So I am finishing up my 1 month free trial and am assuming I am going to buy it outright.

How much did you pay for yours? I know the government pays so much and the price of the unit is $260 but what are the other costs? I'm just trying to get a total.

If it costs too much, I hope someone has one for sale....CHEAP.

I can't imagine you finding a reliable unit for less than $260, therefore it's worth it to get a new unit (about $1150 less the OHIP portion as you mentioned). They should come with at least a 1 year warranty.

I can't remember if the units come with your first set of tubing and mask, but those are about $200. Some people get new masks every 6 months, but if you take care of them they should last longer. Some workplace health plans cover 2 masks a year.

I would avoid getting sucked into buying "cleaner kits" -- total rip off. The "tube cozy" is nice because it helps prevent the warm air from your humidifier from cooling and dripping in your nose at night. They're about $25, but if you can sew and have the time and inclination you can make your own. Some people have heated tubes, but those are more expensive, usually aren't available without an upgraded model and will cost more to replace.

I just got a new machine not that long ago.  I use a full face mask, which are more expensive than the base nasal one that comes with it.  My out of pocket was $260 and that included the machine, tubing, full face mask.  My insurance picked up the $260 I had to pay.

So $260 total?  I figured that there would be "extras".  Like a charge for this, a charge for that.

Well that's not too bad.

 

See my problem is, and I'm going to go against the grain....After my 30 day trial, I still can't get used to the machine.  I have tried 2 masks and I think they are comfortable enough but I hate it.

 I just read the other thread where ppl are talking about loving their CPAP but I don't. I do not wake up feeling refreshed.

So I am not liking the fact that I have to spend lots of money on a machine when I will just wear it for the surgery and that is it.  I wish I could rent or borrow one for the time and not have to worry about this cost.

I hated it too for a long time but I knew I needed it or I could risk dying.  How do you know you won't use it after surgery?  Is it because you just won't use it even though you need it or you think you won't need it once you lose some weight?  As you can see from the other thread there are some of us that have lost our weight and still need it.  I bet it took me 3 months to get used to my machine and even now 14 years later,  I have weeks where I hate it still.  This past summer, I hated it because my mask was not fitting right or sitting right and I have been buying a new mask every 6 months and I always get the same brand because most of the time it's comfortable but for some reason this summer it just didn't sit right.  It was time to buy a new mask so I tried 4 different ones and each was worse than my usual one so back to my usual one I went and finally I liked it again after two months.  Most CPAP providers let you test masks and then you can keep exchanging it within 30 days of getting it if it just doesn't fit right or work properly for you.  Some places do rent them, have you asked your provider if they do the rental there.  If they don't, call around to other providers and ask them if they offer rental machines. I woke up this morning and guess what, I hated my mask last night but not while I was sleepingt, when I got up because my mask dug into my face and now I have a welt on my nose from it but I still slept well.

You can rent/borrow a machine for more than a month -- your machine provider does this all the time (any of them).

That being said, PLEASE don`t dismiss it as "Ì will wear it for the surgery and that is it".  Sleep apnea isn't an inconvenience, it's potentially fatal.  Lethal.  Deadly. 

You're considering weight loss surgery to live longer.  Why on earth would you not work hard to use this life saving therapy?  You are courting a stroke, or a heart attack, which, if they don't kill you, will disable/maim/incapacitate you permanently.

The whole surgical journey is a process towards good health, sleep apnea is part of it.  Please treat it seriously, I implore you.

Anesthesiology and obstructive sleep apnea: A patient safety challenge

JEFFREY S. JACOBS, MD | CONDITIONS | AUGUST 1, 2013

 

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

Obstructive sleep apnea (OSA) has been diagnosed in more than 18 million American adults, but there are likely millions of others who suffer with OSA, but are undiagnosed. While OSA is frustrating to the patient and the patient’s family, it is crucial to remember OSA is a significant disease that can affect the patient’s safety during and after medical and surgical procedures. The involvement of a physician anesthesiologist is critical to a successful outcome before, during and after a procedure. While the care of these patients may seem as conventional as healthy patients without OSA, it is only because the physician anesthesiologist has addressed the unique risks of this patient group and prepared appropriately.

 

Since the care of patients with OSA is not only unusual, but potentially devastating if not done correctly, the American Society of Anesthesiologists (ASA) adopted Practice Guidelines for the Perioperative Management of Patients with Obstructive Sleep Apneain October 2005. This document is being updated with the latest research and is scheduled for release in October 2013.

The first step when caring for a patient with OSA is identifying them. OSA patients often have a high body mass index, large neck circumference, daytime sleepiness and snoring, but many don’t have any or all of these features. To discover these details, the physician anesthesiologist completes a preoperative evaluation by reviewing medical records, interviewing the patient and his or her family members, and conducting a physical exam. The importance of pre-procedure identification is critical because being recognized as a person with OSA will drastically change the care a physician anesthesiologist will provide during and after the operation or procedure. In fact, it is not unusual that a patient with severe sleep apnea has his or her procedure in a hospital as opposed to an outpatient center or office.  If a patient has been diagnosed with OSA and uses a CPAP machine (continuous positive airway pressure) to help breathe during sleep at home, it is ideal for the patient to bring the machine the day of the procedure for use in the recovery room and during sleep in their hospital room.

Next, the physician anesthesiologist decides which type of anesthesia is ideal for the patient and the procedure. The prescription of the anesthetic plan will affect the patient’s postoperative care. Each plan must be individualized to the patient and the procedure. The plan may include an intentional avoidance of general anesthesia, to avoid exaggerated sleepiness and airway obstruction postoperatively. If general anesthesia is required, non-standard approaches to securing the airway may be needed, which means alternate equipment like fiberoptic bronchoscopy or videolaryngoscopy may be necessary. This kind of equipment may not available at all locations. Medications used during the procedure may be different for OSA patients because they are more sensitive to the effects of sedatives and opioids (morphine-like drugs).  Further, regional anesthesia (including nerve blocks) may be used to either provide the sole anesthetic or minimize postoperative pain (which will allow lower doses of opioids).  The anesthetic will not just affect the care of the patient in the recovery room, but also beyond that time, stressing the importance of a physician anesthesiologist who understands the intricacies of OSA.

After the procedure or operation, the patient’s pain relief and recovery from anesthesia should be constantly monitored. In fact, it is recommended that patients with OSA remain in a monitored setting with pulse oximetry (which measures the amount of oxygen in the patient’s blood****il they are able to sleep and maintain an oxygen saturation of at least 90 percent while breathing room air. This almost always requires a longer recovery room stay as compared with patients who do not have OSA. If a patient fails this trial, hospital admission may be required. Pain control should ideally avoid the use of opioids whenever possible because OSA patients are hypersensitive to these medications, which could result in respiratory depression and even cessation of breathing. Options may include non-steroidal medications (like ketorolac) and nerve blocks (local anesthesia anesthetizing a specific body part). If intravenous opioids are needed, continuous infusions should be avoided and supplemental oxygen along with continuous oxygen monitoring is recommended. The complications of oversedation and apnea can be catastrophic (possible brain injury or death), but with appropriate planning, can be avoided.

Patients with diagnosed and undiagnosed OSA are physiologically “different” than healthy patients, and they need to be treated with great care. This treatment begins before the procedure and lasts well into the postoperative phase. Because of the variety of possible strategies and the unfortunate possibility of devastating complications, the anesthetic plan is best orchestrated by a physician anesthesiologist who has been trained in all facets of OSA care.

Jeffrey S. Jacobs is an anesthesiologist. 

TAGGED AS: PULMONOLOGY, SURGERY

 

Hi Alysan,

I tried every mask possible that would hold my high pressure.  Some would work great but would pinch my face and I would wake up with huge sore welts on my face...others would cause me to feel as if I was being suffocated and I would either rip it off my face, while awake or asleep.

I finally found one mask that seems to be the 'go to' mask...its called the true blue..and actually is sort of flexible in the snout area (for lack of a better word.)  I am a side sleeper and find this mask doesn't leak.

I really suggest that you keep on trying different masks before you buy one (your clinic should allow exchanges even after you purchase), because if you can get a mask that fits, you have won half the battle.

I still struggle with the machine, and still do not feel refreshed in the morning.  However, with that being said, I just had some episodes where due to medication and my breathing being suppressed because of it, I felt like I could not catch my breathe (was a little scary ).  Without the machine I could actually feel my breathing stopping, but with it, I could feel it forcing its way in...giving me reassurance.

Anyway, I wish you well...I know its a struggle...but according to most of the vets...its does get easier.

Vicky

Hi,

 

I've had a CPAP for 4 years now, and I won't say that I love it, but when I don't use it, I really feel it!  My pressure is pretty low 7-8, so the mask I just bought is a nasal mask.  My insurance covers it and covered the balance on the machine when I got it.  I think the government covers $750 - something like that.  When I first bought the machine, I bought a mask and actually ended up using the mask that came with the machine!  I got sucked into buying an extra water resevoir, heated tube, wipes etc.  The tube is handy in the winter.  I went to my work Christmas party last Saturday and stayed over at a hotel, and since it was 1 night, didn't bring my machine.  I had a terrible sleep and my throat was so sore.  Many places will tell you that the average person doesn't keep it on all night, they manage 4-5 hours. 

Good Luck!

Pam

In Ontario there is ADP funding which covers $750. So depending on the unit you choose you pay the difference. You want to make sure you get one with a humidifier. The most expensive part is usually the mask which average about $250. You will also need to get extra tubing, filters and distilled water. If you have insurance they should pay for supplied and mask. Depending on how severe or cause you may not need it for too long. I was able to stop about 6 months out.