Now for the big questions

tiredted · Post by **tiredted** » Sun Dec 12, 2004 6:59 am

Based on my experience in my sleep study, I have a feeling my doctor will tell me I have some level of sleep apnea. My appointment for the test results is Tuesday and I would like to go into it with some prior knowledge of the cpap equipment. Here are the questions:

1) What type of machine is best? Auto-pap, bi-pap, cpap? What are the differences between each one (cost, performance, etc) and are there any others out there?

2) Who are the major manufacturers of the equipment and are there any differences between them?

3) What about masks? How many and what kinds are out there? How do you determine which is best for you? Will any companies let you try them before you buy them?

4) What about miscellaneous equipment such as humidifiers and hoses? Are humidifiers necessary? Is one hose just like any other hose?

5) I gather from all the posts that purchasing the equipment online may be the most cost effective way to go. Is that correct? Would going with someone local be better in any way?

6) Did I forget anything?

Thanks for all the help!!

wading thru the muck! · Post by **wading thru the muck!** » Sun Dec 12, 2004 8:44 am

tiredted wrote:Based on my experience in my sleep study, I have a feeling my doctor will tell me I have some level of sleep apnea. My appointment for the test results is Tuesday and I would like to go into it with some prior knowledge of the cpap equipment. Here are the questions:

The answer to all of the questions depend on your person situation, likes, dislikes - factor that in to all the answers.

1) What type of machine is best? Auto-pap, bi-pap, cpap? What are the differences between each one (cost, performance, etc) and are there any others out there?

Auto-pap - This is what I chose, more features, more fine-tuned treatment - more expensive
Bi-pap - High pressure req'd?, frequent "events"? then you may need this one - most expensive
cpap - good straight forward treatment, plug & play - least expensive

2) Who are the major manufacturers of the equipment and are there any differences between them?

Respironics (Remstar) - Good machines, bad masks IMHO.
Puritan Bennett - Good (small) machines, good nasal pillow interface.
Resmed - Good (big) machines, great masks and nasal pillow interface.
Fisher Paykel - Best known for their heated humidifiers (I have one)

They all have websites I would recommend checking them out

3) What about masks? How many and what kinds are out there? How do you determine which is best for you? Will any companies let you try them before you buy them?

This one is all about personal preference. It depends on the shape of your face, beard or mustache?, do you breathe well through your nose? can you keep air from leaking from your mouth while you sleep?, do you wear glasses?, prefer a less obtrusive interface (mask)? back or side sleeper?
The Resmed Mirage Activa is the mask I would most recommend. After that you might want to try a nasal pillow interface like the Resmed Swift or the Puritan Bennett Breeze.

4) What about miscellaneous equipment such as humidifiers and hoses? Are humidifiers necessary? Is one hose just like any other hose?

Your equipment should come with all the hoses you need. You may want to buy a heated hose (only available from an Aussie company Sleepzone) this will help if you have trouble with condesation in your hose. IMHO a heated humidifier is necessary.

5) I gather from all the posts that purchasing the equipment online may be the most cost effective way to go. Is that correct? Would going with someone local be better in any way?

If you pay out-of-pocket, buy online. I some cases even if you have insurance the online cost can be less than the deductable/copay when you purchase from a local Durable Medical Equipment supplier (DME). If you find a good local DME (hard to do) and you are not into investigating yourself (based on your question list I don't think this is you) you may do well with a local supplier. Some people report that with a local DME they were able to try many masks and machines but IMO they are being charged so much that the "free" equipment trials are just included in the BIG ticket price. Call around and see what kind of reponse you get from the local DMEs (that's what I did and chose to buy online)

6) Did I forget anything?

I'm sure there's more to ask and more to answer, but this is a good start

Guest · Post by **Guest** » Sun Dec 12, 2004 9:05 am

Thanks for your answers. Regarding the mask, I do have a beard. In my sleep study, they first put on a mask that just covered my nose. Sometime later, they came in and replaced it with one that covered my mouth and nose because I was breathing through my mouth. Any mask suggestions based on that info? Thanks!

tiredted · Post by **tiredted** » Sun Dec 12, 2004 9:07 am

Oops.. I forgot to log in. The above post was me!

tiredted · Post by **tiredted** » Sun Dec 12, 2004 9:30 am

In reading the info on cpap.com and here, I'm confused about one thing in particular. Auto-pap vs. bi-pap. It is my understanding that bi-pap (or more generally, bi-level), provides two different pressure levels: a higher one for inhalation and a lower one for exhalation. Auto-pap adjusts the pressure level according to your needs. Bi-pap is more expensive that auto-pap. Why is that? Does auto-pap still provide the same pressure for inhalation and exhalation, like cpap only that it can adust that pressure? Alternatively, does auto-pap behave like bi-pap in that it can provide different pressures for inhalation and exhalation?

wading thru the muck! · Post by **wading thru the muck!** » Sun Dec 12, 2004 9:32 am

Hi tiredted,

Don't forget to sign-in so we know it's you posting.

I also have a beard and mustache and occasionaly mouth breathe during the night.

I haven't tried any full face masks but I've read the Resmed Ultra mirage full face is better than others. Full face masks are hard to fit and get a comfortable good seal. Finding a comfortable mask that does not leak is the key to good treatment.

I use either the Mirage Activa (nasal mask) or the Mirage Swift (nasal pillow interface) and then at the suggestion of another poster (rested gal) tape my mouth shut with a silicone scar reduction patch. Sounds extreme but works very well and is comfortable. The brand I use is Curad. If you search the forum for scar reduction you should find some of our posts on the subject.

For good equipment comparison charts check out cpap.com. They have very comprehensive info there.

Keep posting any more questions!

onemorething · Post by **onemorething** » Sun Dec 12, 2004 9:32 am

tiredted,

For some reason my insurance covers everything except $40.00 !! I had stopped breathing 80 times and hour. I am considered severe. That may be the reason I am covered.

When you know let us know the results, so we can learn from you. Thanks

onemorething

wading thru the muck! · Post by **wading thru the muck!** » Sun Dec 12, 2004 9:51 am

TT,

Seems like we're typing simultaniously (you faster than me).

Bi-paps are more expensive because it is more complicated to monitor inhalation and exhalation and provide two pressures.

Respironics has just come out with an auto-pap that have a feature called c-flex that provides some reduction in pressure on exhalation. My guess is not as much as a bipap though (I asked that question for an upcoming online interview with a company rep).

This may help...

Auto-pap will adjust pressure req'd to keep your airway open between a pre-set range only when you need it. Otherwise it stays at the minimum pressure setting. This can help you tolerate being hooked up to the machine better.

Bi-pap is used for people who require a high pressure setting (say 15-20cm) it can be hard to exhale against that pressure. They have one setting for inhalation and one setting for exhalation and do not adjust other than that.

The best case for an auto-pap is someone who has a moderate pressure (say 9-12cm) and less frequent "events" meaning that during the night your airway is restricted from time to time and not virtualy contantly. This way you get a low pressure most of the night and the higher pressure you need only when you need it.

tiredted · Post by **tiredted** » Sun Dec 12, 2004 10:03 am

Thanks for the answers. The auto-pap vs. bi-pap issue makes much more sense now. Getting my test results will go a long way towards helping me decide which machine is best for me.

omorfos · Post by **omorfos** » Sun Dec 12, 2004 12:27 pm

2) Who are the major manufacturers of the equipment and are there any differences between them?

Respironics (Remstar) - Good machines, bad masks IMHO.
Puritan Bennett - Good (small) machines, good nasal pillow interface.
Resmed - Good (big) machines, great masks and nasal pillow interface.
Fisher Paykel - Best known for their heated humidifiers (I have one)

I have a WEINMANN cpap wich has approx. 25dB(A) at 10 mbar.small
size and 7lbs weight.

http://www.weinmann.de see the site fantastic machine.

chrisp · Post by **chrisp** » Sun Dec 12, 2004 9:54 pm

The auto machines may also be operated as a straight cpap . this way you still only have to buy 1 machine . You can always use it in plain cpap mode if you decide you dont want auto.. Also the Resmed S8 pioneer should be available in the USA soon . Small , lightweight and works like A Spirit.

wading thru the muck! · Post by **wading thru the muck!** » Sun Dec 12, 2004 9:58 pm

Chris,

Thanks for adding that - I neglected to mention that additional great feature of the auto-pap.

I'll have to look at that Resmed S8 pioneer. I love the Resmed interfaces.