Remstar M series c-flex VS Remstar Auto

Hi all,
I am a newbie and have only had my permanent machine (Remstar M series with c-flex) for 2 days. Apria had me using an apap during the initial week that they test you to determine your pressure and I had no trouble with it once I got used to it. Now I have the cpap and I don't like it. My sinuses are killing me since I started using it. I called the RT at Apria and left a message saying I wanted to find out what my options are for switiching to an auto and am waiting for a call back. I am a Kaiser patient. I think he is going to tell me that Kaiser only covers cpap but does anyone have any experience/suggestions on what I should tell the RT to make my case for switching machines without me having to pay out mf my own pocket? Kaiser has picked up all costs so far. I feel I was more comfortable before and my sinuses didn't hurt, and I now I have all this congestion. Any suggestions would be appreciated. Thankyou in advance.

I'm not sure, but I think since you're dealing with insurance and a DME, you'd first have to get your doctor to write a new prescription...one specifically for auto-titrating cpap (or autopap) and with a range of pressure -- like 4 - 20 cm H2O, or 6 - 15, whatever the doctor wants to state for the pressure range.

Sometimes there are a ridiculous number of hoops to jump through to get effective, comfortable treatment. I don't really know how easy or how difficult it will be for you to get them (all of them...doctor, DME, insurance) to let you switch back to an autopap. If you're lucky, perhaps just a phone call to the doctor will get it done.

If you were going to buy an autopap for yourself, out of your own pocket, purchasing it online from a cpap supply store like cpap.com, all you'd need is a copy of your original cpap prescription. As long as it had the word "cpap" and a doctor's signature on it, you could choose any autopap or cpap machine you wanted. The Rx wouldn't even have to state a pressure range for you to order an autopap, as an autopap is considered to be a "cpap" machine and autopaps come preset from the factory at 4 - 20. The range can always be changed after the machine arrives.

Hi cinderella,

Here is a link to my experience when I switched my cpap to apap.

viewtopic/t15015/My-Quest-for-Autopap-has-begun.html

RG is right, you need to get the prescription from your doctor that says Auto cpap with Cflex.

You will have less trouble now as your machine is still new. My DME didn't like getting a cpap back that had 1380 hours on it.

I am getting along great with my apap and am waiting for my card reader to arrive. I have it set a 8.5 to 12 right now and will experiment with the upper limit once I get the software going. My titrated pressure is 8 but the new machine seemed a little less on the 8 setting so at 8.5 it seems the same as the previous cpap machine.

Good luck and don't be afraid to go toe to toe.

DerekB

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CPAPopedia Keywords Contained In This Post (Click For Definition): cpap machine, auto cpap, cflex, CPAP, DME, APAP

Thanks for the info! I too am a side and stomach sleeper and I really feel the constant cpap pressure is wrong for me in those different positions. I will take the info I found from your link Derrick and see what I can do. Thanks for all the help....

Through observation (by my wife) of my sleeping position and pressure requirements we've been able to definitely see a correlation between position and needed pressure. My titrated pressure is only 8 anyways... not high at all. When I first got my auto, I saw a few trips up into the 10+ pressure range. So I have my range set at 6 to 11 (2 below and 3 above titrated pressure). I have never seen it hit 11, but it goes down to 6 often and for long periods of time.
My wife says when the pressure is low I'm in the same sleeping position that she noticed I never snored in without CPAP. However, I do roll about some, so when I get out of that position I need more from the auto and it supplies it.
I would be VERY surprised if this same thing were not true in many many people. Where pressure need is related to sleeping position. And while I know there are some people that do great on straight CPAP, my opinion at this time is that the auto gives better therapy to a majority of folks.

I have to agree with yardbird about body positions! My pressure varies from 6 to 10 and I am convinced it has alot to do with what position I am in. (I am a side and back sleeper.)

DerekB wrote: I am getting along great with my apap and am waiting for my card reader to arrive. I have it set a 8.5 to 12 right now and will experiment with the upper limit once I get the software going. My titrated pressure is 8 but the new machine seemed a little less on the 8 setting so at 8.5 it seems the same as the previous cpap machine.

Derek,

Curious as to why you set your minimum on the APAP above your last titrated pressure. Most of us have it set a couple of cms H2O below that number.

Michael

Hi Michael,

I tried it at 6 and it felt like I wasn't getting enough air and my soft tissues were collapsing (just) slightly. I have never used the ramp feature so I guess I was used to the full pressure as I was falling to sleep. The setting is a little higher than my previous (cpap) machine as this machine (apap) feels a little less on the 8 setting so the 8.5 seems to be the same.

Derek

If I had Kaiser I would definitely push for the Autopap. They go cheap in titrations using autopaps then switch you to a cheaper machine. What are the arguments for autopap?

1. Lower overall pressure: if you complain of aerophagia, autopap is the quickest way to relieve it.
2. Positional changes during sleep: PSG's show that if you sleep on your side you have fewer events or require less pressure to stent the airway open.
3. Allergies and frequent weight changes: If you suffer from allergies or have frequent weight changes, the autopap would automatically find the correct pressure every hour.
4. Compliance: Compliance is key, if you are having difficulty using the machine due to cpap pressure, an autopap can improve your compliance rate as it delivers a overall lower pressure.

Complain, complain, complain. If you complain enough about the pressure and items above and they still won't budge then I'd ask about alternative treatments such as dental or surgery. The latter will cost them more money so they may give in and swap out your machine for an autopap. If Kaisers normal procedure is to titrate you on an autopap, they would have a pretty difficult time taking it away from me. The difficult battle you have (as I understand it) you can get a different doctor each visit. At a minimum I would get the doctor to at least write a script so you can obtain it on your own.

Long term the autopap is the best machine to have.