Newbie needs advice quickly

Hi Everyone. I just got my results back and I going to have to get a CPAP machine and need some quick advice.

The doctor has said that I need a machine that provides heat and humidity to the air and will push are in the range of 13 -17 (whatever that means). I was looking out on the internet a few minutes ago and was overwhelmed by the number of different machines that exist so I opted to join this forum to seek advice from those that have been in the same position I'm in now.

What I'm after is some advice on which unit I should tell my medical supplier to get for me and decided I would add in a few extra criteria for consideration.

1. Most of the cost of the machine will be paid for by my insurance and there is a rather high limit that the insurance will pay for a machine. What I have to pay is perhaps 10% of the costs so I want to make sure that what I do get a very good unit. I don't want to be oversold or overspend on a unit but I'm not too concerned about the cost if one unit is vastly superior over another. In other words I'm after a really good unit and not too worried about my out of pocket expence if it cost a bit more to get a nice one.

2. I'm concerned about reliability which factors into which model is best. I don't want to get something that will break down or that will not be well supported.

3. I'm about to retire and my wife and I plan to travel a lot so I want somethng that is fairly easy to lug around vs. something that is big and bulky. I'm also after a unit that once I get on the boat or in a hotel room will be easy to setup and pack away and is reliable on the road as it is in my own home. A unit that has a carrying case to hold the unit, mask and hose would be an added plus

4. I'm concerned about quietness so I'm looking for a unit that is also low on the db scale as far as noise.

5. From what I understand this unit must also have something that tracks how I'm doing so the medical supplier can tell the doctor how much I'm using the machine and whether I'm having any leaks from the mask.

6. I know zero about these machines but I assume that they all require some sort of supplies of some sort (i.e. filters, etc) so I would like to have somthing that wont cost and arm and a leg to maintain.

Any help will be greatly appreciated.

If RX states a range in pressure you will need an APAP machine which is auto adjusting pressure.

If I were you I would limit my research to 3 main players.

ResMed S9 Autoset (not to be confused with the Escape Auto which offers less than optimal data)
Phillips Respironics Remstar Auto CPAP with AFlex...look in my profile for a link to my PR S1 APAP.
Devilbiss Intellipap Auto.

All 3 of the above will offer full data and have software easily available so you can monitor your therapy.
All 3 are quiet and small. Generally the size of a large hardback novel.
All 3 are well thought of by those that use them. As with any brand...occasional lemon but that happens with all things.

I have had the chance to use both the ResMed and Respironics brands. They both do the job and I like each one pretty much the same. The ResMed S9 does have the heated hose option which is a huge plus for people who like a lot of humidity and like cold bedrooms. With the heated hose condensation in the hose is limited (we call it rain out). I own a Respironics machine..they are coming out with a heated hose machine but it is not widely available yet. I bought a heated hose that can be used with any machine and it does the job great.

You will find mostly ResMed and Respironics users here with a few Intellipap users.

So I would narrow the choices down to these 3...see how you feel about them and ask questions about them. F& P machines don't have easily available software yet. The main drawback for me with the Intellipap is the lack of a feature in the software that I think is rather helpful. Flow graph or breath flow.
ResMed and Respironics both have this feature in their software reports.

If you are sleeping in an RV without AC outlets, DC power is an added cost option on all 3.
You will see that the Devilbiss uses a simple cord, where the other two require more complex (costly) adapters;
none of which is normally covered by insurance (unless your plan is a really good one)
I love my machine, by the way.

Welcome, Moondoggy!

I have the Phillips machine and it, the humidifier, mask, hose, and all accessories fit into compartments in a padded travel case that came with it - not heavy at all and I tote it on airplanes and into hotels all over the place. The case is about 7x7x14 inches with enough room inside for a lot of extras. The one thing that it's useful to add (for travel) is a good extension cord since you never know where the hotel outlets will be.

I have no experience with the other machines, but the Phillips is very quiet - I can't hear it at all (and I have very sensitive hearing).

As Pugsy mentioned, the really important thing is to have a machine that tracks data to show how well your therapy is working (as well as hours of compliance that your insurance company wants), so that full data capability would be the thing to not compromise on.

Pugs and Froggy are right on. The resmed or phillips are great machines. The one issue that may and will take time is the mask. Be sure the doctor prescribes a mask "to the patient's choice". Be sure you get a mask that is comfortable and doesn't leak. Ask the place you get the mask to hook up a display cpap machine (set at your prescribed pressure). When you check out a mask, hook up the machine and see if you can control the leaks. Different folks with different face structure will cause some masks to leak for them, but may not for you. The are three kinds of masks and many different brands of each type:
- nasal
-Full face
-total face

Check out each type in the order above. The nasal masks are less intrusive, but you can't breathe thru your mouth at night. If you are are a mouth breather you may need to tape your mouth shut (oh man... my wifey loves this part!!! ) or use a chin strap. If this doesn't work for you, go with a full face. It's more intrusive, but you can breath thru your mouth all you want.

If you open your mouth at night, you'll lose air and cpap therapy will be compromised. Most places you buy your mask at (DME) will allow you to bring your mask back and exchange for a different kind within 30 days... free of charge.

When you get time, do some research here.

Thanks to all of you that have reponded so far (others please post as all info is appreciated).

I never thought about the heated hose issue. I know that my bedroom is cold so avoiding a rainout may be a big selling point.
I also didn't know that there were any variations in the monitoring/compliance software. I assumed that all would do the same thing so thanks for that heads up as well.
I don't think I'll need the DC power converter as I don't have an RV.

Please note that I have a another post on the forum regarding the mask (any help there would be appreciated as well). During my sleep test I tried a nasal pillow model but with my pressure that one would not do even with a chin strap (which the doc has ordered). I also tried two full face masks that leaked anytime I moved and lastly was put into a Fisher and Paykel Zest Nasal CPAP Mask and this one I did pretty well in (with the chin strap on) but my concern is this.... With all the masks out there I'm concerned that having only tried 4 masks in a bit my experience is a bit low. Please see the other post but any help on the mask would be appreciated as well.

moondoggy wrote: I tried a nasal pillow model but with my pressure that one would not do even with a chin strap (which the doc has ordered).

What happened with the nasal pillow mask? What is your prescribed pressure? There are many people here using nasal pillow masks at pressures well above 15 cm without any issues.
Chin strap is used to help keep mouth closed...that is its sole function. If you can keep your mouth closed without it..you don't have to use it.

Pugsy,

I'm not 100% sure what happened with the nasal pillow mask. The tech put me in that one first as that was my first choice. When I started out she had the pressure down low and I thought all was cool but after sleeping in it and cranking up the pressure she indicated that I was having issues and came in and added a chin stap. After the chin strap was on for a while the tech came back in and said that that model was still problematic and swapped me into a full face mask (which leaked badly) and then into another full face mask (which also leaked badly) and finally into a Fisher and Paykel Zest Nasal mask that seemed to work pretty well. Perhaps the model of the Nasal pillow mask I tied was just wrong for my face and that another model will work better but apparently I need a chin stap to keep my trap shut.

Don't give up on the nasal pillows entirely. Sleep titration night is bad time to be trying to sort out masks..anyway.

I just had a thought..With your pressures which are not horribly high believe it or not (though I know it seems awful high to you)...I would suggest the S9 Autoset. It has EPR exhale relief and can be set to as much as 3 cm reduction during exhale which is a substantial reduction and the difference of 3 cm may be more comfortable for you. I use the PR S1 machine and its exhale relief is different and doesn't drop as much during exhale. Neither one is particularly "better" than the other as each has its pros and cons but I have used both machines and I think for a newbie starting out with moderately higher pressures that exhaling using EPR might be a bit more comfortable for you. Add that in to the heated hose thing...and you might want to lean towards the S9 AutoSet.

So while either one (S9 or PR S1) does a good job on exhale...it is the actual difference between inhale and exhale that gives the "feeling" of being easier to breathe out against. I think for a newbie that EPR and using higher pressures might tend to be a little more comfortable. We all can adjust to whatever pressure and exhale relief our machines offer..I went 2 1/2 years before I got to try a ResMed machine for 3 weeks. I could easily use either one but I can see where just starting out that EPR might be a plus to be considered.

Don't think that the PR S1 exhale relief is dog pooh though. It is quite nice and completely comfortable.
I am just thinking out loud that you might like the EPR feature.

Even with good insurance AND a prescription that is likely to say APAP, you need to read JanKnitz's What you need to know before you meet your DME. She's got plenty of advice.

The one thing you need to watch out for with a prescription that says APAP is the Resmed S9 Escape Auto. This machine is indeed an APAP. But it does not record full efficacy data. In particular it does not record leak rate data. And since you were having problems with leaking on the titration study and you are still at least interested in trying to make a nasal pillows mask work, leak data will be critical to you.

If you ask your doctor to specify "leak data"; or a specific model of machine. You ought to be covered.
Important: Read all the nameplates on the bottom/back of the machine. Be extra sure you have been given what you requested.
Not EVERYONE lies to the patient; but we are not allowed to identify anyone by name or company.

Here are some videos that will show you the features of each machine.

http://www.cpaplibrary.com/machine-education.

Hope this helps

Dane

Thanks to everyone that replied. I viewed serveral video reviews of the ResMed S9 Autoset and spoke to 2 out of 3 of the providers in my insurance company's network and they also recommended the S9 Autoset without me doing any name dropping so this one is probably the unit I'll go with. Thanks again.

moondoggy wrote:Thanks to everyone that replied. I viewed serveral video reviews of the ResMed S9 Autoset and spoke to 2 out of 3 of the providers in my insurance company's network and they also recommended the S9 Autoset without me doing any name dropping so this one is probably the unit I'll go with. Thanks again.

Excellent machine.

One BIG warning. If anyone said "S9 Auto", they might be trying to give you an S9 ESCAPE Auto, which is a MUCH less capable machine. Look at the pictures on CPAP.com, and see where it says "AutoSet" next to the power button.

i.e. "AutoSet," not "Auto".

Get the dishwashable water tank, even if you have to buy it out of pocket online. There's no substitute for being able to open up and actually clean the water tank, instead of just trying to flush water through it. In the U.S., ResMed usually ships the machines with the non-dishwashable tank that doesn't open up for cleaning.

chunkyfrog wrote:If you are sleeping in an RV without AC outlets, DC power is an added cost option on all 3.
You will see that the Devilbiss uses a simple cord, where the other two require more complex (costly) adapters;
none of which is normally covered by insurance (unless your plan is a really good one)
I love my machine, by the way.

What do you mean? Respironics PRS1 machines use a simple cigarette plug cord. How is this different from Devilbiss?

https://www.cpap.com/productpage/respir ... -cord.html
https://www.cpap.com/productpage/intell ... -cord.html

ResMed S9 does require a more costly DC-DC converter.