HELP !!! - CPAP Machine Question

cpapjack · Post by **cpapjack** » Tue Jun 06, 2006 2:52 pm

How in the world could I convince my Dr. or equipment provider to get me a new Remstar Pro M Series w/CFlex machine or an APAP machine for that matter? When I went to my equipment provider, I wsn't even given an option of machines. He just brought out the Remstar Plus M Series w/CFlex for me. Granted it's a nice machine and it seems to be working well for me, but who knows, maybe an APAP or some other machine might work better. I also want to be able to monitor my therapy using the Encore Pro software, and my current machine only displays compliance data, not the good stuff that the Dr.s get to see. My insurance covers me 100% and I've only been CPAP'ing it for about 3 1/2 weeks now.

chrisp · Post by **chrisp** » Tue Jun 06, 2006 3:00 pm

Just get a Rx for a cpap and order online from .......cpap.com ! Or billmyinsurance.com.

:twis ted:

cpapjack · Post by **cpapjack** » Tue Jun 06, 2006 3:08 pm

That's not an option as I need to rely on my insurance to pay for this. I'm not in a position to purchase anything myslef or I would.

Moogy · Post by **Moogy** » Tue Jun 06, 2006 3:27 pm

cpapjack wrote:That's not an option as I need to rely on my insurance to pay for this. I'm not in a position to purchase anything myslef or I would.

billmyinsurance can handle insurance reimbursement from many different companies. Check out their link on the main page of this site at https://www.cpap.com .

Moogy

jkeene · Post by **jkeene** » Tue Jun 06, 2006 7:20 pm

As far as getting a different prescription from your doctor, try going in and having a conversation about your sleep as an informed consumer. With an open minded doctor it can really work. Learn about the various symptoms of a CPAP not working precisely right, see which ones you have, and make your case.

I went to my doctor a month ago looking to make some changes, either to an APAP or a BiLevel. We talked about my still having some daytime sleepiness, but a great improvement in things like blood pressure and short term memory. I brought up uncomfortable aerophagia, and he looked over my sleep study again, noticing my titration pressure was only from when I was sleeping on my side. He seemed to surmise higher pressure would be suitable, and I walked out with a prescription for BiPAP 12/8. He asked me to call his office back in a month to let them know how I was doing with it.

But I burned away a month trying to get it from my in-network DME (Apria), only to find out they only rent Bi-levels, never converting to purchase. Not wanting to eat through my large deductible every year on a permanent rental, I finally bought one out of network, and am playing reimbursement roulette with the insurance company. I sure haven't lost any sleep over it, though, because the last three nights have been on a very comfortable BiPAP Auto.

Trying to be reasonable and informed worked quite well with the doctor. Didn't get me anywhere with the DME.

Good luck in your quest.

cpapjack · Post by **cpapjack** » Fri Jun 09, 2006 12:55 pm

Well, I did it. I had a follow up appointment with my Dr. yesterday and convinced him to write me a script for a different machine. He had no problem doing so. But when I called my DME to tell them this, of course they gave me the run around saying that I don't need another machine, yada, yada, yada. Who are they to tell me what I need or don't need? Anyways, after fighting with a number of people there, they finally gave in and ordered me a Respironics M Series Pro. Now I know that that's pretty much the same machine I have now, but I want it for the simple fact that I can get the Encore Pro software and monitor my therapy on my own!! I'm so excited I can't wait.

Guest · Post by **Guest** » Fri Jun 09, 2006 3:21 pm

jkeene,
How are you doing now that you are on bipap. My md has said if I am still having aerophagia when I come back June 13, that he will write me a script for bipap. And I am still having trouble. Also, I don't feel really well, like every one seems to and hopefully this may make a difference. Has it made much difference for you? With my apap, my 90 percent pressure is usually between 16 and 20. So even tho I was titrated at 14, my pressure seems to be higher usually. Do you feel better on bipap auto than on your cpap or were you on auto before? Do you sleep much better? Is the aerophagia better and exhaling much easier? My Remstar Auto is already paid for so I will rent to own the Bipap, if I get it and just would like to know how someone else is doing that has tried both. I really am not looking forward to having to purchase another machine but if it will make things better, I am willing. I have never gotten that surge of energy that so many folks seem to have. And I would really like to feel good again if possible.

Thanks for any input.

elliejose · Post by **elliejose** » Fri Jun 09, 2006 3:23 pm

Sorry, didn't notice that i wasn't logged in. The above post is mine.

jkeene · Post by **jkeene** » Fri Jun 09, 2006 3:45 pm

Better, although I was going to wait for a full week to consider daily variations. Note that I was on a basic Remstar Plus before, not an APAP. Had a couple really good nights so far, AHI of 2.8 on one of them. Had a cough that got nipped in the bud when the BiPAP sent the pressure up fairly far to stop apneas. Aerophagia is much reduced, even though the occasional pressure is higher, and even the 90% IPAP is higher, the EPAP is generally quite lower than the old CPAP level. Used to be even a good aerophagia day on CPAP I felt discomfort until noon. On BiPAP a bad day has discomfort for 30 minutes top.

More later.

elliejose · Post by **elliejose** » Fri Jun 09, 2006 3:56 pm

Thanks j,

sounds good, especially the AHI. My AHI is seldom less than 9 - 12. I have had a few nights on the 420ae with AHI less than 5 but on those nights I also had a valium before bed and felt lousy the next day. Without the valium AHI is also higher on 420ae. What mask do you use? Please keep me posted. I am very interested to hear if you continue to feel better. Or what problems you may encounter. Wonder if it is worth the cost, but I guess I can't really know for myself unless I try it.

NightHawkeye · Post by **NightHawkeye** » Fri Jun 09, 2006 5:30 pm

elliejose wrote:Do you feel better on bipap auto than on your cpap or were you on auto before? Do you sleep much better? Is the aerophagia better and exhaling much easier?

Elliejose, I switched over from the Remstar-auto to the BiPAP-auto about six weeks ago specifically because of aerophagia, and for me it has made a difference. It reduced the aerophagia so much that I also was able to go to fixed pressures as well, which reduced my apnea index to about half of what it had been. Maybe what I notice the most though is that I no longer have to get up during the night. Just looking back through my data, I see that over the past three weeks, I've only gotten up at night three times and haven't gotten up one single time over the past eight days.

Of course, I also started using Poligrip-strips to stop mouth breathing a few weeks ago too, so some of the success may be from that, but not the success with aerophagia. If you have anywhere near the success I have had you'll be extremely glad you changed machines.

Regards,
Bill

Guest · Post by **Guest** » Fri Jun 09, 2006 7:34 pm

Thanks, NightHawkeye,

Positive results are always good to hear. I am apprehensive about switching, but since I do not feel well and still have high AHIs, I am ready to try it. It surely is good to know someone is getting good results from switching. So if he doesn't give me the Bipap Auto, I should probably ask for it? I have been using the Poligrip strips for about a month now myself. And it works great to keep the mouth closed. My problem with my mouth now seems to be that some way I create a vacuum with my tongue and clinch my teeth and still wind up with aching jaws and a very dry mouth. Not sure how to stop this. I wear an appliance for TMJ that pulls my jaw forward, but still wake biting down very hard. Thanks for the encouragement.

elliejose · Post by **elliejose** » Fri Jun 09, 2006 7:49 pm

Uh Oh! Not logged in again! Sorry!

NightHawkeye · Post by **NightHawkeye** » Fri Jun 09, 2006 8:12 pm

elliejose wrote:Positive results are always good to hear. I am apprehensive about switching, but since I do not feel well and still have high AHIs, I am ready to try it. It surely is good to know someone is getting good results from switching. So if he doesn't give me the Bipap Auto, I should probably ask for it?

It's a good machine, Elliejose. Feature-for-feature, it can't be beat. Plus, it's priced like a lot of the other BiPAP machines. Would it be the best for you? Beats me, but I sure recommend you consider it. If it weren't for the auto mode, the choice would be harder. Maybe you'll use auto, maybe you won't. I don't, but I did for a while. It kinda sounds like the BiPAP-auto is a favorite for physicians to prescribe these days, so I doubt you'll have any problems getting one. I guess the DME's aren't complaining about it.

Hope your therapy gets to working better for you, Elliejose.

Regards,
Bill

jkeene · Post by **jkeene** » Fri Jun 09, 2006 8:20 pm

One thing I did notice is what some other users have mentioned, a really long breath can get an early flip done to it partway through. I found this was uncomfortable with a low minimum EPAP of 6. Boosted it to 7 the next night, then 8 the night after. No longer felt that I was trying to drag the machine inside out through the hose when the flip occurred early.

Also noticed that I need to kick up the humidifier one notch using the BiPAP. Not precisely sure why, but I suspect it is because of the greater volume of air flowing when the machine is trying to respond to an apnea.

A third oddity, but it's only one data point so far, is that my low AHI night, of 2.8, occured after I had a rather large cup of coffee at 7:30pm. Usually I switch over to exclusively decaf after 2pm, but was feeling adventurous that evening. Slept great, may try to repeat it.

Further reflecting on the low aerophagia, it's only been six nights on the machine, but every day has been better than any of the best on straight CPAP.

HELP !!! - CPAP Machine Question

HELP !!! - CPAP Machine Question

Changed to BiPAP

Couple more notes about the BiPAP Auto