How to decide which machine/mask to start with?

BrensTiredMom · Post by **BrensTiredMom** » Thu May 24, 2007 9:59 am

Other than going only on Dr. recommendation (or DME supplier recommendation) can anyone tell me what's considered the 'gold standard' for machines/ff masks? (I can't do nasal, I know for sure I want to get a ff, maybe a hybrid, but definitely not a nasal.)

Here's what I've learned so far:

If I get a Respironics machine I can get Encore Pro and the Analyzer software. I'm the kind of person who likes alot of info so this appeals to me, I've seen the posts with copies of the reports and once I know what I'm reading I think I'd like that. But I also read that the PB Silverlining is the 'best' as far as software/reports.

I know I want one that is quiet, relatively small as we don't have a large bedroom, and has a heated humidifier.

And I think it's an APAP I want right? I get that a CPAP can't be an APAP but an APAP can be a CPAP, not sure where the BiLevel ones come in.

I need C-flex...the tech said I did much better with that on during my study.

My insurance has no yearly limit for DME so I'm pretty sure I can choose whichever I want as long as I purchase from an approved supplier. There is a local DME supplier very near my home and they DO carry Respironics, Redmed and PB. Since I'm just learning I probably will want to get things from a brick and mortar store at first and then once I'm more comfortable I can order things online.

As for masks, I would like to try on a few ff ones. I don't know what brand it was I wore during my study. But is there one in particular that overall people tend to like?

Thanks for any input!

DreamStalker · Post by **DreamStalker** » Thu May 24, 2007 11:00 am

Sounds like you summarized it all about right to me. Only thing I would add is that the ResMed software is available ... just not as readily as the other two.

As for masks ... they are very subjective. Some will say this mask is the best or that mask is the worst. Fact of the matter is that it is only true for the person having experienced it. So in the end, you will want/need to try them all out as you can afford to do so.

Why are you tossing out nasal interfaces as potential interfaces?

Wulfman · Post by **Wulfman** » Thu May 24, 2007 11:35 am

DreamStalker wrote:Sounds like you summarized it all about right to me. Only thing I would add is that the ResMed software is available ... just not as readily as the other two.

As for masks ... they are very subjective. Some will say this mask is the best or that mask is the worst. Fact of the matter is that it is only true for the person having experienced it. So in the end, you will want/need to try them all out as you can afford to do so.

Why are you tossing out nasal interfaces as potential interfaces?

Some of us just KNOW......(what will work for us)

Den

BrensTiredMom · Post by **BrensTiredMom** » Thu May 24, 2007 11:38 am

OK...didn't know I was able to get software for Resmed...that's good to know. Is their software as easily readable as the Encore with the Analyzer appears to be?

As for the nasal...I actually started with that at my titration study. I could not keep my mouth shut! (My husband would say that's a big problem for me...LOL!) I've read about the different options for taping/polident/chin straps so I know that I have options but just the idea of it makes me very anxious. I seemed to do fine with the ff mask that we switched to during the night of my study...so I figure if it worked for me why try to force myself to use a nasal when there's no real reason that I can see what I should and if it's going to make me extra-anxious. This whole thing is anxiety producing enough and right now I'm so incredibly exhausted that I just don't handle anything well. I'm not discounting a nasal forever...just definitely not for me to start with.

Guest · Post by **Guest** » Thu May 24, 2007 4:23 pm

Don't be bashful. Call your sleep lab and ask which ff mask they fitted you with for your titration study so that you know which one you want to get from your DME supplier.

The Resmed software is EASY to install and easy to use AND easier to understand (at least for me) than the Respironics EncorePro v 1.5.7 and the printouts I've seen from the later versions.

PLUS there is more information available on the Resmed's good size, easy to read, LED screen w/a simple button combination than is available from the Respironics which also have a more complicated access to the info they do make available.

Both brands are EXCELLENT machines, BUT, Resmed beats Respironics hands-down for ease of data access.

blarg · Post by **blarg** » Thu May 24, 2007 5:26 pm

Anonymous wrote:The Resmed software is EASY to install and easy to use AND easier to understand (at least for me) than the Respironics EncorePro v 1.5.7 and the printouts I've seen from the later versions.

Just to point out the flip side, I find EncorePro printouts easier to understand than different height lines.

Basically just get a machine with software capability if you want it. You'll learn the reports either way. The deciding factor for me was having exhalation relief in Auto mode, which wasn't available on ResMed machines.

So, choose the features that are important to you and then make a (guided) stab in the dark.

Sleepy Dog Lover · Post by **Sleepy Dog Lover** » Thu May 24, 2007 5:33 pm

When I went to my DME, they spent an hour and a half with me trying on every different mask at pressure. They adjusted them, and helped to quell leaks. I ended up with the Twilight NP, it was the most comfortable and produced the least leaks. Luckily, I had read up on this board and knew about the rubber band fix was and that I could use it as an adjustment, so that is what I went home with. I was very happy with my DME's service and the mask fitting. Not so happy that they wouldn't even think about giving me an APAP unless I paid the difference. So I walked out with a Remstar Plus and heated humidifier along with the mask, and came home and ordered an APAP from CPAP.com. I had already checked out the prices, and it was cheaper for me to do it that way and have an APAP and a backup CPAP than to pay the difference in price and get the APAP from the DME. With my insurance, the Remstar Plus was covered 100% from the DME, but if I ordered online, I would have a $500 deductable and then would have had to pay 20%.

tillymarigold · Post by **tillymarigold** » Thu May 24, 2007 6:20 pm

I understand your reluctance to trust your DME's recommendation because there are so many horror stories, but really, a *good* DME respiratory therapist is one of the most valuable resources. The same with doctors: if your doctor isn't primarily a sleep doctor or is a jerk, I can see not following his recommendation; but a good doctor is a great resource.

You should call the sleep center and ask what mask you used. I would say your first one should *probably* be of the same *type* (if not the exact same mask) as the one you used at the study, if you liked it.

Read reviews (cpap.com has reviews for everything), read about the features of different machines and masks, decide what you want ... for example I considered the Swift mask, but as I sleep equally on both sides, I knew it would drive me crazy moving the hose from one side to the other.

BrensTiredMom · Post by **BrensTiredMom** » Fri May 25, 2007 4:41 am

Thanks for the replies.

GREAT idea to call the sleep center...honestly, it never occurred to me! They are very helpful there so I'll call today and get the info on the masks from them.

If I'm reading correctly, as for the machines, if I need C-flex I can't get that on the S8 Auto Vantage...I need to go with a Respironics AutoPro V 1.5.7 machine. Is that right?

I think that whoever said I'll learn to understand the reports from either machine is correct so I'm not going to stress over who has the 'better' reports at this point.

The thought to get the same mask that did work for me at the sleep center was a good one. I really would love to try a Hybrid or the Liberty, the one thing I hated about the ff mask was that there was the forehead part. But I can always get another at a later date. Can any mask work with any machine or only ones from the same manufacturer?

You guys are just awesome!

bdp522 · Post by **bdp522** » Fri May 25, 2007 6:12 am

All masks work with all machines.

Brenda

BrensTiredMom · Post by **BrensTiredMom** » Fri May 25, 2007 8:03 am

Thanks Brenda!

RosemaryB · Post by **RosemaryB** » Fri May 25, 2007 8:14 am

BrensTiredMom wrote:My insurance has no yearly limit for DME so I'm pretty sure I can choose whichever I want as long as I purchase from an approved supplier.
CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, humidifier, C-FLEX, Encore Pro, CPAP, DME, APAP

Er, not exactly. Most of the DMEs (vast majority, it appears) have a strong tendency to tell you things like your insurance won't pay for the higher end machines and will give you the cheapest most basic ones because usually the insurance pays the same for all machines (autopap or cpap, FULLY data capable and compliance only data) and the DME pockets the difference.

What I did was more research on the DMEs and found one that said that as long as I had a script from my doctor specifying an auto machine and the brand, that would be no problem. So, I got the script from the doctor but they still tried to do an end run around me and called the doctor's office and told them to change the script to scratch out the word "auto." (Mine was for a REMstar classic auto machine). When the drs office told me this I called the DME (I calmed myself down first) and asked them what was up. They said that based on my sleep study, I needed a straight cpap, not an auto. I said that there were other health factors involved that the sleep study tech didn't know about (and I never saw the sleep doctor). Even after that they tried to switch me to a ResMed machine (auto) or an M-series. I finally got my auto machine, but not without a fight.

Had I not been advised by people on this and another forum, I'd have the machine the DME wanted to give me (not even a FULLY data capable machine).

So, get your script before you talk with them and don't allow them to switch anything. Don't take home any machine other than the one you have the script for.

BTW, the autopaps have an upper and lower pressure that should go on the script.

I like the REMstar Auto classic (not M-series) due to it's reported durability and the software integration. I'm also using CFlex. It is big, though. One of these days, when I can afford it, I plan to get a P&B 420 as a backup machine and for travel.

Slinky · Post by **Slinky** » Fri May 25, 2007 8:43 am

SleepyDogLover, I would take the Remstar Plus right straight back to your DME and flat out tell them, this machine is NOT data capable other than compliance data. There is no way my sleep doctor can monitor my CPAP therapy and know what pressure adjustments might need to be made. They should at least give you the Remstar Pro2 which is a fully data capable straight CPAP. Its not too late unless your machine was an outright purchase, if it is a rental or capped rental, take it back to them.

And don't let your DME hand you ANY BS about having to pay 1 cent extra for a fully data capable machine. If necessary just tell them right up front that you KNOW they get paid the same for a fully data capable machine as for a bare bones compliance data only machine as for an autoPAP.

If you've got a good sleep doctor he should back you up on the DME supplying you w/a fully data capable CPAP and I'd put it to him about his inability to monitor your therapy w/the cheap, bare bones machine your DME gave you.

blarg · Post by **blarg** » Fri May 25, 2007 8:50 am

BrensTiredMom wrote:If I'm reading correctly, as for the machines, if I need C-flex I can't get that on the S8 Auto Vantage...I need to go with a Respironics AutoPro V 1.5.7 machine. Is that right?

Almost.

C-Flex only comes on Respironics machines, it's true. But ResMed machines often have a feature called EPR, which is much like C-Flex. The only caviat here is that you can't use EPR while using the machine in Auto mode. So, if you're using it as a fixed pressure CPAP, then you can use EPR. If you're using it in Auto, no exhale relief.

C-Flex on the other hand can be used while the machine is in Auto mode OR CPAP mode. And yes, definitely get at least a Pro, and an Auto if you can swing it.

Dark_Star · Post by **Dark_Star** » Fri May 25, 2007 9:10 am

I originally got the Remstar M Series Plus with c-flex. I then realized it did not have the full data capabilities.. SO I ended up selling it after a week and buying the M Series Pro C-flex and the heated humidifier.

The M series machines are rock solid and easy to use. Also, cosmetically not too bad looking either.

I especially like the C-flex and the Ramp features..I do not think I would be as comfortable without these features.

I can recommend the M series Pro (or the Auto if money is not an issue). Then get the Encore Pro software ... My therapy has been a lot more interesting with the Encore data.

AS for masks? This is the toughest part.. But I believe one will need to try more than one mask before they can know which one works best.

How to decide which machine/mask to start with?

How to decide which machine/mask to start with?

Thank you!

Re: How to decide which machine/mask to start with?

Re: Thank you!

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