#cpap

Pre diagnosis: if you have a neck circumference greater than 16-17 inches, it raises your chances of being diagnosed with obstructive sleep apnea. This means that you stop breathing for periods of time during your sleep, resulting in poor sleep quality and over time has the potential for more serious issues. Obesity is a risk factor, but you don't have to be heavy to have sleep apnea. If you sleep with someone, they probably already know if you have sleep apnea (it sounds like snoring with periods of not breathing, and then coughing/choking). If you sleep alone, there are recording apps you can use overnight that highlight any instances of sound for you to listen to in the morning.

Diagnosis: Once you suspect sleep apnea, you can bring it up to your PCP as a concern. They'll refer you to a sleep specialist, and they'll conduct a sleep study. Depending on your insurance, this can be at home or in a lab. If they conduct it at home, they'll send you a small machine attached to two pads that will go on your chest and a finger pulse oximeter. This will collect your data throughout the night about your REM cycle, your heart rate, and your oxygen. (I can't speak for the lab sleep study, but I had no copay for the machine) The specialists will examine the results and then send you a prescription for a CPAP machine, mask, and tubing.

Your insurance will rent out the machine to you for a premium every month. The machine will monitor the amount of time you wear it and send this information back to the specialists and the insurance. You are required to wear it for a minimum amount of time every night and a minimum amount of nights each week. If you fail to meet these requirements, your insurance can deny coverage for the machine, which for most people means they won't be able to afford it and they'll be charged for the full price. If you go on vacation, have an irregular sleep schedule, or have a difficult time adjusting to wearing a mask, these can all contribute to not meeting the minimum hours. The amount that my insurance quoted me for the first 6 months was $1200, and after that amount of the minimum requirements of 6 hours 5 nights a week were met, I would then own the machine.

Don't freak out! You don't have to do all that.

Call the sleep specialist and ask them to send you a hard copy of the prescription for the CPAP machine. They will try to get out of this. My office told me twice that if they sent me the prescription then the insurance wouldn't cover all the supplies I need. I had to be persistent and call back and ask for them to send it again. Once they email you the prescription, buy a second-hand machine off Facebook marketplace or craiglist (you might even be able to find someone offering one for free on a Facebook buy nothing group, or you can make a group post searching for one). It took me a few months of searching to find one I could afford, but there's a good market for them, either from people passing away or upgrading. They retail new for 400-1200, so people can get away selling them for a couple hundred bucks. I lucked out and found an excellent bipap machine, but you don't need a fancy, modern Bluetooth CPAP. Any old working machine will do.

Do not use second hand masks or tubes. These can have gross bacteria. Clean the entire machine with disinfectant, inside and out. Consider replacing the water chamber if it came with one. I bought all of my masks and tubing new on a CPAP supply website, which cost about $100, but they're mine forever. You can find people selling sealed, unused bulk supplies on FB, etc.

CPAP vs BIPAP: a BIPAP is just a slightly fancier version of a CPAP that offers two different air pressures for both inhalation and exhalation. It's okay to wait a little while after getting the prescription until you can find a machine you can afford (you've had untreated sleep apnea this long, you can wait a little longer), but after you get a junker, you can always upgrade to a better one in the future and treat your condition.

Using the machine: look up a manual online for your specific model. Look up a YouTube video for how to plug in your prescription. There's a whole bunch of settings, and options to store the data it collects in a USB/SD card.

Buy distilled water. Don't use tap, bottled, mineral, or spring water.

Different types of masks: there are masks that cover your nose and mouth, masks that cover only your nostrils; different types of headgear that go around your whole head or just your ears, and you might find different types more or less comfortable. The tubing is universal.

It's less loud and less uncomfortable than you think to adjust to. I suggest taking some Benadryl the first night just to get used to sleeping with something on your face. The quality improvement might be so significant that you won't mind the lifestyle adjustments. You can even buy small models of cpaps that are meant for travel. If you don't have hundreds of dollars to throw at insurance, it's better to buy one outright so you own it and no one can take it. You're supposed to replace your tubing/masks every 3 months, but if you take care of your equipment and clean it, you can probably stretch it a little longer.