Machines

SingleMom · Post by **SingleMom** » Thu May 29, 2008 8:18 pm

I just got my CPAP stuff 2 whole days ago and my insurance is giving me issues (unrelated to CPAP stuff). So I'm considering just buying everything. I was looking at some of the ResMed's auto machines. What's everyone's opinions? I have no experience, 2 nights of taking my mask off in my sleep. Right now I'm using (if you can call it that!) a resmed s8 elite and I think I like it (lol), but have no idea what to look for in these.

sleepycarol · Post by **sleepycarol** » Thu May 29, 2008 8:38 pm

If you plan on paying out of pocket get your equipment from an online dealer. Much cheaper and a better value!!

cflame1 · Post by **cflame1** » Thu May 29, 2008 9:07 pm

You may find that Resmed's are pretty expensive, and that your treatment could be just as good (if not better) with another machine if you are looking at purchasing out of pocket.

Slinky · Post by **Slinky** » Thu May 29, 2008 9:25 pm

Never mind the advertised online pricing. Call the toll free numbers and ask the various online DME suppliers if they have an "unadvertised sale" or "unadvertised price" on the Resmed S8 Elite or the Resmed S8 AutoSet Vantage. They are great xPAPs and you can't go wrong w/one.

And check cpap.com's prices on them. Seems to me when I checked just a few days ago that their price was pretty good. Most likely your insurance has paid up front for the humidifier and mask and hose, etc. that you have and it is only the Elite that is on the monthly rent to own payment plan.

Hang w/your insurance long enough for the DME supplier to have been paid for the mask, humidifier, etc. since its not the CPAP stuff they are hassling you over.

NightHawkeye · Post by **NightHawkeye** » Fri May 30, 2008 7:18 am

Welcome SingleMom,

SingleMom wrote:So I'm considering just buying everything.

Excellent plan. That's what I did. It can save a lot of grief.

SingleMom wrote:I was looking at some of the ResMed's auto machines. What's everyone's opinions?

1) ResMed makes the most expensive and least capable auto-PAP machine currently manufactured. A quantitative calculation indicates that ResMed provides the poorest value.
2) The Respironics M-series auto-PAP is a better value. It also offers exhalation relief, a capability which the ResMed Auto-PAP has traditionally not offered, although if you can find their newest model (in short supply) then it would also have exhalation relief.
3) You may not need exhalation relief. That mostly depends upon your pressure. At 10 cm pressure and above, you ought to at least consider it.
4) The Puritan-Bennett auto-PAP, 420E, does not offer exhalation relief but provides the best data reporting of any. It also can distinguish central apneas from obstructive apneas and adjust therapy accordingly. This might be important to you if your sleep study revealed central apneas. Also, the accompanying SilverLining software is the easiest to install and use of any. This may be important to you if you have problems adjusting to therapy.

SingleMom wrote:I have no experience, 2 nights of taking my mask off in my sleep.

Hmm ..., what kind of mask? Why are you taking it off? What is your pressure? Maybe you need exhalation relief ...

SingleMom wrote:Right now I'm using (if you can call it that!) a resmed s8 elite and I think I like it (lol), but have no idea what to look for in these.

First thing is to understand what the problem is which prompts taking the mask off. Could you elaborate? The answers to these questions could point in the direction of particular machines and masks.

Regards,
Bill

tony22 · Post by **tony22** » Fri May 30, 2008 7:42 am

SingleMom, I have to chime in a bit for the Resmeds. If Slinky is right and the humidifier, hose, etc has already been paid for by your insurance then buying a Resmed might be a good idea. NightH's info is correct for Resmed's basic model (Escape), but the Elite and Autoset Vantage both have exhalation relief. These are the current (2007) models.

Be aware that the new (2008) Resmed models are just coming out now in the U.S. These would be the Elite II and Autoset II. They are supposed to be quieter than the '07 models (which are already pretty quiet). While the P-Bs have excellent data reporting (from what I've read), the Resmed front panel is able to provide all of the critical data directly. Saves on having to buy software and a card reader. Granted, the software makes tracking the info over the long haul easier - and provides some additional features. But if you want a data capable machine with front panel reporting and Relief the Resmeds are a good choice, IMO.

The H3i humidifier will fit any of the current and '08 models I mentioned. Good luck.

DreamStalker · Post by **DreamStalker** » Fri May 30, 2008 7:45 am

What Bill was referring to was that ResMeds do NOT provide exhalation relief in APAP mode ... only in CPAP mode.

Respironics DOES provide exhalation relief in both APAP and CPAP mode.

In addition, as I understand it, the ResMed APAP machine's "auto" algorithm stops working for pressures above 10cm ... Respironics and P&B APAP machine "auto" algorithms work all the way up to 20cm of pressure.

SingleMom · Post by **SingleMom** » Fri May 30, 2008 7:46 am

Last night was the first night I kept the mask (fisher & paykel flexfit HC431- no size on it) on. I think I had a decent seal (a small near eyes leak), but my nose hurts now . I have to get through the weekend with it, I can't get a new mask until sometime next week.

I have no idea why I took it off, but hopefully it's over!

I also went to bed late last night, so I may have been tired enough to just sleep and forget about it.

If this insurance stuff settles, I will own my machine in 2 months. Otherwise it's taken Monday morning (if the darn paperwork doesn't get there).

I haven't done enough research, but I like how the resmed has the attached humidifier. I'm sure other companies have that too. I also like the size and the lack of noise. I'm going to look into other stuff, but if I can fight it, I'll get an auto with exhalation relief. I'm only at a 7 but I think I need it, I couldn't sleep (easy) during my study. I'm going to look at respironics now.

SingleMom · Post by **SingleMom** » Fri May 30, 2008 7:47 am

[quote="DreamStalker"]What Bill was referring to was that ResMeds do NOT provide exhalation relief in APAP mode ... only in CPAP mode.

Respironics DOES provide exhalation relief in both APAP and CPAP mode.

NightHawkeye · Post by **NightHawkeye** » Fri May 30, 2008 7:59 am

SingleMom wrote:I've seen one resmed that does.

Correct. As I mentioned, the newest ResMed APAP offers exhalation relief in APAP mode. Make sure of the model if that's the machine you choose. DME's are reported constantly here for pulling switcheroos. If you order online, then just make sure you order the correct model.

Regards,
Bill

bap40 · Post by **bap40** » Fri May 30, 2008 8:00 am

Welcome to this forum. I'm glad u found it!

Just a little note to say that a lot of us have and love our dream machine. Respironic's M series A/flex. It can be run in either Cpap or Apap and has exhale relief in all modes. I had to fight for mine but did finally end up with it. I love it. It will also give some details on the screen as well as has the ability to use a card reader and software program to get ALL your details.

As you have said you are doing, Research and research some more to be sure of the machine you want. As far as your mask, since you can't do anything until Monday on that, go out and buy some Mack's silicone putty and roll out a ring and put it all around your seal. This may help with leaks and pain. These are silicone ear putty plugs and for me work great in stopping any leaks.

Good luck and again welcome.

Slinky · Post by **Slinky** » Fri May 30, 2008 8:21 am

Okay, I'm no pro here. I've only been on xPAP since Oct 06 - but I was started out w/the Resmed S8 Elite w/EPR and LOVED it! I got good therapy w/it but mostly I liked I LOVED the ease of access to so much of my nightly data via the LCD screen w/o having to go the expense of the software and cable reader.

But reading the various apnea forums I soon got "auto fever" so I self-purchased a brand new Respironics pre-M Series Auto w/C-Flex. And I got excellent therapy w/it as well. BUT - I missed the EASY access to the data on the LCD screen of my Elite.

When the opportunity arose to purchase slightly used Resmed S8 AutoSet Vantage (only 505 hours on it) I jumped at the chance and sold my Respironics auto to my son in law to use as a backup and travel machine since he works out of town a lot.

In between I had purcahsed the cable reader and software for both the Elite and the RemSTar auto. I still preferred the Resmeds and their easy of accessing data via the LCD.

When it was determined that I had to go to a bi-level I was adamant that I wanted the new Resmed VPAP Auto. Whilst it doesn't say S8 or S8 II on it it is in the S8 body, it utilizes the Humidaire 3i integrated humidifier AND it has the new EasyBreathe technology. I LOVE it! As I have loved all my Resmeds. And if you travel a lot, the Resmeds are actually 1/2 lb lighter than the Respironics M Series.

Whilst it is true the REsmed S8 AutoSet Vantage doesn't offer EPR in auto mode, it does in CPAP mode and frankly, in automode I fail to see the need for EPR. In addition I'm not wild about that third extra piece, the power brick, the M Series integrated humidifier has been a VERY POOR design since its inception w/3-4 modifications made to POSSIBLE a final effective fix just recently (and you have no guarantee you are going to get the newest), too many have complained of the blue lights that can't be turned off and access to the data on the LCD is still NOT as easy as the Resmeds. The Respironics tend to drop data one or two days a month. In 32 months of use I've never had my Resmeds drop a bit of data.

And as far as online pricing: Both Resmed and Respironics (and supposedly soon Fisher & Paykel) have instituted MAPs (minimum advertised pricing) policies for online DME suppliers. Which means when you find a device that interests you, you call that suppliers toll free number and ask them if they have an "unadvertised special" or "unadvertised price" for that item and how much it is to get an idea of what the REAL price would be for you.

Pineapple · Post by **Pineapple** » Fri May 30, 2008 8:27 am

I agree with bap40 that the M-Series is a nice machine - just make sure you don't get the Plus. It is not fully data capable. The Pro or the Auto (which is what bap has) is fully data capable and makes figureing out if there is a problem with your therapy much easier.

If the insurance won't pay for the AUTO, the PRO will do, but don't accept anything less. If your buying out of pocket, IMO get the AUTO. It costs a little more, but it will run in straight CPAP mode if you need to to, but you'll have the availablity to the AUTO features if you need them later (cheaper than getting a new machine).

CPAP.com is having a sale through June 5 on machines with some pretty impressive prices. PM me your e-mail address and I'll forward you the add.

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CPAPopedia Keywords Contained In This Post (Click For Definition): cpap.com, CPAP, auto

Slinky · Post by **Slinky** » Fri May 30, 2008 8:29 am

BAP is so right about those Mack's Silicone Ear Plugs. You can find them in just about any RiteAid, Walgreen's, Meijer's, WalMart, etc. Just roll one plug out in your hands into a thin rope or tape and lay that on your mask in the area of the leaks or even over any tender point on the bridge of the nose.

Also read the mask fitting tips under the Red Ball w/the Question Mark in it. You need to be laying down w/your xPAP turned on to your set pressure or to 10 cms when fitting your mask. The topography of our facial tissues responds to the law of gravity so laying down is necessary for a proper fit. Don't tighten your straps too tight, the cushion needs to fill w/air to float on your face and not leak. Usually you will need the bottom straps a little more loose than the top straps. NEVER TOLERATE LEAKS AROUND THE EYES.

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