Just Diagnosed

[nonsleeper]

GM! And i say that happily as I just completed my first overnight stay with the CPAP machine! I can't believe I am up at this hour with less than 7 hours of sleep and feel great! I'm hoping you seasoned sleep apnea members can give me some advice. My sleep apnea clinic has said I HAVE to get my machine from them but I can get any type of mask i want. I've seen tons of posts about different machines and I want to make sure I get a really good one, but am confused about what I really need in one. I have allergies and in the winter my sinuses get REALLY dry and i usually HAVE to use a warm air humidifier every night. Any suggestions? Do I HAVE to buy the sleep centers machine? And if so, what are the types of questions i should ask about it? The sleep center says Respironic (?) is the best and that's the one they sell. Any input would be greatly appreciated as I haven't purchased the machine yet!
thanks in advance for all input from a confused newly diagnosed patient!
nonsleeper

[cflame1]

If you end up with a Respironics... get either a Phillips Respironics System One Auto with AFLEX
https://www.cpap.com/cpap-machine/respi ... -flex.html

or

PR System One REMstar Pro CPAP Machine with C-Flex Plus
https://www.cpap.com/cpap-machine/respi ... -plus.html

and make sure that you get a humidifier with it.

[Pugsy]

Ask the sleep center exactly which model of Respironics machine they supply. If it is the same as I use, it is great machine. All depends on the model supplied.

Read This to start education.
http://maskarrayed.wordpress.com/what-y ... me-part-i/

[jimnsc]

You have the option to "buy" your own equipment out-of pocket as I did. If you do get their machine tell them you want a "data capable" machine so you can track your own progress and ask "what" data it will give you.

Didn't see you had posted until I hit "submit," Pugsy, or I would have just gone back to sleep.

[bayourest]

Also, be sure you get clear information about the "any mask you want" part. From what I have read here, nearly everyone goes through more than one mask before they find the best fit and solution. It's like buying shoes. It is my understanding that you have 30 days to try out and return/exchange masks. Masks are not cheap and the provider should have some insurance or agreement with the manufacturer regarding this. The medical supplies company should tell you this up front. Mine only admitted it after I pointedly asked (3 masks later). I would never have known had it not been for this forum.

[AndyCelt]

Glad you found this forum before getting a machine. I did not, but fortunately it looks like a good "data capable" machine. You are going to want to monitor your own data to see how you are doing.

Best of luck to you as you start treatment.

[robysue]

Janknitz has a great blog with lots of useful information that you need to know BEFORE you start talking with the DME and BEFORE you accept delivery on any CPAP machine. Her blog is at: What you need to know before you meet your DME

Unless you are covered by an HMO, it seems highly unlikely that the sleep center can dictate to you which DME you must use. So contact your INSURANCE company or your HMO before signing any paperwork at the DME the sleep center is insisting that you use.

Important Information About the Four Most Commonly Used Brands of CPAP/APAP Machines

NOTE: The information about the DeVilbiss IntelliPAPs is VERY INCOMPLETE since I have not had a chance to fully edit this since adding them to the lists in the first part of the post. I have not yet had a chance to write anything about their on-board data, their software (including the SmartCode), or their data card (and the need for an add-on "module". If there are any DeVilbiss users out there who can add this information to this thread, please write a response so I can add it to this post.

For the four most common brands of xPAP equipment here's what you need to know about their most RECENT lines of machines:

• Full Efficacy Data Machines:
  • Resmed: The S9 Elite CPAP with EPR and the S9 AutoSet CPAP
  • Resprionics: The System One REMstar Pro CPAP with C-Flex Plus and the System One REMstar Auto CPAP with A-Flex
  • Fisher & Paykel: The Icon Premo CPAP and the Icon Auto CPAP
  • DeVilbiss: The IntelliPAP Standard Plus with SmartFlex and the IntelliPAP AutoAdjust with SmartFlex

• Only Compliance Data Machines:
  • Resmed: The S9 Escape CPAP with EPR and the S9 Auto Escape CPAP
  • Resprionics: The System One REMstar Plus CPAP with C-Flex and the System One REMstar DS150 CPAP
  • Fisher & Paykel: The Icon Novo
  • DeVilbiss: The IntelliPAP Standard

Important Notes:

1) It is best to hold out for a full efficacy data machine right from the start. As soon as you accept a brick that records only compliance data, you will have a mess on your hands if you later try to upgrade it to a full efficacy data machine. So if a DME contacts you (because the sleep doctor's office sent the script) and makes an appointment to set up the equipment and then shows up with a compliance-only brick of a CPAP, REFUSE delivery of the machine. Yes, they will tell you, "This is exactly what the doctor ordered." But YOU are paying for the machine (through your co-pay and your insurance company's money) and you are under NO obligation to "accept" a machine that you believe will be detrimental to your health in the long run. Politely inform them that you will only accept <fill in list of machines that you find acceptable> and that if they are unwilling or unable to provide you with such a machine, you will take your business to a different DME.

2) The naming of two of the Resprionics System One straight CPAPs is particularly confusing:

• The System One REMstar Pro CPAP with C-Flex Plus IS a full data machine, but
• The System One REMstar Plus CPAP with C-Flex IS NOT a full data machine.

3) Technically the Resmed Auto Escape is not quite a "only compliance data" machine because it does give a minimum amount of data beyond the number of hours used. But not enough additional data for it to be considered a full data machine. If the choice is between the S9 Elite and the S9 Auto Escape, you're better off with the Elite in my humble opinion.

4) On-board Data: Each brand of machine has its own select set of data can be viewed directly off the machine's LCD. The Resmed S9 AutoSet and Elite have by far the best on-board LCD data of any of these machines since their LCDs will let you see all of the following: AHI, AI, CAI (from which you can easily compute OAI and HI); 95% Unintentional Leak rate; 95% Pressure Setting (AutoSet only); and hours used (of course). You can also easily change the reporting period from 1 day to 1 week to 1 month to 3 months and more. The on-board data for the Resprionics System One machines is limited to 7 and 30 averages for AHI (not broken down by type) and 7 and 30 averages for "Percentage time spent in Large Leak." That Large Leak data is useless in my humble opinion----in part because Resprionics leaves the definition of Large Leak undefined and in part because a Large Leak has to last an awfully long time to show up in a 7-day average (let alone a 30-day average). I've used both an S9 AutoSet and a System One BiPAP Auto so I know those machines really well and speak from direct experience. I am not directly experienced with the F&P Icons, but as near as I can tell (based on information in other apnea forums that I read), the on-board data for the Icon has the following data: 1, 7, and 30 day figures for AHI (but not broken down into type), leak rate, and the 90% pressure level and SenseAwake stats for the Icon Auto.

5) Software:The S9 needs ResScan, which can be downloaded for free once you know where to find it. (Search for posts from a forum member named Uncle_Bob since he keeps a link to the ResScan download in his signature.) The System One needs Encore Viewer (which can be purchased for $100 from a variety of on-line cpap supply stores) or Encore Pro (which is sold to DMEs and doctor's offices, but not patients). If you really want Encore Pro, there are torrent sites from where it can be downloaded. There are also two forum members who are in the process of writing free software for analyzing the System One data: Cpapdork's Onkor program is a web-based program that does not require installing anything on your machine; jedimark's SleepyHead can be downloaded as an .exe file for a windows machine and the source code is available for those who want to try to compile it on other platforms. Both Onkor and SleepyHead are still in the early stages of development, so there are still bugs that the authors know they have to work on eliminating, but both programs can usefully provide some meaningful information to the System One users who cannot or do not want to pay for Encore Viewer. The Icon uses InfoSmart, which appears to be aimed at clinics and sleep doctor offices. I have no information about how a user might find and install the InfoSmart software for their Icon machine.

6) Data cards: The S9 and the System One both use standard SD cards for the data. The Icon uses a SmartStick.

[nonsleeper]

WOW!!! Thank you all soo much for the information! I can see I have a lot to read up on and think about! I greatly appreciate the input ya'll have given and am going to start researching what you've suggested! Especially now that i have all this energy and won't need a nap today!