How do I choose a machine? Mask?

CMF · Post by **CMF** » Thu May 22, 2008 2:08 pm

Hello.

New here and anxious to get started.

The sleep study center gave me the name of a supplier for the machine and mask. They are about to provide me with a machine that I know nothing about. I did a quick scan of this message board and see that I have a choice of machines. Which one should I ask for? Also, I used a full face mask during the sleep study so that is what I asked the supplier for. I tried a couple of others during the test, and the full face mask seemed the most comfortable. Is there a more sophisticated way of selecting a mask?

FWIW - the supplier is providing me with a Respironics M Series Model DS 200H. They tell me it has a humidifier.

Thanks for the quit help.
Charles

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Pineapple · Post by **Pineapple** » Thu May 22, 2008 2:38 pm

I do believe that is the PLUS - no you want at least the PRO.

Don't get me wrong that the M-series machines are bad, I like my M-Series, but I have a PLUS and it is not fully data capable, it only supplies compliance data. Later down the road if you are having problems with your therapy, it will not supply any information to help pin point the problem.

The PRO (DS 400HS Remstar M-Series PRO with Humidifer and Smart card) is fully data capable and reports AHI, Leak rates. This can be downloaded so your doctor can determine if you need a change in your therapy.

There are other machines available and I sure others will chime in on that subject.

Is there a more sophisticated way of selecting a mask?

Not really, if you liked the full face mask you had at your sleep study, start from there. Otherwise my first sugestion is to tell your DME what you liked/didn't like about the mask and see what she has to offer. Most DME's have a "30 day guarentee" - if you try the mask and don't like it they trade you for another one. The mask is the hardest thing for most people. If you don't have one your comfortable with, you'll have a hard time with therapy. You can also ask people here for thier suggestions.

Good Luck

dllfo · Post by **dllfo** » Thu May 22, 2008 2:43 pm

DMEs come in varying degrees of honesty.

They get paid a fixed amount based on the billing code. Whether YOU get the $100 special or the really nice machine for $1200. See what I mean?

Will they give you a machine you can use? Usually. Will it have the bells and whistles you might want? Like the ability to download what happened in your sleeping last night. With Respironics it usually means you need a smart card.

Apria kept my first smart card, they will sell it to you for $10. I complained because it came with the machine and I WANTED IT.

As to what you need? I am not in the medical field, so I can only guess. We have some people here who are pretty good. No substitute for a qualified medical staff. BUT they are better in some ways...like...IMO, they will spend time listening to you after you have 3 miserable nights on your new machine and they can offer suggestions.

What is your machine titrated at? 8 cmH2O? 12 cmH2O?

Get a copy of your sleep study. ASAP and get a copy of the prescription.

My first sleep study showed I was a mess, so my doctor put me on the Respironics BiPap Auto and it worked well for me. Titration of 4-25 initially.
Welcome to the club and I hope you get to feeling better soon....Dave

Slinky · Post by **Slinky** » Thu May 22, 2008 3:36 pm

Well, there a quite a few full face masks available so its best if you know the NAME of the mask you used during your titration study. Of course, you sleep doctor MIGHT have specified that particular mask on your equipment order (script).

Personally, I would NOT accept any xPAP that wasn't fully data capable which would mean the Resmed S8 Elite w/CPR or the Respironics M Series Pro w/C-Flex. In the older, pre-M Series Respironics xPAPs, the Pro was NOT fully data capable altho it did have a data card (compliance data only) but the pre-M Series Pro II was fully data capable. These xPAP manufacturers don't always use much imagination in naming their models.

If your sleep doctor scripted an autoPAP then only the Resmed S8 Elite w/EPR, the Respironics M Series Auto w/A-Flex, the Respironics M Series Auto w/C-Flex and the Puritan Bennett GoodKnight 420E (the KEY is the E) are fully data capable.

Personally, I would call my insurance company and ask them what local DME CPAP suppliers they are contracted with. Hopefully you have the option of more than one so you can "shop" those they are contracted w/to get the equipment you want. I'd look for one w/a lenient mask exchange policy, an on-staff RT I was comfortable working w/AND one that would supply me w/a fully data capable xPAP w/o trying to get away w/charging me extra over a bare-bone, compliance data only xPAP.

rtkeat · Post by **rtkeat** » Thu May 22, 2008 5:25 pm

As a respitory therapist currently working in sleep medicine I would try to get a auto with data recordability. I have had much luck using respironics autom which is capable of cpap and apap modes. The report this machine is capable of producing can be very helpful. Having a versatile machine can improve your experiance and allows for options without having to buy another machine. As for chosing a dme that is tricky. Generally small mom and pop stores are less interested in using more expensive higher tech equipment because they usually pay more per cpap however they have a tendancy to have better customer service. National chains usually get better pricing per machine but they will automatically enroll you in mask replacement programs where you will get a call every three months with the intent to get another mask and supplies (tubing, filter, etc) billed to you insurance. You have to ask guestions about these things and hold the companies to any agreements made and dont be afraind to change companies. You should keep a copy of your original diagnostic sleep study and prescription on file in case you have to change companies. If you are paying cash or have high deductables cpap.com has very good cash prices but very little access to respiratory professionals.
Masks are trial and error. A few good tips are view a mask as a tool to get the job done. If it aint brokedont fix it i.e. changing masks often or to what ever new mask is hot on the market is generally frowned on. Your first mask will hurt....period, only after you acclimate to cpap use will you really be able to judge your mask. Its like buying shoes you have to break them in and they have to break you in. Dont let this discourage you the right mask is out there you have to do your research.
Heated humidity is great for newbies (the inside of your nose is not used to the increased airflow) however over time many people stop using humidifiers as they get used to the flow.
If you are using a dme for you equipment make sure to ask if you are going to have access to a respiratory therapist who can explain pros and cons to different masks and define therapy. Todays trend is have delivery drivers set up equipment and they are only allowed to point out the on button and where to plug it in! They arent allow to fit masks.

Slinky · Post by **Slinky** » Thu May 22, 2008 8:32 pm

Thanks for your input, RTKeat and welcome to the forum. We appreciate the input from caring RTs.

However, my own experience w/local "mom and pop" DME suppliers is that I not only get better SERVICE but they are also more cooperative in getting me the equipment I want - such as a fully data capable CPAP rather than a bare bones compliance data only CPAP "and" w/no "extra charge" for doing so.

My first local DME supplier was a large one, maybe not quite national but darn close to it. And their RT was less than truthful or not very knowledgeable (take your pick), she didn't have the proper facilities to do a proper mask fitting, she wasn't very good at all at mask fitting, she didn't know (yeah, sure) that Medicare would pay for a new mask cushion 2 months after I got the mask, I had to provide a print out of the Medicare reimbursement schedule, code number, etc. to get her to order it for me and it took 3 freaking weeks to get it!!! etc, etc, etc. I don't even remember all her screw ups anymore. I just know I was glad to complete the capped rental and be rid of that DME supplier!!!!!

AND, if you take Apria's reputation amongst "apneans" into account ... well it doesn't speak well for the large DME supplier chains at all. Not that there aren't a lot of exceptions but .... personally, I would ALWAYS check w/the smaller DME suppliers first and then compare.