Help - I'm new and have ????

[onecoknower]

Hi.
I just completed my first sleep study this week. The tech said I had 120+ "episodes" during the night. She said I'd need a cpap and the dr would be calling me re: test results soon. The tech said I'd have to go for another sleep study to be "titrated".

I've been reading these board - very informative, thank you.

Here are some of my questions:

- if you had to do it again - purchase from brick and mortar dme the sleep clinic sends you to or online? What about setting up the machine to fit my "readings". I'm not completely sure what the insurance will cover, but I have a $3000 deductible so it appears the cost of this machine will come out of my pocket anyway.

- face mask, nose mask, nose pillow? What's preferred and why? I never sleep on my back/stomach, always on one side or the other.

- what questions do I need to ask that I might not think of?

Thanks for all your help!
Oneco

[Jaxdad]

Welcome to the forum. We are all here to help.

Just to help a little, on the mask style, ask the sleep tech to let you try several to find which one suits your style of sleep. I, personally, need the FF mask due to a lot of mouth breathing while I sleep. Also, I have some sinus issues that prevent me from using the nasal mask.
As far as setting up the machine, I went to a healthcare equipment provider here in Mayberry and the machine was set for me when I picked it up. I had a follow up visit with my doc yesterday and he asked me how I was sleeping. If there were any issues, they would have reset my pressures there.
Another hint I got from some folks here, when it comes to asking questions...ask them all. Don't assume anything. The docs are there to help you, not just tell you what to do.

Keep us posted and welcome to the 'family'.

[mattman]

Hiya onecoknower! Welcome to the board.

I'll answer your questions as best I can. Your questions are pretty subjective, so you are likely to get several answers.

Brick-n-Mortar or online. That's a very tough one to answer. I work for a brick-n-mortar facility and I can't really say which will be better for you. There are benefits and drawbacks to both.
IF you really do have a straight $3000.00 ded (And that sounds REALLY high. Also, many plans break out DME and other dedectibles so it may be different) then yes, you are likely to pay a good bit more out of pocket going through a regular DME. This is because the Insurance companies set the prices, and the insurance prices will always be higher than cash prices due to the much more significant amount of work involved - plus insurance is just screwy. A provider that bills insurance is required to charge a cash customer the same price insurance pays so you get no cash discount.
Going through an online provider you don't have those problems.

A traditional DME company can often provide much more hands-on care than you get through a online retailer. Not all DME companies are the same though as reading through here will show you. Like any business there are always bad seeds everywhere.

A traditional company will often have a showroom with multiple masks that you can all try on and see how they feel for you. Many will even have loaner masks you can try for a night or two.

My broad, general guideline is that starting out many people will benefit more from a local provider than an online company as there is so much that has to be trial and error at the beginning of treatment. Different masks, different pressures and possibly even different machines.

Would you fall into that catagory? Eh, no one but you really knows that!

2nd question - Masks. Also very subjective. Masks are like spouses. Everyone has a different idea of what's perfect. and on any random night that perfect one might STILL wind up on the floor.

I sleep on my side a lot and I like the Swift or the Comfort Gel. You might ask your sleep doctor to look at your Sleep Study and see if there was anything about 'Mouth Breathing'. That might help determine if you need a full face mask or other type of product.

What other questions? Eh, You've hit the biggies really. You might ask about any central apnea events. That can change your course of treatment potentially. I would request a copy of your sleep study and your titration report (If done on differnet nights) just to have for your own purposes, as well as a copy of your prescription.

mattman

[Goofproof]

If I had a $3000 deductable, I would have the Dr. give me a script for a Remstar APAP (Tank) like mine and a heated Hudimifier, and give it to CPAP.COM and purchase online.

I would also order 6 of the Ultra Filters for the machine, Then you need a mask. If you have a lot of congestion a full face mask works best, later you can try a Nasal if you want. You also need the card reader and the software, to figure out where you need the pressure set.

Shipping is free over $100, so get it all at once and save.

Click on the Yellow light, Rested Girl, did her set-up that way, as did many others. Most studies are $1000, the whole setup should come in less than that.

[oldgearhead]

if you had to do it again - purchase from brick and mortar dme the sleep clinic sends you to or online? What about setting up the machine to fit my "readings".

I've done it both ways this decade. Doing it myself without the Insurance/
DME hassel has been, by far, the less stressful. Furthermore, by purchasing
a used item here and there, its has been less costly than using my insurance for anything other than the PSGs.

Setting up the machines is easy. If you buy a new one online it will come
with a set-up manual. If you buy a used one (Yahoo Auction, Sell-dot-com, or Craigs List), or you get one from a DME without the manual, you can buy the set-up manuals on eBay, or just post a request on this forum.

Be sure and get a copy of both your sleep study and your xPAP script.

[snoregirl]

If you are sure you have a $3000 deductable (and I believe you since our company menu of plans includes one like this) then it is hands down (in my opinion) better to go online.

One exception to this is if your deductable is for both sleep study and equipment. If so, and your 2nd sleep study comes in 2007 and that is a new insurance year, and you meet the $3000 with that sleep study, then maybe your insurance will pay for the machine. A lot of ifs but something to consider. Not that the local DME is better, just getting the machine (if insurance will pay) for less is the point.

Now assuming that there is still a large deductable left in 2007 ..... go online because

1) Get the machine of your choice for which you only need the prescription the doc gives you. Doesn't matter if he writes CPAP or APAP or whatever. No arguing with the doc APAP can be used as CPAP for ultimate flexibility for maybe $200 more. Consider exhale relief and other options.

2) Get the top of the line APAP (whatever brand you choose). If your deductable is that high, I am willing to bet the sleep study was also out of your pocket. If so, you want to avoid doing more of those, I won't have to tell you why. While you can do this with CPAP and data, it is easier with APAP (unless for some reason APAP is contraindicated due to your sleep study, search on this)

3) Even with an out of pocket of $700 - $800 online for the machine, you can buy a number of masks at $100 - $150 and not come close to what you would be billed at a brick and mortar DME. Try both full face and nasal (I like pillows and I always was congested and was a mouth breather, something about air blowing up your nose that makes you breath through the nose). Read comments and see what people here seem to like. Opinions will vary but you can get ideas on what is good for many.

4) CPAP/APAP is not rocket science to set up. Any person who can read can do it in 10 minutes. It is easier than programming a VCR, or programming your phone answering machine, and much easier than setting up a new cell phone with phone numbers etc.

5) Stress level is much reduced dealing online.

6) Comes faster online

7) Good point about stocking filters -- shipping is free over $100, get some extra hoses too. $10 is not bad and they are good tubes.

Get a copy of your prescription and sleep studies from the doc so you have your records.

9) Don't be intimidated and think you need an RT for this.

10) Make sure your titrated pressure is not in BiPAP range so you buy the correct machine the first time. That can indeed get expensive. In otherwords if you are titrated at 19 you may not want to order up an APAP. Won't know this until titration study.

[Wulfman]

First rule: Do NOT let them rush you into making a quick decision.

If you can read, you can set up one of these machines.

This is YOUR therapy......get a machine that's capable of storing nightly statistics and (available) software to monitor your therapy. My titration (prescription pressure) was WAY off. The software told me where it needed to be. Also, periodically your pressure may need to be tweaked and the software will help you find the best pressure (or range) and whether you're having mask leaks and other things you need to know.

I didn't use a local (brick & mortar) DME supplier. I purchased all of my equipment from CPAP.COM and then billed my insurance provider, who reimbursed me for 80% of my purchase.

Do lots of reading here. Click on the yellow lightbulb (above)......and remember the "First Rule".

Best wishes,

Den