I have BCBS. I pay for it each quarter but only after insurance has 'approved' it. It seems to go to the deductible, but I assume the price I pay is not much different than if I just wanted to buy it myself. I have noticed CPAP masks at CVS lately (over the counter). Seems a recent development to me.

Activated my Inspire unit yesterday. Last night first night with it.

Slept fine. Momma advises I have a ways to go to get it to the level it will work most efficiently.

Activation was a breeze.

busdriver88 said:

---

Activated my Inspire unit yesterday. Last night first night with it.

Slept fine. Momma advises I have a ways to go to get it to the level it will work most efficiently.

Activation was a breeze.

---

Good stuff. I tell my patients to go up every 3 days or so, no faster. I have a sneaking suspicion their spouses are pushing for faster. Out of curiosity, what's your starting voltage?

I had the procedure about 60 days ago. So far, no noticeable results in feeling rested. Wife says I snore less tho.
The prep procedures and the actual procedure were more than I bargained for. They tear you up pretty good. Also, you can definitely feel (and even see) the device in my chest. Kind of weird.
I was told by my ENT her experience was 85% success. I'm still hopeful.

Hhilton82 said:

---

I had the procedure about 60 days ago. So far, no noticeable results in feeling rested. Wife says I snore less tho.
The prep procedures and the actual procedure were more than I bargained for. They tear you up pretty good. Also, you can definitely feel (and even see) the device in my chest. Kind of weird.
I was told by my ENT her experience was 85% success. I'm still hopeful.

---

How many settings have you advanced since activation? Are you scheduled for a titration study yet, to determine what your ideal setting is? If you're going up on settings and reach a point of intolerance but suspect you're still having residual apnea, you can ask them to do what are called "comfort settings".
Definitely, in a lot of people, you can see the implant. It's real and it's there.
As far as not feeling more rested, maybe you have residual apnea and haven't hit the right settings yet. Alternatively, a lot of people who do not have severe apnea really don't notice much difference in how they feel during the daytime once their apnea is treated. Treating it, though, should reduce overall cardiovascular morbidity and mortality.
Keep plugging.

Kool said:

---

busdriver88 said:

---

Activated my Inspire unit yesterday. Last night first night with it.

Slept fine. Momma advises I have a ways to go to get it to the level it will work most efficiently.

Activation was a breeze.

---

Good stuff. I tell my patients to go up every 3 days or so, no faster. I have a sneaking suspicion their spouses are pushing for faster. Out of curiosity, what's your starting voltage?

---

Are you asking for my amplitude? I am kind of an idiot on this stuff. Ap shows level 1 at 0.6v. Is that what you were asking?

Doc was pretty clear on moving it up once a week. Sounds like I could go a tad faster if I thought I wanted to.....

busdriver88 said:

---

Kool said:

---

busdriver88 said:

---

Activated my Inspire unit yesterday. Last night first night with it.

Slept fine. Momma advises I have a ways to go to get it to the level it will work most efficiently.

Activation was a breeze.

---

Good stuff. I tell my patients to go up every 3 days or so, no faster. I have a sneaking suspicion their spouses are pushing for faster. Out of curiosity, what's your starting voltage?

---

Are you asking for my amplitude? I am kind of an idiot on this stuff. Ap shows level 1 at 0.6v. Is that what you were asking?

Doc was pretty clear on moving it up once a week. Sounds like I could go a tad faster if I thought I wanted to.....

---

Yes. 0.6 volts is REALLY low. That's great. If your doctor wants you to go up that slowly, then do so. I tell my peeps to go up no faster than every 3 days.

Kool said:

---

Hhilton82 said:

---

I had the procedure about 60 days ago. So far, no noticeable results in feeling rested. Wife says I snore less tho.
The prep procedures and the actual procedure were more than I bargained for. They tear you up pretty good. Also, you can definitely feel (and even see) the device in my chest. Kind of weird.
I was told by my ENT her experience was 85% success. I'm still hopeful.

---

How many settings have you advanced since activation? Are you scheduled for a titration study yet, to determine what your ideal setting is? If you're going up on settings and reach a point of intolerance but suspect you're still having residual apnea, you can ask them to do what are called "comfort settings".
Definitely, in a lot of people, you can see the implant. It's real and it's there.
As far as not feeling more rested, maybe you have residual apnea and haven't hit the right settings yet. Alternatively, a lot of people who do not have severe apnea really don't notice much difference in how they feel during the daytime once their apnea is treated. Treating it, though, should reduce overall cardiovascular morbidity and mortality.
Keep plugging.

---

Thanks Kool. I actually go for appt tomorrow. Not sure where I started. I'm up 6 clicks since I started. (One per week, and I cheated up once). I was having 35 events/hour w/o CP and 25 with. I relay results tomorrow.
Thanks again

Hhilton82 said:

---

The prep procedures and the actual procedure were more than I bargained for. They tear you up pretty good.

---

Can you please expand a little more on this? My mom is trying to get the procedure and is talking like it's nothing.

Of course.
Being a Neanderthal guy I think I'm a tougher than the rest. WRONG.
FIRST: there is uncomfortable probing in your nose in various exams. Nothing too bad, but not fun.
Second: like kool states above, you have to go in for a "surgically/drug induced exam so they can see how your anatomy functions while actually asleep. This is required by insurance to examine if Inspire can help or not.
It is a hospital day procedure (only 30 min or so in OR if I recall), but still the whole day surgery prep/recovery stress and inconvenience.
My meds wore off quick as promised so I went to work next day with sore throat. No real pain.
Third: they cut your upper chest about 3 inches and put an "Oreo" sized device under the muscle. It was scary to see when I came out. Swollen, stitches blood etc. Mine is still very hard and unnatural. They also make an incision in one's neck below the jaw. Again, scary looking for a few weeks.
Fourth: I also had some cartilage cut out of my nose to open passage ways (they suggested after surgical exam). Lots of blood, drainage, bandages. PITA.
Fifth: in # 4 they put temp splints in nose to keep open for healing. A week or so later they took them out (they were uncomfortable while they were in), and it was not pleasant. Office procedure with basically needle nose pliers and elbow grease. They were WAY larger than I imagined and nasty.
Personally, I didn't feel pain much and didn't take meds except to put me asleep at night. The day of the procedure, the meds are strong and I couldn't keep my eyes open.
It wasn't horrible, but I suggest one take it more seriously than I did. I should have done more some mental preparation.
I'm 62 and in good shape for my age, FYI.
Feel free to ask more.

You had more than just the Inspire done, then. Sounds as if, at the same time, they did a septoplasty, probably with turbinate resections. Having splints in your nose after the septoplasty is indeed miserable. As is having the splints removed. I'm not sure why surgeons put them in postoperatively as often as they do - I probably put them in maybe 1% of my posts patients. Regardless, it would probably be hard to tell just how uncomfortable your recovery would have been had you not had the nasal surgery, I would imagine that was way more discomfort than the Inspire.

I typically write for a total of 10 hydrocodone for my postop Inspire patients. I have never had anyone ask me for more, and if they did it would make me think they were having a complication. A good number of the patients tell me they didn't take any of their pain meds. These days, people are (rightly) afraid of narcotics.

I have had one patient who had prolonged postoperative pain - it lasted over a month, was NOT at the incision sites but instead in the back of his tongue and radiated to his ear, away from the operative sites. I have NO IDEA why that happened other than the possibility that we later discovered he was latex allergic and perhaps he was having a reaction to the cuff. Regardless, it thankfully resolved. We both decided to blame it on the fact that he is the brother-in-law of a hospital administrator where I practice, who referred him to me. Good as any other reason.

Just saw my clinic. I'm on 1.4. Should have been more but I guess I wasn't synching it correctly.
Not fair to evaluate yet.

Good to hear. That's really low. You've got lots of room to increase voltage and get better results

Pick up my Airsense 11 tomorrow.

Going to consult with a doctor anyway since mine is so severe - Kool do you have any suggestions in the Houston area? Assume ENT is the way to go? I have a BCBS PPO.

I'm sorry I wish I did. I've been out of the state for over 25 years now

First night with Airsense 11: 3.4ahi. My garmin usually reads 13-14 breaths per minute and said 11 last night.

Guitarsoup said:

---

First night with Airsense 11: 3.4ahi. My garmin usually reads 13-14 breaths per minute and said 11 last night.

---

3.4 is great. Keep it up. Breaths per minute might not be all that important of a metric. Oxygen content is, if your Garmin measures it

Kool said:

---

Guitarsoup said:

---

First night with Airsense 11: 3.4ahi. My garmin usually reads 13-14 breaths per minute and said 11 last night.

---

3.4 is great. Keep it up. Breaths per minute might not be all that important of a metric. Oxygen content is, if your Garmin measures it

---

I can turn it on, but just haven't to save battery. During my sleep study, my ox dropped to 82, which scared me to see. My father's dropped to 88 when he started to transition.

I had a strange question: My garmin quantix 7 watch tracks HRV when I sleep. My baseline was between 30-40ms prior to the CPAP. Since starting the CPAP, my HRV has measured in the mid-20s each night. Last night was an average of 24 with a low of 12 and high of 39. Should I worry about that at all?

Guitarsoup said:

---

I had a strange question: My garmin quantix 7 watch tracks HRV when I sleep. My baseline was between 30-40ms prior to the CPAP. Since starting the CPAP, my HRV has measured in the mid-20s each night. Last night was an average of 24 with a low of 12 and high of 39. Should I worry about that at all?

---

Oh, crap, now you're making me work.
Huge caveat/disclaimer ahead of this answer: I am not a cardiologist.
All I know about HRV comes from Peter Attia, to whose Podcast I subscribe.
Loosely paraphrased, it appears HRV over 14.7 is ASSOCIATED with less cancer, heart attack, and overall cardiovascular disease than lower. A HRV over 22.3 appears to give another "bump".
I am not sure how well the Garmin tracks HRV. That being said, a much easier metric to follow would be your O2 saturation. Time below 90% is important. Track that. Understand, also, that you drop a couple of percentages from your baseline as you go to sleep, then a few percentage points again when you enter REM sleep. And, just as with a home pulse oximeter, it's not uncommon to get a spurious reading here and there. Don't be shocked if you get an O2 minimum of 72% with only 3% of your night spent below 90%. That's likely artifact and not real.
IF you have a cardiologist, ask them what the think of the HRV data.

Thanks. My watch spot checks my PulseOx and it is 95+ in the night since starting this. In my sleep study it dropped as low as 82 and varied a lot between 92-98.

I don't really know how good the Garmin is on either pulseox or HRV. My BP is still in normal range, despite being a bit overweight. Now that I am getting good sleep, going to add some cardio and remove some saturated fat from the diet. Baby steps.

Guitarsoup said:

---

State of Texas said:

---

I have been needing to do a sleep study for a while, but last time I checked it was $800. I have BCBS also guitar - where did you have it done at?

---

I used Comprehensive Sleep medicine, but do not recommend them at all.

---

Does it not work or do you have some side effects? Can you please tell us a little more about that.
Also do you have the exact name of the medication? I would like to read about that on Canadian Pharmacy website and see what main points i should be aware of before even starting this treatment.

Kool said:

---

busdriver88 said:

---

Kool said:

---

busdriver88 said:

---

Activated my Inspire unit yesterday. Last night first night with it.

Slept fine. Momma advises I have a ways to go to get it to the level it will work most efficiently.

Activation was a breeze.

---

Good stuff. I tell my patients to go up every 3 days or so, no faster. I have a sneaking suspicion their spouses are pushing for faster. Out of curiosity, what's your starting voltage?

---

Are you asking for my amplitude? I am kind of an idiot on this stuff. Ap shows level 1 at 0.6v. Is that what you were asking?

Doc was pretty clear on moving it up once a week. Sounds like I could go a tad faster if I thought I wanted to.....

---

Yes. 0.6 volts is REALLY low. That's great. If your doctor wants you to go up that slowly, then do so. I tell my peeps to go up no faster than every 3 days.

---

Up five clicks now. You are correct on the wives pushing for progressing up the chain. Two nights at this setting, and I can for sure tell when it turns on with the sensation at the base of my tongue. No complaints so far.

My sleep has been jacked, as I am 21 days post op from a total knee replacement. So the damn leg is keeping me awake way more than I anticipated. But progress is being made.

That's great. Keep plugging away. Knee pain is going to interfere with your sleep as well. I'm not sure why it's the case, but the initial stimulus is stronger than the stimulus for the rest of the night. It's not uncommon that it irritates people. I would recommend that you wait until all of your nighttime knee pain is gone before going in for an in-lab titration, assuming your surgeon wants you to do one, as the knee pain will be just one more thing to disturb your deep sleep.

Hey Doc!

Sleeping better now as knee pain is almost entirely gone. Went in and the DOC scheduled my in lab stuff for a couple of weeks out. I was up 7-8 clicks, but to be honest I backed down yesterday as the night before I could feel my throat/tongue firing during the night, keeping me from falling asleep. Last night way better. I am assuming that is an indicator that I have moved up too far too fast.

My Doc says in a bit, after I have "climbed the ladder", he will move my ladder upwards to give me more upward room to move. Sounds like I am still in the beginning or middle of the process.

busdriver88 said:

---

Hey Doc!

Sleeping better now as knee pain is almost entirely gone. Went in and the DOC scheduled my in lab stuff for a couple of weeks out. I was up 7-8 clicks, but to be honest I backed down yesterday as the night before I could feel my throat/tongue firing during the night, keeping me from falling asleep. Last night way better. I am assuming that is an indicator that I have moved up too far too fast.

My Doc says in a bit, after I have "climbed the ladder", he will move my ladder upwards to give me more upward room to move. Sounds like I am still in the beginning or middle of the process.

---

That's fine just play around until you can't tolerate going higher and at some point do an in lab titration to determine where your setting needs to be