info and guidance needed after 3 years of cpap

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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plasma800
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info and guidance needed after 3 years of cpap

Post by plasma800 » Wed May 06, 2015 1:49 pm

Hi all,

I got my cpap about 3 years ago. I did a sleep study at a little independent place, paid cash, don't recall how much but it wasn't enough to freak me out.

Anyway, i got my resmed machine, paid cash, everything was fine for a while. If I recall my setting is like 7 on the air flow, very low.

Well over the three years ive gained 20-25 lbs and now I'm snoring IN my mask, my wife hates it.

So I go to a new ENT, and he says to me "well, there's two options... we could just turn up the pressure a little at a time til it works, or better, you could do another sleep study and then we know exactly where to go. All you need is the titration"

So I get the study all lined up, supposed to go tonight and they call me today and tell me that my insurance hasn't met my deductible and that I would have to pay them $1427.00 dollars TONIGHT.

I about fell out of my chair and cancelled the appt.

Here's where some advice and education would be nice. First off, this seems like just too much money out of pocket, but then again, I honestly don't know just how critical (or not) the titration is.

Why would the doc suggest just turning up the pressure a little until it works if that was a terrible, horrible idea? Is it?

When you turn up a machine like this, what's the increment? 7 -8 -9 -10? or 7 - 7.1 -7.2 -7.3 ?

Also my machine of course has the little sd card in the back, but that stopped working long ago, just says data corrupt, please reformat - works for a night, then the same thing, probably just a bad card but i've been too lazy to plop another one in there... i actually haven't been back to an ENT in probably 2 years.

I also took my machine with me on our motorhome, which sometimes had inconsistent power, and I wonder sometimes if it didn't damage the machine itself - but it "seems" to work fine.

Any advice here?

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kaiasgram
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Re: info and guidance needed after 3 years of cpap

Post by kaiasgram » Wed May 06, 2015 2:05 pm

A plain old generic SD card will work just fine.

If your machine records therapy data you can figure the pressure adjustments out yourself. Which model do you have? What's the name right by the Start/Stop button -- like Escape, Elite, Escape Auto, Autoset, VPAP ....

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Darth Lady
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Re: info and guidance needed after 3 years of cpap

Post by Darth Lady » Wed May 06, 2015 2:08 pm

(Sigh). A lot of these insurance plans nowadays look great on paper, until you actually have to PAY the deductible...

A real sleep study in a reputable establishment is an insanely expensive thing, several thousand dollars (Which my insurance has paid four times now, without batting an eyelash, because my husband pays through the nose for it!). So if you have a high deductible plan, which it sounds like you do, that's not out of line. It's better to know ahead of time what your deductible is, and how much is left, so you can either nibble at it with smaller things, or save for this.

You can home titrate a bit at a time (the increment I've seen here is .5 to 1 cm at a time). Or use an APAP, which after a bit will settle on a level. More experienced folks will have more to say about that.

But after all this time, if you've found a good place, it might be worth it to have another sleep study.

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plasma800
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Re: info and guidance needed after 3 years of cpap

Post by plasma800 » Wed May 06, 2015 2:08 pm

ill look

says AUTOSTART and EPR

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plasma800
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Re: info and guidance needed after 3 years of cpap

Post by plasma800 » Wed May 06, 2015 2:19 pm

No doubt on the insurance deal. I have a 5k deductible. I've paid in some towards it but sheeeeesh...

I also dislike my mask pretty good. It slips around pretty easily, leaks in the same two places depending on how the straps catch the pillow. All in all, i of course sleep better than before it, but I still strongly dislike it. I would like to learn more about some masks that would work with it.

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kaiasgram
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Re: info and guidance needed after 3 years of cpap

Post by kaiasgram » Wed May 06, 2015 2:21 pm

plasma800 wrote:ill look

says AUTOSTART and EPR
Autostart is not a ResMed model name. Did you mean Autoset? The name is right by the Start/Stop button. How much therapy data is available depends on which model.

Unless you have a complicated case you don't need to shell out $$$ for another sleep study. You can do it yourself with SleepyHead software and a new SD card (Walmart, Officemax...). We can help.

And frankly if you are unlucky enough to have a no-data machine it would cost you less to upgrade your machine to a full-data model than to have another sleep study.

I would not refer to three years as "all this time" -- most insurance plans won't even cover a new machine earlier than five years.

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plasma800
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Re: info and guidance needed after 3 years of cpap

Post by plasma800 » Wed May 06, 2015 2:40 pm

kaiasgram wrote:
plasma800 wrote:ill look

says AUTOSTART and EPR
Autostart is not a ResMed model name. Did you mean Autoset? The name is right by the Start/Stop button. How much therapy data is available depends on which model.

Unless you have a complicated case you don't need to shell out $$$ for another sleep study. You can do it yourself with SleepyHead software and a new SD card (Walmart, Officemax...). We can help.

And frankly if you are unlucky enough to have a no-data machine it would cost you less to upgrade your machine to a full-data model than to have another sleep study.

I would not refer to three years as "all this time" -- most insurance plans won't even cover a new machine earlier than five years.
Spot on - AUTOSET

I didn't even realize there were different models of the S9. Is there any place you could point me towards that just educated me a little on the differences between models?
Last edited by plasma800 on Wed May 06, 2015 2:43 pm, edited 1 time in total.

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plasma800
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Re: info and guidance needed after 3 years of cpap

Post by plasma800 » Wed May 06, 2015 2:42 pm

I'm going to be putting another card in there tonight. Is there any size requirement?

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Darth Lady
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Re: info and guidance needed after 3 years of cpap

Post by Darth Lady » Wed May 06, 2015 2:46 pm

I don't believe there is. And anyway, the amount of space the data takes up is minuscule, and the cards are really cheap. If you get one with a few gig on it, it will last a long long time (if you don't get corruption anyway).

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kaiasgram
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Re: info and guidance needed after 3 years of cpap

Post by kaiasgram » Wed May 06, 2015 2:47 pm

Perfect! You don't need a new machine OR a new sleep study! You can get yourself a new SD card, download SleepyHead, and easily figure out what adjustments you need to your settings. First thing is to get the card so your machine can start writing data to it.

The card doesn't need more than 2 gb memory but it's hard to find cards with so little memory these days. Larger memory capacity works fine too -- just get whatever is on sale.

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chunkyfrog
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Re: info and guidance needed after 3 years of cpap

Post by chunkyfrog » Wed May 06, 2015 2:48 pm

Not really, use the smallest you have. 2 or 4 Gb.

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plasma800
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Re: info and guidance needed after 3 years of cpap

Post by plasma800 » Wed May 06, 2015 2:58 pm

kaiasgram wrote:Perfect! You don't need a new machine OR a new sleep study! You can get yourself a new SD card, download SleepyHead, and easily figure out what adjustments you need to your settings. First thing is to get the card so your machine can start writing data to it.

The card doesn't need more than 2 gb memory but it's hard to find cards with so little memory these days. Larger memory capacity works fine too -- just get whatever is on sale.

DEAL - I'll get one today and get that started tonight. I'll grab the software and start seeing what's going on. You all just made my day.

purple
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Re: info and guidance needed after 3 years of cpap

Post by purple » Wed May 06, 2015 3:01 pm

Did you say your mask leaks? And you do not like your mask? Do you dislike it because it leaks or because it is uncomfortable? Have you never replaced your mask? If your mask is old, surely it needs replacing. What kind of mask do you think you would like, Nasal, nasal pillows, full face mask? What mask do you have?

purple
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Re: info and guidance needed after 3 years of cpap

Post by purple » Wed May 06, 2015 3:07 pm

If you have a bunch of health problems, and are going to have to pay the deductible this year anyway, and can afford it. Then ask them to give you whatever break in price they will. If you want, negotiate a month to month payment. Go in, play with their masks. I wonder if the problem is that the sticker shock of a titration is what caused you to cancel. Yes, it is really expensive to do a titration test. I think a complete blood panel, you know chemistry, and lipid levels costs like $1200.00. then maybe I was not paying close enough attention the last time I saw that number for basic blood tests. Medical costs are like several zip codes from where I live.

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plasma800
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Re: info and guidance needed after 3 years of cpap

Post by plasma800 » Wed May 06, 2015 3:25 pm

purple wrote:Did you say your mask leaks? And you do not like your mask? Do you dislike it because it leaks or because it is uncomfortable? Have you never replaced your mask? If your mask is old, surely it needs replacing. What kind of mask do you think you would like, Nasal, nasal pillows, full face mask? What mask do you have?
I use the ResMed Full Face Mask Mirage Quattro. I replace the cushion about every 2 to 3 months, and I replace the straps as needed.

What happens to me is that the straps sort of grab the pillow in the back, and when i turn my head the straps hold the mask where it was and it shifts a little. So I end up with a little leak just underneath one of my eye balls blowing straight into my eye. Which side depends on which way I turned my head.

If I sleep on my side, sometimes I drool in the mask, the drool then collects and starts to work it's way out right next to the corner of my mouth, and as soon as that happens I lose the seal there.

So basically it doesn't fit my nose allll that great. I've got the straps pretty tight right now so it yanks my jaw back a little where it crosses under my mouth.

I've tried nasal and it didn't turn out so good. I have a pretty deviated septum and I'm a mouth open while sleeping type. All in all, it's not the worst mask in the world, but I think there might be something that just fits a little better.