After the Sleep Apnea DX - check list of things to ask

[Tracy]

After the Sleep Apnea Diagnosis
Check list of things to ask your sleep doctor and CPAP provider

You have been diagnosed with sleep apnea. For most patients, sleep apnea is for life and this is the time to be proactive in your prescribed treatment therapy. You are most likely in a sleepy fog when you visit the sleep doctor for your follow up visit. You will be given the results of your overnight sleep study, have a follow up visit with the sleep doctor; then be referred to a CPAP provider and not necessarily in that order. This is a critical time as you begin CPAP therapy and the information you will be receiving is important yet may seem overwhelming; your brain may be on overload. This is all new to you and so how will you know what questions to ask?

The following is a checklist of important information you should receive and questions you should ask your healthcare providers.

Questions for your Sleep Doctor

What is my specific diagnosis and what is sleep apnea?
Obstructive sleep apnea, Central Sleep Apnea or Mixed Sleep Apnea (both obstructive and central)

What is the difference between the diagnoses?
If you are diagnosed with central sleep apnea, ask for a thorough explanation of what it is, why you have it and how it may be treated differently in your case.

WHY do I have sleep apnea?
Ask the doctor what your physical/anatomical reasons are for having sleep apnea and discuss your treatment options. CPAP is typically first line treatment, but familiarize yourself with other options that are appropriate for your condition. Treatment options are dependent on WHY YOU have sleep apnea in the first place.

Please provide me with my sleep study summary report
Your overnight sleep study summary report should be considered your baseline diagnosis. It contains a summary of the data collected in your overnight stay. It is very likely that you will have subsequent visits to the sleep lab in the future to monitor your CPAP pressure requirements. It is important that you have and maintain a folder with all of the paperwork you will receive at diagnosis and afterwards. It is prudent for you to keep copies of your records rather than relying on requesting copies in the future as often doctors move, close their doors or send your records to their archives which makes it more difficult for you to obtain them.

Please explain the relevance and details noted on my summary report
On your sleep study summary report, you will see AHI – apnea hypopnea index – it applies to the severity of your apnea condition, ask for details. You will also see information about your oxygen levels, limb movements and other notable details. Ask your doctor to go over each category of details so that you fully understand them.

Please provide me with a physical copy of my prescription for CPAP and equipmentIn most cases, the doctor will just fax this to your CPAP provider, but you should have a physical copy to keep with you. Should you move or wish to buy equipment from any other source, you will need the prescription. Should you be traveling outside your home area and need equipment, you will need the prescription. Should you decide to change CPAP providers, you will need the prescription. It is your right to have the prescription, ask for it.

What is your protocol for after care?
How often will I have a follow up with you, my doctor? You may have been referred to the sleep doctor by your primary care physician and never see the sleep doctor again outside of the initial follow up visit. Your follow up may be with your primary care doctor who will now manage your condition. Ask what the plan is and be comfortable with it.

How often do you recommend future titrations?
Titrations may be routine annual visits to the sleep lab to confirm or change CPAP pressures if needed. Find out what your doctors philosophy is on this important subject.

Questions for your CPAP Provider

Will I be allowed to choose my own CPAP machine, mask and humidifier, or has my doctor chosen specific brands?
Ask to be informed about the difference between CPAP, Auto CPAP and BiLevel machines. Generally, CPAP is given first and then if patient is not successful, more expensive Auto or BiLevel is tried. Inform yourself about these different machines and how they work so that you will be able to suggest upgrading if CPAP is not affective. The upgrade only happens if the patient fails on CPAP, so YOU must keep THEM informed of your progress or challenges.

What are the features of the machine I have been given?
Some features are preset and controlled by physician or home healthcare provider only. There are other patient controlled comfort features like ramp, expiratory pressure relief, auto on/auto off, altitude adjustment. Some features must be enabled before patient use. Find out if your machine features have been enabled for your use and learn how to use and change settings if needed. Don’t throw away the instruction booklets that come with your equipment!

Do you have a 30 day mask exchange program, if so, how does it work?
Most CPAP providers have a 30 day mask exchange program that allows you to choose a mask, try it at home for up to 30 days and if it does not work, exchange it for another mask of the same manufacturers brand.

How should we communicate during the adjustment period as I am starting CPAP therapy and beyond?
Beginning CPAP therapy can definitely be challenging and you should not feel alone in the process. Find out how often they will contact you to check on your progress or if they expect YOU to contact them with any difficulties you face. Each CPAP provider has their own follow up program, some better than others. This is where you need to be proactive and make sure to keep your healthcare team in the loop. Your CPAP provider is charged with the responsibility of assisting you, so don’t be shy in keeping them informed and asking for their help; this is part of what they are paid to do!

How often should I replace my CPAP mask cushion, CPAP Tubing, machine filters?
Equipment supply replacement will depend on your insurance coverage. Some CPAP providers may offer you an automatic replacement program where they will simply send you replacement items as often as your insurance allows. You may choose to only replace as needed. Masks for instance may be covered by your insurance to replace every 2-3 months, yet most patients can use the same mask for 6 months or more with good care and cleaning.

How should I care for and clean my equipment?
Regardless of whether or not you have insurance, CPAP equipment and supplies are expensive and you want to clean regularly to get the longest life out of your machine and other supplies.