I've been using a Resmed CPAP for about a year now and have become convinced that I would profit from getting an APAP. There are several reasons for this:
1. My CPAP is set at 7.0 and while this worked pretty well originally, as time has progressed it seems to be working less well.
2. It seems quite sensitive to "episodic" considerations such as (a) nasal congestion and allergy symptoms and (b) a couple of glasses of wine or beer. This greatly affects the amount of snoring I do (sometimes waking me up and always waking my wife up).
3. It seems almost impossible to get a decent response from the (Apria) people I deal with in addressing such issues, and going back and working through real medical people is quite cumbersome and time consuming. Even some of the Apria folks said I'd be better off with an APAP, but they couldn't "justify" one.
4. My doctor will probably write a script for anything I can coherently describe to her, and I'm now willing to pay for this out of pocket.
5. I would really like a smaller and more portable unit for travelling, including intercontinental travel with different power parameters.
So I'm looking at the P&B 420E. What do I need to tell my doc in order to order this, and what information does the vendor need in order to fill the order?
Do they, for example, need me to specify a "range" (such as a low of 7.0 and a high of -- say -- 12.0)? How do I decide what that range should be?
After I get the unit, will I be able to reprogram it to a different range? Will the standard software allow me to do this? Or is there software available to my physician that will allow this?
Will this unit work with a full face mask. I really need one since I'm just not comfortable with anyting else and have been successfully using an Ultra Mirage successfully. If this unit won't work with a full face mask (I know I've seen some folks using masks of this sort with the 420E), what suggestions are there for other small portable APAPS?
What's needed to order APAP?
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Handgunner45
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This will give you the requirements for our sponsor cpap.com
https://www.cpap.com/cpap-faq/Prescriptions.html#133
https://www.cpap.com/cpap-faq/Prescriptions.html#133
"Remember, I'm pulling for you. We're all in this together." --Red Green
http://www.keepsakeacres.com
http://www.keepsakeacres.com
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rested gal
- Posts: 12881
- Joined: Thu Sep 09, 2004 10:14 pm
- Location: Tennessee
Good link, handgunner!
ghmerrill, in the section about APAP on the page handgunner directed you to, note this comment... I added bold highlighting:
______________
* Contains your pressure range (Optional, Not Required)
______________
Since an autopap comes from the factory with a pre-set pressure range of 4 - 20 cm H2O, it's not necessary for cpap.com to see a pressure or pressure range on the Rx. The reasoning being...the factory pre-set of 4 - 20 already encompasses whatever single pressure anyone would be prescribed for a cpap machine...like your current "7".
The reason that the simple single word "cpap" on an Rx would allow you to buy an autopap is because an autopap IS a CPAP machine. An "auto-titrating cpap" machine. Medicare (and consequently other insurance companies, since they usually follow Medicare's lead for reimbursement codes) makes no distinction between a straight cpap machine and an auto-titrating cpap machine. The same reimbursement code is used for either one. Both blow a single Continuous Positive Air Pressure at you. One of them, the autopap, just has the ability to find what varying single pressure you need during the night, when your needs might change depending on sleep stage, sleep position, and many other factors.
Of course, if you were buying from your local DME, they'd want the doctor to spell it all out, including the pressure range for them to set.
So....just the one word "CPAP" on the Rx will get you an autopap from cpap.com - already set 4 - 20. If you or your doctor would prefer having cpap.com set a range for you before they send it to you, they will do that.
That pre-set low of 4 can make a lot of people feel stifled in a mask (I'm not a doctor...I'm just guessing what I'd do if I were you!) so, if I were you, I'd ask your doctor to put this on the Rx, if you intend to buy a 420E:
autopap 6 - 14, IFL1 off
I use a 420E too. There's a reason why I suggest you have it sent to you with IFL1 turned off in the "Advanced Settings." You can turn IFL1 "On" after you've looked at your 420E's data for a few nights, and compare things to see if you want IFL1 on or not. With IFL1 "on", if the machine continues to use essentially the same pressures as it did with IFL1 "off" and doesn't go running up to the highest pressure the machine is set for, then IFL1 suits you ok, and can be left on. IFL2 should be left on, regardless of whether you turn IFL1 on or off.
IFL1 "ON" suits most people: but when that particular trigger doesn't suit someone, it can really be troublesome, blowing unnecessarily high pressures. So...I personally would recommend that anyone who gets a 420E start out with IFL1 turned off for the first three or four nights of using the 420E, then turn it on to see how it goes. Of course, the software is needed to make that kind of comparison. You won't be missing out on any necessary treatment with IFL1 "off". To make my 420E read my breathing right, I have to leave IFL1 off. Behaves fine and treats me fine like that. A super nice machine.
The therapy setup manual will be in the box with the machine when you receive it from cpap.com, showing you what buttons to push to get into the clinical menu on the machine. Plus you have any number of us 420E users posting on this board who will be happy to help you access the clinical menu via the buttons.
And yes, you can also change all the settings through the Silverlining software, which is the "standard" software used by the Puritan Bennett machines like the 420S and 420E. The newest version of the Silverlining software is 3.8.
You've picked out a very good machine, imho, ghmerrill!
ghmerrill, in the section about APAP on the page handgunner directed you to, note this comment... I added bold highlighting:
______________
* Contains your pressure range (Optional, Not Required)
______________
Since an autopap comes from the factory with a pre-set pressure range of 4 - 20 cm H2O, it's not necessary for cpap.com to see a pressure or pressure range on the Rx. The reasoning being...the factory pre-set of 4 - 20 already encompasses whatever single pressure anyone would be prescribed for a cpap machine...like your current "7".
The reason that the simple single word "cpap" on an Rx would allow you to buy an autopap is because an autopap IS a CPAP machine. An "auto-titrating cpap" machine. Medicare (and consequently other insurance companies, since they usually follow Medicare's lead for reimbursement codes) makes no distinction between a straight cpap machine and an auto-titrating cpap machine. The same reimbursement code is used for either one. Both blow a single Continuous Positive Air Pressure at you. One of them, the autopap, just has the ability to find what varying single pressure you need during the night, when your needs might change depending on sleep stage, sleep position, and many other factors.
Of course, if you were buying from your local DME, they'd want the doctor to spell it all out, including the pressure range for them to set.
So....just the one word "CPAP" on the Rx will get you an autopap from cpap.com - already set 4 - 20. If you or your doctor would prefer having cpap.com set a range for you before they send it to you, they will do that.
That pre-set low of 4 can make a lot of people feel stifled in a mask (I'm not a doctor...I'm just guessing what I'd do if I were you!) so, if I were you, I'd ask your doctor to put this on the Rx, if you intend to buy a 420E:
autopap 6 - 14, IFL1 off
I use a 420E too. There's a reason why I suggest you have it sent to you with IFL1 turned off in the "Advanced Settings." You can turn IFL1 "On" after you've looked at your 420E's data for a few nights, and compare things to see if you want IFL1 on or not. With IFL1 "on", if the machine continues to use essentially the same pressures as it did with IFL1 "off" and doesn't go running up to the highest pressure the machine is set for, then IFL1 suits you ok, and can be left on. IFL2 should be left on, regardless of whether you turn IFL1 on or off.
IFL1 "ON" suits most people: but when that particular trigger doesn't suit someone, it can really be troublesome, blowing unnecessarily high pressures. So...I personally would recommend that anyone who gets a 420E start out with IFL1 turned off for the first three or four nights of using the 420E, then turn it on to see how it goes. Of course, the software is needed to make that kind of comparison. You won't be missing out on any necessary treatment with IFL1 "off". To make my 420E read my breathing right, I have to leave IFL1 off. Behaves fine and treats me fine like that. A super nice machine.
Yes, you can reprogram it to a different range simply by using the buttons on top of the machine. IFL1 can be turned on and off from the clinical menu on the machine, too.ghmerrill wrote:After I get the unit, will I be able to reprogram it to a different range? Will the standard software allow me to do this?
The therapy setup manual will be in the box with the machine when you receive it from cpap.com, showing you what buttons to push to get into the clinical menu on the machine. Plus you have any number of us 420E users posting on this board who will be happy to help you access the clinical menu via the buttons.
And yes, you can also change all the settings through the Silverlining software, which is the "standard" software used by the Puritan Bennett machines like the 420S and 420E. The newest version of the Silverlining software is 3.8.
You've picked out a very good machine, imho, ghmerrill!
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Guest
Thanks for the info -- some of which I've now also now read in other threads. It also seems that some people are using the 420e with the Ultra Mirage FF mask, and so I'm feeling pretty comfortable with the idea of getting this machine.
I may have my doc be more specific about the "APAP" designation in the (probably vain) hope that I might coerce the insurance company into honoring a claim for this -- though I think the chances are slim. Unfortunately, I think it may be the case that the insurance company (Aetna) is willing to deal only through a short list of "preferred" DMEs. But I'll deal with that over time. I may at least be able to get them to reimburse for "supplies" (hoses, etc.).
From what I can tell (without using it), the software looks pretty good and the data visualization isn't bad.
I may have my doc be more specific about the "APAP" designation in the (probably vain) hope that I might coerce the insurance company into honoring a claim for this -- though I think the chances are slim. Unfortunately, I think it may be the case that the insurance company (Aetna) is willing to deal only through a short list of "preferred" DMEs. But I'll deal with that over time. I may at least be able to get them to reimburse for "supplies" (hoses, etc.).
From what I can tell (without using it), the software looks pretty good and the data visualization isn't bad.
5 posts
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