Changing settings (UPDATED WITH SLEEPYHEAD DATA)

I know there are no absolutes but generally speaking and based on personal experience, has anyone changed the settings on their machine and then had insurance refuse to pay?

I just figured out it is even possible to change my settings but I haven't messed them for fear of my insurance nailing me for "non-compliance" or something like that. My BiPAP pressures are 24/20 and I have huge problems with leaking, even with a mask liner/pad and half the time I have zero events and the other half of the time I have less than one event per hour. My sleep clinic said they have authority to change it and they seemed to agree that it might be beneficial for me but it's a co-pay every time I go there and I would like to just slowly lower my pressure by one every week or two and monitor my own treatment.

Any comments or suggestions?

As long as you use the machine the required number of hours/days...the insurance could care less what changes you make. It's your therapy...do what works for you.

Most insurance companies only care about the usage hours, and will not check details.
If your commercial driving license is considered, somebody may check efficacy.
Unless you are in Europe and your provider is a control freak, it should not be an issue.

corwin1968 wrote: My sleep clinic said they have authority to change it and they seemed to agree that it might be beneficial for me but it's a co-pay every time I go there and I would like to just slowly lower my pressure by one every week or two and monitor my own treatment.

Any comments or suggestions?

Do you have a modem on your machine? Have you asked the folks at the sleep center to download your reports and make the adjustments electronically? Not that you can't make the changes yourself but it's another option.

corwin1968 wrote:I know there are no absolutes but generally speaking and based on personal experience, has anyone changed the settings on their machine and then had insurance refuse to pay?

I just figured out it is even possible to change my settings but I haven't messed them for fear of my insurance nailing me for "non-compliance" or something like that. My BiPAP pressures are 24/20 and I have huge problems with leaking, even with a mask liner/pad and half the time I have zero events and the other half of the time I have less than one event per hour. My sleep clinic said they have authority to change it and they seemed to agree that it might be beneficial for me but it's a co-pay every time I go there and I would like to just slowly lower my pressure by one every week or two and monitor my own treatment.

Any comments or suggestions?

Mine was a little different situation. I bought my initial equipment out of pocket (from CPAP.COM) and then my insurance provider reimbursed me, so there was not an issue of proving compliance.
My prescribed pressure was so high I couldn't sleep well and had lots of leakage........so, I reset the pressure to something I could start out with to get used to the therapy. Fortunately, the pressure I picked also treated me very well.

But, I agree with some of the others. Change your pressure to something reasonably therapeutic to get started with your therapy and monitor the results with software. They shouldn't give you any "static" as long as you're using it.


Den

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At this point, I'm a bit confused as to who I should contact about changing the settings, at least until my 60 day insurance compliance check. I got the BiPAP machine from one company, it was prescribed by a sleep specialist/pulmonologist and now I go to a sleep center as well. I guess I need to figure that out.

I got curious today and calculated my 14 day AHI average (all that MyAir stores and I'm too lazy to pull the memory card). My initial sleep study was an AHI of 115. Now my 14 day AHI average is .07 Yes, that is two decimal places. A bunch of goose eggs, several .2's and a couple of .1's over the course of 14 days.

corwin1968 wrote: My BiPAP pressures are 24/20 and I have huge problems with leaking

corwin1968 wrote:Now my 14 day AHI average is .07 Yes, that is two decimal places. A bunch of goose eggs, several .2's and a couple of .1's over the course of 14 days.

People with pressures that high and the kind of problems you are having can benefit the most from using Sleepyhead software.

If your leak levels really are high, your AHI numbers may not be that good. At high leak, the machine cannot detect all breathing events.

Good luck.

corwin1968 wrote:At this point, I'm a bit confused as to who I should contact about changing the settings, at least until my 60 day insurance compliance check. I got the BiPAP machine from one company, it was prescribed by a sleep specialist/pulmonologist and now I go to a sleep center as well. I guess I need to figure that out.

I got curious today and calculated my 14 day AHI average (all that MyAir stores and I'm too lazy to pull the memory card). My initial sleep study was an AHI of 115. Now my 14 day AHI average is .07 Yes, that is two decimal places. A bunch of goose eggs, several .2's and a couple of .1's over the course of 14 days.

If you're not pulling your memory card to monitor your therapy, it might be a good idea to contact whichever doctor will be monitoring it (who is your follow up care scheduled with?) The DME where you got the machine is not authorized to make changes without a doctor's prescription but depending on your follow up care, it could be either the sleep specialist who prescribed it or the doctor at the sleep center who can send a script to the DME to have the settings changed electronically. If the original prescriber is not going to do the follow up, call the sleep center, but if the sleep center is just helping with technical issues as opposed to a doctor who can prescribe, go back to the prescribing doctor.

The Choker wrote:
If your leak levels really are high, your AHI numbers may not be that good. At high leak, the machine cannot detect all breathing events.

Good luck.

Like The Choker said, if you're only looking at the one number (AHI), you're not really monitoring your therapy and don't know what is really happening (the AHI won't be accurate if you're having high leak rates). While many on this board successfully monitor their therapy and make changes themselves to meet their needs, making those changes yourself without knowing more about how your therapy is working may not be the best idea.

I don't mean offense, but if as you say, you are too lazy to remove the card and monitor your therapy thoroughly, it might be best to leave it to the professionals.

My comment about being too lazy to pull the card was just in reference to my spur-of-the-moment decision to calculate my AHI average. If pulling the card to monitor is preferable to just reading the machine's readout, I have no problem with doing that. But, at this time I don't have the knowledge to do that so I'm posting my stats page reflecting 41 days of therapy. My large leaks are only in comparison to before when no leaks were registering at all. I think they are still low and the two most recent columns reflect leakage since I got the mask liner.

From what I see here (kinda hard to see and when I click on it to enlarge it imgur is down for maintenance so I can't see clearly) leaks are NOT excessive so leaks aren't an issue in terms of maybe being so big that the AHI data is invalid....at least on what is shown here.

Now that's not to say that leaks aren't causing a problem waking you up but they aren't big enough to hugely impact therapy or the data you see.

You have included graphs that aren't really needed...we only need the usual stuff on the left side and on the right side these graphs.
Events
Flow rate
Pressure
Leak

I would think the AHI is valid and if you wanted to reduce the pressure a little that you have some wiggle room to do it without causing much of an increase in OAs.

It is something you can do yourself if you are comfortable doing it...if you want the DME to do it then you will have to get the doctor to okay the change or get the DME to ask the doctor to change it.