How to get a good machine?!?

[Wannagoodnitesleep]

First of all...thank you all for your help. I am a newbie and because of your forum, I am a much better educated more powerful consumer.

I have not yet gotten my equipment and want to make sure I get the best possible product. My DME told me, basically, that they would give me whatever machine I want I just need the doctor to write the script for it.

Can you give me some talking points to give to the doctor that justifies a higher end machine?? He has written the script requiring heat and humidity, but I would also like to get equipment that I can pull some data from.

Thanks for your help!

[Janknitz]

Ask him to specifically write: "Patient access to AHI and leak data". That will get you a machine with full EFFICACY data. If you want a specific machine, ask him to write the script exactly for that, e.g. "ResMed S9 Elite" or "Philips REspironics System One Auto with A-Flex". You can also have him add "Dispense as written".

You don't need to justify anything to your doctor. He works for you. Tell him you want a specific machine and you want him to write the script to ensure you get it. If he won't write the script as requested, ask another doctor, like your PCP. Some sleep doctors don't like APAP's. Remind him that an APAP may also run in straight CPAP mode, but if you ever need to do some quick home diagnostics, the APAP will give you that option. Some sleep doctors would rather bill your insurance for another sleep study, so that may be one motivating factor in refusing if you are asking for an APAP. Just understand what you are dealing with.

Good luck, stick to your guns!

[archangle]

Try to get a ResMed S9 AutoSet or Philips Respironics System One (PRS1) Auto.

If it's the S9, be sure it says "AutoSet." There's an Escape Auto that doesn't do as much data. Some DMEs will try to bait and switch. If you have a doctor who is a fossil who doesn't like auto cpap, and you have to settle for manual CPAP, get the Elite, do not accept the Escape. Look next to the power button when you get the machine for the actual model name.

If it's the PRS1, it's also called "Philips Respironics REMstar Auto CPAP Machine with A-Flex." If you have a no-auto fossil doctor, the machine is the "PRS1 PRO." Avoid the PRS1 PLUS at all costs.

There's also a PRS1 PRO AutoIQ, that turns from an Auto machine into a manual CPAP after a certain amount of usage. It is NOT as good as a PRS1 Auto, but in theory is better than a PRS1 PRO.

There's a brand new PRS1 Model 60 auto that has a heated hose option, but I'd wait until some people have tried them out and figure out the quirks.

Be sure your DME is in network for your insurance. Find out what local DMEs are in network and be ready to swap if they won't give you what you want.

Do you have the script in hand? If so, just ask the DME for an S9 AutoSet or PRS1 Auto. If they balk, go back to the doctor or call other in-network DMEs. Do not walk out of the DMEs office with the wrong CPAP even as a "temporary" machine unless you've exhausted all your options. You can wait a few more days for CPAP.

If you get the correct S9 or PRS1 machine, don't worry about access to the data. They're really easy to reprogram on your own if you know the secret tricks.

[Pugsy]

There's a brand new PRS1 Model 60 auto that has a heated hose option, but I'd wait until some people have tried them out and figure out the quirks.

Not me. I would risk the possible quirks to have this machine for the next 5 years with the heated hose instead of maybe battling rain out every winter for the next 5 years till insurance would maybe buy a new machine.
Right now the only Respironics model with the heated hose is the APAP. This insures a fully data capable APAPmachine without having to mess with the Plus no data or the other limited machines. As soon as the other models are dispensed people will have to fight again for data and APAP ability machines.

[archangle]

There's a brand new PRS1 Model 60 auto that has a heated hose option, but I'd wait until some people have tried them out and figure out the quirks.

Not me. I would risk the possible quirks to have this machine for the next 5 years with the heated hose instead of maybe battling rain out every winter for the next 5 years till insurance would maybe buy a new machine.
Right now the only Respironics model with the heated hose is the APAP. This insures a fully data capable APAPmachine without having to mess with the Plus no data or the other limited machines. As soon as the other models are dispensed people will have to fight again for data and APAP ability machines.

Valid points, but does it work with SleepyHead? Can the user still get into the clinicians menu easily? Too big a risk for me.

[Pugsy]

but does it work with SleepyHead? Can the user still get into the clinicians menu easily? Too big a risk for me

I know you aren't a risk taker.

I doubt that there is any great change to data storage on the SD card to impact using SleepyHead or Encore.

If I have time next week I will try to get over to my DME office and check things out. They supply Respironics machines now. If it works with the old Encore programs...it will work with SleepyHead.

[archangle]

but does it work with SleepyHead? Can the user still get into the clinicians menu easily? Too big a risk for me

I know you aren't a risk taker.

Actually, I AM a risk taker. I just try to understand the risks and warn others about the the risks and let them take the risks.

If I wanted a heated hose, I'd try to get the S9 AutoSet.

Actually, if I were buying a new machine with insurance, I'd try to get the S9 AutoSet, heated hose or not.

Do you see any particular advantages of the S60 vs. S9 AutoSet?

[Pugsy]

Do you see any particular advantages of the S60 vs. S9 AutoSet?

Nope. Unless the independent temperature and humidity settings might allow for more variables than we can get with the S9 climate line in humidifier auto mode. I could see that being an advantage to some one. Heck maybe even me since I happen to pretty much like the humidity so high it is just barely short of snorting water. So rain out has always been an issue for me and hence I can relate to having more options in the humidifier department.

I now own a ResMed S9 VPAP Auto and a PR S1 BiPap Auto. There are pros and cons to both.
There will always be pros and cons within models and also within brands.
If I wasn't on BiPap now...I would be one of the first to try the 60 series APAP.

To be afraid to try something new, just because it is new, that might perhaps offer more comfort... seems a bit over cautious IMHO. Especially since we have to use these machines for years before we can get new ones unless we buy out of pocket. If we could trade within a year...yeah wait to see if there are any bugs to be worked out but not wait 5 years.

The new PR S1 ASV machine came out this past summer...we didn't tell people to wait till they had been tested longer before wanting them. We told people that the Legacy series ASV machines were old technology and they wanted new technology. I feel the same way about this new 60 series APAP.

[Janknitz]

I got the idea from reading CPAP.com that the new prs1 60 requires you to use the proprietary heated hiss even if you don't want to use the heat feature. If they have the same quality issues as the ResMed heated hose I would be concerned. At least with the ResMed you have a choice of hoses to use.

I rarely see people complain of rainout with the prs1, and while I might sometimes wish I had a heated hose, other times I would not want it at all.

[-tim]

Do you see any particular advantages of the S60 vs. S9 AutoSet?

Nope. Unless the independent temperature and humidity settings might allow for more variables than we can get with the S9 climate line in humidifier auto mode.

The S9 has a mode where I can set the humidity level (mine is 2.0) independent of the air temp (21 deg C). Does the S60 have more options and what would they be? I figure all they can do is heat up the tube or heat up the water tub.

[Pugsy]

Does the S60 have more options and what would they be?

From the information given on the product page that I read, it appeared that there were more options. I am currently using a S9 machine with climate line hose and while I have options...I don't have near these. I also have used a stand alone heated hose with my PR S1 machine which is a simple on/off thing which worked great. I don't know that all these settings are of a critical need but I imagine that being able to customize temp and humidity will greatly benefit some people. I am happy with what I have now but it doesn't mean that I couldn't appreciate more customizations. I like lots of moisture but I don't want warm air in my nose. If I can get lots of added moisture and still have cool air (not ice cube cold air) it would be ideal for me.
https://www.cpap.com/productpage/pr-sys ... -tube.html
Copied this from the above link to product info page
Use the on-screen menu to select one of three available levels of relative humidity (70, 80 or 90 percent). Next, adjust the control dial to choose from 5 levels of heated tube temperature, ranging from 4 to 16 degrees above room temperature. The optimum humidification level at the mask is easy to maintain when using the PR System One REMStar 60 Series Auto CPAP with humidification assembly.

System One 60 Series Humidifier has a redesigned humidifier resulting in an increase in surface area and greater humidification output.

[Spinory]

Hello everyone!

I am also a newbie, yet to acquire my CPAP. This forum has been incredible; so many people who are intelligent and willing to help.

I had 2 sleep studies: one diagnosed with severe OSA and the second one for the titration. The sleep center itself (run through a hospital) has their own DME. (warning bells right there yes?)

When I talked with my doctor (NP I think really), she didn't really even listen to me when I asked about getting an AUTO machine and a data capable one. She seemed to think that I wasn't the "appropriate" candidate for an AUTO. Since then, I have talked with my insurance provider, the DME and left a message with my NP about getting the machine I want. They want to set me up with the Respironics System One CPAP with C-Flex. So no AUTO and no data. They say it's a $1500 machine, which I know isn't true. I can buy it on cpap.com for $295 plus $100 I think for the heated option. It is very confusing figuring out all the machines-too many similar names but I think I have them straight =)

I am pretty frustrated, ticked off and a little worn down but NO WAY WILL I GIVE UP UNTIL I GET WHAT I WANT!! (I have to keep telling myself this so actually putting it out there will help me follow through Without this forum I'm sure I would have settled for the "brick". So a huge thank you for all the information and empowerment. I have decided that if my NP won't give me the machine I want (either the S9 Autoset or the Respironics AUTO with A-Flex) I will cancel my DME appt and call my psychiatrist, who will gladly write me a script for what I want. And find a different DME or perhaps go online.

I am happy to know I am not alone. Thank you again. I will keep you posted.

Heather

[cflame1]

Heather,
A lot of that is the DME (and their profit margin) and not the Dr. Whatever happens, make sure that you don't end up with a dataless "brick", even if you do end up with a straight CPAP, as there are straight CPAP's with AHI and Leak data.