New to board, first CPAP tomorrow

[Dive Apnea]

So, I got diagnosed as stopping breathing 28 times per hour. Sorry, I dont have all the lingo down. Anyway, tomorrow, I go to a 1 hour class from the DME company on how to use machine, clean, etc.

Before I go, is there anything I need to know? Ask? Machine style? etc. etc. Other helpful hints that maybe some of you all may have wished you had asked when you first got your CPAP.

I have been reading a lot of threads, and am a little worried that this machine may not "cure" my condition, seems like it takes a while for people to get their energy back...

thanks for your help,

Dive Apnea

[JohnBFisher]

... So, I got diagnosed as stopping breathing 28 times per hour. Sorry, I dont have all the lingo down. ...

LOL! Do not worry about that. You will be learning like crazy over the next three months or so. But that's perfectly normal. When you are done, you may wonder just how the miracle of respiration ever took place without an CPAP device!

... Anyway, tomorrow, I go to a 1 hour class from the DME company on how to use machine, clean, etc. ...

Cool! Mine never did that. And trust me, it would have made it a bit easier to get used to it. A good DME there.

... Before I go, is there anything I need to know? Ask? Machine style? etc. etc. Other helpful hints that maybe some of you all may have wished you had asked when you first got your CPAP. ...

Okay, here's a list:

• Be sure the unit is "data capable". That needs to include tracking central apneas, obstructive apneas, hypopneas, snoring, etc.
• Ask if the unit includes a humidifier.
• Ask if the unit has filters. (Answer should be yes). And some should be included.
• Ask if the unit has fine filters. Not all do. I personally like those that do, but for most people it's not necessary.
• Ask about their policy if the mask does not fit. They should allow you to return it within a few days / week.
• Ask about how often you can get a new mask, hose, headgear, etc.

... I have been reading a lot of threads, and am a little worried that this machine may not "cure" my condition, seems like it takes a while for people to get their energy back... ...

It seems to depend on the person. I've been using an xPAP device for over 20 years. When I was first diagnosed, obstructive sleep apnea was pretty new. So, I did not go to my doctor until the symptoms were SEVERE. And I mean REALLY severe. I was so starved for REM sleep that I would literally dream when I blinked. Gads! Talk about dangerous - especially behind the wheel of my car.

In my case, it was easy to adjust to the xPAP therapy. But I don't recommend waiting until you are that tired!! It's a minor miracle I did not get into any accidents at the time.

But I sure hope you can and do adjust fairly quickly to a CPAP. Even if you only sleep a "little" better, it does not take all that long before you start to notice that you don't feel as if you will fall asleep at the drop of a hat. You are more focused. You can think more clearly. You remember things better. You will feel more alive than you have in a while.

[Dive Apnea]

I appreciate the reply.

I will take those questions with me. I was infomed, my CPAP has filters, and I get a humidifier.

thanks!

[cflame1]

try this blog:
http://maskarrayed.wordpress.com/what-y ... me-part-i/

[Dive Apnea]

Thank you for that link! I am going to call my insurance prior to my class.

[archangle]

So, I got diagnosed as stopping breathing 28 times per hour. Sorry, I dont have all the lingo down. Anyway, tomorrow, I go to a 1 hour class from the DME company on how to use machine, clean, etc.

Before I go, is there anything I need to know? Ask? Machine style? etc. etc. Other helpful hints that maybe some of you all may have wished you had asked when you first got your CPAP.

I have been reading a lot of threads, and am a little worried that this machine may not "cure" my condition, seems like it takes a while for people to get their energy back...

thanks for your help,

Dive Apnea

You are a sheep heading into the lions' den. Many DMEs are worse than used car dealers. DME (Durable Medical Equipment provider) is the person who sells you the machine.

First, realize that, for most insurance carriers, you can choose between any DME who is a preferred provider for your insurance. If your DME doesn't give you what you want, DO NOT take the machine they offer, leave and check out your other options. It won't hurt you to wait a few mode days to get your CPAP machine if you've survived this long.

Get your own prescription written on paper. Don't let your doctor send the prescription to his favorite DME without giving you a copy. By law, they can't choose the DME and they have to give you the prescription if asked. If he's already sent it to the DME, get your own copy from the doctor.

DMEs often have cozy relationships with a particular doctor. This may not necessarily be anything "sneaky", but the doctors best interests are not necessarily your best interests. I think there's sort of a "medical mafia" where they tend to look out for each others interests, not necessarily the customer's (patient's) best interests.

Remember, DO NOT accept a machine that doesn't meet your requirements. You are not dealing with a friend. You are dealing with a car dealer. If you're not happy, shop at other car dealers.

The way insurance works in most cases, there are a number of "Preferred providers" for your insurance. The DME gets the same amount of money no matter what CPAP machine they give you. They have a financial incentive to sell you the cheapest machine, not what works best for you.

My opinions on machines:

1) I would only accept the latest version of a particular manufacturer's machine. The older machine may be a very fine machine. The new machine is better. With insurance, you and your insurance probably pay the same price for both. It's like going to your new car dealer and being offered a 2011 model year car or a newly manufactured car built to the 1980 model year design. Both cost the same price. Yes, the difference between the previous and current model CPAP machine IS as big as 1980 to 2011 in cars. CPAP has only been around a few years.

For Respironics, I would not accept any machine that does not say "Philips Respironics REMstar." Any machine that does not say "Philips" is an older model that's probably missing very important features that are on the new models. Most of the older machines say "Respironics REMstar." I'll call these PRS1 (Philips Respironics System One) machines.

For ResMed, I would NOT accept any machine that says "S8," only accept "S9."

These are the most common manufacturers, but there are some other fine machines I'm not familiar with.

2) Do not accept machines that do not record events and waveforms. They should record Hyponeas, Apneas, leaks, snoring, and some other events.

For Respironics, I would accept a REMstar PRO or AUTO. I would NOT accept a REMstar Plus. (Don't let them confuse you with "Plus" vs. "Pro." )

For ResMed, I would accept an Elite or AutoSet. I would NOT accept an Escape or Escape Auto. (Don't let them confuse you with "Escape" vs. "Elite")

There have been reports that some DMEs will tell you that one of the lesser machines records data and show you the data card. The lesser machines usually only record the time you turn the machine on and off to prove compliance, and record little or no data that tells you how your therapy is working.

The truly data capable machines (PRS1 Pro or Auto, S9 AutoSet or Elite) record data that will help your doctor or you whether you're having apneas and some other breathing problems at night. You or your doctor can use software to look at actual waveforms showing your breathing through the night. It looks a bit like the heart monitor graphs you see on TV.

3) Be sure they give you 30 days to exchange a mask if it doesn't work for you. Most manufacturers will exchange a mask for free through the DME. Some DME's are not willing to go to the effort to exchange masks.

4) I would not accept a FFM (Full Face Mask) for the first try. An FFM is one that covers both your mouth and nose. In my opinion, a mask that does not cover your mouth is much preferable for several reasons. Some people will let air leak out of their mouth and can't use a nasal mask. You should try a nasal mask first, then use a chin strap if necessary to stop leaks. If you can't make the chin strap and nasal mask work, then you should use the FFM only as a last resort.

Some DMEs want to sell you a FFM to start. I think they simply don't want to deal with having to switch masks or handle leak problems so they just give out FFMs and say "tough it out."

If you need an FFM, they can work just fine. It's just much better if you can make a nasal mask work.

5) I'd like to get an Auto machine if possible. The Auto machine will do everything the non-auto machine plus some more. The price to the DME is not that much more. Getting an Auto machine instead of a manual CPAP usually requires a cooperative doctor to write the prescription for a pressure range. You might be able to get DME B to give you an auto if you tell him that DME A won't give you one, and he gets your business if he does.

Some DMEs will tell you that you can't get an auto machine unless the doctor prescribes it. That's not true. If the doctor prescribes a fixed pressure, the auto machine can be set to give you fixed pressure.

6) With the doctor's prescription, you can buy your own machine online. You won't get as much handholding. Obviously, you won't get face to face service. Your insurance may not be willing to pay for a machine bought online. Price will be MUCH less. Cpap.com sponsors this web site, but I'm not affiliated with them. They seem to be reputable, but there are other online sites as well.

Good luck. Remember, DO NOT take the machine right away if it's not the "right" one for you. Walk out and shop the other used car dealers. Be polite, but say you want to do some checking on your options. Don't burn any bridges if you don't have to. You might end up back at the same place later.

[archangle]

One more thing. Get an integrated heated humidifier. Most of us need one. If you don't need one, you don't have to use it.

Edit - one more one more thing.

Be sure your DME is a "Preferred Provider" for your insurance if that matters. Or "in network." In both of these cases, your insurance sets a price for everything and the DME has to accept that price and can't charge you any more. Just because your doctor, sleep clinic, hospital, etc. is "in network," that doesn't mean they won't send you to an "out of network" provider.

[mayondair]

Dive Apnea, my first dME tried the "class" ploy . DO NOT sign anything or take home any machine until you have done your homework. read Janknitzs excellent blog, take time to research machines and decide what is best for you. I'd hold out for a fully data capable autopap. Ask about mask policies. You may be better off purchasing online. Crunch some numbers. You will be using the machine you get for many years , every night, get the best for your therapy. DMEs really can be worse than used car salesmen, do not trust them to have your best interests in mind. Ask questions, we are here to help. Kathy

[rested gal]

My list of machines that record "full data" and those that don't --
Oct 24, 2008 New user, saying hello...with some questions...
viewtopic.php?p=307168#p307168

[dtsm]

1. Insist on auto [apap], not just straight cpap unit.
2. Insist on unit that has full data capability.

For ResMed, the S8 AutoSet II and the newer S9 [check cpap.com for exact model name] complies with above two key parameters. Someone earlier said get the newer S9 if possible. The major problem with the older S8 is not the unit itself, it's that you need a card reader to download data and that card reader is proprietary and sometimes very difficult to purchase. I have two S8 and completely satisfied with it but I do have the card reader.

As far as masks are concerned, you need to experiment to see which type, which brand fits you both. This might take some time so don't get frustrated that the first mask doesn't work just right for you. Make sure your DME has a 30 day swap policy on the masks.

[archangle]

The major problem with the older S8 is not the unit itself, it's that you need a card reader to download data and that card reader is proprietary and sometimes very difficult to purchase.

Do the S8 models record waveforms? I know the appropriate S9 models do.

[napstress]

Good luck at your appointment today!

Archangle gave you some excellent, detailed advice. I would second what he said about making sure you get what the doctor actually prescribed. Take a minute to compare the prescription with the machine and mask. Make sure all the little letters and numbers are exactly the same. You're going to be paying out hundreds of dollars over the course of this adventure. It's important to get what will serve you.

I had a 3-week setback when the DME gave me the wrong sized headgear. You have just three months to reach compliance; you don't have time to diddle around with the wrong item.

[chunkyfrog]

Note to OP:
Beware of the Resmed S9 models with 'Escape' in the name.
Look at the machine itself (not just the carton)--the good ones have 'Elite' or' Autoset' clearly marked on the top-
--UNDER the clear mask around the LED display--mask should be all one piece--
A fake sticker would be raised--and you can get your fingernail under the corner--Fraud.!
I wouldn't put it past some DME's--so watch out.

[Pugsy]

Do the S8 models record waveforms? I know the appropriate S9 models do.

S 8 models do not record waveform and do not record centrals.

[archangle]

A fake sticker would be raised--and you can get your fingernail under the corner--Fraud.!
I wouldn't put it past some DME's--so watch out.

I doubt a local DME would do this. They can stick most of their victims with a bad machine without the victim ever noticing. If they got caught by the manufacturer, they'd probably lose their lucrative authorized dealer status. The risk/reward just isn't there, even for a DME with low morals. Anyone smart enough to care about "Elite" vs. "Escape" is probably going to figure it out when they find it doesn't record data.

Maybe for some sort of grey market internet operation, craigslist, or fleamarket scammer.