Noisy M Series Pro, Encore question, DME's, Doc gripes.

[Rustyolddude]

3 nights so far and doing good compliance wise. The only issue I'm facing is the noise from the M Series Pro. The changing whining as I breath. I called the DME/RT and asked for help, my wife can't sleep listening to the machine following my breath & it sucks sleeping in the guest room. The DME offered to mail me ear plugs I have plenty of ear plugs and have been wearing them so I can cope with the noise, wife isn't going to use ear plugs. DME suggested I place the machine under the bed, kinda tough with a six foot hose unless I hang my head off the bed or sleep on the floor. No offer of a 10' hose. Really just irked me be cause the DME clearly is one of those persons that you can tell doesn't "really" care, she just puts a suger glaze on anything problem that you have; "oh, I'm sorry to hear that, well just keep trying, it's an adjustment period" I mean come on, 4 days into a new therapy, you'd think they would be concerened with really helping. Anyone have suggestions for quietening this particular machine? (other than shoving it in a DME's orfice) Going to fiddle with the humidifer tonite and see if a lower water level makes a difference. I never use all the water in it. I did contact Respironics via the website. Either way, I will win even if I have to engineer & fabricate something.

I asked the DME about enabing the AHI/Leak menu during the machine introduction that she did at the sleep lab. Got a negative response to that. Yeah, I came home and enabled the function myself (Italian salute!). When I got the machine, the DME gave me an envelope to mail the smart card back on a certain date (just so they get paid by the ins. co. no doubt). The sleep lab has a support period every week and they will read the card & print the report but it's during my working hours. I brought this up with the DME and asked what I could do to get the card read and reports generated after a week or so of use. I thought I asked some forbidden question Anyway, the DME told me that reading the card erases it, is this true or am I getting a line of B/S?

Gripe:
Called the sleep doc to get a 30 day Rx refill for AmbienCR. Pharmacy needed a preapproval/medical neccessity for a non generic in order for the insurance co. to cover the larger part of the cost. I was told by the nurse 2 weeks ago when the doc. was out of town & the pharmacy was trying to sort out the ins. approval on a 7 day refill, that the doc. the prefered the CR for CPAP patients to get them thru the adjustment period. Makes sense since the CR flavor is prescribed for long term use and the plain aka. now genric Ambien is for occasional use and will lose effectiveness with long term use. Doc. had written me a 7 day supply with multiple refills &I just decided to pay out of pocket as it was only 7 pills & I had a coupon. Anyway, long story short, today the office mgr. for the Doc. aka. office queen told me that it's too much effort to get insurance co. preapproval for the CR flavor each time they have to fill an Rx. Too much effort? At least lie to me and say the insurance co. won't approve it, don't tell me you're too lazy to make an efforst to see that your patients get the best of care. Going to call my PCP and see if she'll accomodate me, she's far more concerned with my health. And I'm gonna air my grievance with the sleep doc. when I have my 2 mo. follow up. I think I'll pay my co-pay in rolled coins since it's too much effort to convert them to paper currancy.

[Treehorn]

I read here that you can get device that acts like a "muffler" called Whisper Cap. Some like it - some say it does nothing. Search for whisper cap on the forum.

https://www.cpap.com/productpage/respir ... r-cap.html

Also some suggest putting the machine on a mouse pad or something soft to help a bit.

Are you using C-flex? Can you tolorate the machine without it? Turning off C-flex may help.

I am a newbie so I am just regurgitating things I read here in other posts. Still learning.

[Pugsy]

Anyway, the DME told me that reading the card erases it, is this true or am I getting a line of B/S?

Well..... BS
With the Encore viewer software it is not possible to erase the card when you upload your results.
There is a utility tool that will format the data card but that is by obvious choice.
I read that with Encore Pro software there is a function with it that will erase data unless you tell it not to but I don't have that software to tell you the specifics. I only have Encore Viewer.

My M series auto CPAP does not seem noisy to me. My husband says he never hears it. I was showing my daughter what it was like to have this wind blow up my nose and I had to lean my ear down to the machine to hear if it was even running/blowing. I don't think I need a hearing aid..... It sits on a small night stand just below the head of my bed. No special mufflers. No towels, no mouse pads, no hiding in drawers. Even if I turn off my fan, I don't hear it and certainly not when I am hosed up. Maybe I just got lucky.....

CFlex use may or may not impact blower noise. Again, I noticed no change.

[LSAT]

I had the same problem with the M series. My wife kicked me out of the bedroom. I called my DME and they exchanged it for my current machine...quiet, but not data capable. The specifications shows it only slightly quieter than the M series, but it doesn't have the Darth Vader inhale and exhale sounds.

[GumbyCT]

Using Aflex or Cflex does increase the noise the M series machines make. Try disabling those functions. When your DME comes over to check and puts a hand to block the end of the hose, then looks at you as if to say "What are yo complaining about"? Understand it is the exhaling against the pressure that makes the noise people complain about. No exhale = NO NOISE.

Also higher pressures seem to increase the noise levels. What pressure are you at? Ask for an 8 or 10ft hose to put the machine farther away AND the whisper cap. Avoid the 10ft hose for now if you are using an auto. That is a topic for another discussion.

Encore Pro, which is what your DME will use, does in fact erase the card data without asking - by default. This setting can be changed for the home user but the DME will prob not know (or care) how to do this cuz they reuse the cards. So either read the card yourself or simply get another card from the DME. So what if the doc has two reports? BIG deal. The 1st 2 weeks are prob the most problematic. Get copies so you have them when you go to the doc and they can't find their copy.

If you feel comfy, try Melatonin instead of Ambien. No script required. Do a Google 1st.

HTH

[zaban3]

My husband thinks the sound of the machine is much more preferable to loud snoring! Personally, I find the rhythmic sound of breathing quite calming.

[mattman]

I'm going to play devil's advocate here just for a moment and somewhat stand up for the DME company. That being said, everyone should always be treated with courtesy and respect and there's no excuse for doing otherwise. I don't know if anyone has acted in such a way in your case - I'm just throwing it out there that I don't support bad treatment.

First off - the noise issue. There really isn't a lot that can be done about the noise. A cpap machine is going to make noise. How much noise is fairly subjective. Yes you can do sound tests on the machines and find one that is a few db quieter than another but still this tends to be a subjective issue. Some don't mind it, others do. If your wife is one that is bothered by it then this can require an adjustment. I suspect your company was trying to help as much as is really possible in this type of situation.
Unit placement can help sometimes. This is tricky though because a cpap does need to have good ventilation all the way around. This means enclosures are a *very* tricky problem and not something I'd really suggest. Under bed is an option but this can potentially work but as you stated hose length can be troublesome. By the way, you'll very rarely if ever see a 10ft hose suggested by a DME because there can be some pressure issues using a hose that long. It generally falls under the 'more trouble than it's worth' catagory.

For me, I just use a stand fan in the room. That smooths out the up and down sound of the cpap enough that I'm now used to it and it doesn't bother me at all even without a fan.

Yes, ear plugs can and often are a perfect, easy and low tech solution.

Other than that, as someone already said - what's worse? The sound of you suffocating as you snore or the hum of the cpap?

The card issue. There is a common misconception that reading a card is a revenue item for a DME provider. It's not. It's something a provider does in the interest of keeping a patient and his/her doctor informed of their progress. It's also required at times (usually within the first 3 months) by an insurance company to show compliance with treatment but that is again not something that's billed for.

As somone mentioned, the standard settings for the card reader do erase the card when it's read. Most of the providers I know leave it that way so that every time the card is read it's fresh data. Once you have all the data off it, I don't personally see any reason to keep it on there. To me, the more room on the card for new information the better. You could always talk to the provider and see if they will change their standard practices for you, but they may not be able to.

You could always talk to your provider about coming in daily, weekly, monthly or whatever to get your card read. I'm sure they wouldn't really mind it.

mattman

[jdm2857]

The noise issue is a manufacturer issue more than a DME issue, although I doubt any DME considers the noise issue when selecting which machines to carry. And, since dBs are on a logarithmic scale, a "few dBs" can make a big difference. My ResMed S8 AutoSet II is very quiet.

I think the "reading the data erases it" bit is a ploy to deter users from reading their own data. If reading the data erases it, then it will not be there for the DME, right? So you b better not dare read your data. Nonsense.

[JayC]

When I took delivery and setup from DME over a year ago on starting therapy, I was also told that data transfer erased data from the machine......

I did not misunderstand this exchange.....


One of the many factual errors....

J

[carbonman]

I mean come on, 4 days into a new therapy, you'd think they would be concerened with really helping Anyone have suggestions for quietening this particular machine? Either way, I will win even if I have to engineer & fabricate something. :

Duuude, get real. It's about you, not them.
Time for you to take control.

Here is fabricated noise abatement. Took about 10min to engineer.
Works great.




I put my Mseries in the bottom of my night stand and
put a big pillow over the opening. That worked pretty well, also.

[DreamDiver]

Anyway, the DME told me that reading the card erases it, is this true or am I getting a line of B/S?

Encore Pro software is set by default to erase all sleep data off the card except patient information stuff once it's finished downloading the data. If the DME is truly clueless or hasn't really studied their manual, they don't know that the software can be set to ask if the data should be erased, defaulting to 'no'. So they may technically not be lying so much as omitting the truth. Either that or they're actively attempting to keep you from having and interpreting your data. I've found this to be the case.

Just give them the compliance numbers off your machine over the phone and don't give them the card. That's all they really care about anyway. Buy the software online and interpret your own data. As soon as your lease-to-own contract is up with them, get shed of them and buy all your stuff online.

If you feel compelled for some forlorn reason to actually loan them your card, get a second card and use the myCPAP software to duplicate what's on your card onto another card. Loan them the duplicate and don't expect it back with your data intact. That's okay though because you've got the original.

Edit: I have to admit, I think my M Series Pro is noisy too. I doubt an whispercap would do anything but make it labor more. I'm going to get a different machine when I have the money. Fortunately, my wife doesn't seem offended by it. I wear earplugs and use a 10 foot hose. I tried a 20 foot hose, but found it was too long to be able to turn it on automatically from the other room. Plus, I'm not sure the pressure is accurate at that hose length. 10 feet seems ideal. My local DME wouldn't supply one either. That's when I told them 'good bye'.

[LinkC]

Keeping data on card: Sheesh! It's a simple tick box. Once ticked, it becomes the default. And anyone who can't figure it out probably SHOULDN'T be reading their own card...let alone interpreting the data.

Noise: We both find it soothing, like the sound of surf. But if you don't, set the machine on a mousepad. Or a carpeted floor. Or in a ResMed box...lol

Hose: Unless you sleep standing up--or in an upper bunk--a standard 6' hose should be plenty. If not, spend $10 for an 8'.

[Rustyolddude]

I mean come on, 4 days into a new therapy, you'd think they would be concerened with really helping Anyone have suggestions for quietening this particular machine? Either way, I will win even if I have to engineer & fabricate something. :

Duuude, get real. It's about you, not them.
Time for you to take control.

Here is fabricated noise abatement. Took about 10min to engineer.
Works great.

I put my Mseries in the bottom of my night stand and
put a big pillow over the opening. That worked pretty well, also.

That's what I was working on last night, couldn't find the right size box. I was thinking about trying the carry case, it has a mesh bottom which might be ok for machine ventilation. I did try the machine without the humidifier, pulled the pollen filter, compared the C-flex setting and ramp. I'll also experiment with the nightstand & pillow door. Thanks for those suggestions.

I moved the machine to an upturned wastebasket putting it below the mattress. This helped along with leaving my radio on in timer mode and taking a pill, no ear plugs either. Slept VERY well last night, It's amazing the transformation, Jekel & Hyde, or maybe Bi-polar when I actually sleep.

What is frustrating is so many people here are battling the difficult human interface problems, mask fit, taking the mask off, psychological adjustments, etc. I have to have a simply mechanical issue, supposedly it should be the easiest to fix; it repeatable & constant and comes from a box. Meanwhile, I'm racking up therapy hours, 8+ hours a night and no problems with breathing discomfort. Though the prior night when I didn't take a pill and slept poorly, my chest hurt the next day, I'm sure I was fighting the machine. I guess I'm weird but I'm finding the CPAP very comforting.

Really need to get the Encore Viewer so I can see what my AHI's and leaks are looking like, only had one cheek leak last nite and I was sleeping on my side, pretty good for the Quattro I think.

Anyway, going to subject the wife to my therapy tonite, I think the box Idea below mattress level will be quiet enough for both of us, she keeps an older Hamilton Beach TrueAir filter plugged into the wall for noise. http://www.hamiltonbeach.com/special-lines-trueair.html (in case it interests any of you). She carrys it when we travel, small & compact and the best thing is it doesn't blow & stir up dust like a regular fan.

I'll give the melatonin a try again. Took it (GNC brand) years ago with little effect, might pick some up from the CVS on the way home. I recall 3mg was the best dose, any brand preference folks?

I was cranky when I posted yesterday about the DME & Doc. I just hate it when someone sugar coats b/s. I can deal with "suck it up and tough it out because that's the way it is, sorry can't help you" But don't give me a poverbial spinal tap and tell me how it hurts you more than it does me, and it's really not as bad as my nerve endings say it is.

I'm glad this forum is here, you folks have helped tremendously, both preparing & educating me beforehand and helping me make the adjustment now.

[BeanMeScot]

I have my M Series with A Flex on a step stool beside my bed. Nothing extra. I have a hard time hearing it.

[old64mb]

I was told by the nurse 2 weeks ago when the doc. was out of town & the pharmacy was trying to sort out the ins. approval on a 7 day refill, that the doc. the prefered the CR for CPAP patients to get them thru the adjustment period. Makes sense since the CR flavor is prescribed for long term use and the plain aka. now genric Ambien is for occasional use and will lose effectiveness with long term use.

If that's what the nurse told you she's wrong. CR is the exact same stuff (zolpidem) and will lose effectiveness just as easily as the generic version as you develop tolerance. It's just got a much more sophisticated release mechanism to try to slow down the release. Unfortunately, if you actually look at the blood plasma concentration levels, CR is kinda underwhelming. I wouldn't worry too much about trying to get CR.