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Good points, Guest who wrote " A lot of doctors write prescriptions for specific machines for any number of reasons."

I agree about all the things you mentioned. But even regarding those points, it may often be a matter of which rep gets to them first or does the best job convincing them (regardless of facts) as to which brand and/or type of machine is "better." Busy doctors with "sleep" as a sideline probably aren't really researching info about xpap machines themselves.

Suggestions by brick and mortar DMEs (very much befriended lately by resmed's internet policies) are also likely influencing many docs since a lot of doctors would probably rather leave the nuts and bolts of the treatment completely up to the DME.

[quote="Wulfman"]Interestingly, my sleep doc put "w/C-Flex" on MY prescription.....which would have narrowed my selection down to Respironics machines. Other than that, he didn't specify a machine brand or model. At this point, I'm sort of glad he did because I wouldn't want to be tied to a ResMad machine (yes, I misspelled it on purpose).

It is interesting about these prescriptions. When I saw the doctor and he wrote a prescription for the month of auto-pap, I told him I wanted one with C-Flex. He said he didn't think auto-paps had the C-Flex, but I was prepared with a printout of the RemStar Auto and showed it to him. He wrote the prescription with that on it. However, the DME loaned me the ResMed Vantage. Maybe they choose to use that as a generic term, like Kleenex for tissues. Since I am not paying for this month of data collection, I did not complain.

I don't think I want the Vantage machine permanently. I don't like the limitation to just those masks, for example. I also do not like to be controlled or manipulated by someone's choices for equipment which I am purchasing. If I felt it to be the best machine for the treatment, I suppose I would have to consider it.

My son goes to the same doctor and will receive his prescription in a few days. One of us will report what is written, but the DME has already told him they plan to furnish him the ResMed machine. He is prepared to ask for something else or deal with a purchase as he has $1000 deductible and may have to have a 10 month rental. That would hit again in January. My son and I had our sleep studies done in different places, so that may show if all of them have the same company thing going.

I will let you know.

Catnapper,

I don't know if any of the preceeding posts have mentioned it, but the Vantage (Auto) does not have EPR in Auto mode, while (as you showed your doctor) the REMstar Auto does have C-Flex in auto mode. To get EPR from a Vantage, it has to be set in single pressure mode (CPAP).

From a financial standpoint (deductibles), it would be advantageous to get your insurance provider to pay for whatever machine you and your son decide to get before the end of your insurance calendar year and the new deductibles kick in again.

Best wishes,

Den

[quote="Catnapper"]Thanks for the replies. I will try to answer.
I had no central or mixed apneas, and I think that is a good sign. One less thing to worry about.

The PLM Index was 103 before CPAP and 22.2 with CPAP. I had no idea I was dancing all night. The graph of that is pretty energetic looking. No wonder I was tired. That may indeed be the reason I am still waking up so frequently. I will be sure to bring that up when I have the follow-up appointment. Are there other effects from that medication?

As to machines, the Vantage is strictly a loaner. It will go back as well. The way that worked out is that I continue to pay rent on the Escape and they let me use the Vantage for free because the doctor wrote a prescription for using it to get more data. I was told by the RT that there is no outright purchase because I had heard from the insurance company that buying was cheaper than renting. I am glad I did not press to buy that machine. I would be stuck with it. Maybe being ignorant came in handy that time. I will press the issue now to see if straight purchase is an option,

One of my problems is that I want everything the minute I realize I want it. No patience here. I have seen improvements. I am very happy to be able to see the reduction in AHI because that surely means I am making progress, and most likely have improved the O2 saturation, although I have no way to test that. I would not have that info using the first machine either.

My prescription says: Referral for Home Medical Equipment.
Diagnosis: Obstructive Sleep Anea Syndrome
Mode of Therapy: ResMed Escape S8 or Elite.
(Does that mean I am restricted to those machines? )
It goes on to list the pressure settings, mask, ramp, humidification, and a chinstrap.
So far I have not needed the chinstrap.

I appreciate the responses I have received. Great insights and suggestions. I am so glad I finally decided to post. I am not usually shy. Thanks again.

Catnapper

Snoredog wrote:Script written for a particular brand of machine means he/she hasn't written a script before or wants to ensure his golfing buddy DME gets the business.

Or, it could be any one of the other things listed in the earlier post:

A lot of doctors write prescriptions for specific machines for any number of reasons. Some of them are just more comfortable or familiar with certain machines, some docs simply don't like certain units. Some docs feel very strongly one way or the other on the cflex/epr arguments. Some doctors simply want as many patients as possible on a specific machine for ease of tracking change. I think a lot of docs - just like everyone here - just flat out have a favorite machine.
And then yeah I'm sure some are called on by reps and get extolled on the virtues on one machine over the other.

Or hell, it could be something else entirely that no one has thought of. Who really knows? I'm an eternal optimist though so it's a pretty steep order to get me to buy into conspiracy theories though. Regardless I have a feeling the truth is generally somewhere in the middle.

Catnapper, Go for the auto CPAP and if the doc insists, he can write the prescription for a fixed pressure. Then you can change it to auto later.

Hi Newbie,
Welcome to this wonderful forum. I was issued a resmed elite and then switched to the resmed s8 vantage.........I agree with previous posters that have been here alot longer and know alot more than i do. tomorrow I am ordering the remstar auto the resmed is too aggressive for me and I did have central events on my sleep study. Now i will have to eat the out of pocket but it will be worth it in the end.. my dr, didn't know the difference in machines, she has a resmed elite and loves it......I am going to take care of my osa with my new machine, software and help from everyone here.........good luck your on the right road, I wish I had taken it before i got locked in with a machine that doesn't work for me