Done Cpap/BiPap, should I try Apap?

I started with Cpap (REMstar Pro 2 C-Flex CPAP) with a 9 setting. Didn't do well on it, and was only using it 4-5 hours a night. Did this for 3 months.

Three months in, Doctor responded to complaints of not feeling better, by doing a new study with BiPap. I am unsure as to why but,........ I suspect that for my insurance company to pay, he raised my setting on a new BiPap to 13/9. This seems to be the magic number for insurance companys from what I have read.
I got a The BiPAP Pro 2 w/ Bi-Flex. Bi-Flex, is like C-Flex (I think) I have now been on this for three months, I average 8.1 hours a night, but I still wake up feeling drugged, and brain fog for the first hour in the morning. I still get tired in afternoon and need a 10-15 minute snooze to feel rested.

Tomorrow I go back to doctor, and I am thinking that a REMstar Auto C-Flex CPAP might just be better fit for me. Seems like it could do more for me. It would certainly be cheaper than the BiPap that I have.

Any ideas

Hi ~ I'm a senior (almost 73 years young) and was diagnosed with a mild case of sleep apnea and have had similar struggles. I'm quite thin and thought I just had insomnia. My setting was originally set to 8, which I couldn't tolerate, and then it was lowered to 6. Medicare and our secondary insurance, BlueCross BlueShield, is covering it so that shouldn't be your problem. Your insurance should cover it regardless of the setting.

I am renting my CPAP machine (a Breas PV-10 ~ never heard of it before) through Medicare. My doctor wants to raise my pressure back to 8 again. I'm using the Breeze nasal system and am finally sleeping better...finally. Being that he still wants to raise my pressure to 8, I decided to do some research.

After being busy at the computer, I thought it might be a good idea to have an auto CPAP machine. Being that I'm using the Breeze, the Puritan Bennett's auto CPAP (I forgot the name) is the only auto CPAP which would be compatible with the Breeze ~ most important for me. I like the idea of an auto CPAP because it automatically adjusts to the individual's requirements as needed. I hope I'm correct with this assumption.

My physician wrote out a Rx for an auto CPAP machine and my supplier refused to honor it. They even had the nerve to tell me that Medicare wouldn't cover the rental. I called Medicare and was informed that they definitely will cover the rental, but a supplier has the right to refuse. All I have to do is have my physician fill out a Medical Necessity Form and they must honor it.

As if things aren't bad enough ~ who needs this hassle? Good luck.

klady, it's amazing what people have to go through with some DMEs, isn't it? You've probably already found the name of the machine you're thinking about...the Puritan Bennett GoodKnight 420E autopap is the autopap that was designed to be compatible (or vice versa) with the same company's Breeze nasal pillows. I used that combo for almost a year - very, very good auto and very, very good mask, imho.

P.S. I've used the Breeze/nasal pillows, as well as other nasal pillows masks, just fine with other brands of autopaps I've had - Respironics REMstar Auto (two of them...one with and one without C-Flex) and with the ResMed Autoset Spirit.

You might want to check http://www.cpapforseniors.com

I am sure that they would not give you the run around that you experienced...

I was hoping someone would comment on whether my thinking was out of line, or if I may be on the right track.

ML,

If you have a 9cm CPAP pressure then 13/9cm on a Bi-level is correct. Your Doc did not change it just to get the insurance to pay. As far as the auto working better for you, it depends on what about the other two has not been working. Liam was not able to sleep no mater what he tried while using the CPAP and based on his personal experience my guess is an auto or a bi-level for that matter would probably not be any better. From your symptoms, it sounds to me like you are still not getting good sleep and may not have resolved your apneas or oxygen desaturation (if you have it). Do you sleep soundly for the 8 hours with the bi-level? Have you had the smart card read to see your unresolved AHI (if the bipap pro 2 records that)? Unless the higher pressure is keeping you from sleeping or causing leaks that interfere with preventing you apneas, I don't see how an auto will provide any improvement.

Thanks.

My ox saturation doesn't fall that far, about 4%.

I didn't get a card with my machine, and that is my list of things to ask the doctor for. If he doesn't I'll get my own. I have had this machine for three months, and other than sleeping longer, I can't say I'm getting better.

I do sleep good (I think) usually only waking up to unwind from my hose around my neck. Just got a 10 footer and first night didn't get all wound up. Extra 4 feet will probably make look like the Michelin Man.

Probably the next step should be a card and reading it so we know what is going on.

I am just anxious after 6 months to feel better.

I think Wader hit on a very important "unless"... high pressure related things that could indeed be causing micro-arousals that you aren't even aware of, Martini. Things that you simply "sleep" through, but are disrupting real sleep.

Unless the higher pressure is keeping you from sleeping or causing leaks that interfere with preventing you apneas

Autopap with C-Flex might very well be worth a try. Might not make a difference at all, but certainly worth trying, imho.

Klady,

I started with a setting of 7 which is considered low and it took some time to be able to stand the pressure even tho I had cflex. I have tried it up to a pressure of 11 so far and no longer have a problem.

Rested Gal uses a breeze and Remstar Auto w/cflex which is her favorite machine. Since breathing with this machine is easier, it probably would be better to go with this machine.

If your physician will not fill out the Medical Necessity form (mine wouldn't because my pressure was low), one of the gals on the forum asked her DME if she can pay the difference which is about $200 and the DME went along with it. The reason the DME will not give you the more expensive machine (autopap) is because they lose the extra $200. The billing code for Medicare is the same.

Yes, yes, try it. It may take some getting used to, but I personally am happier with the auto feathre. Who needs air blowing your head off with higher pressures than you need. Or who needs straight cpap with such high pressures, causing so many discomfort problems, it's a wonder there's any compliance at all.

RG can steer you thru the remstar, she is very knowledgeable and helpful.

I only have the PB 420E, works for me. Got the software, so I can monior myself daily. And I think the 420E holds over 200 nights (or events) so I can save my data and follow along how I'm doing. Dr. isn't looking at me, DME haven't heard since she dropped the machine off, but OH MY the rental bill comes in nice and timely!

MartiniLover wrote:I started with Cpap (REMstar Pro 2 C-Flex CPAP) with a 9 setting. Didn't do well on it, and was only using it 4-5 hours a night. Did this for 3 months.

Three months in, Doctor responded to complaints of not feeling better, by doing a new study with BiPap. I am unsure as to why but,........ I suspect that for my insurance company to pay, he raised my setting on a new BiPap to 13/9. This seems to be the magic number for insurance companys from what I have read.
I got a The BiPAP Pro 2 w/ Bi-Flex. Bi-Flex, is like C-Flex (I think) I have now been on this for three months, I average 8.1 hours a night, but I still wake up feeling drugged, and brain fog for the first hour in the morning. I still get tired in afternoon and need a 10-15 minute snooze to feel rested.

Tomorrow I go back to doctor, and I am thinking that a REMstar Auto C-Flex CPAP might just be better fit for me. Seems like it could do more for me. It would certainly be cheaper than the BiPap that I have.

Any ideas

hi gailzee,

I only have the PB 420E, works for me. Got the software, so I can monior myself daily.

Awww...I'd take the word "only" outta there! The 420E you have is a great auto. I loved my 420E. Just because I'm using the Remstar Auto with C-Flex now doesn't mean I think the Remstar is a "better" machine at all. I simply enjoy having C-Flex. If the 420E had a "relief on exhalation" C-Flex type of feature, you'd see me right back using a 420E Auto and recommending it all the time.

I do think the 96 hour graph in the Silverlining software the 420E uses is more informative than the graphs in the Encore Pro software used by Respironics' machines.