talked to DME about apap

Sneezie · Post by **Sneezie** » Wed Nov 08, 2006 11:22 am

I spoke to the DME and asked about the apap and she said that the Dr. prescribed the one I have and that must be what he thought I needed. She said I have to discuss it with the Dr. Will Drs. normally do that? I don't want to call their office only to feel like an idiot. Everything I read says they are so much better. Does it matter that my apnea is mild?

mattman · Post by **mattman** » Wed Nov 08, 2006 11:30 am

A DME company is required to go by what the prescription is written for - so if it does not say APAP or Autopap or similiar then they will not be able to provide an auto. In that case you would be instructed to speak with your doctor about the unit.
Your doctor should be willing to discuss the matter with you - but in so doing don't be angry with the doctor if they disagree with you regarding the need for an autopap.
Auto units would typically be prescribed in cases where a patient has aerophagia or another type of symptom that prevents them from being able to use a traditional CPAP.
If you just want data collecting abilities there are many standard CPAP units that collect data as well so that may be an option to consider.

mattman

sleepylady · Post by **sleepylady** » Wed Nov 08, 2006 11:35 am

Sneezie,

If you are wondering what your dr. prescribed, you can always call and ask for a copy of the prescription they wrote. Then you will know what was prescribed and then how to proceed.

For me, my dr. specified the type of APAP I was to get, however, the DME wasn't going to give it to me until I said NOPE you need to go by what my dr. prescribed. I won in the end and am very happy with my APAP.

Melinda

snoregirl · Post by **snoregirl** » Wed Nov 08, 2006 11:56 am

There are many reasons for wanting an apap. The air swallowing issue is one of them.

Others are higher pressures (I am at 13, and while that is not way way at the top of the range, I am much more comfortable most of the night with my machine running at 10 and only going higher as needed.

Weight flux issues are a reason

Positional sleeping issues are too

Questionable titration sleep study is another

Wanting to avoid the unpleasantness of another titration study too soon as well as the cost is yet another.

One can buy an APAP out of pocket with a CPAP script. Depending on how good your insurance coverage is you might only sacrifice $100 or $200 by bypassing insurance and buying online.

It is also possible to get the humidifier and mask from the DME using your benefits and just buying the APAP online.

Only you can figure if APAP would be better for you and if it is worth persuing.

I don't by the "your doc must have thought this was best for you". Many doc's don't know the difference or know that getting insurance to cover an APAP and getting the DME to issue one will be a struggle.

As stated above, I also got mine by telling the DME over a couple of times "I want what my doc ordered"

If you have any of the issues I mentioned above as reasons for wanting an APAP ask your doc. Can't hurt. You don't say your pressure or if you had central apneas in your sleep study which could make APAP not a good choice for you.

WHatever you do get the script from your doc and copies of your sleep study and file them at home.

Sneezie · Post by **Sneezie** » Wed Nov 08, 2006 12:37 pm

when you go for your cpap study are you supposed to get a report from it like when you have your sleep study?
My pressure is set at 6. I don't have my study in front of me but I beleive I had centrals also.

snoregirl · Post by **snoregirl** » Wed Nov 08, 2006 1:39 pm

Yes there is another report to be had.

If you have a pressure of 6 I can't see the value to an AUTO at all.

There is no where to make a range with that low a pressure. Most can't get air at 4 and I personally have trouble at 5 even. As long as the 6 is a good number don't waste you money or go through the hassle of trying to get AUTO.

You might want a machine that records data however. That would in the respironics line be a Pro2 in the older model and M series Pro. All depends on whether or not you like to look at data or go by how you feel. The M series also has some limited data on the LED screen you can use without software the Pro2 doesn't.

Also I have read that having centrals you shouldn't use apap. I would htink the report from your second sleep study should show at what pressures you had centrals.

sleepylady · Post by **sleepylady** » Wed Nov 08, 2006 1:47 pm

I agree with snoregirl IF your pressure of 6 is a good one AND you feel better and not tired, then stick with a CPAP.

My original titrated pressure was 14 on CPAP, however, that didn't seem to work. After increasing it to 16 and still having problems, I went to an APAP. I started at 12 - 17 and tried that for 3 months. Since I was still tired it was upped to 13 - 17 and after a month it was switched to 14 - 17. After that final change in pressure I felt a HUGE difference. Now I'm tired maybe one day a week if that. Some weeks I'm not tired at all...YEAH. In other words, keep a close watch on how you feel. With your pressure a CPAP may work great for you. If it doesn't, then APAP is the way to go. For me I didn't necessarily need a solid higher pressure, but I did need to start with my titrated pressure and have the flexibility an APAP can give me.

Sneezie · Post by **Sneezie** » Wed Nov 08, 2006 1:47 pm

Thank you for all of the advice. There is a lot to learn and that is why I am asking so many questions. Ok, so I don't need the auto, thats good because I really didn't want to fool with trying to get one anyway. Do you have to have a specific prescription for a machine that records data? Or does the insurance company even pay for that, is it considered an extra? On the description of my machine it says Optional Encore Pro SmartCard capability for basic compliance reporting
Data display for phone-in compliance Would that be something I would have to pay for out of pocket? I guess it depends on insurance company. I have a good one.

Sneezie · Post by **Sneezie** » Wed Nov 08, 2006 1:53 pm

I do NOT feel better, I am soo tired all of the time, but I am not sleeping through the night because of mask issues I think. I know it has only been less than a month since starting and have heard it takes some a good 3 months to really sleep well. That is why I am asking so many questions. Is this an issue of just getting used to things or do I have the wrong equipment? I just want to be sure.

Guest · Post by **Guest** » Wed Nov 08, 2006 2:04 pm

My sleep study titrated pressure was only five. After about one week, my wife told me I was still snoring through as ususal and I felt no better. Spoke to my dr and raised the pressure to six. Seemed to work a bit better. Got an auto machine and the found that the 90% pressure in the first month was 8.

My experience has been that the sleep study while diagnosing the apnea and finding a pressure of five as optimal was optimal for that one night of sleep (pretty bad sleep for me as well with all the wires and stuff). I like the auto because it uses the pressure that is necessary for each particular night (for example if I drink, have a cold, sleep on my side more than my back or vice versa, it adjusts).

TM

Sneezie · Post by **Sneezie** » Wed Nov 08, 2006 2:10 pm

Thanks! Its good to hear from someone that also has a low pressure. did you start with the auto?

Wulfman · Post by **Wulfman** » Wed Nov 08, 2006 2:12 pm

Sneezie wrote:On the description of my machine it says Optional Encore Pro SmartCard capability for basic compliance reporting

The "compliance" information amounts to the record of the hours you slept....not the details of what happened during those hours.
You don't need a specific prescription for a machine that records detailed info.
You might see if they'll upgrade your current machine to a REMstar Pro 2 or a Series M Pro.
Basically, they gave you one of the cheapest machines in the REMstar line so they could make the most profit from your insurance provider.

Usually, in the case of "central" apneas (if there were very many), the doctor (if he/she knows anything) would probably prescribe a specific machine.....like a specialized Bi-PAP to deal with them. IF you are prone to central apneas, having the software to track your apneas would be of great benefit. An occasional central would probably not be of great consequence unless their duration was significant. With the Encore Pro and specifically the MyEncore software, you can find out how long the apneas are lasting.

Keep asking questions.

Best wishes,

Den

Sneezie · Post by **Sneezie** » Wed Nov 08, 2006 2:15 pm

Thank you so much for making me feel welcome here. It was a blessing I found it!

tmaiberger · Post by **tmaiberger** » Wed Nov 08, 2006 2:16 pm

I did not start out with the auto machine. I started with a S8 (can not recall the model name, but it was the bottom rung S8). It was a fine machine. I asked my doctor for the prescription for an auto machine and wanted a respironics machine for the software to monitor. Did not matter to me whether the "classic" or M auto, my DME got the M for me.

TM

Sneezie · Post by **Sneezie** » Wed Nov 08, 2006 2:25 pm

I had an overall AHI of 4.5 an hour 2 obstructive, 5 central, 1 mixed and 14 obstructive hypopneas AHI during REM was 7.9 an hour. The AHI during the supine (back) position was worse at 8.7 per hour

talked to DME about apap

talked to DME about apap

I am glad I found this group

I dont feel betteer

ok, found my first sleep study