10 days in the CPAP game

arezius wrote: ↑

Wed May 12, 2021 2:51 am

From what I understand about how it works with insurance in France is :
- 1st month after starting treatment appointment with care provider and sleep doctor is mandatory
- 4th month after : new sleep study is mandatory
- Once a year : Appointement with sleep doctor is needed for prescription renewal.

At no time I'm the owner of the machine. It's just lended by the care provider... So that's why I'm not sure on what I can change or not on the machine settings.
On the other side, I told them that I want to try another mask, so they'll bring me a new one this afternoon. I have nothing to pay.

What I need to know, and I'll ask this afternoon, is that if I order a mask by myself, will it be refund by my insurance? (Or I think it social welfare in US? )


In fact, I'm so unsure about what I can do or not, that I'm not even sure that it's legal for me to import my data to OSCAR...

It's up to you to prioritize rules or your health.

Would the people monitoring compliance even know your pressure Rx?
Or care?

From what I read here, docs only care about AHI and compliance.
Then they just give you a pat and off you go - again France ... Shrug.

Getting data into OSCAR is no problem. You're not modding anything on the CPAP.
No way for them to find out if you lock the SD card before putting it into your computer.
Did they even provide you with a SD card?

Another alternative...

If you can afford it, pay out of pocket. Used machines with low hours are inexpensive Stateside IF you're willing to deal with flaky sellers on OfferUp, Craigslist, Facebook Marketplace, etc.

My brother lives in the Bay Area.
I was/am looking for machines there so that he can ship them to me overseas.

I tried to get the S9 below a month ago.
But the seller ghosted my brother after a normal exchange of email.
Yet it is still up for sale as of 4 days ago.

https://sfbay.craigslist.org/sby/ele/d/ ... 19229.html

It's a ResMed S9 Autoset (Same therapy algo, same blower/motor as AirSense 10 Autoset) with 275 hours (used for one month??? almost new) for $150 vs $500 for a new AS10.

It's been a while since I have had anything to do with someone in France but I do remember that their level of AHI reported from the machine is much more generous before they get worried and will start wanting to change settings. Like AHI of 15.
I don't know if that is changed now or not.
I think the NHS in England uses the same criteria before they will supply a machine. Sleep study AHI less than 15 and they won't supply a machine.
I don't know if this criteria in France has changed or not but I doubt it has when it comes to insurance supplying stuff to patients at no cost.

Things are indeed much different in other parts of the world from here in the USA.

There's no way anyone would even know you used OSCAR unless you tell them.

The only machine that it is necessary to lock the SD card is the ResMed S9 model. Otherwise it isn't needed and the reason for locking the S9 has to do with what some computers do to the SD card that the S9 doesn't like.
You have the AirSense 10 model ResMed...don't need to bother locking SD card if you use OSCAR.

Even if OSCAR isn't used there is information available on the machine's LCD screen for the patient to see.
You just have to set "essentials" to "Plus" in the clinical setup menu to see it. It's not a lot of information but it might be enough to get a person by as long as they aren't having problems somewhere that need to be sorted out.
Explained in the manual
https://www.respshop.com/manuals/ResMed ... %20her.pdf

Ok, so I got my appointment Wednesday and all I can say is my disappointment!

The doctor was here for only 5 minutes, barely look at the data, write a letter, talk briefly to the care provider, and then... gone.

The care provider was more present, but except the fact that he change my settings to a fixe pressure (first he wanted to put 9, then doctor said 8... so it was he didn't do much.
I asked him for my nasal pillow (I had the P30I in mind), he showed up with the N30I. Was a little disapointed, but I understand why later, it's cheaper....

So, back home I set my pressure to 8.6 (it was the average pressure with the autoset). But I must admit that I'm not confortable with the N30I mask.
I'm actually waiting for an answer if they can give me P30I cushions. Otherwise I'll have to order them.

Actually, the only things that I need to do to have nothing to pay for the machine is to use it more than 4 hours/days. Which is actually way below my usage (more thant 7hour/day).
So I'll do what you advise me, make my own settings. Play with them until it's good!

Pugsy wrote: ↑

Wed May 12, 2021 6:42 am

It's been a while since I have had anything to do with someone in France but I do remember that their level of AHI reported from the machine is much more generous before they get worried and will start wanting to change settings. Like AHI of 15.
I don't know if that is changed now or not.
I think the NHS in England uses the same criteria before they will supply a machine. Sleep study AHI less than 15 and they won't supply a machine.
I don't know if this criteria in France has changed or not but I doubt it has when it comes to insurance supplying stuff to patients at no cost.

Doctor told me that under 5 it's good for him. But I have an appointment for a new sleep study with treatment due to september. To see if it's really effective or not).

In France, from what I understood, machine is provided if your AHI is above 30. Between 15 and 30 it's depends on your O2 level. But I think that each doctor can do whatever he want...

In the U.S. if you have insurance they want to see usage of at least 4 hrs before they pay for machine... that may be similar to what they told you about 4 hrs, BUT it doesn't mean you should only use the machine 4 hrs - DO use it all night to get the benefit of it, just don't use it for less than 4 hrs.

Julie wrote: ↑

Fri May 14, 2021 6:08 am

In the U.S. if you have insurance they want to see usage of at least 4 hrs before they pay for machine... that may be similar to what they told you about 4 hrs, BUT it doesn't mean you should only use the machine 4 hrs - DO use it all night to get the benefit of it, just don't use it for less than 4 hrs.

In fact, my average usage is 7.5 hours / day. I must admit that I am quite happy to accept the mask quite easily, I know that it is not the same for everyone.

Finally got an answer from my care provider...

They don't provide Airfit P30I cause it's the same than the N30I.
Really? Why would resmed sell two different product that are exactly the same? How a P30I could leak like a N30I?

From what I read here, it's not the same no? Beside the fact that they use the same structure.
Am i wrong thinking that there is more leak with the N30I than the P30I?

They use the same frame.

One uses nasal pillows, p30i.

The other use nasal cushion, n30i.

There are a lot of videos that show the difference.
Show them this video for example
https://youtu.be/uGXI0wWirjI

Some people who do well with nasal pillows (e.g., P10i) don't do well with a nasal mask (e.g., N10i). I think there might be two reasons. First, although the pillows sit on the outside of your nostrils, not inside, they are to some extent anchored in place by their fit to your nostrils. Second, the perimeter that touches your face is less, providing fewer opportunities to leak.

I'll stick to the N30I for the moment, can't afford the P30I for now...

I have a question about my leak rate, I find it a little "high". What do you think? Can this explain why my AHI is so low? Like, does leaks could prevent CPAP machine to count correctly events?
Or does CPAP work really well? (on theory... )

For reminder, I was diagnosed with AHI of 33. Here, it's only 0.5.

While not a pretty leak line it is well within the machine's ability to compensate for leaks. It doesn't have to be perfect 0.0 leak to work.
The machine actually can do a decent job up to a little over 30 L/min excess leak.
If you spent much time up over 35 L/min then the time above that number might be questionable in terms of accuracy....but you don't seem to be doing that.

Your AHI is nice and low...the machine is doing a good job preventing apnea events.

The P30i nasal pillow cushion....did you know you don't have to buy a whole new mask gear set up to try it? All you need is just the nasal pillow part. It will attach to your current using mask frame.

You only need this part and it shouldn't be horribly expensive.
https://www.cpap.com/productpage/resmed ... al-pillows

Now I know you can't order from cpap.com but there should be some way for you to find it in France or have it shipped to you.