6-month CPAP'er needing equipment upgrade, advice

[Guv]

Hi guys, first post here. I've looked around these forums for a couple of hours and have been really impressed at the support and help you give each other. I'm 27/m, who was diagnosed with OSA by a family MD. At first I wanted a cheap way in, to see if a CPAP would help me get better rest (I wasn't complaining about sleep probs, the MD just kindof insisted I take an at-home sleep study). I've been using a REMstar Pro 400M (BiPap I think?) that I got from a local DME the Doc recommended. They said it was a Medicare non-compliance repo, had about 1200 hours on it, paid $250 for it. First 4-5 months were amazing. Started sleeping better, felt better, everything was easy.

The last two months, I've increased my physical activity ten-fold, significantly more exercise (and sweating), and I frequently work outside and I have to be careful to stay well hydrated. Since I greatly increased my physical activity, I've been waking up after 3-5 hours of rest with a painfully dry nose. It's hard to describe but at first it made me rip my mask off wondering, "what in the world?!" because my nose wasn't congested, I was breathing fine, just something felt wrong. It seems pretty simple that with all the exercise, sweating, and 100F+ degree heat we've had, it's probably a hydration thing. So I'm looking to get a new CPAP with a humidifier. I don't have insurance, which I think will make this easier but expensive of course. I don't really care about the money, I figure this will cost me $750-$1000 for what I need, but I'm still relatively new to all this even with the reading I've done I would very much appreciate some recommendations on what I might want. I'm very technology oriented and like the idea of a fully data capable machine, a humidifier of course, and maybe a machine that knows what pressure I need? The Doc set me at 12.0, I bumped it to 13.0, seems fine to me, but who knows if this is what I "need".

Last thing, I didn't know I was using a BiPAP until I went in my bedroom a few minutes ago to figure out what kind of a machine I was using to put in this post. Maybe I should go to a DME and see if I can test a CPAP? If I've been using a BiPap all this time I might be in for a rude awakening if I buy an expensive CPAP machine that I'm stuck with. Sorry for the long post, hopefully it wasn't too much info. Thank you for reading and I welcome any advice or comments, anything that I might need to think about. I look forward to making some new friends here.

Guv from Arkansas

[Pugsy]

Let's figure out exactly what you have right now.
I assume it says M series? Can you tell me all the words you see on the machine?
Does it look like this?
https://www.cpap.com/cpap-machine/Respi ... -CPAP.html

Are you sure about the 400 model number? If it is 400 then it is this machine I have linked to above.
If you are seeing BiPap mentioned on the machine somewhere then the model number should be either 600 or 700.
The 600 is the fixed pressure machine and the 700 being the auto adjusting machine.

The M series Pro model 400 offers full data. At least the data that was available when the machine was offered. It doesn't gather all the data that the new model series (PR System One) gathers. It will give AHI, event break down, leaks, snores.
I can get you a copy of what it shows.

Are you saying that you aren't using a humidifier right now?

I can get you going with the data that is available on your current machine, if that 400 model number is correct, for about $45. Does it have one of these in the back of it?
https://www.cpap.com/productpage/respir ... -card.html
That smart card requires a special card read that costs about $45. I can get you software that will work and won't cost you anything.

If you aren't using a humidifier and just want to upgrade to have the latest equipment along with a humidifier than there is no sense in buying the card reader. If new is what you want...let's figure out exactly what you have now and what you want.
Online purchases require RX...do you have a RX that you can send to an online supplier?

This machine is the latest and it is one of those that will adjust the pressures (APAP mode).
$647 will get you the machine and the humidifier and the heated hose.
Full data and I can help with the software. It uses a SD card so no need for special card reader.
https://www.cpap.com/productpage/pr-sys ... -tube.html

If you really have a BiPap we get to have a different discussion.

[Paulrp]

You can probably get a humidifier for your current machine. But first you have to identify it. I also use Ayr Gel and Saline Spray to help with dryness.

[jweeks]

Last thing, I didn't know I was using a BiPAP until I went in my bedroom a few minutes ago to figure out what kind of a machine I was using to put in this post. Maybe I should go to a DME and see if I can test a CPAP? If I've been using a BiPap all this time I might be in for a rude awakening if I buy an expensive CPAP machine that I'm stuck with.

Guv,

A BiPAP machine is between $1500 and $2000, whereas a good APAP is around $750. If you don't need a BiPAP, then get an APAP. Don't bother with a CPAP, the limitations are not worth the few dollars of cost savings.

In order to effectively use a BiPAP, you need a pretty high grade sleep study with a respiratory tech who knows how to titrate someone on BiPAP. I suspect that, if you did get a BiPAP, you are actually running in CPAP mode. There is no harm in doing that, but it is a needlessly expensive solution if you don't need BiPAP.

I'd suggest one of two things:

1) I'd prefer if you did a hospital sleep study to get a formal diagnosis and a titration that is based on 24-channels of data.
2) If you don't do that, then you need to run an APAP for a while and dial in the pressure levels yourself.

The first suggestion is the medically sound thing to do. The second suggestion is doable for someone who is tech savvy, but it leaves that possibility that you might have a little more complex syndrome that needs an expert to diagnose and treat, and a smarter machine.

-john-

[Pugsy]

Not everyone who uses a BiPap has complex sleep apnea. Sometimes just plain old aerophagia gets you a bipap machine.
Sometimes needing higher pressures get you a bipap machine. Sometimes just sleeping better with one gets you a bipap machine.

The higher end bilevel pressure machines in the ASV category for people with a lot of centrals...yes those machines are much more intricate and expensive.

I use a bilevel machine. I don't have anything other than plain jane vanilla OSA. I use it because I sleep better and feel better with it. It doesn't do the ASV stuff though. Doesn't breath for me if I don't breathe. There are different levels of features on the bipaps.

[archangle]

Maybe you just got the BiPAP because it was available at a good price.

You can set most BiPAP machines to do manual CPAP and they will work exactly the same as a dumb, manual CPAP.

Once we find out what machine you have, we can probably tell you how to figure out what pressure and mode it's set at.

[jweeks]

Maybe you just got the BiPAP because it was available at a good price.

Hi,

I suspect that is how Guv ended up with a BiPAP. I was similarly lucky. I needed a BiPAP, but didn't have insurance. A local DME called me up and said that they had a M-Series BiPAP Auto available from a person who turned it back in with 80 hours on the blower. I picked it up for around $400 with a humidifier. 80 hours is about 10 nights of usage, so it was practically brand new. At that time, after paying for the sleep studies, saving $1500 was a very welcome treat.

-john-

[Xney]

80 hours? O_o For $400?

Yikes. but that's a great deal. That's the machine I have right now!

You could justify BiPAP based on high pressure, usually around 15 or so.

[greatunclebill]

fpr what it's worth, i thought the same thing about my m-series cpap w/c-flex. on the bottom of the machine it has the registered bipap logo because, i think, the cpap and bipap use the same logo sticker. it also has the correct sticker that identifies my machine that is not a remster bipap. see below picture:

[RandyJ]

You can get the M series humidifier here for $50:

http://www.secondwindcpap.com/Used_CPAP.html

(scroll all the way down to the bottom of the page)

[Pugsy]

i think, the cpap and bipap use the same logo sticker.

This is correct.
Respironics did do this in the past. The BiPap sticker part of it was stuck on it for purposes of identifying it as a medical device requiring a RX. They stuck that sticker on a large number of the older machines. I can't remember if my M Series APAP had it or not though. There was some discussion here a few years ago and a Respironics rep mentioned that they used that sticker only for the RX part of it. I guess they had a lot of those stickers laying around that they didn't want to go to waste.

Anyhow the M series BiPap clearly states BiPap on the top of the machine.
There were 3 models...the BiPap Plus (no data beyond hours of use...the BiPap Pro which had full data and only offered straight bilevel pressures in bipap mode and the BiPap Auto which of course was full data and had the added auto adjusting pressures.

[Guv]

Okay, my machine looks extremely similar to Pugsy's first link, with the exception of a slightly different font on the front of the machine. On the front of the machine it says, "Respironics" in black (hard to read), and "REMstarPro M SERIES" in white. The back looks just like greatunclebill's picture, except it says, "Model REMstar Pro MSERIES" and "Model #: 400M" down at the bottom it has the BiPAP stuff which I suspect is just a general sticker that doesn't really belong on that machine. Pugsy, it's definitely a 400M, and it does have a smart card in it from the DME. I'm fairly certain this is a fixed pressure machine since I can't find anything in the (what do you guys call it, programming menu? secret menu? it's where you can change the pressure) menu that mentions more than one pressure or anything about auto. The machine does give a fairly limited amount of data on-screen, I believe AHI and leak info, maybe a little more.

As far as the humidifier, no, I'm not using one. Yes, I feel silly. Yes, I want one! Although I'm a gadget freak and like the latest and greatest of most things, I'm not in a hurry to spend a ton of money on a new machine unless I need to. From what you guys have said already it looks like I can get a new or use one quite cheap.

So if I get a humidifer for a machine like I have, being an older generation (I think) it won't have a fancy heated hose or anything right? How big of a deal is that anyway?

[Xney]

If it's like my machine, you hold down the <- and -> buttons together after plugging it in to get to the provider menu and see the pressures. It can either be in auto or set pressure mode.

[jweeks]

So if I get a humidifer for a machine like I have, being an older generation (I think) it won't have a fancy heated hose or anything right? How big of a deal is that anyway?

Guv,

This depends on what your long term plan is. Heated hose isn't that big of a deal. A humidifier can really help. There are still a lot of folks using this style machine out there. If you add an inexpensive humidifier, you will be set for a while. If you want the data to help monitor your progress, then I'd suggest getting something newer. Having a machine with an SD memory card is really nice, but it will cost some real money. You can get machines that are one generation old on the used market. The only real drawback is that they need a special card reader and software, which is getting harder to come by.

It is always nice to have a spare machine. That way, if something breaks, you have a spare ready to go. If you are a little adverse to spending money right now, you can always get the humidifier for the machine you have, then plan to get a more modern machine down the line. That will get you through the near term, and gives you a good plan for the longer term.

-john-

[RandyJ]

A heated hose can be nice in the winter if you keep your bedroom really cold, but it's not a deal breaker. I have used an S9 with heated hose and now I'm using a PR System One without heated hose, and I don't miss it. There is also the Hybernite heated hose that can be used with any machine, which retails for around $60.

If you spend the $50 and get the humidifier for your M series, you may find that is all you need to feel more comfortable.

(Make sure you use distilled water in your humidifier if you get one.)