I recently completed a sleep study and was diagnosed with sleep apnea. The Dr. told me my case was relatively severe. I have no problem believing this as I have felt completely miserable for the past few years and display the classic symptoms of the disorder.
After my appointment with the doctor, one of his associates began to explain the CPAP machine. The practice only distributes the Respironics REMstar Plus C-Flex with humidifier. She explained that the selling price of the unit was approximately $2,300 but that Blue Cross would pay for $1,424, leaving me with a bill of $876. I felt as if I was getting more of a sales pitch than unbiased advice, so I told the nurse that I would like to do some research before making a decision.
I found this website last night, which lead me to cpap.com. I discovered that they sell the same product for $500. I also started to do some research on features offered on the higher end models (automatic pressure adjustments, humidifiers, units that decrease pressure while exhaling, etc) that sound like they would make using the CPAP much more comfortable. I called the doctor's office and verified the features on the CPAP that they distribute, requested an explanation for the price differential, and inquired about the features offered with other machines. The answers I received were less than satisfactory. The nurse also told me that I would need to speak with the Dr. again before he could fax my prescription to CPAP.com.
At this point I have no problem spending the money to feel better, I just want to make sure that I'm doing the best thing. My questions are:
1. Is purchasing a CPAP through a doctor worth paying more? I am relatively technically competent but am not sure how much expertise is required to adjust the CPAP if I have difficulties.
2. Is using CPAP.com as easy as it appears? Are the reputable?
3. Are the extra bells and whistles on the newer machines worthwhile?
Any advice would be extremely appreciated.
Could use some help
7 posts
• Page 1 of 1
HI Markpear and welcome.
I will try to answer some of your questions however I am not from the US so will not be able to answer all.
I have very recently received my remstar auto from cpap.com and apart from minor hiccups, associated with not ordering from the the Us, they were fine and delivered promptly.
I am not technical and if you buy the software with the machine it is pretty easy to set up and if you have problems there is a bunch of people here on this forum willing to help. You cannot get the software from DME usually.
I am really pleased I bought the machine and am monitoring what is going on.
What you do need however is a copy of your prescription.
I will try to answer some of your questions however I am not from the US so will not be able to answer all.
I have very recently received my remstar auto from cpap.com and apart from minor hiccups, associated with not ordering from the the Us, they were fine and delivered promptly.
I am not technical and if you buy the software with the machine it is pretty easy to set up and if you have problems there is a bunch of people here on this forum willing to help. You cannot get the software from DME usually.
I am really pleased I bought the machine and am monitoring what is going on.
What you do need however is a copy of your prescription.
Hi Markpear,
I'm really new to this board and the world of OSA so I don't think I can offer you much advice on machines. I have a Remstar Pro2 with C-Flex and a humidifier. Until I found this board, I didn't have a clue what any of that meant. Several people seem to like the APAP machines...I would like to try one someday. I have tried several different masks and nasal pillows. I like the nasal pillows but I have the best luck with the Activa mask. I move around alot in my sleep and prefer sleeping on my side. The Activa holds a seal all night for me.
My advice to you is to keep reading posts from other people. You might also consider looking through CPAPopedia...it will help you understand the lingo here. There are some great people here with good advice. Be patient...it may take them awhile to respond to your request.
Hang in there! Amy
I'm really new to this board and the world of OSA so I don't think I can offer you much advice on machines. I have a Remstar Pro2 with C-Flex and a humidifier. Until I found this board, I didn't have a clue what any of that meant. Several people seem to like the APAP machines...I would like to try one someday. I have tried several different masks and nasal pillows. I like the nasal pillows but I have the best luck with the Activa mask. I move around alot in my sleep and prefer sleeping on my side. The Activa holds a seal all night for me.
My advice to you is to keep reading posts from other people. You might also consider looking through CPAPopedia...it will help you understand the lingo here. There are some great people here with good advice. Be patient...it may take them awhile to respond to your request.
Hang in there! Amy
My sleep doctor wanted to sell me a machine without telling me ANYTHING about it (including the brand) I was told insurance would pay all but $300. I had already found that I could get a cpap online for $320 so I was very suspicious. My regular doctor wanted me to buy from HIS source. They told me the insurance company would be billed $1300 and I would pay $300. That company only sold one brand, Invicta. My conclusion??? Something STINKS! I will buy whatever I want and I dont care if insurance pays a penny.
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rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
Hi Mark,
Welcome to the message board!
The main thing that jumped out at me was this:
You asked:
1. Is purchasing a CPAP through a doctor worth paying more? I am relatively technically competent but am not sure how much expertise is required to adjust the CPAP if I have difficulties.
I don't think it's worth paying more to the doctor or the company he is pushing you toward. He may lose interest in you, though, if you don't fall into line like a good little cash cow. However, you can't count on holding his interest anyway, so I'd do what I thought best - both for my treatment and my pocketbook. You'll have no trouble adjusting your machine if you buy the software for it and read all you can on the message boards.. There are plenty of people who will try to help if you run into any hitches. For that matter, if your doctor shows any signs of not being interested in helping you, there are plenty of other sleep doctors to go to.
2. Is using CPAP.com as easy as it appears? Are the reputable?
Yes. Yes. I don't work for them. I've been very pleased with anything I got from them and with their service. The support phone people are wonderful. There are many reputable online stores selling cpap equipment. cpap.com's prices seem to be the lowest on most things.
3. Are the extra bells and whistles on the newer machines worthwhile?
Just depends on what you want. And of course it's understandable that you don't necessarily know what you want or need this early. I'm a big believer in getting an autopap machine with software to monitor your own treatment. If it turns out that a single fixed pressure works better for you, an autopap can be operated as a straight cpap.
For example, if you bought a Respironics REMstar Auto with C-flex and heated humidifier, then switched it to run in straight cpap mode with C-Flex, you'd have essentially, the exact same machine the doctor's associate is trying to sell you...but with these rather important bells and whistles:
You'd still also have a machine that could be switched back into auto mode any time you wanted to. Can't do that with a machine that starts out its life as a plain cpap.
You'd have a machine that could actually give you a great deal of overnight information about your treatment, each and every night, whether you were running it in auto mode or cpap mode. The REMstar Plus the doctor's associate is selling cannot give any information about your treatment other than the number of hours you use the machine.
As a side note, the REMstar Pro 2 that "yawn" has is a straight cpap which can give overnight data beyond just hours of use. But the REMstar Plus cannot.
As you've probably been reading, there are two ways to get relief each time you exhale. One is a machine with C-Flex which will give an unspecified but definite reduction in pressure when you exhale. The other way is with a bi-level machine like the Respironics BiPAP Pro 2 or the ResMed VPAP III or the Puritan Bennett 425. Bi-level machines can be set for a specific exhalation pressure.
A bi-level is going to give you a single high pressure though, all night long. It can't vary the inhalation pressure "as needed" the way an autopap can. Either type of machine can be more suitable for one person or another. Difficult to know ahead of time. If you were able to rent several different types of machines, that would be a good way to go about it, but it doesn't sound like that would be the case given that you're up against a DME (the doctor's "associate") who already has a low end cpap in mind for you.
Perhaps that would be something to discuss with the doctor...letting you try several types of machines. If he's not willing to let you do that, or if the DME really doesn't have other machines you could use on a trial rental basis, you're probably better off making the guess based on your own research and reading.
If you are prescribed a high pressure (what's high is relative to each person, but I personally think of "high pressure" as being 13 or more) then it seems logical to think a bi-level machine is needed. There's no question that a bi-level's precise inhalation/exhalation settings can be very comfortable to breathe out against.
However, I'd not rule out an autopap even if prescribed a high pressure. You might not even need that single high pressure most of the night. An autopap might let you spend most of your night at more comfortable lower pressures and with less potential mask leak problems. Add C-flex to the autopap and you would have even more pressure relief than with just an autopap.
What if you made a mistake? What if you bought an autopap and it turned out you possibly could be more comfortable with a bi-level machine? There are people who might have a bi-level and are itching to have an autopap. If you posted you were willing to sell your autopap or trade it for someone else's bi-level, it's very likely you'd have takers. Both machines might find happy new homes.
Good luck!
Welcome to the message board!
The main thing that jumped out at me was this:
I may be wrong, but I think you probably have a right to your original Rx, or at least to a copy of it. Then you, not the doctor, can take it or fax it wherever you please. Sounds to me like the nurse expects the doctor will persuade you to stay in the fold and spend your money (or your insurance's money) with them.The nurse also told me that I would need to speak with the Dr. again before he could fax my prescription to CPAP.com.
You asked:
1. Is purchasing a CPAP through a doctor worth paying more? I am relatively technically competent but am not sure how much expertise is required to adjust the CPAP if I have difficulties.
I don't think it's worth paying more to the doctor or the company he is pushing you toward. He may lose interest in you, though, if you don't fall into line like a good little cash cow. However, you can't count on holding his interest anyway, so I'd do what I thought best - both for my treatment and my pocketbook. You'll have no trouble adjusting your machine if you buy the software for it and read all you can on the message boards.. There are plenty of people who will try to help if you run into any hitches. For that matter, if your doctor shows any signs of not being interested in helping you, there are plenty of other sleep doctors to go to.
2. Is using CPAP.com as easy as it appears? Are the reputable?
Yes. Yes. I don't work for them. I've been very pleased with anything I got from them and with their service. The support phone people are wonderful. There are many reputable online stores selling cpap equipment. cpap.com's prices seem to be the lowest on most things.
3. Are the extra bells and whistles on the newer machines worthwhile?
Just depends on what you want. And of course it's understandable that you don't necessarily know what you want or need this early. I'm a big believer in getting an autopap machine with software to monitor your own treatment. If it turns out that a single fixed pressure works better for you, an autopap can be operated as a straight cpap.
For example, if you bought a Respironics REMstar Auto with C-flex and heated humidifier, then switched it to run in straight cpap mode with C-Flex, you'd have essentially, the exact same machine the doctor's associate is trying to sell you...but with these rather important bells and whistles:
You'd still also have a machine that could be switched back into auto mode any time you wanted to. Can't do that with a machine that starts out its life as a plain cpap.
You'd have a machine that could actually give you a great deal of overnight information about your treatment, each and every night, whether you were running it in auto mode or cpap mode. The REMstar Plus the doctor's associate is selling cannot give any information about your treatment other than the number of hours you use the machine.
As a side note, the REMstar Pro 2 that "yawn" has is a straight cpap which can give overnight data beyond just hours of use. But the REMstar Plus cannot.
As you've probably been reading, there are two ways to get relief each time you exhale. One is a machine with C-Flex which will give an unspecified but definite reduction in pressure when you exhale. The other way is with a bi-level machine like the Respironics BiPAP Pro 2 or the ResMed VPAP III or the Puritan Bennett 425. Bi-level machines can be set for a specific exhalation pressure.
A bi-level is going to give you a single high pressure though, all night long. It can't vary the inhalation pressure "as needed" the way an autopap can. Either type of machine can be more suitable for one person or another. Difficult to know ahead of time. If you were able to rent several different types of machines, that would be a good way to go about it, but it doesn't sound like that would be the case given that you're up against a DME (the doctor's "associate") who already has a low end cpap in mind for you.
Perhaps that would be something to discuss with the doctor...letting you try several types of machines. If he's not willing to let you do that, or if the DME really doesn't have other machines you could use on a trial rental basis, you're probably better off making the guess based on your own research and reading.
If you are prescribed a high pressure (what's high is relative to each person, but I personally think of "high pressure" as being 13 or more) then it seems logical to think a bi-level machine is needed. There's no question that a bi-level's precise inhalation/exhalation settings can be very comfortable to breathe out against.
However, I'd not rule out an autopap even if prescribed a high pressure. You might not even need that single high pressure most of the night. An autopap might let you spend most of your night at more comfortable lower pressures and with less potential mask leak problems. Add C-flex to the autopap and you would have even more pressure relief than with just an autopap.
What if you made a mistake? What if you bought an autopap and it turned out you possibly could be more comfortable with a bi-level machine? There are people who might have a bi-level and are itching to have an autopap. If you posted you were willing to sell your autopap or trade it for someone else's bi-level, it's very likely you'd have takers. Both machines might find happy new homes.
Good luck!
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sir_cumference
- Posts: 240
- Joined: Wed Jun 29, 2005 10:47 am
- Location: UK
Sounds to me like they're trying to take you for every penny they can get!
there are plenty of good cpap sellers on line - I doubt you'll have a problem with any of them.
This site, and particularly people like restedgal will be able to help you probably far more than your Doc - as most Doc's know precious little about OSA and what's involved.
My advice is go for the best machine you can. At the very least get an auto adjusting machine. I use the Resmed Autoset spirit - and it's wonderful. However, think about the type of life you live. For example, do you travel a lot? If so, look at the Puritan Bennett 420E auto as it is very light and easy to use.
My machine doesn't have C-Flux but then again my pressures are quite low. I get the impression that C-Flux is really a suitable option for people on higher pressures, so if your on 10 or less, you may well not need it. Having said that, there are plenty on far more than 10 who see no need for it as well - its what you feel you need.
Another point about the CPAP/APAP issue is the level they set the CPAP at. In the UK they set it at 95% of your max titrated figure, which means 5% of you problem is not being addressed. Whereas APAP, as long as the range is set widely enough will cover your whole need, and that can make a significant difference (it certainly did for me).
So good for you for holding back and checking things out for yourself
you have done the right thing and will save yourself a lot of money, probably ensure you have much better treatment and, you've found a site that can really help you along the road as you get use to xPAP and become a fully paid-up member of the hosehead society
sir_cumference
there are plenty of good cpap sellers on line - I doubt you'll have a problem with any of them.
This site, and particularly people like restedgal will be able to help you probably far more than your Doc - as most Doc's know precious little about OSA and what's involved.
My advice is go for the best machine you can. At the very least get an auto adjusting machine. I use the Resmed Autoset spirit - and it's wonderful. However, think about the type of life you live. For example, do you travel a lot? If so, look at the Puritan Bennett 420E auto as it is very light and easy to use.
My machine doesn't have C-Flux but then again my pressures are quite low. I get the impression that C-Flux is really a suitable option for people on higher pressures, so if your on 10 or less, you may well not need it. Having said that, there are plenty on far more than 10 who see no need for it as well - its what you feel you need.
Another point about the CPAP/APAP issue is the level they set the CPAP at. In the UK they set it at 95% of your max titrated figure, which means 5% of you problem is not being addressed. Whereas APAP, as long as the range is set widely enough will cover your whole need, and that can make a significant difference (it certainly did for me).
So good for you for holding back and checking things out for yourself
you have done the right thing and will save yourself a lot of money, probably ensure you have much better treatment and, you've found a site that can really help you along the road as you get use to xPAP and become a fully paid-up member of the hosehead society
sir_cumference
7 posts
• Page 1 of 1