Sleep Study in a few days, how to justify S9 Autoset

[STL Mark]

As a 50 year old I've suffered with sleep apnea like symptoms for years and never accepted recomendations for sleep studys. I've finally decided to persue this through a referral from my doctor. From what I have read here the S9 Autoset with H5i and ClimateLine is my desired equipment. I know the facility likes to refer people to one of their preferred DME providers.

How do I assure that I can get the equipment I desire? What should I be asking about? What symptoms further justify the need for this type of equipment? How can I justify APAP over CPAP?

[frh]

I don't think I am qualified to answer most of your questions. But I think I'll throw in my two cents worth anyway.

In my case the sleep study doctor was un-cooperative when I brought up the subject of data. My GP was willing to re-write the prescription for the S9 APAP machine, but knows little about Sleep Apnea.

It occured to me I might have saved a lot of stress, phone calls and even money when I got my S9. I should have been smart enough to locate and call Resmed's rep. He probably could have told me which DME suppliers in my area would most likely honor my request for a S9. If they were on my insurance provider list, I might have saved the $250 extra I had to pay the DME supplier for each of the S9's my wife and I got.

Hope this helps.

[Uncle_Bob]

APAP and CPAP are billed under the same code.

The S9 Autoset can also be run in CPAP mode.

If they don't want your business just walk out and go and buy on line at approved Resmed vendor like cpap.com

[nosenabook]

Ask the provider for the machine you want. If they don't want you to have it, then ask the doctor for a prescription, and they MUST give that one to you.

You can get around the possibility of the providers not providing the equipment you want, by asking the doctor to write a prescription before you go to them. Makes no difference to the doctor, except as he/she wants you to be compliant.

I hope it's all working out for you, only probably slower than you'd prefer, now you've taken the plunge.

[kurth83]

To be most proactive do this:

1) get your doctor to prescribe the S9 auto with humidifier, beg nicely.
I had an argument prepared: I had to live with the machine for 3-5 years
and needed the flexibility to accomode potentially changing needs,
plus I needed a super-quiet machine, and climateline because our winters are cold.
Turned out I didn't need any of that, I asked and they said yes.
2) your doctor probably works with one or more DME's,
get the list and call them in advance to make sure they will provide it to you
given that it will be presecribed.

I did all of the above because I was really worried I wouldn't get the S9 auto
unless I did some legwork in advance, and I think it paid off, I have no idea
what I would have ended up with if I hadn't been proactive.

- Kurt

[Slinky]

Call your insurance company and ask THEM what local DME CPAP suppliers they are contracted with. THEN shop each of those DME providers.

Be diplomatic, be tactful. But keep in mind it is YOUR health, YOUR sleep, YOUR therapy AND YOU are paying for it, whether thru insurance or out of pocket is immaterial.

Forgive me, I am NOT feeling all that great today. I've posted repeatedly the information you need and want but I've never kept a record of the URLs.

[beadedbiker]

Ultimately I didn't need any of the following arguments as my sleep doc gave me a script for an S9 with nothing other than a 'sure, no problem'. Getting one from a DME - whole 'nother ball game. Definitely call Resmed, get them to call your Rep and find out who is most likely to be able to supply one (in my case I'm having to go to a different town in my state ).

Anyway. This is what I had lined up for the Doc in case I needed them.
Arguments for an APAP (and its difficult to say a lot of this *before* you've had a sleep study because some of it depends on your results). Positional apnea, where you need a lower pressure on your side than on your back. Its very common. I had less events on my side. I used that as my example in my case. This is especially useful if you really don't *like/stand/cope* with the high pressure you are set at to cover events on your back.

You want to be able to titration your own pressures at home, over time in place of repeated sleep studies, especially if you think your weight may change, as losing or gaining weight can alter pressure requirements. An APAP can be set to a range and it will tell you what your 90% is (the level which is less than or equal to the pressure you require for 90% of the night). Especially useful if studies have a long wait/you have trouble sleeping with all the wires/have to pay exorbitant amounts towards them. Studies show at home titrations are just as if not more so accurate than lab studies at determining accurate CPAP levels.

Studies show APAPs have better compliance rates.

Arguments for an S9 over any other brand - say you sleep in a very cold room, and need a lot of humidity. The S9s heated tube is about the only one that can provide it. The PR System One will sacrifice humidity to prevent rainout. There is an F&P with a heated tube, but it doesn't have data, and data is non-negotiable - we gotta keep an eye on those AHI numbers and leak right?

[elena88]

hi there..
congrats on getting your ducks in row ahead of time!

i had a sleep study in february.. so Im new at this too..

at your sleep study, IF you sleep long enough they will put a mask on you..

I did not sleep long enough, only an hour, so they sent me home with an auto to titrate me at home for one week..

I could not breath against the machine, it was a nightmare of a struggle.. but I got better at it later... you will too..

If they put a mask on you, and you have ANY trouble breathing against it, complain...
the sleep tech should make a note that you complained about breathing against the pressure (while you were awake)
perhaps it made it hard for you to go to sleep.. aha another reason.. after all isnt that the point? to be able to
go to sleep easily??? and how can you if youre struggling against the pressure?

It it takes you longer to fall asleep than the ramp feature lasts, thats another good reason for an auto..
there is nothing quite so surprising as just laying there with the machine at a low pressure of four, and whammo, forty five
minutes later, its up to ten...

I just asked my doctor for an auto, and she said SURE>> anything you want.. Im not sure how all this works, but

shallow breathers have a tough time exhaling against even low pressures.. I think if you test severe, they give you what you want too.. just
to make you happy.. at least my doctor does that... I would hope everyone else is that lucky...

I sleep in a cold room, and trust me, that climate hose will help you from drowning in the middle of the night from a rainout storm!

so..
COLD ROOM..
CHANGE POSITIONS SLEEPING..
MAYBE YOU ARE SEVERE.. and they better give you whatever you ask for..
SHALLOW BREATHER, OR HAVE TROUBLE EXHALING AGAINST THE PRESSURE..

[ZQuest]

Hello: STS Mark I agreed with Uncle Bob, in my case after the sleep study the doc recomended cpap also ,the one thing that i did mention to the doctor was that i really wanted a very quiet machine since i did not want to disturb my wife's sleep more than i allready was,and she seems to understand.Another point of view that you might bring up to your doctor is that the S9 with climatline system virtually eliminates rainouts another less headache that you dont have to deal with,and help's with your compliance and if your insurance is paying for it the billing codes are the same as a cpap machine.remember you have to wait 5yrs. before your elegible for another machine thru your ins. provider,so really try to explain these thing's to your doc and i hope that he or she will be as understanding as mine..... also if your doc specify that you get the S9 on your scrip that is what you will get and the DME has to provide that for you... i hope that everything work's out for you and Good Luck !! Ps. I believed that the S9 has the lowest noise decibel level in the market........... Super Quiet

[STL Mark]

Thanks to each of you that have replied to this thread and sent me PMs with suggestions.

I called resmed, got the name of dme's in my area that order the autoset. Called the dme's and found out which doctors order the autoset for full time use. Have my appointment set with one of those dr's and cancelled my original sleep study.

Seems that the primary sleep lab in my area only writes for respironics CPAP units. If they can't decide on a setting they on rare occasions write a script for one month of apap use to acquire data for your cpap script. The DMEs get everyone on a 13 month rental with you owning the unit at the end.

Very sad system. Learned much more after about 40 hours of research. Wish me luck.

Will report more later.

[Slinky]

Yes, but, Mark, look at what you have accomplished!!!

... I called resmed, got the name of dme's in my area that order the autoset. Called the dme's and found out which doctors order the autoset for full time use. Have my appointment set with one of those dr's and cancelled my original sleep study. ...

THAT is a lesson every newbie could benefit from.