Choosing CPAP equipt.

[klalman]

I have recently been diagnosed with Moderate-Severe sleep apnea with an average AHI at 4% of 16.9

Events
Cumulative AHI 4.3 events per hour
Cumulative AI 0.4 events per hour
Cumulative HI 3.9 events per hour

My doctor didn't call to discuss but wrote a prescription for a Nasal CPAP at 12 cm H2O
I have read a lot of post on this site and was amazed at the amount of info. that is given to help people with OSA.
I am 57 years old, weighs 139 pound and am 5' 7" tall. I suffer from heart disease and hypotension.
I am seeking info. on the best type of CPAP machine and accessories(mask, humidifier etc.) that would suit my condition.
My Titration was done using a Resmed Autoset II with a Mirage Swift II Nasal Pillows System and it was not too much of a bother to me.
My insurance only pays 50% of the cost and has APRIA Healthcare as their DME.

[snoregirl]

You need to do the math, but in general with 50% coverage and a DME like Apria, you may be money ahead buying out of pocket with no insurance at CPAP.com.

The prices that Apria "charges" from which your 50% coinsurance is derived will very likely put you in that no go position.

But to really know, you need to choose a machine and ask Apria what YOUR cost will be. And you don't want a monthly cost. You want the total cost until you own the machine (that specific machine).

They will not want to answer your question, but you must be persistant so you know if it is worth it to use insurance or not.

Make sure they include humidifier (usually a one time cost), specific mask, and all the "rent to buy" payments until you own it.

[harry33]

you generally get what you pay for, check out CPAP and mask prices on the net
look for a well known brand with service and parts backup and a long warranty

if you like data, get a more expensive data capable CPAP but many of us do OK on basic cheap CPAPs with no data at all

a CPAP that will accept 12 volts DC also is helpful for camping or loss of AC power

[midnightdweary]

If you liked the Autoset II, why not stick with it?
I have, and its worked out fine. I also have Apria, and they have treated me very well.
I am coming up in about a week on my 1 year anniversary with the Autoset. (AHI is just below 3)

The Resmed Micro mask has been the staple for me, among the five masks that I have.
All in all, I feel that I am very lucky.

regards

[klalman]

Thanks Guys. I will follow up on the advices given by Snoregirl, Harry33 & midnightdweary first thing tomorrow.
Regards

[Guest]

I have decided to go with APRIA as my DME. However, my doctor ordered a fixed CPAP for me. Can I change that to an Auto CPAP.
The fixed CPAP is cheaper but I read somewhere that they are a bit noisy. Also, do I need a humidifier?
Regards

[Julie]

Cpap vs Auto is not necessarily noisier except possibly with an individual machine, so don't go by that at all in deciding. The difference is that if you have an auto machine, you can still run it in 'just' Cpap mode, but not the reverse, so an Apap is definitely better. Bug your MD to write you a script for it. You don't 'need' a humidifier as such, but most people use it (and it's often a built-in) I think (my machine has one, but I've never needed it, and I know some people initially set theirs to high and become congested, but that doesn't mean you shouldn't have one as an option. I live right at the ocean, but I imagine most others don't and if they're uncomfortable enough without one, then I guess you would say they need it.

[snoregirl]

Julie,

I disagree about whether or not you "need" a humidifier. Much depends on where you live and the relative humidity as well as you own personal sensitivity to dry air.

While I don't tend to "need" one in the summer when it is humid, I sure as heck "need" it in the winter unless I want to sneeze all day and have my nose and eyes running as well.

No one but the person who is getting the machine can truly say if they will "need" a humidifier or not. Getting one included is a small price to pay if you find out later that you "need" one.

[Autopapdude]

Sometimes the doctor or the services provider can be the worst person to make decisions for the patient. They often fight new trends in treatment (e.g. Doctors who don't believe autocpaps work as well as fixed titrate machines), and health care providers who dump equipment on a patient, and provide no instructions or logical plan of use. You should always be informed, and aware of how you feel, and how effective the treatment is, and frequently, self monitoring is the rule of the day.

[LinkC]

Doctors who don't believe autocpaps work as well as fixed titrate machines.

Not to sidetrack this discussion, but do you mean only for titration? There are valid reasons that CPAP provides better "regular" therapy. That's why many of us run our APAPs in CPAP mode, and self-titrate in APAP only occasionally.

I ask because I've never heard of a Dr claiming APAP was inferior for titration...just for normal therapy.

[Autopapdude]

Not to sidetrack this discussion, but do you mean only for titration? There are valid reasons that CPAP provides better "regular" therapy. That's why many of us run our APAPs in CPAP mode, and self-titrate in APAP only occasionally.

I ask because I've never heard of a Dr claiming APAP was inferior for titration...just for normal therapy.

First, there may be SOME valid reasons for constant pressure as "regular" therapy, but since sleep apnea is not a constant process, variable rates of pressure make sense. Some people (myself included) have apneas only on their back, and have pressure needs that vary during the night. Also, maximum pressure is not a "constant--" it can vary considerably from night to night (e.g. one day the maximum pressure might be 13 cmh2o, whereas the next night, it might peak at 10CMh2o). Thus, the variable pressure of an autopap can frequently provide BETTER therapy for many. I think that fact is well borne out by the testimony of others on this board, and my 10 years of experience as a a CPap user.

Second, as regards doctors, evidently you haven't met my former ENT specialist. There are lots like him, who think the Auto Cpaps are ineffective. This feeling has been repudiated by studies, but is still prevalent with some of the more unenlightened sleep and ENT doctors.

[DoriC]

Of course there are some like my husband who is sensitive to pressure changes which disturb his sleep, so he does better with the auto set to cpap at fixed pressure.