Buying CPAP machine

[lopor3]

Hi,

I am a new to the use of CPAP and need to buy one. I live in Canada and the m/c here are VERY expensive. I will be going to Galveston at the end of April and would like to buy one there.

I need advice on :

a) Where I can buy a m/c in Galveston

and

b) What is a good type of M/c. Some one recommended a RESMED. Model? Any comments or advice for a newbie?

With thanks.

[Jersey Girl]

I can't tell you where to shop in Galveston - sorry about that!

But, I can highly recommend the Resmed s9 APAP with climateline hose. Make sure that you have a humidifier as well. You will also need a mask and mask choice is VERY personal. You should try on masks with the machine running and you lying down.

Hopefully others can recommend the best way of purchasing a machine if you live in Canada.

Best regards,

Jersey Girl

[lopor3]

HI jersey girl,

What is a APAP versus a CPAP?

[Jersey Girl]

APAP allows you to use your machine with a pressure range. A CPAP machine can only run in a straight pressure. For example, I have a Resmed s8 Autoset II APAP machine. I have it set to a pressure of 8. If I wanted to fine tune my pressure to see what the best pressure for me really is, I could run it at in a range from 8 to 12 and see how my 95 percentile looked after a week or 2 and then run it at the 95% pressure. This machine can run with a pressure range like 8-12 or with a straight pressure all the time. I am most comfortable running at a constant pressure. I am sensitive to pressure changes. Some people find it more comfortable to use their machine in APAP mode with a pressure range. I think that it is better to always have the choice. Even if you prefer a constant unchanging pressure, like me, it's always good to have the option of fine tuning your pressure from time to time.

It also VERY important to have a DATA CAPABLE machine so that you can utilize software and see how you are doing from time to time. For example, right now I am having a pain issue with a pinched nerve. I am seeing that my AHI has risen up to 4.3. This is not good. I may need to up my pressure for a short time while I am experiencing this condition. If I did not have the software, I could not really see how I was doing. Also, it is important to check your leak info. I saw that my AHI number rose, but it was NOT due to air leaking from my mask. My leak rate was very low.

I did not know about any of this stuff until I came to this forum. I was very lucky to have a caring sleep doctor who ordered the best data capable APAP for me and he set me up with a titrated pressure was perfect for treating my OSA. However, thanks to this forum, and reading and learning, I now know how important it is to keep track of how I am doing myself and take control of my therapy.

Don't settle for a machine that is not data capable. Sometimes the durable medical equipment company tries to push cheaper equipment on you. Sometimes you have to demand the exact machine that you want. In order to do that, you may have to ask the doctor to actually write you a prescription for a Resmed s9 APAP, humidifier and climateline hose. Mask of choice is what my doctor wrote as well. Oh, and ask your doctor for a copy of your sleep study, titration and your prescription. You are entitled to have all of this. With prescription in hand, you can shop around for your equipment.

Best regards,

Jersey Girl

[lopor3]

Thanks, Jersey Girl.

I understand and appreciate most of what you said but I see I have a lot to learn but will take your advice and get a m/c with the appropriate features.

What is "titration"?(reminds me of my old chemistry lab days) My doc. or therapist haven't mention that word to me yet.

To all forum members out there, I will be in Houston for a day before heading to Galveston. Where is a good place in Houston to buy a Resmed ?

[Pugsy]

Titration sleep study, where they hook you up to all the electrodes and the mask then they monitor sleep and events to establish (hopefully) the right pressure for you to use. Sometimes this is done on a separate night than the first sleep study and sometimes done during the last half of the first sleep study.

You will of course need a copy of your prescription to purchase a machine, humidifier and mask.

Houston? Isn't cpap.com main office there? Seems like it was but I could be wrong. Cpap.com is the online business that hosts this forum. You can check prices by going to cpap.com. I don't know for sure if it is in Houston or even if they have walk in business. They can't ship ResMed machines or supplies to Canada but with the script you could purchase online and have it shipped to where you will be at in Galveston. They will ship other brands of machines and supplies to Canada. It is a rule that ResMed came up with.

[Otter]

Houston? Isn't cpap.com main office there?.

Yes it is, and they have a bricks and mortar store there too. https://www.cpap.com/cpap-store-location.php

Lopor3, since you'll only be here for a few days, I strongly suggest that you call ahead to any DME you plan to visit. You may need an appointment, and they may present you with bureaucratic obstacles that you won't be able to clear in your brief visit unless you come prepared.

Be sure ask what paperwork you need to bring to satisfy their policies and what other hoops you might have to jump through. Also make sure that they recognize Canadian doctors. They should, of course, but ask before taking precious time out of your trip. Some DME's here in the States have rather bizarre policies that I suspect arose from unrealistic or outdated information about the dangers of CPAP given to their lawyers. I also think it's likely that the limited knowledge of most DME employees is a contributing factor. Paranoid restrictions may actually be necessary if your people don't know what they're doing.

I recently contacted a local DME to try on a mask, and after a great deal of back and forth about whether or not they had what I was looking for, I was suddenly told they couldn't help me because I'd never had a sleep study. Never mind that my doctor prescribed an auto-titrating machine for me in lieu of a sleep study, or that my machine has been checked by an RT already, or that all I was asking for was a mask, and I have no interest in them inserting themselves into my therapy. CPAP is DANGEROUS and their corporate policy won't let them have anything to do with me unless I have polysomnography first.

I don't know how it is in Canada, but this sort of idiocy is common among DME's in the States. As you won't have days to play Simon says with them before you head home, it's best to be prepared and deal with any lawyerly paranoia ahead of time. Better yet, if you can, find a DME that's both owned and run by people who know what they're doing. Fear of CPAP is directly proportional to ignorance of CPAP, and hence, anyone who warns you that your head will explode if you change your ramp setting isn't likely to be a useful source of information anyway.

All cpap.com needs for an online transaction is a relevant prescription. (I wound up ordering my mask from them.) But make sure that this is also true if you go to their shop. I found their phone staff to be both friendly and helpful. When one of them wasn't able to answer my question about Resmed filters, he was willing to research it. He called back two hours later and apologetically told me he wasn't able to find out any more than I had, but I believe he did make a strong effort, and that Resmed has decided that the particle efficiency of their filters, like the definition of hypopnea used by their S9 flow generators, is a trade secret. If you're going to be in Houston, the cpap.com store is probably worth a visit. I'd definitely call them well before your trip, though.

If money is tight, you may want to consider buying a used machine online from secondwindcpap.com. After several long phone conversations, I can say that Mark Seager, the RT that owns the company, is clearly much more interested in helping people than making money and has training and experience that go far beyond the cookie cutter expertise I've found elsewhere.

I hope you have a great trip and good luck with the DME's.

(edited typo)

[Pugsy]

Brick and mortar DME stores may charge a whole lot more than online supplier. Example, I was quoted $2300 by a brick and mortar DME in my small town for the ResMed Escape. This was the cash price or insurance billed amount even though we know that they don't get all of what is billed.

I would check out cpap.com DME store in Houston. Call them ahead of time to find out exactly what is required to meet RX regulations and also verify prices on the equipment you choose.

While part of the higher price for DME bought machines is the "service" they provide I doubt they will offer much personal service to Canada from Houston area. Later on you might find Canadian online supplier for mask and supplies that will have reasonable prices. Someone mentioned clinicalsleep.com as being competitively priced.

[DocWeezy]

Depending on where you are going to be staying while in the states, could you make arrangement with them to accept and hold a shipment for you? Then maybe you could just order what you want online (and pay the lower online prices), and have it shipped to the location where you can pick it up.

That might avoid the hassles of the unknown re prescriptions because you'll know far in advance whether the prescription you have will be acceptable.

Then maybe schedule a visit to a brick and mortar to try on some masks if you want.

HOWEVER, regarding trying on masks, I found it to be more cost effective to just buy what I wanted to try from cpapauction or from members here. Trying a mask on for a few minutes in the DME's office doesn't always give you a realistic idea of what it will be like to sleep in it.

And I second the comment about Secondwind and Mark there. He's great and willing to answer any number of questions. I bought my backup/travel machine from them and have bought several masks from them. Great customer service!

Weezy

[archangle]

Properly using a CPAP machine requires some knowledge of what you're doing. It's not really a "plug in and go" proposition. That's part of the reason it requires a prescription in the USA. Doing it wrong can be dangerous. Of course, not treating sleep apnea is dangerous, too.

Do you have a prescription? No authorized USA dealer is going to sell you a CPAP machine without a prescription. If you can get a Canadian doctor to write you a prescription for a CPAP machine, you can probably buy one from a US web based seller. It's illegal in the USA to sell a CPAP machine without a prescription.

cpap.com hosts this web site and seems to be a reputable seller who will ship to Canada (with a prescription). Check with them, there might be some restrictions on which brand and machines they'll ship. You probably won't find any other legitimate authorized sellers selling for a lot less. Some web based sellers won't sell outside the US. I think someone mentioned some Canadian web based sellers, too.

Most brick and mortar USA based sellers are going to be much more expensive, and a lot more arrogant. Many of them think they're little tin gods and won't give you much information about how to adjust or use the machine. They're part of the medical mafia here in the USA. They're not like a legitimate store with a "serve the customer" attitude. They have the attitude that you're stuck with them and have to do what they tell you to.

The official US medical system would probably want you to go to a sleep specialist ($$$), have a sleep study done ($$$$), then buy from a DME (Durable Medical Equipment) supplier ($$$). Each one of the providers will probably charge you at least double the going rate if you don't have USA based insurance. They do things on their own schedule and it would probably take weeks to go through the process. As a wild guess, $5000 minimum.

You can buy a CPAP machine from a private seller, for instance, by checking craigslist or garage sales. It's probably technically illegal.

[lopor3]

Hi One and All,

Thanks for the good advice from so many of you.

I do have a prescription from my local Canadian Dr. I will call the Houston store tomorrow to see what they have to say. I didn't realize the store would make such a big deal about buying a APAP or CPAP m/c. I can get a RESMED from a Canadian distributer in Ontario but they charge more then the US Company. (The price for being Canadian). Will let you all know what the guys in Houston have to say.