If you'd known then...

hayeswildrick · Post by **hayeswildrick** » Wed Feb 21, 2007 4:51 pm

A few weeks ago, much to my surprise, I was diagnosed with sleep apnea. Here all along I thought it was my wife's problem, being a light sleeper!

Tomorrow night I go in for my follow-up sleep study to get fitted with a CPAP device. Am I looking forward to it? Not really, but I sure would like to wake up feeling refreshed, and I'll be even happier if my wife can sleep through the night because I'm not snoring.

Come Friday morning I'll be heading out of the sleep center, and (I guess) early next week I'll have a prescription from my doctor to buy a full CPAP setup. All of which makes me very aprehensive. After all, I've never done this before, and based on my reading here, it sounds as though there's lots of room for error, especially in dealing with medical equipment dealers.

So my question is, if you knew then what you know now, how would you have approached the purchase of your first CPAP kit? What would you do differently, or what are you glad you did?

All in all, I'd like to have a fighting chance of getting this right the first time!

Thanks!
Jeff

backdoc · Post by **backdoc** » Wed Feb 21, 2007 4:56 pm

I would have gone directly to CPAP.com and bought a unit. If fact I'm trying to figure out a way to return this unit that I insisted on renting and buying an Auto with software so I can know what the heck my numbers are so that I can tweak my setup.

Steve

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): cpap.com, auto

onecoknower · Post by **onecoknower** » Wed Feb 21, 2007 5:05 pm

I think you're doing exactly the right thing - reading all about life as a hosehead on this forum. I found it before I had my titration study, and it helped me know what to ask for. I knew I wanted an apap and heated humidifier. I knew I wanted to start with a less invasive mask. I asked for what I wanted before they even wrote the script. And, since the DME was in the hospital, I went home from the study with a machine.

Good luck to you.
Donna

Wulfman · Post by **Wulfman** » Wed Feb 21, 2007 5:19 pm

hayeswildrick wrote:So my question is, if you knew then what you know now, how would you have approached the purchase of your first CPAP kit? What would you do differently, or what are you glad you did?

I wouldn't change a thing. I think I "did it right" the first time.

When my GP thought I had sleep apnea and referred me for a sleep study, I went to the Internet to learn as much as I could absorb about apnea and the therapy.
Started looking at the equipment online....got some idea of what I was in for.
Had my split-night sleep study. (the tech clued me in that I had had apnea events during the night)
Got prescription from sleep doctor. (practically ripped it out of his hand)
Visited and called a few local DME suppliers......then "did the math".
Went home and called CPAP.COM and ordered my equipment. (they helped me determine which machines had the best data recording capabilities)
A few days later I started my therapy.
Installed Encore Pro and later MyEncore on my computer to read the card and monitor my therapy.
Submitted an invoice to my insurance provider and they reimbursed me 80% of the equipment costs.

Best wishes,

Den

Linda3032 · Post by **Linda3032** » Wed Feb 21, 2007 5:24 pm

Hayeswildrick, welcome.

You are one of the smart ones -- getting info before you get stuck with inferior equipment. I would give the DME a chance, but don't accept equipment that you don't want. There are so many things to remember, but here are a few tips.

A good DME should let you try on lots of masks, and let you exchange it if it ends up not working for you. That in itself is a big plus -- getting hands on help instead of buying over the internet. (I bought over the internet, but I live in a small town and had no "good" DME).

1. Click on the yellow lightbulb at the top of the page. That leads you to lots of beginner info.

2. Get a copy of your prescription, and keep the original.

3. Get a copy of your sleep study.

4. If you are not happy with your DME, try to find another one. Otherwise, consider buying online at cpap.com.

5. If you want to buy online, check with billmyinsurance.com (a partner of cpap.com) and see if they will deal with your insurance company.

6. Depending on what your prescribed pressure is, I would try to get an Auto (APAP). But if your pressue is high, then a Bi-Pap might be what you need.

Remember, an Auto machine can also be a straight cpap, but not vice-versa. Your DME might tell you "lies" about the Auto machine -- that's crap.

7. The only non-auto machine I would accept from a DME would be a Remstar Pro 2 with cflex, or the newer version of it, the Remstar Pro M series with cflex. But only if your pressure is below 10.

8. If the pressure was over 10, I would definitely insist on an Auto.

Here is a list of machines that I would recommend -- and usually are highly thought of on this forum.-- not saying that there are others that aren't good also. I'm only personally familiar with the Remstar Autos, and own two.

Respironics Remstar Auto with Cflex (old style), and
Remstar M Series Auto with cflex.

Respironics Remstar Pro 2 (old style), and
Remstar M Series Pro
You can easily find the card reader and software for the Remstar machines.

Resmed S8 Vantage Auto with EPR (card reader and software is hard to find).
Puritan Bennett Goodnight 420E (I believe is an auto)

These are my opinions. I'm sure other members with offer more and different ideas.

Rafe · Post by **Rafe** » Wed Feb 21, 2007 5:26 pm

I would find all the DME's in my area that provide CPAP equipment and services and who work with my insurance. Then, I would at least call them all and talk to them about what their process is for providing equipment and masks. Then, I would choose the DME I wanted to work with, not the one my sleep doctor/sleep center referred me to. After you start the rental period normally required by the insurance company, it's usually too late (and/or costly) to switch.

Linda3032 · Post by **Linda3032** » Wed Feb 21, 2007 5:29 pm

Also find out what your insurance requirements are. Some make you rent for several months. Some buy outright.

From what I've read, buying outright usually is less expensive. but check in advance.

snoregirl · Post by **snoregirl** » Wed Feb 21, 2007 5:49 pm

I would, not necessarily in this order...

1) Get the prescription from my doc (saying what I wanted it to say, machine brand and type as well as mask patient's choice fface or nasal) and a copy of my sleep studies

2) I would check what my insurance will cover and what my copay and deductable is and decide just how much I am really getting from the Insurance company (The "is it really worth it question"

3) I would check bill my insurance to see if they will work with my insurance
because they will give me the machine I want

4) If it will save me a lot of money I would talk to all the local in-network DMEs that my insurance company will accept and see who will get me what I want

5) If I can managed to save that money and walk out with the machine I want I would sign up with a local DME, otherwise I would walk and buy from Cpap.com

6) If I buy from a local dme I would make sure all the parts are included (nasal pillows in all sizes, filters, gaskets, manuals...)

7) Buy software from CPAP.com and card reader from same or the other cheaper alternative

Enjoy my cpap

Offerocker · Post by **Offerocker** » Thu Feb 22, 2007 9:28 am

IF I'd known THEN, I'd do exactly as Linda3032 stated.

Unfortunately, I thought I was 'locked in' to 'that' DME, etc.......

THEN I found this forum, purchased my own apap w/c-flex, etc., from cpap.com, and am still learning and being supported.

sleepingBear · Post by **sleepingBear** » Thu Feb 22, 2007 10:32 am

At a minimum fight for an APAP, any reason they give for you not needing one can be shown to be false.

Check the prices on cpap.com, if you need resons for apap look on this forum they are here and there are medical studies that show that an apap is as effective and results in lower long term medical costs.

Keep reading this forum.

ColoZZZ · Post by **ColoZZZ** » Thu Feb 22, 2007 10:42 am

Lots of good advice here. The only things I'll add are:

1) It may be longer than you expect until you actually have a machine sitting on the bedside table.

2) Depending on what you want/need, it may be quicker, cheaper and easier to buy a second-hand machine on your own from Craigs List or some other online auction source than through the DME. This is especially true if you have a high copay. If you're in a metro area, Craigslist - dot-org is the way to go because you'll get hooked up with a local seller and be able to inspect the machine before buying.

Just remember "Buyer Beware" and that you should really do your research before handing someone a hand full of $$.

Good luck!

WillSucceed · Post by **WillSucceed** » Thu Feb 22, 2007 11:13 am

I WOULD push hard for an APAP machine... it has a broader range of treatment (plain CPAP, APAP) as well as data collection.

If buying an APAP, I would NOT be lured by the promise of C-FLEX over other non- C-FLEX machines. This means that I WOULD trial as many APAP machines as possible, even if it cost me some $ out of pocket. By trialing several different APAP's, you will find the ones that give your specific breathing & obstruction patterns the best treatment.

If the C-FLEX eqipped APAP does not give you good treatment in auto mode, the C-FLEX feature is of zero value.

While all the machines are good, the ONLY way to know for sure is to try before you buy.

_________________

CPAPopedia Keywords Contained In This Post (Click For Definition): C-FLEX, CPAP, auto, APAP

KimberlyinMN · Post by **KimberlyinMN** » Thu Feb 22, 2007 1:10 pm

One good thing (for me) about going through my DME was that I found out that a CPAP machine was not the machine for me. Because my insurance required me to rent the machine for three months, I was able to exchange the machine for a Bi-PAP machine. I was also required to rent this machine for an additional three months. Because I had met my $300 deductible already, the monthly rental was only $30. By the time came for me to buy the Bi-PAP machine, I had already met my out of pocket maximum so that my insurance paid for 100% of the machine.

Although I am a gadget geek, I don't really care to know what my numbers are regarding my nightly treatment so having a machine that I can read info from via software doesn't appeal to me. According to my sleep study, the treatment brought my number of episodes from 216 to zero. I know I shouldn't "assume" that every night is as good as that, but so far I've felt great practically since day 1 of starting my treatment. (Well besides the bloated, chest achy feeling when using the CPAP which switching to Bi-PAP solved.)

The biggest "down" side to my DME is that they only have maybe four or five interfaces to choose from. They never had even heard of the ComfortCurve and tried to tell me that it must be a discontinued interface.

So, like others have said, check to see what your insurance covers. Check their "out of network" reimbursements since buying online would most likely be considered out of network.

Kimberly

hayeswildrick · Post by **hayeswildrick** » Thu Feb 22, 2007 1:35 pm

WillSucceed wrote:I WOULD push hard for an APAP machine... it has a broader range of treatment (plain CPAP, APAP) as well as data collection.

If buying an APAP, I would NOT be lured by the promise of C-FLEX over other non- C-FLEX machines.

_________________

[]

THANK YOU everyone for your thoughts and support. I feel well armed as I go into my second sleep study tonight. I'm still a bit wary of dealing with my insurance company, but this too shall pass.

Could you tell me what you mean when you say "Don't be lured by the promise of C-FLEX"? I've been reading a lot of reviews and folks seem to love it.

Jeff

taterbug · Post by **taterbug** » Thu Feb 22, 2007 2:30 pm

Hi Jeff,

It seems as though we're at about the same point here. I'm also doing my second sleep study this evening. I posted a note earlier asking for advice in picking a machine for a Gadget Junkie. I think my best chance of success would be with something that I can tweak and see documented results from, so I guess I'm looking for an APAP with software.

I'm afraid I'll give up on it because of the discomfort if I don't have some bells and whistles to play with . On the other hand, I may feel so great after a good night's sleep in ??? years that I may not trade if for anything.

Looking forward to hearing about your experience if you don't mind posting it. I'll be happy to share my results as well.

Good Luck!
Greg

If you'd known then...

If you'd known then...

I'd have bypassed the DME completly.

I would...