Critique my thinking: do I need a new machine?

I currently own three PRS1 760P machines with 7900, 2100 and 1400 blower hours respectively. They all seem to be in good shape at this point and my therapy seems fairly well dialed in. My AHI averaged 0.78 for last year and while I'm not a very good sleeper I tolerate the 760P well. Only concern I have is Periodic Breathing which can go as high as 4% occasionally but usually hovers in the 0-2% range. Since I have no centrals I don't worry about it too much. (I should add that in an effort to smplify things, I recently tried straight CPAP for a week at pressure 9.5. AHIs were OK but PB jumped up to 8-14%. Still no centrals but I wrote it off as a failed experiment.)

I'm seeing my doc for the first time in 3 years in a couple weeks and since it's been over 5 years I was thinking about trying for a new machine. My reasoning is that I'll likely be morphing over to medicare in the next 6-8 months and I figured that I'd have a better chance getting a new auto bilevel machine with my private insurance than with medicare. Plus, new machines are shiny aren't they?

But on somber reflection, I can think of a bunch of reasons not to get a new machine now:

*Newer versions of either ResMed or Respironics machines may be coming out soon
*I understand from reading here that the newer Dreamstation machines aren't materially different from the older S1 machines anyway, although at some point I'm sure the S1s will slip into obsolescence.
*By the time I pay copays and deductibles against my DME's grossly inflated prices, I can just about pay cash out of pocket when I actually need a machine and come out about the same.
*I hate going through the ritual of being spied on by the DME during the time they and the insurance company own the machine.
*I know my way around my current machines pretty well and am comfortable with them. Only issue I've ever had is trying to set them up to run successfully on auto bipap, and the DME couldn't do it either. Something about the conflict of having to specify pressure support even though you just set parameters for EPAP and IPAP. I'm sure I could get help here if I got serious about it, but fixed pressures of 11/7 work pretty well so I don't worry too much about it.
*My original prescription for this bilevel machine was at pressures of 18/13. There's no guarantee that this doc would even write for a bilevel at 11/7.

There's more, but you get the picture.

Your thoughts would be appreciated.

As far as I know, periodic breathing is not dangerous in and of itself. It is potentially an indicator of underlying health problems, but I don't know that any harm can derive directly from it.

I don't think you need the expense and bother of getting an additional machine. You are getting excellent results, and none of your machines has excessive hours. The expected service life of a machine is 15,000 + hours and even your highest usage machine is just half that. Personally. I say just stay the course, and resist the urge to get yet another device.

TheDuke

+1 TheDuke.

Wait until two of them die, then just buy out of pocket.

+1

old dude wrote: ↑

Sat Jul 21, 2018 8:17 am

three PRS1 760P machines with 7900(2.7 years), 2100*0.71 years) and 1400(0.47 years)

two barely used, one with years left.

old dude wrote: ↑

Sat Jul 21, 2018 8:17 am

Plus, new machines are shiny aren't they?

And there's the crux of it, eh?

How about some white paint on the ones you've got?

old dude wrote: ↑

Sat Jul 21, 2018 8:17 am

*Newer versions of either ResMed or Respironics machines may be coming out soon

There's always some new hotness on the horizon. At some point, you have to say "oh, fine, I'll just stick with 'this'."

old dude wrote: ↑

Sat Jul 21, 2018 8:17 am

*I understand from reading here that the newer Dreamstation machines aren't materially different from the older S1 machines anyway, although at some point I'm sure the S1s will slip into obsolescence.

Yup, same problems (and some new ones), just wrapped in a new skin.

old dude wrote: ↑

Sat Jul 21, 2018 8:17 am

*By the time I pay copays and deductibles against my DME's grossly inflated prices, I can just about pay cash out of pocket when I actually need a machine and come out about the same.

Now, THAT is thinking

old dude wrote: ↑

Sat Jul 21, 2018 8:17 am

*I know my way around my current machines pretty well and am comfortable with them. Only issue I've ever had is trying to set them up to run successfully on auto bipap, and the DME couldn't do it either. Something about the conflict of having to specify pressure support even though you just set parameters for EPAP and IPAP. I'm sure I could get help here if I got serious about it, but fixed pressures of 11/7 work pretty well so I don't worry too much about it.

auto Bilevel setup is easy. I can walk you through setting it up in 2 minutes, just let me know

I am not a good role model. I have lost count of the number of machines I have bought, used, sold but I currently have 3 right now. Would I get a new one...sure I would if the deal was right.
I am a cpap hoarder. Not a good person to ask.
Never have used my insurance though. Always bought privately and paid less than than my co pay with my insurance (Medicare) and no headaches with the DME about getting what I want...when I want it and no big brother watching.

Thanks all, and PR at some point I'll take you up on that.

old dude wrote: ↑

Sat Jul 21, 2018 4:40 pm

Thanks all, and PR at some point I'll take you up on that.

Sure, anytime.

I'm not surprised you had problems, because while it's not at all difficult, it does take a shift in the way you think about the settings, and you may not have had the right info to make that shift.

Your DME being unable to do it is *inexcusable*.

palerider wrote: ↑

Sat Jul 21, 2018 5:12 pm

old dude wrote: ↑

Sat Jul 21, 2018 4:40 pm

Thanks all, and PR at some point I'll take you up on that.

Sure, anytime.

I'm not surprised you had problems, because while it's not at all difficult, it does take a shift in the way you think about the settings, and you may not have had the right info to make that shift.

Your DME being unable to do it is *inexcusable*.

Indeed, but from my experience not atypical.

old dude wrote: ↑

Sat Jul 21, 2018 5:46 pm

palerider wrote: ↑

Sat Jul 21, 2018 5:12 pm

old dude wrote: ↑

Sat Jul 21, 2018 4:40 pm

Thanks all, and PR at some point I'll take you up on that.

Sure, anytime.

I'm not surprised you had problems, because while it's not at all difficult, it does take a shift in the way you think about the settings, and you may not have had the right info to make that shift.

Your DME being unable to do it is *inexcusable*.

Indeed, but from my experience not atypical.

Yours, and many others.