Test Results and More..

[SleepyEyes21]

Hello All - at my doc visit yesterday, I did receive my in-home apnea test results. Here is some info from it, although I have no idea what it all means yet, other than I do have "moderate sleep apnea."

[Report Info: Total Recording and Analyzed Sleep Time = 355 minutes; Total Number of Apneas - 19; Average Apnea (sec) - 19; Apnea Index - 3.2; Apnea Max Dens. Index (>10 Min): 30.77
Total Number of Hypopneas - 168; Average Hypopnea (sec)-24; Hypopnea Index - 28.4; RDI (AHI) Max Dens. Index (>10 Min): 98.46; RDI (AHI) - 31.6
Apnea Analysis Summary: Total of 19 apneas and 168 hypopneas were identified; the Apnea Index was 3.2 per hour; the RDI (AHI) was 31.6 per hour; Note: During some portions of the recording, (for a period>10 Min) the Apnea Index was elevated up to 30.77 and the RDI (AHI) was elevated up to 98.46.
Predicted Initial Pressure is 7 cm H2O; Evidence of Moderate Sleep Apnea.]

So - here are my doc's comments about the report: " ...you have slight apnea...you could benefit from CPAP...the hypopneas and apneas have nothing to do with each other...the hypopneas are not serious..."

When I asked him to write the script for a particular machine, he refused, saying "Your insurance will not cover it...I will not write for a specific machine because the DME may not have it, and then I'll have to write another prescription..." When I explained the difference between straight CPAP and Auto CPAP, and told him I wanted auto CPAP, he said, " I don't want you to have it...a CPAP machine will take care of your apnea..."
However, in the end he did concede, and put in my machine preference in the 'Comments' section of the order.

He gave me a script for "cpap supplies", with my preferred machine in the Comments section. He would not write any specifics for a mask.

(Before anyone tells me to 'change doctors,' here is part of the problem: I have HMO insurance, and every doctor on this plan in my county either has already dropped the coverage or is not taking new patients until January 2015. I have called all of the docs on the provider list, so I know there are no other PCP options with this insurance for 2014. Trust me - I will NEVER have this kind of insurance again, and plan to 'end it' with this doc as soon as possible.)

Okay - from doc's office, on to the local DME that had indicated they had used ResMeds and PR's earlier in the week. Turns out, neither of the machine brands with model I am looking for, are in used inventory with this DME currently. RT was very nice and very helpful though, and spent the better part of an hour with me, explaining things and letting me try machines and Airfit F10 mask. LOVED the fit and feel of F10 mask (if you can love them )- very light, not very intrusive in my opinion - very impressed with that 'piece' of the CPAP puzzle.

Machine first tried was a PR (not sure of model #) though I know it was straight CPAP - not auto. RT put pressure at 7 and let me try. Have to say I am somewhat shocked because I was expecting a fairly forceful blow of air into my mouth and nose, and that didn't happen. Machine came on upon first breath inhale and I felt no exhale pressure against air coming in. I am wondering if the pressure of 7 is enough to keep my airway open when sleeping, as I didn't feel any 'force' at all. RT did say that if I felt CPAP wasn't working at 7, I can ask doc to up pressure.

Second machine was a ResMed -and yes, PR, it WAS the dreaded Escape , so of course I knew that was a 'no go' for me. I noticed while trying it, that the air flow seemed somewhat more 'pressurized' than the PR, although the set pressure was a 7 for both tries. Feeling that, I am leaning ever more so towards the PR S1 Auto CPAP.

Finally - headed home and on to more searching for that elusive PR 560 or 550. Now I am getting really confused with machine models and labels. I am seeing PR S1 Auto CPAPS, but with words like 'Pro,' 'Plus,' or 'SE' in label. I have no idea if these are what I want, or if they will do what I am expecting out of a 560 or 550. Can someone please post info or point me in right direction to figure out all these differences?

I found a Remstar Auto AFlex on secondwind last night. Remstar is part of the PR label, right? The info I found on AFlex put me off - it sounds like AFlex will measure what average pressure I have for 30 days, then stay at that one pressure afterwards. I do not want that- I want a Flex type (CFlex?) that will adjust to my pressure needs on any given night. Does anyone know if this AFlex is a function that can be turned off on this machine?

Many thanks for all of your continued help!

[palerider]

Finally - headed home and on to more searching for that elusive PR 560 or 550. Now I am getting really confused with machine models and labels. I am seeing PR S1 Auto CPAPS, but with words like 'Pro,' 'Plus,' or 'SE' in label. I have no idea if these are what I want, or if they will do what I am expecting out of a 560 or 550. Can someone please post info or point me in right direction to figure out all these differences?

I found a Remstar Auto AFlex on secondwind last night. Remstar is part of the PR label, right? The info I found on AFlex put me off - it sounds like AFlex will measure what average pressure I have for 30 days, then stay at that one pressure afterwards. I do not want that- I want a Flex type (CFlex?) that will adjust to my pressure needs on any given night. Does anyone know if this AFlex is a function that can be turned off on this machine?

Many thanks for all of your continued help!

just focus on the 560 if you want a respironics, that's the system one, 60 series, auto. anything with pro, or se, you don't want, and plus is like escape, escape from the plus, .. or the escape

respironics has very confusing names. they like to stick 'cflex, aflex, biflex on things, as if you could get an auto without aflex. it's like saying "buy our new car, WITH WHEELS!" as if they offered a model that doesn't have wheels.

respironics has stuck 'remstar' on their machines for many many years, it means nothing, more product marketing people twiddling with things

no aflex is the same flex 'easy breathing' thing that respironics puts on most everything, if it's on a cpap, they call it cflex, if it's on an apap, then it's aflex, if it's on a bipap, it's biflex.

you're thinking about 'auto-trial' which is sort of like a home sleep study, where it adjusts itself for a few days and then goes into cpap mode, and checks you every now and then for changes. it's optional on the 560 auto.

[SleepyEyes21]

just focus on the 560 if you want a respironics, that's the system one, 60 series, auto. anything with pro, or se, you don't want, and plus is like escape, escape from the plus, .. or the escape

respironics has very confusing names. they like to stick 'cflex, aflex, biflex on things, as if you could get an auto without aflex. it's like saying "buy our new car, WITH WHEELS!" as if they offered a model that doesn't have wheels.

respironics has stuck 'remstar' on their machines for many many years, it means nothing, more product marketing people twiddling with things

no aflex is the same flex 'easy breathing' thing that respironics puts on most everything, if it's on a cpap, they call it cflex, if it's on an apap, then it's aflex, if it's on a bipap, it's biflex.

you're thinking about 'auto-trial' which is sort of like a home sleep study, where it adjusts itself for a few days and then goes into cpap mode, and checks you every now and then for changes. it's optional on the 560 auto.[/quote]

PR- thanks so much for all the info! I was just reading the specs on a PR S1 Auto with Aflex (from a link in another user's post), and the specs say that this machine comes with all 3 Flexes - A, C, and C+. Not sure if that's really the case, but if the 560 auto-trial thing can be turned off - great!! I am trying to make this purchase soon, so I can start treatment by sometime next week. I don't think I can reach secondwind on the weekends, so will have to wait til Monday to talk with someone. Will keep all posted.

Thanks again!

[palerider]

PR- thanks so much for all the info! I was just reading the specs on a PR S1 Auto with Aflex (from a link in another user's post), and the specs say that this machine comes with all 3 Flexes - A, C, and C+. Not sure if that's really the case, but if the 560 auto-trial thing can be turned off - great!! I am trying to make this purchase soon, so I can start treatment by sometime next week. I don't think I can reach secondwind on the weekends, so will have to wait til Monday to talk with someone. Will keep all posted.

Thanks again!

here's what it says in the manual about flex.

The REMstar Auto A-Flex device offers the following optional Flex comfort features:
• C-Flex – Provides pressure relief upon exhalation to improve comfort based on your needs.
• A-Flex/C-Flex+ – Provides pressure relief taking place at the end of inhalation and at the start of exhalation to
improve comfort based on your needs. When providing Auto-CPAP or Auto-Trial therapy, this comfort feature is
called A-Flex. When providing CPAP or CPAP-Check therapy, this comfort feature is called C-Flex+.

so, mainly, it's marketing confusion and calling what's basically the same thing different names and more of that sticking 'remstar' and x-flex on everything

that's one of the minor nitpicky reasons that I like resmed, less confusing names. you want an auto? autoset. not the 'Resmed grand poobah s9 whoopteedoo autoset with epr and sleek lines" as the official name... verses of course, the "resmed grand poobah s9 whoopteedoo elite with epr and sleek lines" just 's9 autoset'. easier

back when I started trying to figure out what I wanted to look for a few months ago, the respironics names annoyed, and tricked me up somewhat... I guess I still hold a small grudge it is a fine machine though.

[SleepyEyes21]

PR- thanks so much for all the info! I was just reading the specs on a PR S1 Auto with Aflex (from a link in another user's post), and the specs say that this machine comes with all 3 Flexes - A, C, and C+. Not sure if that's really the case, but if the 560 auto-trial thing can be turned off - great!! I am trying to make this purchase soon, so I can start treatment by sometime next week. I don't think I can reach secondwind on the weekends, so will have to wait til Monday to talk with someone. Will keep all posted.

Thanks again!

here's what it says in the manual about flex.

The REMstar Auto A-Flex device offers the following optional Flex comfort features:
• C-Flex – Provides pressure relief upon exhalation to improve comfort based on your needs.
• A-Flex/C-Flex+ – Provides pressure relief taking place at the end of inhalation and at the start of exhalation to
improve comfort based on your needs. When providing Auto-CPAP or Auto-Trial therapy, this comfort feature is
called A-Flex. When providing CPAP or CPAP-Check therapy, this comfort feature is called C-Flex+.

so, mainly, it's marketing confusion and calling what's basically the same thing different names and more of that sticking 'remstar' and x-flex on everything

that's one of the minor nitpicky reasons that I like resmed, less confusing names. you want an auto? autoset. not the 'Resmed grand poobah s9 whoopteedoo autoset with epr and sleek lines" as the official name... verses of course, the "resmed grand poobah s9 whoopteedoo elite with epr and sleek lines" just 's9 autoset'. easier

back when I started trying to figure out what I wanted to look for a few months ago, the respironics names annoyed, and tricked me up somewhat... I guess I still hold a small grudge it is a fine machine though.

LOL!! Too funny Again - thanks for the info. Guess I can 'breathe' a bit easier knowing the manual promises all this with an AFlex.

(I will be glad when this "figuring out the machine part" is over!)

[bwexler]

If you have insurance why are you looking for used machines? Most insurance companies will only pay for new machines. They generally have one code and one price they pay for the cheapest brick all the way up to the S9 Autoset or the new A10 Autoset that just became available last Monday.
You need the list of DMEs your insurance will pay and the answer to the question will they reimburse you if you buy online. Most will not.
In your search just know there are few choices. PRS1 DS560, Resmed S9 Autoset, Resmed A10 Autoset for her.
Just refuse to accept anything else. You can explained you must have a data capable machine and since your requirements are likely to change over time, you require a machine capable of auto titration.

[SleepyEyes21]

If you have insurance why are you looking for used machines? Most insurance companies will only pay for new machines. They generally have one code and one price they pay for the cheapest brick all the way up to the S9 Autoset or the new A10 Autoset that just became available last Monday.
You need the list of DMEs your insurance will pay and the answer to the question will they reimburse you if you buy online. Most will not.
In your search just know there are few choices. PRS1 DS560, Resmed S9 Autoset, Resmed A10 Autoset for her.
Just refuse to accept anything else. You can explained you must have a data capable machine and since your requirements are likely to change over time, you require a machine capable of auto titration.

All good advice, bwexler, and have already done my 'homework' here. Here's why I am purchasing a used machine: I have a very crappy HMO insurance policy. I will definitely NOT have this insurance next year, so any/ all monthly costs & co-pays for a rental will be null & void after 12/14. I do not want a "cheap brick." Neither my insurance nor the DME will tell me which machines are covered under my insurance policy. The DME does not have a local office; I only have an 800 # for them. The DME rep had no idea what the difference is between compliance data and efficacy data capable; if I (the patient) have to educate the DME, why should I trust anything they have to say?

My doc refused to specify a machine type on the script because "insurance won't pay for it." And he's probably right about that, given that it is a crappy HMO. I can't make the man do what he's not going to do. My intention for the past three months has been to merely get tested and start SOME kind of CPAP treatment, because I don't want to risk my health to this any longer than I have to. It has been insane that I have had to fight for three months just to get basic medical care for this, when it is quite a common problem. Although neither my insurance nor the DME could tell me my out of pocket costs to rent a CPAP, I'll bet it could be as much or more for the next 4 months, than what I will pay for a used machine that I want and is not just a 'brick.' And no - my insurance will not reimburse me for online purchases or buying out of pocket (although it's much cheaper for them.)