DOT And CPAP Compliance

I live in western WA State. My friend is on a CPAP but having a hard time sleeping with it. His DOL exam coming soon? Any suggestions on a Tacoma Area clinic to get DOT? In Tacoma area? Recent CPAP requirements?

To maintain compliance: Drivers must use a CPAP machine at least four hours per night, 70 percent of the time. ... The compliance data should not be more than 30 days old and should be for a minimum of 90 days (some medical examiners may require a year of data if available

Has your friend tried a different mask? There's really no way around it. A doctor may be willing to give him a 6-9 month certificate if he explains the problem and how he's trying to fix it, but that's usually just a one time pass and not every doctor will be willing to do it.

I was first diagnosed with apnea about 15 years ago and had a very difficult time sleeping with my mask and eventually gave up. My sleep study doctor said if I slept on my side and lost some weight that I might be okay. With frequent headaches in the morning, I decided I needed to try again about four years ago.

I found the help at http://www.apneaboard.com/forums/index.php excellent. My new sleep doctor really tried to push him Respironics machine and Respironics mask (forget which models). But I had read grew reviews on the ResMed Airsense 10 AutoSet from some very experienced users and bought that (I paid 100% for it since I have high deductible insurance, but found a supplier that offered a discounted price). I also went with ResMed masks. Many users at the apnea forum above highly recommend the Resmed AirFit P10 which I tried and still sometimes use, but a deviated septum makes it very irritating after a few days. I ended up liking the Resmed AirFit N20 mask and find it quite comfortable, a far cry from my experiences a decade ago.

Some people get prescribed with a full mask covering their nose and that is harder for many people, though some tolerate it fine. One guy in that forum suggests some training methods to avoid mouth breathing (pull tongue back in mouth before closing tightly, it becomes a habit after a while) and another forum member recommends using surgical tape and taping lips shut. Sounds drastic, but it's not (also a helpful tip for anyone with snoring problems but not apnea).

This forum also offers a free software download that is extremely helpful and many members take screenshots of their readings to get help on adjusting the settings on their machines. Perhaps your friend can get by on a lower pressure than the doctor recommends. When I had a sleep study my doctor had me take valium before going to sleep and I think that exaggerates the readings (drinking alcohol before going to bed is also said to increase apnea readings). I use a fixed pressure of 7 which is fairly low and I only very rarely have any AHI above 1.0 and many nights am at 0.0. I took my laptop to my doctor once to show my readings as I had some questions and he was literally shocked at what he saw as it was much more detailed than what he saw with his software but he preferred just referring to his software information which was more high level summary sort of information and told me not to worry about the smaller issues.

I continue to try new masks from time to time when I read people rave about a new mask but just keep going back to the ResMed AirFit N20.

Keeping your mask clean and replacing the cushion every 3-6 months also makes it more comfortable. If my mask starts bothering me several nights in a row, I know it's time to replace the cushion.

I struggled badly with CPAP use when I was first diagnosed. I second the rec to look at apneaboard. However I caution you, some sleep Docs don't appreciate being second guessed, and will fire you as a patient for it.

*****I am not a medical provider, and my answer is based solely on personal experience, and what worked for me*****

What I had to do, was bring my data to a new sleep doc, and explain my theory of what was going on. (My pressure needs jump from low support needs to high, randomly, and a fixed pressure doesn't work for me.)

"Compliance" for DOT (and insurance companies) is 4 hours per night, 80% of the time. I have seen friends sit in bed with the machine and mask on watching movies so that they could get acclimated to it. Also, most DME providers will allow a patient to exchange a mask within 30 days to find one that works.