First Time CPAP User-OK/not OK to buy online?

[Moogy]

I am wondering if I should attempt to convince my primary care doc to let me buy my first CPAP online. How likely is it that a newbie will need the help of a trained person to get everything adjusted ok? And after reading online posts, I wonder if the local DME would give me the right kind of help anyway.

I just had my overnight study with the CPAP, haven't gotten the official results yet. At my initial overnight study, I had AHI of 102.5 and oxygen minimum of 77%, so I know the docs will want to do SOMETHING soon.

I would like to get an automatic CPAP with cflex (breathing OUT was my biggest issue) , and I don't know if my local DME will have it or will have a decent price (after insurance).

I have messaged billmyinsurance and I am waiting to hear from them about whether I can get coverage if I buy online.

Any suggestions or issues or comments?

Thanks for all the help I have received from reading all the prior posts.

[Linda3032]

Moogy, welcome to the forum.

I bypassed a DME and purchased all my equipment online, then my insurance company reimbursed me. So check with your insurance company - they might be very pleased to save themselves money. With the help of this forum, you should have no problems whatsoever. Everyone here is very helpful.

Don't get your heart set on an Apap (auto) until you talk to your doctor. If your pressure is around 15 or more, he might want you to start on a Bi-level, which has greater ability to exhale (more than cflex). I've read posts talking about auto Bi-level, but I know nothing about that. If you need a bi-level, be sure to search the forum, or ask a question about if it comes as an auto.

You should be fine. Good luck.

[Linda3032]

I answered my own question. There is a Bipap/Auto (pretty spendy). Click below (if you end up needing a Bipap).

https://www.cpap.com/productpage/bipap-auto-biflex.html

[Guest]

Moogy-

I have a OSA profile much like yours: AHI 98, minimum oxygenation 60%. I was titrated at 17/13 pressure (17 on the inhalation and 13 for exhalation). I very successfully use a BiPAP Pro 2 (Bi-Flex) with a Remstar Heated Humidifier [sells for $1457.99 including bag, hose, and manuals on cpap.com].

It is my opinion that with such a high AHI as yours and mine that an auto version would not be all that helpful in that, for us, apneas and hyponeas occur so close together-- for example, with an AHI of 100, either an apnea or hyponea occurs on the average of every 36 seconds. Remember that either one would have to last at least 10 seconds to even count, and probably most exceed 10 seconds. That leaves little time inbetween. For us, it is not as though one has a clustering of apneas and hyponeas here and there during the night, which might be able to be avoided if the pressure is temporarily increased during that clustering. With such a high AHI that you and I both have, it is very unlikely that there is much of a clustering effect (the high AHI would preclude that possiblity I believe) -- if there were such a clustering, we would have to go without any oxygen for a very long time during the clustering, and we would not be here on this forum to talk about it. It seems to me that the Auto would pretty much end up acting just like a straight BiPAP because it would be almost constantly calling for the higher pressure. But there does exist the possibility that many of the apneas and hyponeas could be taken care of at lower pressures, so that I can not be sure of my analysis. Perhaps someone with an equally high pressure and AHI, who has an auto BiPAP, could tell us about how it was worked out for them.

That is my opinion, and of course I could be wrong about the auto in regards to such high AHIs. But I do want to convey to you that my BiPAP Pro 2 with humidifier is very comfortable. It sticks with my breathing rythm and is reasonably quiet. I think getting the right interface (mask, pillows, etc.) is much harder.

Good luck with your search for the right equipment.

Ann

[Guest]

Moogy-

By the way, I have frequently bought from Cpap.com and have been very pleased with the service and products. No problems at all, and their products as priced very competitively.

Ann

[The Youngs]

My husband just had a sleep study -- AHI=58.9, O2 sat was 65%! I wanted to get him help urgently, so as soon as the sleep study came back, I talked to our local DMEs who were incredibly ignorant and unhelpful. They couldn't even tell me what kind of mask they would give him!

I bought from billmyinsurance.com (cpap.com's sister site). They were wonderful!!!! They contacted my doctor to get the okay for an APAP, and had the Remstar Auto w/ C-flex on my doorstep the next morning - a Saturday! It might have been a little cheaper to take the straight CPAP the local DME wanted us to have, but after reading this forum, I wanted the best for my dh.

It was easy to set up, and when I had questions, this forum answered them pronto. I would definitely consider buying online. You are more likely to get what you want.

Hope that helps!

[snorzalot]

I have been VERY PLEASED with my Respironics BiPAP Auto with Bi-Flex. I think it's going to be the best of both worlds. My currently AHI is 50.5 with a 16 cm H2O iPAP and 12 cm H2O ePAP.

The part of your initial post that stands out in my mind is your exhale concerns. PLEASE note that C-Flex is not going to lower your exhale pressure like a BiPAP system. C-Flex is a comfort setting (0, 1, 2, 3) between the end of an inhale and beginning of an exhale that helps with SOME patients. It is NOT a 1, 2 or 3 cm H2O pressure setting drop.

The BiPAP Auto will run in the following modes:

- straight BiPAP (fixed iPAP, fixed ePAP) without BiFlex (0 setting)
- straight BiPAP (fixed iPAP, fixed ePAP) with BiFlex (1, 2, 3 setting)
- auto BiPAP (a scaled setting for both iPAP and ePAP) w/o BiFlex (0 setting)
- auto BiPAP (see above) with BiFlex (1, 2, 3 setting)

I'm currently running in straight BiPAP mode since that is what my doctor requested and I'm being monitored for compliance. However, I'll be switching to auto later as I had less apneas with an 18 setting during my titration study although my sleep efficiency was slightly lower. I'll probably switch my standard 16 cm H2O (which is VERY comfortable for me) to a scale of 16-20) and I'll likely let me 12 ePAP stay in that range as it's quite comfortable for me now. The cool part about BiPAP is most machines can climb out of the standard 3-20 cm H2O scale and go up to 25 cm H2O if necessary to treat severe OSA cases. At any rate, I'll be using monitoring software and my smartcard as I "tinker" for best results over time.

If you loose a lot of weight/gain a lot of weight/etc. it's often necessary to increase or decrease your pressure setting. Having an Auto (PAP or BiPAP) system might prevent a costly titration study if you monitor your own therapy. My wife caught me snoring the other night with my 16 cm H2O setting I'm wondering if I had been in Auto mode if it would have opened my passage enough to stop the event by increasing to 18 or 20 cm H2O? It's hard to argue (if affordable to you) against an automated machine WITH patient monitored smartcards. Especially since both C and Bi PAP technology come in automated versions.

Thanks and good luck!