advice on replacing current cpap

[suneilp]

I want to get a better machine to replace my current one, which is a Respironics M series DS100. Its a very basic machine with no data capabilities, which is something I really want. I, like many others, want an APAP, and am looking at the Resp. Auto/A-flex machine.

I was going to order one today since I managed to get a Rx from my doctor today that's for a CPAP (glad cpap.com takes CPAP Rx's for APAPs).

The thing that is now holding me back is the in-lab sleep study I just did last night. My doctor had originally prescribed 12 cm for me just as a guess based on an initial home sleep study. However, the technician told me after the sleep study last night that I actually got a good solid deep sleep with a pressure of 9.

For one thing, I just want to rant about how pissed off I am at the doctor for guessing. 12 is a lot higher than 9 and I've been using 12 for 2 months now without getting any sleep. This technician seemed incredibly helpful at the very least. He was telling me that too much pressure can fill the lungs with too much oxygen and keeping the co2 levels down, or something like that. According to him, that tells the body it doesn't need to breathe in since it has plenty of oxygen and that effect disturbs your sleep. I certainly had a sensation that matches what he said. In the beginning of the night with the CPAP I often felt like not breathing and it was rather disturbing so I would force myself to breathe in deeply which ruins my attempt to fall asleep.

Now back to the topic, is an APAP necessary for 9 cm? Tonight I'll be switching to 9 cm since I know how too and its a lot faster than waiting for doctor to get the results and inform the DME and then having to drive over there....what a pain in the ass. Also, is it wise for me to just drop down to 9 cm? I remember reading on these forums that changes should be done slowly and incrementally? Is it gonna hurt?

I definitely want to get a new machine, one that is data capable. I'll probably get the APAP anyways, I've read enough to know that almost everyone suggests an APAP since they have a CPAP mode, you can do self titrations, and some of them have exhalation relief which is something I had really desired. Although, with a pressure of 9 cm, perhaps I won't need that relief. I guess I won't know until I try the new pressure out.

Any other suggestions for auto machines? I'm not rich but I can afford the Resp. Auto A-flex even if the insurance ends up not reimbursing me and that machine seems to be one of the highest priced machines. I'll probably stick with the integrated humidifier for now, I haven't had any problems with the basic CPAP I have now and its the same HH. If there are additional benefits for something like that seemingly popular HC150 then I'd like to know so I can put it up for consideration.

I do plan on getting software/reader for whatever machine I end up buying so I'm not terribly concerned about being able to view stats on the LED. I do want to be able to save detailed data for a long time and it seems for the Respironics machines, I'd need Encore Pro instead of EncoreView which is a bit annoying as the pro version is obviously more expensive.

[GumbyCT]

Exactly the reason everyone should have a data capable machine.

Why not ask the doc to script the Aflex then if required settle for one that at least has data. DME will have to honor the script.

The HC150 at least you can pre-warm plus it holds more water.

[WilsonVilleUSA]

Here is my unedumacated reasons for getting an APAP even though the Doc and sleep study said CPAP would be fine....

- As far as insurance is concerned, there is no difference. They all use the same billing code, CPAP or APAP, date recording or not. Might as well get all the bells and whistles.
- You may not need APAP now, but a year from now it might be decided that you do, APAP machines can run as CPAP, but if you buy a CPAP, then you'll need to buy a new machine if it is decided that is needed down the road.
- I find that I sleep more comfortably on APAP. Sure, you can ramp up on CPAP, but once you are at your pressure, there you sit even if it isn't needed. With APAP it goes up and down as needed to respond to your breathing, I spend a LOT of time below my max. I think being comfortable has a lot to do with compliance and the more hours you get therapy.

As to machines, I have been using a Remstar Auto M-Series and have been very happy with it. I recently bought a Sandman Auto HC as a back/up travel machine and am liking it so much that I am actually using it as my main machine. I think the encore software is a little easier to use, but my experience is the Sandman software is more Windows Vista friendly.

[jules]

suneilp has an HMO - all things change then as they don't care about codes

[GumbyCT]

I think a doc changing the script is the ONLY hope in an HMO.
JMMO.

[suneilp]

My doctor is resistant to APAPs. When I asked for one he said he'll order a titration study since I never had one. After talking to some of the guys through the chat on this site, I asked for a lab titration study. The technician even said he thinks an auto will be a good idea based on the data and will recommend it and told me what to say to the doctor.

I didn't realize HMOs don't care about the insurance codes. I was counting on that to get reimbursed but if that won't work then I guess I'll have to fight the doctor for an APAP.

Thankfully I have an appointment for a supposedly better doctor even though its a month away. The technician even said my doctor needs to retire..... and the one I am switching too is a lot better. I just don't want to wait a month and it seems this doctor is ridiculously popular hence the month wait time.

I don't mind buying it now and then waiting until I can get a new prescription. I doubt the insurance co will say anything if a doctor prescribes it after the purchase.

[jules]

unless your HMO is unusual, they won't reimburse anyhow

we always suggest for anyone with insurance, HMO or not, to check with insurance if they will reimburse a cpap.com purchase

glad you did the titration and yes the doc guessed poorly

[suneilp]

I did ask my insurance about reimbursements if I buy it on my own first. They said that is fine as long as I have a prescription.

[RipVW]

Hello & Welcome, suneilp! Glad you found this forum--SO much useful info and everyone here is so willing to help!

After more than a year of using a straight CPAP with very poor results, I found this forum, got an AUTO APAP, and all has been great ever since. I think all CPAP users should have a machine that has data and auto capability.

"You are getting sleepy . . ."

[GumbyCT]

Try asking docs office to get on cancellation list. Or even try another doc? But glad to hear you are getting away from the 1st doc. Yea, with an auto - you would have had all the info already.

Be sure to keep writing down your Q?'s so they are ready.

ps. Get your software and reader on order, that ALL takes time.

Keep an eye on CL and cpapauction.com for the machine too. Even here I saw an Aflex pop up last week or so.