Newbie needs advice

I'm a newbie (both to sleep apnea treatment and boards/forums -- have never participated in one so I'll need some advice if I'm not doing this correctly. Thanks for your patience.

I've read so many of your posts and find this to be so helpful and informative -- a great place to visit.

I'm seeing the tech. this Thursday to be set up with my machine. I've been told I will be prescribed the REMstar Plus M CPAP and don't know what type of face mask I'll get. Does anyone have suggestions to offer before I see the tech? I'm feeling a little overwhelmed with all the info/details of treating sleep apnea -- ASAPs vs. CSAPs; type of breathing mask, etc. Is there really a lot of trouble with nose and skin drying out and what do you suggest about that? I'm suppose to rent a machine for the first 3 months until we find out what works best; then I will purchase (my insurance co will allow this approach).

I would greatly appreciate any advice you can offer to a newbie -- there's lots to learn but I feel a certain degree of excitement in getting my energy up, eliminating my morning headaches, and dreaming again. My husband is excited about eliminating the loud buzz-saw snoring (most unattractive!) and the leg jerking during the night -- his sleep is probably worse than mine!

Anyway, thanks in advance.

Hello Cathy

Yes you posted correctly, do not worry.

There is also a chat, which is live time. On the left hand side where you see Chatting Live. If you click there you will see people talking.

Cathy you are not prescribe a machine unless it is a bi level machine or an auto machine. An auto can be bought online with a CPAP Rx.

Advice you need to know.

Make sure you have an original copy of your Rx for CPAP with the name CPAP on it.

Get a copy of your sleep study.

Get a copy of your titration study.

Make sure you get a heated humidifier to help with drying of the nasal passages.

The plus machine only collets complinat data, no other info.

The REMstar Plus M CPAP, is the low end machine it doesn't see any useful data, if you want to take charge of your treatment, you want a better machine. The one they are trying to put you on, makes them the most profit.

Hi Cathy,

Welcome to the forum!
I had also never participated in a forum till this one......looks like you're doing fine.
Yes, it IS kind of overwhelming with all of this new terminology and dealing with all of the doctors, insurance, Durable Medical Equipment suppliers, etc.

Have you gone to the "lightbulb" (above) and done some reading yet? There's lots of information there.

As far as machines go, try your darndest to get a machine that records nightly sleep statistics to a Smartcard (like the Respironics machines) and for which you can get the software to monitor your therapy. The "M Series Plus" won't record the detailed information. I'd suggest (strongly) twisting their arms for the REMstar M Series Pro or the REMstar M Series Auto. They're going to charge your insurance for the same amount of money anyway, so you might as well get the best you can get. They're going to push the cheapest machine on you because they'll make more profit from it.

It's YOUR therapy! (not theirs)

Best wishes,

Den

Hi Cathy,

I'm new to all this stuff too and have learned a lot on this forum. I'm local in Denver and am curious about what/who you're dealing with. From what I understand a humidifier is key here in the arid climate. Other folks will have a lot to say about APAP vs. CPAP, smart cards, and so forth. Don't let the alphabet soup overwhelm you.

Are you dealing with Alpha Sleep Diagnostics? I can also tell you about my experiences dealing with them and their lab manager, and would be glad to compare notes, and help strategize on how to get the better deal for managing our care, rather than letting the Durable Medical Equipment vendor (DME) do it.

One BIG thing I've learned here is that our (the patient community) best interest and the medical industry's interests are not the same so we've got to fight them to get what we need, not let them provide what will get them the best profit.

--Andy

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CPAPopedia Keywords Contained In This Post (Click For Definition): humidifier, CPAP, APAP

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CPAPopedia Keywords Contained In This Post (Click For Definition): humidifier, CPAP, APAP

ColoZZZ wrote:Hi Cathy,

Are you dealing with Alpha Sleep Diagnostics?

Thanks so much for your encouragement and help. I am dealing with National Jewish Medical Sleep Center. I"m going to call them and inquire about flexibility re medical equipment. I've been very pleased so far; the sleep study went well and seemed very thorough and I really like the MD.

I'm learning a lot and tend, by nature to be proactive about my health. I hope by Thursday I'm well informed and know that this forum will be the place to be and read.

Thanks again

Cathy

My goodness! I was so surprised to get responses from so many of you. Thank you for putting the bug in my ear about not getting pushed around about the equipment I end up with. I'm going to call my physician's office today for the sleep study report and a copy of the prescription. Hopefully, I"ll find out more at that time as I inquire about the exact details of the equipment they are prescribing -- don't want to go without a smart card, even if I have to pick up the extra $$$'s.

Again, thank you all. I'm learning so much!

Cathy

[quote="SelfSeeker"]Hello Cathy

Get a copy of your titration study.

/quote]

Thanks for the advice. What is a titration study? I must have had one!

I'll try my hand at this question:

The titration study is a sleep study where the sleep lab puts you on a CPAP for the entire night and monitors your sleep while they gradually increase (titrate) the CPAP pressure to figure our what your proper pressure setting should be. The result then goes to your Dr. who uses it to write the prescription for a CPAP machine. In my case this was done after a "split-night" study during which I was evaluated half the night without, then half the night with, a CPAP.

Also, from what I understand, in addition to our testing results, we patients want to get the ORIGINAL prescription rather than a copy. CPAP veterens please correct me if I'm incorrect about that.

--A

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[quote="ColoZZZ"]
we patients want to get the ORIGINAL prescription rather than a copy. CPAP veterens please correct me if I'm incorrect about that./quote]

Thanks for that clarification.

--C.

To add to the other posters.

As long as you have your script and copies of sleep studies you can go anywhere in network for your insurance if you choose to use your insurance.

If you don't care about insurance you can go anywhere period with this documentation.

If you buy online CPAP script will buy APAP (not at local DME)
Get the script to specify heated humidifier and any features you need. That way the DME can't argue.

I assume that your doc faxed your prescription somewhere he chose? You can indeed go there or move on elsewhere.

Really depends on your insurance benefits. If they are good you will probably want to work with a local DME. If the copay and deductable adds up to a large amount you may want to purchase oneline cash. Only you will know that.

You mention the 3 month rental. That is typical for insurance companies. They want to know that you are actually using the machine before they buy.

Doesn't matter to them that they are paying much more for this than by reimbursing an online purchases.

I agree that you should get a machine that records data at the minimum. I personally vote for APAP as it can help you avoid futured titration studies easier than the plain data recording CPAP machines, but the data recording machine can also do this, just with more itterations and tweaking. If your pressure is high, then an apap is very useful for comfort. However, these machines are hard to get the insurance to approve and the DME to give due to the fact that the DME makes more profit on the base model machines because the insurance pays the same for both. Some insurance companies (mine included) insist that they are deluxe machines and won't cover. However in reality, the bill is submitted E0601 and they pay it (in my case) since it is the same billing code. APAP can be set as CPAP but not vice versa.

So that said, research the types of machines on our host's web site and decide what is important to you. Exhale relief, size, auto altitude adjustment, data, etc and jot the prices down (so you know which machine is more expensive than which). The prices won't hold at a local DME, but will tell you when they are trying to shovel a cheap basic machine at you.

Between brands you can't use this comparison as ResMed artificially inflates prices online. ALso they don't sell their software to patients anymore. So just because a respironics machine is cheaper on cpap.com than a equivilantly configured Resmed machine it doesn't mean the Resmed is necessarily better because it costs more.

Go Thurs and listen to the DME. But go informed and don't be scared to walk out if they don't give what you want. Call your insurance co tomorrow and get a list of all the DMEs that are in network. Gives you leverage to at least get the data recording machine.

Don't believe the DME if they say "this is what your insurance company approves" or "no one use an auto as their normal machine" May not be so.

Watch carefully as the DME sets up the machine if you are getting it and make sure he does it correctly. Any questions ask them here. My machine was incorrectly set up. Who knows if yours will be

Be aware that once you start billing with a DME it may become harder to go elsewhere.

Get everything that should come with the machine. Both types of filters if your machine takes more than one, extra washer for the humidifier connection if it comes with one. All the parts to your mask (for example if you have swift pillows there should be 3 sizes) etc.

Will be hard to get both manuals. Give it a try but if you fail others here can help you on that (one contains info on adjusting your machine)

Good luck, be prepared, and be strong.

Denver Cathy,

As a side note, you mentioned your hubby will be glad for the leg jerking to be eliminated. Once you are on cpap treatment, ask him if your leg movements have stopped. Most often leg movements are a part of your body's struggle to awaken and breathe during periods of apnea, and are resolved with cpap treatment. If your hubby says you are still jerking, compare what the diagnostic study and the titration study say about limb movements. Some people have Restless Leg Syndrome (RLS) or Periodic Limb Movement Disorder (PLMD) in addition to sleep apnea. But if hubby says you no longer jerk, don't give it another thought.

Cincy Kathy

snoregirl--

Thank you for taking the time to give me so much info (the insurance co.suggestions are especially helpful -- will call today). From everything everyone has replied back to me, it sounds like I should be prepared to walk out without a machine on Thursday if they don't have what I want -- should have joined in this forum 2 weeks ago. The md "ordered" my equipment the day of our follow-up when I learned that "yes, indeed, I definitely have sleep apnea." I had 40 episodes an hour at my sleep study! I will be getting a copy of both my sleep study and my titration study -- something another generous forum member suggested yesterday. The md told me I would rent it (through insurance) for 3 months before buying so that I could return it for a different machine if I don't like it. Sounds legit. Am I being suckered? I'm proactive with my physicians but it's easier to be so if I am prepared and know what I'm doing. I will make some calls today to insurance and DME cos as suggested. All of the info I getting from you and others helps me be "armed" when I see my doc Thurs.

Thanks again to you and to others on the forum for responding to my plea for help -- it's the pits being a newbie to all of this; a bit overwhelming. The encouragement is so helpful! I clearly have the benefit now of some buddies to help me through these (and probably other) early hurdles -- small ones, no doubt, in the whole scheme of things, but nonetheless still hurdles.

Cathy

[quote="kteague"]compare what the diagnostic study and the titration study say about limb movements. Some people have Restless Leg Syndrome (RLS) or Periodic Limb Movement Disorder (PLMD) in addition to sleep apnea.
Cincy Kathy /quote]

Dear Kathy,

Great suggestion! Yet another good reason for getting a copy of both my diagnostics study and titration study. He will tell me, I'm sure, if I continue to awaken him! He's a dear; doesn't complain; just wants me to be healthy!

This is soooooo helpful -- everyone has been just great and I feel so lucky to have found this great group of people!

Many thanks,

Cathy

PS: Since I'm newbie to forums, too, and don't quite know what to do, how do I respond to someone's post without doing the "quote" thing -- do I hit the "quote" button but then erase the whole message? Just a little snag in my abilities here!

Thanks again!

[quote="SelfSeeker"
Advice you need to know./quote]

Thank you for taking the time to respond to my shout out for help. I appreciate your good advice and have started a list of questions for my insurance co and md because of all the helpful posts. Everyone's been great!

Cathy