Do I have to have an APAP to get usable sleep data?

[gdpeck]

Hi All,
I was recently diagnosed with OSA, and have been adjusting to live with a CPAP for a little over a week now. After a lot of reading here, I have "almost" come to the conclusion that I would like to have more detailed data. My current machine provides compliance data only. Specifically I'd like AHI numbers and leakage data. There might be other data points that would be helpful as well. I spoke with the owner of the DME that was chosen for me, and he said that the only way to get that data is with an APAP. However in looking at the specifications of both the Resmed S9 Elite and the Respironics System One Remstar Pro from their respective web sites, it appears that both there is no difference in data gathering capabilities between the APAP and CPAP models. It does look like the Respironics machines gather different data than the Resmed machines, however. My current prescribed pressure is 7cm, and I quickly got used to breathing against that relatively low pressure, so I'm not sure what value EPR/C-Flex would be, and I'm also not convinced that I need APAP capabilities. Am I missing something else here? The DME owner told me he would "upgrade" me to an APAP, but wants me to pay the "upgrade fee" out of pocket.

Thanks!
George

[Nord]

Hi George

You are right... the DME is wrong. Elite by ResMed and Pro models by Respironics are completely data capable. Any Plus models by Respironics and as you already know, Escape by ResMed have compliance data only.

You might want an AutoPAP for other reasons and the cost can be nil/ not much different. If you get the opportunity of choice then choose Auto and you can run it in CPAP... but then you also have other choices.

Nord

[gdpeck]

Hi George

You are right... the DME is wrong. Elite by ResMed and Pro models by Respironics are completely data capable. Any Plus models by Respironics and as you already know, Escape by ResMed have compliance data only.

You might want an AutoPAP for other reasons and the cost can be nil/ not much different. If you get the opportunity of choice then choose Auto and you can run it in CPAP... but then you also have other choices.

Nord

Hi Nord,
Thanks for the reply. The problem I'm facing right now, is that I think the DME is not being entirely forthcoming with me. He's telling me that he get's paid the same amount from my insurance company regardless of which machine he provides and that he will need to charge me an additional amount of money to "upgrade" to the Auto machine. I can look at my insurance company's EOB online and what I see is that the DME was paid almost exactly what it would cost for me to purchase the S9 Elite (not Auto), humidifier, climatline hose, and the same mask I currently have. I don't know the correlation between ResMed's MIRP and actual MSRP that I would pay to a brick and mortar DME, but I'm guessing they are pretty close. So I'm almost positive that the DME would still make money on that machine, and that his proposed "upgrade fee" is a scam. I'm not sure I'm in a position to demand anything from this DME, since I already accepted the non-data capable machine before I had educated myself enough to know that it might not meet my needs.

[Nord]

I understand from others here that the Insurance code is the same for both Auto and CPAP... the only difference is whether the script specifies what you "need" and what profit the DME wants. Many posts here have confirmed that the difference in their cost is minimal.

I think that since you have already been bitten by them once... you are now "entitled" not to be bitten again. I would contact my MD and have them specify for example: AutoPAP ResMed S9 with H5i humidifier and Climateline hose set at 11 - 15 cm or whatever you decide. Take your written out instructions to your Dr and have him write it that way. He is on thye same side that you are... your side.

Nord

[BlackSpinner]

even a resmed Elite s8 will give you data on your screen. The guy doesn't know his products.

[DreamOn]

Welcome to the forum, gdpeck! Here's a list of machines that are fully data capable, as well as the ones that are not: viewtopic.php?p=307168#p307168. You'd want to avoid the ones in red. The ones in blue are capable of reporting full data.

The insurance billing code is exactly the same whether the machine is fully data capable or not, CPAP or APAP. So the DME does receive the same amount from your insurance company regardless of which machine he provides. That's why they often sell the most basic machine -- more profit for them!

Best wishes with your therapy.

[jules]

your insurance may allow them to charge an upgrade fee - they may not -

also online prices are a lot lower than what brick and mortar DME's charge because overhead is less for an online vendor - they don't allow credit - don't bill insurance etc. so it is like going to the local convenience store for a soda versus having your stash at home in the fridge across town - you pay for convenience

so what you think is a scam, might be and might not be

[sarcher]

Hi. compliance data is important if you dont have good follow up but not absolutley needed. If you are feeling better and have had a follow up test to confirm that the pressure of 7 is good then usually can go without it. At our clinic historicallyl about half buy a lower price unit but in canada it works a bit different. I always give a choice based on if they have insurance or if they are a self pay,and what they really want. Some people are fine with a repeat oximetry and feeling great during the day . And people usually know when there mask is not fitting well. But some people really like to have more info... i think the patients i have seen on this forum really know there stuff and like the extra data. I am a rt but am very impressed with the level of knowledge and detail about cpap... good luck.... steve (vancouver)

[gdpeck]

Welcome to the forum, gdpeck! Here's a list of machines that are fully data capable, as well as the ones that are not: viewtopic.php?p=307168#p307168. You'd want to avoid the ones in red. The ones in blue are capable of reporting full data.

The insurance billing code is exactly the same whether the machine is fully data capable or not, CPAP or APAP. So the DME does receive the same amount from your insurance company regardless of which machine he provides. That's why they often sell the most basic machine -- more profit for them!

Best wishes with your therapy.

Thanks for the response! I notice in your profile that you have the S8 Elite II. What data is available onscreen without a card reader and additional software? I'm mainly interested in AHI, AI, and Leakage data, and not sure yet that I want to graph my nights with additional software.

Also, if I do decide to graph my nights what else will I need to buy? I think from reading other posts that I need a card reader (because the S8 series uses proprietary data cards), and Resscan software. Is that everything?

Thanks!
George

[BlackSpinner]

Thanks for the response! I notice in your profile that you have the S8 Elite II. What data is available onscreen without a card reader and additional software? I'm mainly interested in AHI, AI, and Leakage data, and not sure yet that I want to graph my nights with additional software.

What I see on the led display is leak rate, HI, AI and AHI as an average per hour for the night. one needs to check before noon (or what it thinks is noon) I can also see my weekly averages. If I got a card reader and software then I could see detailed graphs. Since my therapy seems to be working really well I haven't bothered to try and get that.

Lena

[gpk111]

UPGRADE:
My DME wanted $150 for the APAP (S9 Autoset model) from the S9 CPAP model. The rationale was that they pay extra and insurance pays the same as the base model. Probably true. They took my old CPAP machine in lieu of the $150.

PRESSURE:
My pressure was diagnosed at 8 in a sleep study. The S9 automatically adjusted it to 6, as averaged over 30 days. It feels just fine. Also reviewed it with DME and doc and they're ok with it. AHI is about 1. My takeaway: Sleep studies are a snapshot and not as reliable as continuous tracking. It's also important to track this stuff due to the additional motivation and challenge it provides.

STATUS:
Good success with my new rig after 2 years of hit or miss with a CPAP S8 without data analysis capabilities.