area (mine is at the back) is kept clear. I find it makes a huge difference. Clogged filters will make the machine noisier, and in a dusty environment they need to be changed frequently. A mask should be quiet (not silent, but v quiet). If its not there may be a leak. Remember that you shouldn't be breathing out your mouth.

I do have trouble using CPAP if I have sinus issues or a cold - as you can't use the machine with your mouth open, if you need to breathe through your mouth it's best not to try to use the machine.

Lastly, sleep apnoea is always worse on your back so try to sleep on your side - you should be able to go to sleep on your side. Perhaps a smaller pillow will stop the mask being pushed to the side (I'm assuming that is what is happening).

We should start a thread of tips for using CPAP/APAP machines. But as you can see by this thread, it's complicated and a good sleep technician is well worth his/her weight in gold!

Once you get it sorted you will wake so refreshed that it will become a real security blanket. Good luck with it.

Hey Woo woo,

Thanks for the response! That's a bummer about the pillows, though I'm glad she wasn't telling me stories.

I actually started with the mask that just goes over the nose. It's not NEARLY as claustrophobic as the full face one, but I still feel like I can't breathe out. I read some articles about the high pressure sometimes interrupting sleep and causing more issues than the apnea itself. Maybe my pressure is just too darn high.

I've often wondered how I could cheat. Like wear the mask while I'm awake reading in bed for a few hours or something to trick it. Sad, isn't it?

Hey Sydney Susan,

Didn't get the notification that you'd posted until after I sent the last message! Thanks for all the info!

I think the ramp up time on mine is 40 minutes as well. Generally when I lay down, I will read or something for a bit and then go to sleep. I don't put the mask on until then. However, three hours later (I've never been able to wear it longer than three hours), I will wake up and pull it off and gulp in air. Feels like I'm suffocating.

I'll check my machine and see if there's another setting for temp. I don't *think* there is, but it's worth a look.

The noise of the machine itself isn't the issue for me. It's the noise of the air blowing at my nose. I actually sleep with ear plugs all the time (light sleeper) and a box fan, so I'm used to that muffled white noise sound, but for some reason the air from the machine is highly annoying.

Thankfully I usually sleep on my side (I always begin sleep on my side), though usually when I wake up and yank the mask off, I'm on my back. Unfortunately I don't know of a way to make myself stay in one position while sleeping.

I really wanted the CPAP to give me a better night of sleep, but I certainly haven't seen that yet.

Edited December 5, 201312 yr by Melodica

Do you wake up with a dry mouth? If so you may be opening your mouth in your sleep - all the air will rush out of your mouth, not get into your lungs and cause you to wake up feeling like you are suffocating.

I haven't used nasal pillows but I don't think you should be experiencing that noise. My husband is a very light sleeper and he tells me that when my machine is set up right both I and the machine are v quiet. Can you exchange your mask for the nasal type (not pillows)? Or buy one?

Do you have access to a sleep technician? I am a firm believer that we can all get CPAP to work for us - and I've benefited so much from mine.