Gadget Junkie needs recommendations

taterbug · Post by **taterbug** » Thu Feb 22, 2007 10:15 am

Let me start by admitting that I am a cpaptalk newbie, and YES I have read the "collective wisdom" section.

I am going for my second sleep study tonight (this one will be with an xPAP trial). When it comes time to select a machine, mask, etc. I think that I will have the most success with something that has the most "bells and whistles". So I guess I'm wanting an APAP, right? Software, feedback, adjustments and the like.

Which machine, humidifier, software combo would befit this self-proclaimed (and wife-proclaimed) "gadget junkie"?

BTW, I know I'm kind of on my own for masks.

Also if anyone has any tips on how to convince an ornery insurance company to go for an APAP instead of a cheaper CPAP, lay that on me as well.

Thanks,
Greg

Hurricane · Post by **Hurricane** » Thu Feb 22, 2007 10:31 am

Your doctor has to prescribe it.

sleepingBear · Post by **sleepingBear** » Thu Feb 22, 2007 10:38 am

I recommend the Remstar M Series Auto with heated humidifier, smart card and reader.

Being a geek myself, I wanted to ability to view all the data available and with Encore Pro and Encore Pro Analizer you can do that easily.

For convincing the Dr and all for your need for an APAP check out this thread

viewtopic.php?p=147851&highlight=#147851

I outlined my arguments for wanting an APAP and the Dr agreed with me.

Good luck and keep reading.

Slinky · Post by **Slinky** » Thu Feb 22, 2007 10:45 am

Your insurance shouldn't balk at all in paying for an AutoPAP since a bare-bones xPAP and an AutoPAP are billed w/the same HCPCS code: A0601. The local DME just has to swallow the differenc in pricing for the two. The only difference is if a Bi-PAP or Bi-level PAP is needed. The bi-levels have a different HCPCS code.

Therefore it is just your sleep doctor you have to convince about the AutoPAP.

Slinky · Post by **Slinky** » Thu Feb 22, 2007 10:52 am

What? Medicare is slow paying its bills? I just went to mymedicare.com to check out my sleep study and titration study claims and get a page offering the site domain mymedicare.com for sale!!!!

taterbug · Post by **taterbug** » Thu Feb 22, 2007 11:25 am

Thanks for the quick replies thus far. I'll check out the post you recommended and keep the HCPCS codes in mind as well.

Great site! Thanks again for the info.

blarg · Post by **blarg** » Thu Feb 22, 2007 8:27 pm

Unless you need a BiPAP, you're probably looking for an APAP like you suspect. Any of the major companies' APAPs will give you what you're looking for, namely:

ResMed
Puritan Bennett
Respironics

Personally I love my M Series Auto. RemStar APAPs are probably the most well known around here, but you'd do great with any of those APAPs unless you have specific needs. Respironics APAP for example is the only one that provides exhale relief in auto mode, which is why I was originally drawn to it.

sleepinginseattle · Post by **sleepinginseattle** » Thu Feb 22, 2007 8:50 pm

I'm a gadget junkie too but it never occurred to be to get different machine than the type my doctor prescribed. Call me old fashioned but if you're going to get the most out of your treatment, shouldn't you follow your doctor's directions?

I maybe naive but what sort of recourse would you have if your health took a turn for the worse and it was discovered that you had been prescribed one machine and were using another? You wouldn't have any attractive legal recourse.

There are gadgets and then there are medical equipment products. I don't consider these two remotely related.

blarg · Post by **blarg** » Thu Feb 22, 2007 9:50 pm

sleepinginseattle wrote:Call me old fashioned but if you're going to get the most out of your treatment, shouldn't you follow your doctor's directions?

If the doctor prescribes a CPAP, then any CPAP machine would fill those needs. It's not like it's a drug where ResMed air is different than AEIOMed air or something. The APAPs use different algorithms to adjust pressure, but that's not something a doctor takes into account when they Rx a machine.

Usually if there's a scrip for a specific machine it's at the patient's request or the doctor is in cahoots with a DME and therefore stays loyal to a particular brand.

You're the one sleeping with it, you should get what you want out of treatment.

Oh, and as for your legal statement....

a) If he's using any of those machines, it'll fill the Rx. Period.
b) The doctor isn't liable anyway, regardless of CPAP use or not, as it's not negligent to Rx a CPAP for OSA. If his health makes a turn for the worse, what brand of machine he has will make ZERO difference. What would his attractive options be even if he DID get Rxed a specific brand of machine and did get it?
c) I'm not sure if you know that we're just debating TYPE of CPAP.

CollegeGirl · Post by **CollegeGirl** » Thu Feb 22, 2007 10:02 pm

Sleepinginseattle - look at it this way. If the doctor prescribes you a wheelchair, he doesn't care what brand you get - if you get the most basic, inexpesive kind, or the electric kind that helps you get around more easily. What brand and "gadget" level you get are between you, your insurance (if applicable), and the place you purchase the chair from.

Oh, and if you decide to use it to drag race tractor trailers on the highway, no matter WHAT brand you use, your doctor is not liable.

The same principle applies to CPAP.

sleepinginseattle · Post by **sleepinginseattle** » Thu Feb 22, 2007 10:12 pm

blarg wrote:The APAPs use different algorithms to adjust pressure, but that's not something a doctor takes into account when they Rx a machine.

My understanding is that APAPs are not fully researched. But if you want to take into account algorithms and potential benefits and recommend those to individuals that have not even completed a full sleep study, be my guest. I stand by my suggestion that he listen to sleep professionals.

blarg · Post by **blarg** » Thu Feb 22, 2007 10:18 pm

sleepinginseattle wrote:My understanding is that APAPs are not fully researched.

Where does that understanding come from? My understanding is that it's a proven technology. Oh, and you can put them in CPAP mode anyway....

sleepinginseattle wrote:...individuals that have not even completed a full sleep study...

I assume you're talking about titration, since he has had a sleep study. Please see this thread: viewtopic/t17600/PSG-not-better-than-am ... study.html

sleepinginseattle wrote:I stand by my suggestion that he listen to sleep professionals.

That's what I'm trying to tell you. The only sleep professional that will care what specific machine he uses is his DME. My DME didn't even leave my machine configured correctly. YMMV.

I stand by my suggestion that he listen to his doctor, and then get the machine that will give him the best treatment. I don't think he needs to listen to DMEs, since their primary aim will be to make money, not to ensure he's taken care of.

You also didn't answer my question about your legal comment...

sleepinginseattle · Post by **sleepinginseattle** » Thu Feb 22, 2007 11:17 pm

blarg wrote:Where does that understanding come from? My understanding is that it's a proven technology.

APAP design may be mature but the health benefits for ALL patients suffering from OSA are far from clear.

blarg wrote:I assume you're talking about titration, since he has had a sleep study. Please see this thread: viewtopic/t17600/PSG-not-better-than-am ... study.html

So..you're betting someone has a better approach. Same as with the APAP. Maybe you're right, maybe Dr. Désirée Lie is right. But what if you're both wrong. The findings nothwithstanding, clinical trials are the fodder of medical equipment manufacturers and others with a vested interest in an outcome that suits their needs. I'm not convinced.

Aside, Dr. Lie has no board certification in sleep disorders or neurology. I find her study less than credible.

blarg wrote:That's what I'm trying to tell you. The only sleep professional that will care what specific machine he uses is his DME. My DME didn't even leave my machine configured correctly. YMMV.

Others have posted that APAPs can be prescribed by the doctor. I don't see any conflict of interest here. Sorry your DME didn't help you, mine did so I guess I got lucky.

blarg wrote:You also didn't answer my question about your legal comment...

You're speculating about legal outcomes. Every insurance agent I've spoken with (including life insurance) takes OSA very seriously. Perhaps you're rignt, but being cautious on this point may serve my family well in the future.

blarg · Post by **blarg** » Thu Feb 22, 2007 11:27 pm

sleepinginseattle wrote:APAP design may be mature but the health benefits for ALL patients suffering from OSA are far from clear.

Again, where do you get this understanding?

sleepinginseattle wrote:So..you're betting someone has a better approach.

No, I'm betting that a patient can figure out their own pressure better than a titration, which is only representative of one night and often wrong in the first place.

sleepinginseattle wrote:Others have posted that APAPs can be prescribed by the doctor. I don't see any conflict of interest here. Sorry your DME didn't help you, mine did so I guess I got lucky.

Doctors can prescribe CPAP, APAP, BiPAP, etc. APAP is considered a specialized CPAP. If you have a scrip for CPAP you can get an APAP. And you did get lucky if your DME was helpful.

sleepinginseattle wrote:You're speculating about legal outcomes. Every insurance agent I've spoken with (including life insurance) takes OSA very seriously. Perhaps you're rignt, but being cautious on this point may serve my family well in the future.

As are you. I'm not downplaying OSA at all. I'm just saying that a doctor very very rarely Rxes a specific machine. Do you have a copy of your prescription?

sleepinginseattle · Post by **sleepinginseattle** » Thu Feb 22, 2007 11:32 pm

blarg,

Your approach to this subject does not reflect mine. Let's leave it.

Cale