Problem with new machine Remstar 150P

Glad I found this site…..what a wealth of good information!
Background…..5 years ago I was diagnosed with OSA. The machine I received 5 years ago was a ResMed Tango. A basic unit, so I was told. I use it every night (14,000+ hours). Mask is a F&P 400 series Nasal Type. The ResMed Tango came with a humidifier but I stopped using it years ago. I sleep pretty well with the ResMed Tango. Wanting to get a more modern machine I ask my doctor for a new script. He told me I had to get another study. Got the study and was given a new script. I decided to go with an alternate equipment provider that was part of the large regional hospital my doctor was part of.

About one month ago I received the new machine keeping the same mask that I was used to. The new machine is a Philips REMstar 150P with snap on humidifier. The hospital also provided a SD memory card and a plug on modem with antenna that they supposedly are going to monitor via a cellular link.

I was told that this large hospital standardized on this unit because it was a basic unit w/o all the features to keep the cost and complexity down. The respiratory therapist also told me that the hospital decided to include the modem link as they are finding that some insurance plans are validating how much the person uses their CPAP and may cut off some benefits if usage drops below 70%. She said probably only a matter of time before all adopt this policy (her opinion).

My sleep with the new REMstar 150P, is terrible. Waking up gagging (this does not happen with the old machine). Feeling tired during the day. The pressure on both machines is 9.0 and I tested both with the simple manometer (ball and tube) I purchased on-line.

I notice with the new machine, it is harder to exhale. I have run the new machine with and without humidity. I use the same mask with both machines. I also notice on the new machine I hear a faint noise in the unit from inhale to exhale……could it be some sort of valve actuating?

I called up the therapist to state my problem. They said never heard of this. They agreed to give me a new machine. I received the new machine last week and I still have the same issues, no improvement.

I am presently back on my old machine (ResMed Tango) until I can get this resolved.

So is their some setting on the REMstar 150P that can help me?
Is there a better machine for me?
Should I just return the REMstar 150P and get my money back?

I appreciate any insight you can give me. I want the new machine to work, but as it stands it is not usable to me.

Hi ElKabong,

I'm so sorry your machine is not giving you the experience you need for good treatment & sleep. As you hear (or read) from others, the Philips Respironics System One model 150 is the lowest model, and does not have any features (other than being able to report hours of use, on the card and via the optional modem). It is also a model that has been superseded by the newest version which offers a heated hose on the humidifier.

To see what is going on with your therapy you'd need to have a higher number model. Model 450 would be the lowest number, it would tell more than just hours of use. Model 460 is the current version. That's what I use. It has several exhale relief settings (which your model does not include).

Others can help you think through the sleep study and what to do, but I'd encourage you to ask for the higher model numbers and turn in this unit.

--SleepyCPAP

Unfortunately the 150 model doesn't even have pressure relief (C-Flex); it is the least expensive Philips Respironics model in the System One line, commonly referred to as a "brick." The only comfort feature offered is ramp.

If you can replace it with the 460 (or higher) model, as was suggested above, you will have C-Flex and will also have access to efficacy data.

ElKabong wrote:Should I just return the REMstar 150P and get my money back?

Curious....just how much did you pay for this little jewel (cough, cough) of a machine?

Wow…thanks for all the information. Knowledge is power and with this information I will call my provider and request a better machine. Again so glad I found this great resource on the web.

As far as the cost……the invoice shows $651.54 for the base unit plus $167.32 for the humidifier for a total of $818.86. My insurance is 80/20 so I paid $163.77 out of pocket. Came with a power supply, SD card, tote bag, manuals and (1) extra filter. No mask or tubing. Also came with the cellular modem but I was told I was not being charged for this. The ticket states “rental” equipment but I thought I owned it. Hope this helps.

Thanks again!!

Hi ElKabong,

I also found this forum very helpful when my provider attempted to set me up with a cheap machine which would not record therapy data. That was about three years ago, and though I don't respond much on here I keep reading and learning!

There are steps you can take. One is talk to your doctor about your troubles, and ask about how the prescription needs to be re-written. You are having trouble with the exhale, so can he put "with exhale relief" on the new prescription for the machine? Also, you don't know why you are waking up gagging, so it would be helpful to have a machine which shows "AHI and leaks" (could the doctor put that on the new prescription too?). I don't know your relationship with your doctor, but by saying "I can't comply with therapy with this machine, can you help me get this fixed so I can get into good therapy?" would be one way of putting this in a partnership for good health (rather than "I've heard there are really great machines, let's see if you can get me one!") With that resulting new prescription in hand you would be upgraded (ask for a copy). I'm guessing you might be switched to a model 450, since you already have the humidifier that fits that model series (I'm assuming your humidifier and machine do not have raised silver letters "System One" on their casings, which would be the new 60series).

Yes, there can be inhale/exhale noises with these machines. If you've had the chance to try two of these and they are similar then I'm guessing you are hearing a normal amount of sound (it wasn't just one bad machine). Personally I don't find it so bad if it is the machine itself which makes the noise, because the machine can be put on a shelf or on the floor mostly out of earshot -- but when the noise travels up the tube, that isn't something which can be dampened.

It is odd that your machine did not come with tubing. When buying online I seem to remember that came with the machines I've bought, it was in the box. You could look on CPAP dot com to compare machine listings, I admit I have not looked up the model 150 and what it includes in the box.

Do work quickly on resolving this, as that modem is reporting back that you are not in compliance (since you are not using the new machine), and the clock may be ticking for a window of easy exchanges of machines.

--SleepyCPAP

Didn't realize you had insurance.
Here's the deal. Most insurance pay a set amount for the HCPCS billing code for cpap/apap machines (they all use the same code).
Might want to read these two blogs.
http://maskarrayed.wordpress.com/
http://maskarrayed.wordpress.com/what-y ... me-part-i/

The supplier gave you the cheapest machine they could give "to keep costs down" ....well, really so they could make the most money off of what your insurance will pay. Those less expensive basic models cost less so their profit margin is greater.

I think it would be a good idea to check with your insurance as to exactly how things work and see if you can maybe use a different supplier who is willing to supply more than a bare bones machine.
While checking things out with insurance you might also ask about the compliance thing and is it a rent to own thing.
Don't rely on the DME supplier to tell you what you insurance will do....you check yourself. DMEs/suppliers don't always convey things accurately.

What Pugsy said.

I might add that this link helped me as well:

http://maskarrayed.wordpress.com/2011/0 ... h-a-brick/

I am extremely grateful for the resources provided here as well. Less than a month ago my DME gave me a brick, today they swapped it out with a full efficacy machine. It wouldn't have happened if I didn't have the insight I've gained here.

Thanks again.

Well after 2 months I finally got the machine I ask for, Remstar DS460. Seems like I expected stellar service from my DME but they treated me like I was a problem child. No direct line to the therapist---leave voice mail---call you back thingy. Calls me back and caller ID is blocked. I told them I wanted to return for a full refund and they said no refund. After many phone calls they agree to swap out the DS150 for a DS460 but there would be a $290 up-charge for the swap (with new style humidifier). I already paid $163 so my total co-pay was $453. So with my 80/20 insurance that means the new unit “cost” $2,265 (ouch). I went over the math with them and told them I could buy it online for about $800, but they just said that was the best they could do. Take it or leave it….I took it.
So I have the new machine and I am done with this DME. Now that I got educated (via this site), next time I will just buy online. Thanks for all the help and links, I feel now I can monitor, tweak and optimize my treatment.

The exhale relief alone is worth the money.