O2 consentraters-anyone own one? Rent one?

[TahoeGal]

I saw my sleep doc today and found that my o2 levels are going too low when I sleep. So I need to get an o2 concentrator. Has anyone bought their own? Cost? Upkeep? Brand/model? Can you do it on your own, or do you have to use a DME? I'm more interested in a portable one, because space is tight in the bedroom, and I travel a lot. Thanks. TG

[kteague]

While you're waiting for replies from those knowledgeable about this equipment, I'll go ahead and ask the general question that is likely coming. Since you've been a member of the board for some time, I'm assuming you're saying you are using your cpap when your oxygen is low, it is documented to be effective, and the low oxygen levels are from some cause other than your OSA. Is all that correct?

[PoolQ]

I don't use one, but know "some" things about them.
You can get used and refurbished ones, how used is used I don't know
They are prescription only.
They use a natural mineral to absorb the nitrogen and leave the O2, this needs to be replenished, I have no idea how often.

[Hammerhead]

I use one and rent it from my DME but you can buy one as long as you have a prescription for it. I found that if you want to buy you have to use an online supply house for the best prices.

What flow rate did your doctor prescribe ?

You probably will not be able to use the small travel sized ones because I think most of them use a pulse or on-demand delivery and you will need a constant flow for it to work inline with your xpap.

[Stormynights]

I have both the home model and a small one. I was told that I couldn't get the portable one for night use only. Now I am on O2 all day and night so I was able to get both. My small one can be set for either pulse or continuous flow so I can use it at night. My insurance pays for rental. I do not own them and never will.

[TahoeGal]

For the o2, they're going to start at 2 lpm for a month, then retest.

We don't know the cause of the low o2. The doc seems concerned about it. I had 67 minutes under 88 (mostly 85), and most of the rest of the night 88.5. My o2 sat when in their office is 94. Their office is at 4500' and I live at 6200'. When my o2 sat is checked by my gp up here, it's usually 92.

No one has looked into the cause of the low sat specifically. No cause was found for the apnea. I have central apnea, asleep and awake. I've lived at this altitude for almost 30 years, any hike is uphill from here- I survive OK hiking, tho I do run out of breath easily. Same thing happens at sea level.

Thanks for the replies. Sounds like another tether for me.

TG

[M'ohms]

I am on O2 at night. This was my process: from my insurance company, I got the names of the DMEs in my area where I could get a concentrator. I studied the home concentrators online to determine which one I wanted. After calling all the DMEs on my list, I eliminated those that didn't carry the one one I wanted. With the remaining ones, I asked what I would have to pay on a rental basis vs outright purchase. You wouldn't believe the wild ranges of pricing I was given! All using the same insurance, at that! I compared my best DME price with the my best online price.

What I ended up doing was purchasing an EverFlo Q concentrator from my local DME. My total out of pocket for the unit was $73. Maintenance should be low. I wash the filter monthly and fill the humidifier bottle as needed. I haven't needed servicing.

I've taken 3 trips with the concentrator (by car). It really is trouble-free. I'm planning a trip by plane and will leave it at home then. Since I'm using 2L of O2, my doc said I could do without it for a couple of weeks.

The added O2 was an overnight success with me. I had felt lousy on APAP, BiPap, and ASV for a year and a half, and the oxygen made me feel like a new person overnight! Hope this helps!

[JDS74]

Have you tried increasing the Min EPAP? That can have the effect of increasing O2 level.
Otherwise, make sure that the unit you get can do continuous flow AND has a higher flow capacity that 2 liters so if you need more the capacity is there. Check with any online supplier about maintenance, the local DME's don't usually do maintenance on equipment they don't supply it.

[TahoeGal]

M'ohms, I like your plan of attack. When I got my adapt, the insurance wanted $560/month rental, with no buy out option. I priced the unit, and found that I could buy the unit for less than a years rental. I'm going to do just that with the concentrater.

JDS74, I did increase my min epap a few months after I got my machine (2 years ago). It was set at 4, and I was suffocating at that rate. I now have it set at 5.5. The overnight oximetry was at that setting. Good idea, though. I will make sure the concentrater can work at higher pressures. I have met my out of pocket maximum this year with my insurance, so maybe I can try before I buy? I'll get on the phone today and find out. Unfortunately, there's only 1 DME here that's contracted with my insurance, but I will call the non-contracted company as well. Not a lot of choices in DME's here.

TG

[JDS74]

My concentrator works just fine at high pressures so that's not an issue.
If you can take a higher EPAP, you might try up to 7.5 cmH2O to see what the effect on SpO2 is.
I suspect your centrals issue may be related to altitude.
When traveling, do you ever go to lower altitude and get fewer central events?

[TahoeGal]

I will look back at a time I spent 2 weeks at sea level. Good idea. I'm hesitant to up my epap minimum. I may not understand all the differences between cpap and vpap- in my titration study, my centrals increased dramatically on cpap and bi-pap. The vpap adapt does a great job at keeping me breathing. My AHI is about 1.

TG

[M'ohms]

M'ohms, I like your plan of attack. When I got my adapt, the insurance wanted $560/month rental, with no buy out option. I priced the unit, and found that I could buy the unit for less than a years rental. I'm going to do just that with the concentrater.

TG

Yup, one DME wanted to charge me $500 per month with no buy out ever. At that rate, I could own mine with one and a half months rental payments. I asked why would anyone want to do that and they said that they would maintain the equipment at no charge. That's a lot of maintenance!

[TahoeGal]

JDS74,
I looked at the last years data. There was no difference between home and sea level. However, there's a big difference in my numbers the last 3 days- I got sick with a dripping nose and subsequent sore throat, and hacking cough. Dr diagnosed bronchitis. Started Z-pack yesterday and feeling much better this afternoon. 1st time sick since starting treatment.

[popcpoo]

I was on O2 for almost a year while waiting to get my bipap. When I was in the hospital for knee replacement surgery, it was noted that my O2 level was dropping during the night. My doctor requested an overnight oximetry test after I went home, and had an O2 concentrater delivered the next day. I used it for almost a year while I went through four sleep tests and two sleep doctors before I finally got my bipap machine. The DME billed Medicare over $300 a month for the machine, but Medicare paid $98 a month for the machine. They hooked me up to one during my third sleep test because my blood O2 was dropping dangerously low (under 60%). Since being on bipap, I have not used supplemental O2.

[TahoeGal]

Wow. The bipap really helped! I don't remember how low my o2rates went without the vpap, but using the vpap helped bring my saturation come up. Your saturation low is scary! I keep setting off the o2 alarms when I had out patient knee surgery a few weeks ago.