[bluesquared]

I've commented on this before on HN. I have sleep apnea and a ResMed CPAP. A very US-centric response:

Insurance also seems to have access to this data in one way or another (not sure if direct with ResMed or via your doctor). If you don't hit your "compliance target" for treatment, insurance will cease paying 'their share' of the cost.

So I found myself in a downward spiral of 0. Struggling to sleep with sleep apnea. Tons of ramifications of not getting good sleep that I don't need to get into. 1. Struggling to adapt to sleeping with this device strapped to my face. I would take it off unconsciously.. I would often find the hose laying next to me in the morning still "pumping", or be told by my wife of belligerent (unconscious) responses to her prompting me to put it back on in the middle of the night. 2. Losing sleep from constantly waking up throughout the night because of the CPAP/from anxiety 3. Anxiety over not meeting my compliance target of 4 hours of use per night (as interpreted by the CPAP knowing the proper amount of back-pressure when in use i.e. not just turned on and not worn). 4. Getting charged more because I did not meet my targets for enough time 5. Eventually owning the CPAP outright 6. Eventually discontinuing therapy and somehow having slightly improved levels of sleep that I've never bothered to attempt to restart therapy

[NelsonMinar]

I'm so sorry you've gone through this, that sounds miserable. When you feel up for it I hope you can seek treatment again.

For context for other readers: the cost of one of these machines is about $800. That's a very small amount of money, often less than a single month's insurance premium. And for that the insurance companies turn medical treatment devices into anxiety-inducing spy machines. It's hideous.

[Fiahil]

> 800 […] That's a very small amount of money, often less than a single month's insurance premium.

Jesus fucking christ, what the fuck ?! How much does health insurance cost in the US ?

[bluesquared]

I pay ~$500/month for "pretty good" health insurance, and my employer pays roughly the same (a "benefit" that the employer pays 'half'! /s )

And then you have to pay small fees when you go visit a doctor ($25-ish each time), pay for medications (expensive). Emergency room swipes your credit card before a doctor even sees you ($150 co-pay for my plan). Pay thousands for an MRI (that the insurance company has graciously negotiated down 95%!)

[BenjiWiebe]

"thousands for an MRI"

MDSave.

I got a brain MRI for ~$450.

[NelsonMinar]

Prices vary widely and many Americans have no idea because their employer pays it.

You can shop California's market yourself; try 94114 for San Francisco. https://www.coveredca.com/

For a 30 year old it's $400 to $1100 a month depending on coverage level. A mediocre "Silver" plan is $400 at age 20 to $1060 at age 65, at which point you qualify for nationalized healthcare.

[missedthecue]

Is this really the first time on the internet that you've encountered a discussion about US healthcare costs?

[Fiahil]

Healthcare cost, no, but monthly insurance cost, yes.

$800 per months plus out of pocket sums for each appointment is batshit insane.

Plus, loosing it when you loose your job is even more difficult. I think I finally understand why every Michael Bay movie is starting with a surprise medical bill. I always thought it was somewhat silly.

To give you a example, I pay 75€ per months for the entire family, and we don't have to pay anything when going to the doctor.

[sp332]

I am American, and that sounds really high.

[bluesquared]

I have been having enough difficulty I've actually tried to restart in recent times. Vicious cycle of allergies and sleep deprivation make it hard to continue certain times of the year.

It was a lesson to be learned, I was unaware when starting treatment that you could buy one outright. Being a 60601 medical device I thought I had to just go along for the ride...

[GiorgioG]

It took me weeks to get used to mine, but I find I do sleep better with it than without my CPAP machine. With respect to insurance, I replaced my original machine without going through insurance. It would have cost me more out of pocket for the doctor visit and on-site sleep study.

The state of health “insurance” in this country is mind-boggling. But we continue to vote for politicians that vote against our own best interests. We need more than these two f’d up parties.

[alistairSH]

We need more than these two f’d up parties.

I've said it in other threads, but these "two f'd up parties" are the expected end result of our electoral system[1]. While we very occasionally see one of the parties replaced with an upstart, the parties eventually return to a similar status quo. Grassroots movements to implement run-off elections, approval voting, or other similar plans are seeing some traction. If you really want to see change, searching for these groups locally (and volunteering or donating) might be worth the effort.

1 - https://en.wikipedia.org/wiki/Duverger%27s_law

[hackernewds]

As someone who couldn't hit compliance either, any other sleep apnea solutions that have worked for you (or others?)

(apologies about derailing into subthread)

[cagataygurturk]

Here in Germany, "Mandibular advancement splint"[1] is a popular device recommended by doctors for less severe apnea cases. I was diagnosed with a light apnea and now I am getting this device as my test results showed that a CPAP treatment would be overkill but this could help. I am afraid I can't share more experiences as I am waiting the device to be prepared after 2 hours of dentist visit where they took some measurements.

[1] https://en.wikipedia.org/wiki/Mandibular_advancement_splint

[bluesquared]

Sorry I can't be more helpful, as I have no good answer. I do have good periods and bad periods.

Though not massively overweight (26.5 BMI), better eating and fitness habits seemed to have helped. Still working on getting to a healthier shape. Depending on the type of apnea, this can help a good deal.

Less electronics/screens in the evening. No more streaming tv/video games until right before bed. Jury's still out on the effects of blue light etc but I really try to limit my electronics to a Kindle (Oasis with the warm color temp feature) before bed.

I admit I didn't try too hard with different masks/setups, that could help. Though I was mostly using one of the most comfortable "nasal pillow" interfaces already.

I will second another commenter's suggestion of a more elevated pillow setup. I use a regular pillow with a buckwheat hull pillow on top. Bad for my neck but I've slept that way for awhile and have adjusted, it's hard to go back to a "more optimal pillow height".

[ianai]

For me, it's a combination of always ensuring my sinuses stay open and proper head placement for the mask to stay tight. Google "ayr gel" - I use the gel specifically. In dry periods or for congestion, that seems to (often) be enough to keep my sinuses open. For my current cpap mask I have to lay flat with no pillows for a proper fit. Then there's all the sleep hygiene stuff - no lights, proper bedroom temperature (cold), etc. (No lights means no lights - not even reflections from hall lights or the indicator lights from electronics can be tolerated.)

[NelsonMinar]

There's a couple of sleep apnea forums that might be helpful to you; I like http://www.apneaboard.com/

Before I got my CPAP set up the one thing I found that really helped me was sleeping on an inclined pillow, up about 20 degrees. Not comfortable but helped me breathe. There are other treatments for sleep apnea if CPAP isn't working for you; some surgical options, oral appliances, fancier breathing machines. Worth talking to a sleep specialist doctor about.

[dylan604]

>(apologies about derailing into subthread)

this is the natural evolution of a conversation. i feel no apology should be necessary. taking a conversation to new related directions is often where that Aha! or Eureka! moment is found.

personally, i find people that get upset and feel an apology is warranted are people i find quite boring to have a conversation with

[abduhl]

Well I broke up with my long term girlfriend and complaints about my sleep apnea stopped. Not sure if this approach is viable for you, but it will solve most peoples’ sleep apnea problem (snoring annoying other people).

Other good ideas are to try one of the mouth guards or a new pillow that keeps your head/throat area sort of tight.

[dylan604]

>Well I broke up with my long term girlfriend and complaints about my sleep apnea stopped

If we just stop testing people, the number of cases will go down.

If you turn up the radio, that weird noise the car is making will go away.

[x3n0ph3n3]

If you haven't already, take a look at the Phillips Dreamwear. It is the least uncomfortable CPAP mask.