Most Important CPAP Feature/Attribute
- rock and roll
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Amen to that! I am also an 18 and brand new to CPAP (actually, VPAP I guess - just did some research on my ResMed VPAP III to determine just what kind of machine I have - God forbid the sleep center or DME explain any of this). My ramp goes up to 20 minutes and that's where I set it each time to make sure I can get to sleep before the hurricane begins. I swear I could blow the leaves off the lawn with this thing. Earlier this week, I switched from a Breeze nasal pillow mask to an F & P Flexi-Fit HC431 full face mask. It is working out much better for me though I haven't quite found just the right tightness of the straps yet to prevent air leaks when that puppy starts the windstorm. The combination of 18 and a nasal pillow mask just did not work for me! I found it impossible to exhale against the prevailing wind and, for me, it was downright uncomfortable. Last night (my second night with the F&P FF mask) was the best so far. In total, I had it on for three hours. Not nearly long enough but I hope to get there soon.LDuyer wrote:The RAMP....!!!!
Alright, I'm a little dependent on that button, for sure.
Can't help it, though. My 18 high pressure is one tough monster to deal with. It wakes me up (or at least SOMETHING wakes me up), and once awake, I just gotta hit that ramp button. Otherwise, I feel like I'm breathing into a strong wind tunnel. Hopefully I'll get used to this thing, but until then, it's the RAMP, the RAMP, the RAMP...!!!!! God, help me!
:(
Linda
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Excellent points, Janelle. I'm not sure about the chronology of what was introduced when, but you summed it up nicely. There's yet another more advanced machine on the horizon, currently being trialed for FDA approval - the ResMed Autoset CS2 - a combo autopap/bipap (remarkable technological advance!) machine targeted for people with the Cheyne-Stokes breathing pattern typical of CHF (congestive heart failure.)
Probably nothing much will change in what type of machine doctors prescribe (even if doctors understood modern day autopaps) until the bean counters at Medicare understand that comfort=compliance=saves$$$ ....in machines or masks. As I understand it, many insurance companies follow Medicare's lead regarding what will be reimbursed for diagnosis and treatment.
To date, Medicare has turned down reimbursing for at-home sleep studies and has turned down establishing a separate code of reimbursement for auto-titrating CPAP machines (autopaps). I suppose Medicare would rather pay out millions of dollars more in the future, when undiagnosed sleep apnea and non-compliance with uncomfortable leaf blowers cause devastating (and much more expensive) health problems - stroke and heart attack, to name just two.
Probably nothing much will change in what type of machine doctors prescribe (even if doctors understood modern day autopaps) until the bean counters at Medicare understand that comfort=compliance=saves$$$ ....in machines or masks. As I understand it, many insurance companies follow Medicare's lead regarding what will be reimbursed for diagnosis and treatment.
To date, Medicare has turned down reimbursing for at-home sleep studies and has turned down establishing a separate code of reimbursement for auto-titrating CPAP machines (autopaps). I suppose Medicare would rather pay out millions of dollars more in the future, when undiagnosed sleep apnea and non-compliance with uncomfortable leaf blowers cause devastating (and much more expensive) health problems - stroke and heart attack, to name just two.
Interesting to read your post, since we have similar pressures and difficulties dealing with it. The nasal pillows were recommended by someone on the forum. My doctor adviced against them, saying the pressure would feel even worse with them. I've hesitated to try them, for I really don't think I'll like anything touching my nose, just a thing with me. So I suspect I wouldn't like them either, with this pressure. I am thinking about getting a full face mask, as a backup for times when I have congestion. The doctor didn't recommend that as a full-time mask, because of the shape of my face (the shmuck!). My nose mask seems comfortable, and tightening up on the mask seems to have helped most leaks, but there are still some, so I may try other nose masks recommended here, down the road. I'd like to hear more how you do with your new mask.JerryR wrote: .....Amen to that! I am also an 18 and brand new to CPAP (actually, VPAP I guess - just did some research on my ResMed VPAP III to determine just what kind of machine I have - God forbid the sleep center or DME explain any of this). My ramp goes up to 20 minutes and that's where I set it each time to make sure I can get to sleep before the hurricane begins. I swear I could blow the leaves off the lawn with this thing. Earlier this week, I switched from a Breeze nasal pillow mask to an F & P Flexi-Fit HC431 full face mask. It is working out much better for me though I haven't quite found just the right tightness of the straps yet to prevent air leaks when that puppy starts the windstorm. The combination of 18 and a nasal pillow mask just did not work for me! I found it impossible to exhale against the prevailing wind and, for me, it was downright uncomfortable. Last night (my second night with the F&P FF mask) was the best so far. In total, I had it on for three hours. Not nearly long enough but I hope to get there soon.
Linda
Voted none of these see reply. Here it is, short story fashion:
Bounced out of work today - still feeling good. Hopped in the car, put it in drive and arrived at my computer. Will not bore you with details.
I want my xPAP machine to be that simple.
Go to bed.
Put on mask.
Be comfortable.
Get proper treatment.
Wake up refreshed.
OK, so maybe a little sex, piddle if I really need to, sneak a snack, take dog for walk or at least kick off bed - normal everyday things (except for apniacs who choose to post messages at 4 am) - (yeah LDuyer I mean you, who is still trying to figure out how we know it's you when you post as a guest!).
What we need is - an xPAP with no pressure settings. Put it in drive and wake up for breakfast.
Take DME's and return titration visits out of the loop.
One size fits all pick your own mask.
The xPap will automatically determin what pressure you need all the time. Sure, throw in a dial to fiddle with so the patient can get the comfort feeling to begin each night, have ramp feature if you like but then let the machine do it's thing.
We're just about there. A smart card for the derek's of the world and an old fashion screen to show the rest of us if it needs a drink or filter. Otherwise old silent Joe will say "Good morning, you had a great night now have a good day". For those of us who want a really big smile in the morning we could download " Daily Quips from Liam" - for additional cost of course!
The treatment delivery system is there, just needs to be fine tuned. We should only have to decide what color we want.
Masks should be the same way. Had to get a dental crown so they made an impression and it fits perfect. Do the same thing with my face and - Voila!! a perfect fitting mask, psychedelic lime green no less!
Coming soon to a pharmacist near you.
Bob F
Bounced out of work today - still feeling good. Hopped in the car, put it in drive and arrived at my computer. Will not bore you with details.
I want my xPAP machine to be that simple.
Go to bed.
Put on mask.
Be comfortable.
Get proper treatment.
Wake up refreshed.
OK, so maybe a little sex, piddle if I really need to, sneak a snack, take dog for walk or at least kick off bed - normal everyday things (except for apniacs who choose to post messages at 4 am) - (yeah LDuyer I mean you, who is still trying to figure out how we know it's you when you post as a guest!).
What we need is - an xPAP with no pressure settings. Put it in drive and wake up for breakfast.
Take DME's and return titration visits out of the loop.
One size fits all pick your own mask.
The xPap will automatically determin what pressure you need all the time. Sure, throw in a dial to fiddle with so the patient can get the comfort feeling to begin each night, have ramp feature if you like but then let the machine do it's thing.
We're just about there. A smart card for the derek's of the world and an old fashion screen to show the rest of us if it needs a drink or filter. Otherwise old silent Joe will say "Good morning, you had a great night now have a good day". For those of us who want a really big smile in the morning we could download " Daily Quips from Liam" - for additional cost of course!
The treatment delivery system is there, just needs to be fine tuned. We should only have to decide what color we want.
Masks should be the same way. Had to get a dental crown so they made an impression and it fits perfect. Do the same thing with my face and - Voila!! a perfect fitting mask, psychedelic lime green no less!
Coming soon to a pharmacist near you.
Bob F
unclebob
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Hey, hey, hey!!!unclebob wrote: ......normal everyday things (except for apniacs who choose to post messages at 4 am) - (yeah LDuyer I mean you, who is still trying to figure out how we know it's you when you post as a guest!). .....
Falsely accused!
You could give a woman a complex!
You yuckster!
Linda, posting as me.
Unclebob,
You covered all the bases very well in that post. I'm brand new to the world of "hoseheads" so I'm still learning but your post sure rings true to me. Makes me wonder - is the whole subject of sleep apnea relatively new to the medical world? Has it so far been the case where all the manufacturers simply rushed in with product to get their share of the pie as seems to be the case with so many other issues/problems of life? Hopefully, technology and patient feedback will soon get us to the utopia you describe. As for me, I'm not dealing with this very well so far. I know I have to though because life can't continue as it has for far too many years.
You covered all the bases very well in that post. I'm brand new to the world of "hoseheads" so I'm still learning but your post sure rings true to me. Makes me wonder - is the whole subject of sleep apnea relatively new to the medical world? Has it so far been the case where all the manufacturers simply rushed in with product to get their share of the pie as seems to be the case with so many other issues/problems of life? Hopefully, technology and patient feedback will soon get us to the utopia you describe. As for me, I'm not dealing with this very well so far. I know I have to though because life can't continue as it has for far too many years.
[/quote]Interesting to read your post, since we have similar pressures and difficulties dealing with it. The nasal pillows were recommended by someone on the forum. My doctor adviced against them, saying the pressure would feel even worse with them. I've hesitated to try them, for I really don't think I'll like anything touching my nose, just a thing with me. So I suspect I wouldn't like them either, with this pressure. I am thinking about getting a full face mask, as a backup for times when I have congestion. The doctor didn't recommend that as a full-time mask, because of the shape of my face (the shmuck!). My nose mask seems comfortable, and tightening up on the mask seems to have helped most leaks, but there are still some, so I may try other nose masks recommended here, down the road. I'd like to hear more how you do with your new mask.
Linda[/quote]
Well, so far Linda, I'm not doing very well dealing with CPAP (or VPAP in my case I guess). I do like my FF mask better than the nasal pillow mask but, likely because of the high pressure - 18 - I have to tighten the straps so much in order to prevent leaks that it hurts my face and head. The F and P HC431 I have does come with an alternate, larger seal you can install so I will try that tonight. If I don't have any luck with it, I believe I will take the whole system back to the DME and ask for the Respironics unit with cflex that I read about here and the ResMed Ultra Mirage FF mask. From what I've read here, that appears to be a very good combination.
Linda[/quote]
Well, so far Linda, I'm not doing very well dealing with CPAP (or VPAP in my case I guess). I do like my FF mask better than the nasal pillow mask but, likely because of the high pressure - 18 - I have to tighten the straps so much in order to prevent leaks that it hurts my face and head. The F and P HC431 I have does come with an alternate, larger seal you can install so I will try that tonight. If I don't have any luck with it, I believe I will take the whole system back to the DME and ask for the Respironics unit with cflex that I read about here and the ResMed Ultra Mirage FF mask. From what I've read here, that appears to be a very good combination.
All of the choices are reasons for choosing one cpap over another. I think ease of use might be another choice. How hard/easy to clean the filter, humidifier, refill the humidifier, turn on and off are more reasons to select one cpap over another.
Howdy,
Well, the CPAP poll is winding down. Breathability wins the official poll and "just get me a small APAP with a battery that does its duty night after night" wins the real poll. I know it wasn't a mask poll, but the point is well taken that the best CPAP in the world is useless without a comfortable mask.
Batteries have not progressed with the rest of technology. If you want a machine to run on them, you have to use minimum juice (read: minimum features) or you have to charge them frequently. It'll be very interesting to see if the AEIOmed CPAP can live up to expectations.
unclebob, you mentioned getting a "Face fitting" just as one does for dental appliances. I thought it was an interesting idea, but have some questions about it:
1. To make sure it would be done right the first time, such a test would most likely be done in a DME establishment OR it would add another link in the care chain. (Doc, SL, Mask Fit, DME). I don't see how this would be done remotely without a patient preparing a mixture and pressing it against their face (breathability?). Perhaps there could be some kind of remote electronic solution?
2. Mask prices on the net are in the sub 200 dollar range. This price reflects mass producing certain designs, shipping them in bulk, and selling them (there are a ton of other factors, but for the sake of this discussion...). Taking a facial measurement and then sending it to the factory to make a specific mask for a specific patient would make for one expensive mask! No bulk, individually shipped (from Asia most likely), and there's still a given error rate with mass production that would be unacceptable for such a system. Would you really be willing to pay $400+ for a mask? Would producers be willing to shoulder the risk of doing all of that and they having to do it again on a manufacturing error?
Even with all of that said. It's a neat idea.
Johnny
Well, the CPAP poll is winding down. Breathability wins the official poll and "just get me a small APAP with a battery that does its duty night after night" wins the real poll. I know it wasn't a mask poll, but the point is well taken that the best CPAP in the world is useless without a comfortable mask.
Batteries have not progressed with the rest of technology. If you want a machine to run on them, you have to use minimum juice (read: minimum features) or you have to charge them frequently. It'll be very interesting to see if the AEIOmed CPAP can live up to expectations.
unclebob, you mentioned getting a "Face fitting" just as one does for dental appliances. I thought it was an interesting idea, but have some questions about it:
1. To make sure it would be done right the first time, such a test would most likely be done in a DME establishment OR it would add another link in the care chain. (Doc, SL, Mask Fit, DME). I don't see how this would be done remotely without a patient preparing a mixture and pressing it against their face (breathability?). Perhaps there could be some kind of remote electronic solution?
2. Mask prices on the net are in the sub 200 dollar range. This price reflects mass producing certain designs, shipping them in bulk, and selling them (there are a ton of other factors, but for the sake of this discussion...). Taking a facial measurement and then sending it to the factory to make a specific mask for a specific patient would make for one expensive mask! No bulk, individually shipped (from Asia most likely), and there's still a given error rate with mass production that would be unacceptable for such a system. Would you really be willing to pay $400+ for a mask? Would producers be willing to shoulder the risk of doing all of that and they having to do it again on a manufacturing error?
Even with all of that said. It's a neat idea.
Johnny
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Johnny,
At the risk of getting chewed out for going agaist my own (thread Nazi) comments, I'll respond to your comments regarding unclebob's face fitting mask. I agree that the logistics of such a endeavor would be prohibitive. Besides an acurate form fitting at a given time would not guarantee the fit would last based on weight loss/gain and/or fluid retention.
My thought on finding a mask that is most universally functional is to minimize the seal area. This seems to be accomplished with the nasal pillow interface, but for this type interface to be widely accepted the designer also need to address the issue of mouth leaks. This is the area in which a custom formed appliance to address and prevent these leaks is very feasible. This appliance would last much longer than a custom formed mask seal, hence justify the expense of custom fabrication. Maybe if some of the dentists out their focused their efforts on finding a dental appliance type cure for mouth leaks while using xpap rather than finding a dental appliance cure for appnea, they would be serving a community of individuals who would greatly benefit.
OK Rock & Roll, your turn to bark at me!
At the risk of getting chewed out for going agaist my own (thread Nazi) comments, I'll respond to your comments regarding unclebob's face fitting mask. I agree that the logistics of such a endeavor would be prohibitive. Besides an acurate form fitting at a given time would not guarantee the fit would last based on weight loss/gain and/or fluid retention.
My thought on finding a mask that is most universally functional is to minimize the seal area. This seems to be accomplished with the nasal pillow interface, but for this type interface to be widely accepted the designer also need to address the issue of mouth leaks. This is the area in which a custom formed appliance to address and prevent these leaks is very feasible. This appliance would last much longer than a custom formed mask seal, hence justify the expense of custom fabrication. Maybe if some of the dentists out their focused their efforts on finding a dental appliance type cure for mouth leaks while using xpap rather than finding a dental appliance cure for appnea, they would be serving a community of individuals who would greatly benefit.
OK Rock & Roll, your turn to bark at me!
Sincerely,
wading thru the muck of the sleep study/DME/Insurance money pit!
wading thru the muck of the sleep study/DME/Insurance money pit!
- rock and roll
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- wading thru the muck!
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How is posting my opinion on the subject, moderating? Are your opinions more valid than mine? It seems all I did was provide my comments regarding the discussion. I was not the one suggesting anyone "go to hell"rock and roll wrote: ...when you felt the need to moderate
Sincerely,
wading thru the muck of the sleep study/DME/Insurance money pit!
wading thru the muck of the sleep study/DME/Insurance money pit!