Yet another newbie question

Part of me has known for some time that I have apnea events, but I've recently decided to address the issue. I did my sleep study a few nights ago, and had 26 or so events per hour (I don't have the report in front of me), loud snoring, and blood-oxygen index of about 91%. Titration resulted in a prescription pressure of 12 cm, with few or no apnea events at that pressure. I used a full-face mask, as I am a mouth-breather.

The DME outfit called yesterday to set up an appointment. I've not set a time yet, due to scheduling problems, but will address that Monday. I'm told that the DME plans to bring me a RESMED Elite (I'm not sure what variant--probably the , with integrated humidifier and a full-face mask (again, I don't have the model name in front of me).

Other factors involved: a) I spend a couple of nights per week away from home, so whatever machine I get should be portable within reason. b) My insurance (PPO) has a $1000 deductible, after which they pay 80% on durable medical equipment or office work or whatever. The sleep study itself will likely take care of that for now, but in two and a half months I'll be facing a new calendar year and a new $1000 deductible. The insurance company is likely to push for a ten-month rental period, after which the machine would be mine (I think), rather than buying me the machine after a one-month period (which seems more reasonable to me--after all, they want to see that I'm going to use it, and I am aware of the compliance chip).

My question: What machine should I push for, and why? I think I can get a different machine than the RESMED Elite if I can support my request.

Thanks in advance for your help!

I think the question is what type of machine vs what brand. Do you want straight cpap which delivers the same designated pressure set by the DME or apap (auto titrating) which can be used as a cpap and auto which will only deliver the pressure that your body is needing. You also have to ask yourself, do you experience any difficulty exhaling at any given pressure. If so, you want to go with something called c-flex, if you choose the auto machine or EPR if you are going to use a machine in straight cpap mode. Both will give you relief so that you can exhale more comfortably. You will see supporters of both different types of machines on here in many, many topics. My belief is that an auto cpap gives you the ability to manage your therapy more than straight cpap. You won't have to back to the sleep lab to be titrated again, everytime your weight flucuates, or any other reason that warrants a return visit. The machine does it for you. Why be stuck at one pressure for the whole night, when your body's needs change through out the night? This of course, is just my opinion.

You might also want to consider if you're interested in monitoring your nightly results to see how well you're being treated so you can adjust the pressure accordingly. If so, you'll want to get a machine that has accompanying software which gives detailed event data. (Not all machines do.) Keep in mind Resmed software is no longer available from U.S. internet suppliers, but is obtainable from your DME. However, your DME might not sell it to you either, because it pretty much eliminates your need to go back to them for future appointments.

I pretty much support guest in that you should consider CPAP vs. APAP.

Another major thing you need to know is something you already are thinking about.

10 month rental with new $1000 deductable come next year.

If you must rent for 10 months you might as well skip the insurance right now with 80% - 20% split as your Jan and Feb payments from a typical Brick and Mortar DME (with no insurance since you haven't made deductable for that year) will probably be more in total than an outright purchase from CPAP.com since the price is much lower than the DME will bill you and your insurance company.

If you can do compliance and buy outright in 3 months, you still get might stuck with January payment (depends on when they bill ahead of the month or behind). If you can squeezed 3 months into this year and are sure that the insurance co will buy after 3 months then the local DME may be the cheapest way to go.

So really look into your insurance before you take anything. YOU look into it, not what your DME says your insurance will cover. Call yourself.

If you decide that due to the time of year and number of rental months required it is not to your financial advantage to use the DME then get your prescription from the doc and copies of your sleep studies (do this no mattter where you decide to buy) and buy from CPAP.com. You can buy any brand CPAP or APAP with the regular CPAP prescription.

One other thing to consider is the recent price action against internet DMEs by Resmed. I, and a number of others are not happy that Resmed is dictating minimum prices in order for internet DMEs to sell their stuff. Some of us choose to boycott their equiptment. You will notice that Resmed prices are higher than Respironics. Don't assume the higher priced machine is necessarily better.

Pricing policy aside, Resmed and Respironics make nice machines. For APAPs though you can only use exhale relief in the straight CPAP mode in the Resmed. CFLEX can be used in CPAP or APAP mode.

You are thinking about the right things. Just don't let the local B and M DME push something at you too quickly.

If you buy online due to price, remember that if you have any medical issues next year that break the deductable, you may want to go get a machine through your insurance at that point. DME shouldn't know you don't have one. Get it and do the compliance/rental and you will have a backup machine for $300 or so.

That last one was me (I thought I was logged in GRRR)

I can't change the last mistake.

I meant to say the DME and Insurance shouldn't know you HAVE a machine already if you choose to use them next year if you use the deductable.....