Hey look! It's the new guy!

[BlackSpinner]

You will also want a copy of the prescription.
In case you want to order over the internet, in case you are travelling and something goes wrong or just because you want to be in charge of your therapy.

Call your insurance company and find out all the local area DME's that are in network. That way if the ones the doctor prefers are total jerks you can immediately switch to another, especially if you have a copy of your prescription in hand. You don't have to use the ones your doctor prefers!

[ISnoreBadly]

I just spoke with the DME, they seemed to be very nice and helpful... but they said they just got to my prescription today and hadn't had a chance to fully review it.

They said the most common CPAP machine they use is the Respironics System One Model 460. From what I can see it looks like it's a decent machine, is that right?

[Julie]

The 560 is newer...

[grayghost4]

The 460 and 560 are both current models, the difference is the 560 is an auto, and the 460 is NOT .

I would suggest that you insist on getting the 560... for comfort reasons.

[ISnoreBadly]

The 560 is newer...

Yeah but newer does not always mean better... does it in this case?

Looking at this comparison guide https://www.continuedcare.com/wp-conten ... -Guide.pdf it looks like the difference between the 460 and the 560 is the 460 is a CPAP and the 560 is an APAP. Otherwise the specs look to be pretty much the same?

[palerider]

The 560 is newer...

no, it's not. same generation.

the 460 is set pressure, the 560 is auto pressure.

[bwexler]

If it were me I would insist on the 560.
Most of us have different requirements during the night as we go in and out of REM for example.
Over the five years or so that you will have the machine your requirements may change.
If you have a cold, your requirements may change.
The 560 checks your requirements breath by breath and automatically adjusts.
The 460 is set at a prescribed single pressure as determined by the sleep titration study and you hope it works for the next 5 years.
The 460 does provide data so you can see if it is working or not. It can be manually adjusted, but you won't have a lab attendant there all night every night to make your adjustments.

[ISnoreBadly]

If it were me I would insist on the 560.
Most of us have different requirements during the night as we go in and out of REM for example.
Over the five years or so that you will have the machine your requirements may change.
If you have a cold, your requirements may change.
The 560 checks your requirements breath by breath and automatically adjusts.
The 460 is set at a prescribed single pressure as determined by the sleep titration study and you hope it works for the next 5 years.
The 460 does provide data so you can see if it is working or not. It can be manually adjusted, but you won't have a lab attendant there all night every night to make your adjustments.

Sounds like a good enough argument to me. I'll push for the 560.

[ISnoreBadly]

I got the results of the titration and the prescription today.

The prescription is for "CPAP at 12 cm H20 with filter, tubing, heated humidifier and mask to fit".

The titration result says "CPAP was initiated at 4 cm H20 and incrementially advanced to 11 cm H20. The patient had very mild and infrequent respiratory events at CPAP of 11". The data shows 1 central apnea (0 during the first test), 7 obstructive apneas (292 the first time) and 11 hypopneas (110 the first time). The AHI was 0 at 4 cm H20, 46.9 at 5, 4.6 at 6, 0 and 8 and 9, 1. at 10 and 2.3 at 11. According to the chart I spent most of the time at 11 (from about 2 AM to 5:20 AM).

Oxygen didn't go below 92%, it was in the 70s during the first test.

[MarylandCPAPer]

Since a single pressure was prescribed (not a range), it sounds like the DME to which you were directed wants to provide a machine that does not provide the option of a self-titrating range. When I was diagnosed, my prescription was similar, with a constant pressure. Within 2 weeks, it became clear that the constant pressure setting would not work for me and that I needed a machine capable of a self-titrating range (APAP). Fortunately, my DME had initially provided a machine that was APAP-capable, without me knowing to even ask for it. I lucked out.

If I were you, I would not accept the machine that only does fixed-pressure CPAP. Insurance mostly only pays for one CPAP machine every 5 years or so, so you need to be sure you have something flexible enough to have a good chance of meet your needs for that period of time. Adjustments in settings are often needed over time (and sometimes very early in treatment), so you need a machine that is flexible. Also, one that will provide data on which to base future adjustments, not just compliance data.

You are not stuck with the DME to which the doctor sent the prescription. Check with your insurance company to find out what DME's are in network. Have you read this yet? It will help you prepare for your meeting with the DME.
https://maskarrayed.wordpress.com/what- ... me-part-i/

You may want to start a new thread with specific information in the subject on the models to which you are being directed.

I am getting a new machine today, my second one after 5.5 years. I started off with a machine that may be the same model as the one everyone here has mentioned based on what your dr. prescribed. A year ago, my DME was still providing that make of machine, but when I asked what they would suggest replacing it with this month (so I could get the doctor's CPAP prescription written accordingly), they said ResMed Airsense 10 with Heated Humidifier. They said they were not using the Phillips Respironics machines any more because of problems with the humidifier. I think that is also a newer model than the Phillips Respironics CPAP/ APAP models. People here recommended I ask for a prescription of the "FOR HER" version of the Resmed S10 machine (even if I was a HIM), because it has an additional titration algorithm. Since I only can get a new PAP machine every 5 years, that's what I asked for and that's what my doctor prescribed.

Good luck in starting treatment.

[MarylandCPAPer]

Also, the titration was done from 4 to 11 and they are recommending 12?? Definitely sounds to me like you are likely to need a machine with APAP capabilities and DEFINITELY one capable of providing data from your nightly sleep experience, using software such as Sleepyhead. They didn't even test you at the CPAP pressure the dr. prescribed. I would think they should have kept going above 11 at your sleep study. At best, 12 is a guesstimate and you may need a higher pressure. Another reason for a machine that adjusts according to your breathing while asleep and data from the machine (using Sleepyhead).

[ISnoreBadly]

Yeah I thought that was a little strange too (the higher pressure). I will call the doctor and the DME to see if I can find out what that's all about. And also as I said earlier in this thread I'm going to push for getting a machine that adjusts as needed and doesn't just stick with a single pressure.

[ISnoreBadly]

I haven't been able to get in touch with the doctor yet but spoke to the DME today. They said that since my prescription is for a CPAP at a fixed pressure (12 cm H20) even if they were to give me the 560 it would be programmed for that pressure only and would not automatically adjust. Is that correct?

They also said that since I would be renting the machine for the first 11 months (due to how my insurance pays for it) if after analyzing the data my doctor decides that I should be using an APAP instead of a CPAP they would be able to swap it for a different unit.

I have an appointment Friday afternoon to get the machine.

[poppi2]

Get the 560. I have my 550 set to a single pressure (min=max). Don't rely on your doctor requesting the APAP.
Get your insurance info from your insurance company, not the DME.
You need to run the numbers. Eleven months times your copay. Don't forget that your yearly deductible gets reset in January. It might be more cost effective to buy from our sponsor, or used market.

[ISnoreBadly]

So I was just looking at the results from the CPAP test and was wondering why they would recommend a higher pressure when I had an RDI of 0.0 at both 8 and 9? The mean SpO2 was lower at those pressures than it was at 11, would that be why?