18 YrOld Newbie: Equipmt Choice?

My information: 18 years old, male, 5’11”, 142#. RDI=14 (114 for the night). The initial setting noted in my record is for an APAP machine with setting=10-14cm water, but the doctor who was filling in and reading me the numbers said that was too big a spread and I’d need to talk to my regular doc next week to get the final numbers…I have a fairly narrow face and a crooked nose (sort of like you put your hand on the side of a nose and pushed over toward the ear). (The mask for the titration study really pressed hard on one side of my nose and really hurt all night!).
Insurance will pay for most of the equipment, but my parents will pick up anything over and above that.
My parents’ highest priority is COMPLIANCE. They want a machine/mask that’s quiet, comfortable and easy to use so that I’ll actually use!
Cont

I would go for the S9 Autoset with EPR from ResMed. You can check their product page and find out more information.
You also want the H5i humidifier and maybe the climate controlled hose.

Yep have to agree with mary about the S9 autoset with humidifier and climate line hose. I have had mine for two weeks now and its great. You may want to look into nasal pillows if the nasal mask hurts your nose, or a full faced maybe. I have a nasal mask and find it is uncomfotable at times on my rudder so I may try a nasal pillow style next myself.

I like the S9 ResMed Autoset except for five things:


READ HERE: viewtopic/t53451/Comparison--S9-AutoSet ... -Auto.html (two complaints)

THEN HERE: viewtopic/t53500/Newbie-ResMed-S9-feedbacl.html (three complaints)

I printed all this information and took it to my doctor when it was time to get a new machine, the DME works out of her office,
so I just pointed to it, and said I want this....

You might want to print it too, so you are familiar with all the terms and parts and capabilities of the machine..
and the online cost compared to what equipment provider will charge your insurance.
My insurance was charged over 2600.00 for this s9 autoset, humidfier and filters. My insurance would not cover it.
be aware, check your policy, call the insuarnce company, and dont sign anything with the equipment providers unless you are
certain you are happy with the situation.

this machine (its a data capable auto, and you can get your readings right off the machine in the morning.. its VERY QUIET..

https://www.cpap.com/cpap-machine/resme ... n=HeroShot

(there are threads here of how to get the software and download info)

this humidifier (THIS is made for this machine)

https://www.cpap.com/productpage/resmed ... ntrol.html


this nasal pillow mask with nose pillows included (will solve problems with your nose getting hurt)
I think they are the most comfy nose pillows made
https://www.cpap.com/productpage/fisher ... -Mask.html

edit: p.s. you can tape your mouth so you dont get mouth leaks if you learn how to mouth breath with nose pillows..
and I cut a tiny slit in my mouth tape so I can cough, etc.. it has been working very well..
chin straps did not work for me at all..

MADE FOR THE S9 AUTO SET
this climate line hosing for the winter (you may want to also have this on hand for the summer if its dry where you are)
https://www.cpap.com/productpage/resmed ... ntrol.html

MADE FOR THE S9 AUTOSET
this slimline hose for the summer (I just bought one to use when I wasnt using climate line hosing..
by the way the climate line hose can ONLY be used WITH the humidifier so that is why I bought a slimline host I could use
when not having the humidifier out.

https://www.cpap.com/productpage/resmed ... ubing.html

MADE FOR THE S9 AUTOSET
and these filters ( these are disposable, but I have found you can gently rinse them in cold water and pat them dry once a week)

https://www.cpap.com/productpage/resmed ... eric.htmlx

In my opinion, 10 to 14 cm is a very good spread on an auto machine. What is your titrated pressure?

The S9 autoset is a very good machine but there are other brands out there and you may be able to get them more readily. It depends on what the DME may have in stock and what they would be willing to order AND how soon you want to get started.

There is the Philips Respironics System One Auto, also the Fisher & Paykel HS 254 and the Intellipap Auto. Only the S9 Autoset and the Philips Respironics System One Auto will give you exhalation relief. That lowers the pressure when you exhale and makes it easier to breath out against the pressure. This may mean the difference between using the machine and not using it. On the S9 it is called EPR and on the Philips Respironics it is called C- Flex and A-Flex.

With any of these machines, you should get the accompanying humidifier. Some people don't use it but it is good to have. It depends mostly on the climate where you live whether it is a necessity or not.

These are all good machines and you can get software for all of them if you want to although you have to buy it extra. They are all auto. That gives you the option of setting it in cpap mode (one pressure) or auto mode ( a range like the one suggested on your initial writeup). All these machines will give you detailed data so that you know how often and how long you used it as well as information about your AHI ( which you want to be below 5) and your leak rate. The leak rate is very important so that you are not losing your therapy with a leaky mask or mouth breathing.

The S9 will give you the most information on the LCD screen if you don't want to buy the software at least right away but all will give you leak rate and AHI on the screen if it is set up correctly.

THE MOST IMPORTANT THING is a mask that feels comfortable and fits you properly. That's what will make the difference in compliance. With a mask that fits you and feels comfortable you will be more likely to comply with your therapy.

A lot of us use and like the nasal pillows because so little touches your face and so they fit a larger number of people. If you are a mouth breather though you will need a full face mask so that you don't lose therapy out of your mouth. With a full face mask you NEED someone who can fit it well for you.

even though you are 18, accordingg to FDA you are still a pediatric patient until the age of 21. Please look at units that are FDa approved for peds pts.....the s8 is one. I'm not sure of the s9, same with masks.

I agree with the S9 setup. Software is easier to get and run under some operating systems. For the mask, I suggest the Hybrid mask. It is simular to the ResMed Liberty mask but the nasal pillows can be independetly set to different hights which may help your problem.

Sleep Well

Steve

DJ DK, welcome to the forum. Congratulations on going on XPAP therapy at 18, before you've damaged your body as much as those of us who waited years to get better sleep. The S9 is the current state-of-the-art machine, but any auto machine with full data capabilities will work for you. They're all easy to use (just mask up and press the button!) but they are all a bit different. The key points are: autotitrating, full data capabilities, a mask that works well for you (I second the motion about the Hybrid!) and the knowledge to tweak your treatment as needed. Mask selection is REAL personal, so try all you can and get the most comfortable one. Read all you can here, ask questions (yes, your mom can come ask questions, too!) and feel better.

You may have better luck with a total face mask than any of the other types. They will not touch your nose. There are two different total face masks manufactured by Respironics, the FitLife and the Total Face Mask. I think both are very comfortable to wear and not at all claustrophobic because you can see through them. Both are available on CPAP.com or through your DME provider.

I'm surprised that your doctor has not recommended fixing your nose. If it's bent, you may have a deviated septum, which would affect your ability to breathe properly. I had mine fixed years ago; it made a huge difference.

I'm still loving my S9 Elite with EPR. Slimline hose (I'll be looking at the Climateline for the dry winter). H5i heater humidifier. Resmed Activa LT mask (Medium).

The 3.10 ResScan software rocks.

THANK YOU all!!! Great suggestions with good reasons and wonderful links. I now have my "shopping list" to take to the DME. Next step is dealing with the insurance company!

Does anyone have any thoughts on whether to go to a big company with local branches (like Apria I guess) or go to a small operation? I read other posts about insurance price caps so the DME tries to sell you a cheap machine to pocket the difference. Any other thoughts for the DME appointment (other posts= bring pillot and lay down -- I will!) Thanks again everyone. DJ

DJ, Whether to use your local DME or not is based on how good the provider is. Many people have excellent luck with their local shop, quite a few others can recount extreme horror stories. There's no way to know until you visit with them. If they happen to be people you want to do business with, 2 advantages are that they're handy and able to bill your insurance. Do NOT let them swindle you into purchasing outdated equipment, no matter WHAT they say! If they turn out to be that sort, our host (CPAP.COM) provides excellent service at very reasonable prices. And don't assume the $ works out in your favor by using your local DME, run the numbers yourself and see what the best deal is.

I would avoid Apria for sure. I was very naive when I started therapy, and went to Apria because my doctor's office suggested it. The staff if not knowledgeable, bu that didn't matter too much after I found this site. But their billing is done from India, and it's next to impossible to get any questions answered or any errors corrected. I have not been happy with Apria. If you do a search on this site, you will find out what others think. I was able to get a list of nearby independent DMEs, and I checked several out personally and found one I am very happy with.

hi there,
I would start by calling YOUR insurance company, and ask them how much they negotiate the rate DOWN on the equipment you want..
the machine, and the humidifer, and the hose, and filters..

Whatever the dme charges, they will probably be willing to pay half of that, and the dme eats the rest.. they usually double or triple the charge
in the first place anyway..

Once you know what YOUR insurance company will cover, you can shop around for a good DME..

Have your presctiption in hand of what you want.. there is a form on cpap.com you can dowload and print..
https://a0fa1b452dd65abe2907-3115b881cb ... on-LMN.pdf

You may want to be able to purchase a mask on line if your insurance will only cover one mask, if your doctor fills that form out
you can fax it to cpap.com and know that you wont be stuck buying just what the dme has to offer, or be stuck with the insurance company
telling you they will only cover one mask.. try to get insurance to cover everything possible, and anything else you have an option to buy online
if you HAVE to..

When you visit with a DME take a list of questions to ask them..

pretend you are buying a new car.. you want to know how much it costs, whats in this contract, what will you be responsible for paying, if nothing,
what is the warranty? what is the return policy on masks and the machine? They never told me I had thirty days to switch my machine, nor did they
tell me I had seven days to return a mask.. so get stuff in writing from them.. good luck, you are going to do well, I can tell!