New to CPAP - Advice from experienced users would be welcomed

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
Slobdiddy
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New to CPAP - Advice from experienced users would be welcomed

Post by Slobdiddy » Mon Feb 13, 2023 12:05 am

Apologies for what may turn out to be a slightly lengthy post.

I've had Obstructive Sleep Apnea (coupled with loud snoring) my whole adult life, but when I have been at my fittest and lightest it has mostly been in remission. 8 years ago I was a reasonably OK marathon runner and very fit. Today Im 100lbs heavier and 54. My wife has long suffered my apnea, but since I had Covid before Xmas I have reached new levels of volume and she can no longer stand the noise of my snoring. It's so bad that when my daughter came to stay (in the next-door bedroom), she ended up deciding to sleep in the basement of our house to escape the noise.

So I went to see an ENT doc and he referred me to a CPAP provider for a fitting. Here's my concern and why I'm here for advice:

The CPAP provider stocks only Philips-manufactured goods. At the top of their product list is the DS CPAP Auto which in US terms is around $2,600 (for the machine alone, and so with tubing and mask and the other bits and pieces it's going to end up costing a lot more). I want the absolute best solution for my condition - and will spend whatever it takes - but would rather not invest in all Philips gear and then find out that there are better options out there. I'm a Westerner in Hong Kong and so if I want the best product for my condition then I'm probably going to need to order from the USA or UK - the voltage here is 220 same as in the UK.

I suspect I need a nasal mask as I move around a lot and mostly sleep on my side. I'm also not sure I can tolerate my mouth being covered. However, my apnea is truly awful and so I probably need a really good nasal mask that will enable high pressure if necessary.

My priorities for a CPAP solution are: mask needs to be as light and as small as possible (and I guess able to cope with higher pressures) - only one strap if possible. Machine needs to be super quiet (if possible). Also I see in Philips' literature that they are pushing their humidifiers - are these important and are decent combined CPAP machines and humidifiers available?

Sorry if these are very basic questions and thanks in advance for your help. Product-specific advice would be appreciated.

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Respirator99
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Re: New to CPAP - Advice from experienced users would be welcomed

Post by Respirator99 » Mon Feb 13, 2023 6:40 am

Welcome to the forum.

I just Googled some prices in Hong Kong and they are much higher than in the US or Australia. Even so, US$2,600 for a Dreamstation is very expensive. And a lot of people share your view that Philips should be avoided.

Probably the best machine around for ordinary obstructive sleep apnea (which sounds like your problem) is the Resmed Airsense Autoset - either the Airsense 10 or 11. You can order these online from the US for a LOT less than your local price. Alternatively there are some Chinese machines like the BMC Luna III which would be cheaper again, but perhaps don't have the solid reputation of Resmed. Most of these machines come with the humidifier built in, and not an additional cost. Most machines also have a universal voltage (110 - 240V) power supply, so that shouldn't be a problem for you.
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Sheriff Buford
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Re: New to CPAP - Advice from experienced users would be welcomed

Post by Sheriff Buford » Mon Feb 13, 2023 7:13 am

Look at CPAP.com and see if they can help you. If not, ask them to point you in the direction you need to go. The Resmed Airsense S10 is a good machine and cheaper than the S11. Whatever you purchase when buying a Resmed, stay away from the elite. Cpap.com had a one day sale recently and they had the S10 for $499. Heck, you can't find used ones at that price. The S10's are probably around $850 and the S11 are probably $899. The Resmed S10 is a very good machine so if you want to save a little, so don't hesitate in getting it. Get a Resmed Airsense S10 or S11. There may be some issues shipping the machine internationally, and Cpap can direct you.

You'll also need a prescription. Any type of doctor can write you a prescription (dentist, chiropractor, etc). You can attach your prescription to your account on the cpap.com website.

Sheriff

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Pugsy
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Re: New to CPAP - Advice from experienced users would be welcomed

Post by Pugsy » Mon Feb 13, 2023 7:24 am

Everyone please remember when offering cpap.com as a source for equipment....cpap.com cannot ship ResMed products outside the USA. OP appears to be in Hong Kong. Cpap.com can't send any ResMed products to Hong Kong...not even a ResMed filter.

Now there are ways to work around the restrictions when pushed but it's not as simple.
First there's the RX requirement to get past....what with international RX requirement needs.
Then there's the shipping outside the USA limitation but someone could maybe use one of those re-shipping businesses or if you know someone in the US a product could be shipped to them and then they forward it on out of the country.

cpap.com also cannot ship any Philips Respironics products outside the US.
These shipping restrictions come from the manufacturers.

Hong Kong may also have restrictions on things imported.

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Julie
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Re: New to CPAP - Advice from experienced users would be welcomed

Post by Julie » Mon Feb 13, 2023 8:57 am

I wonder if he could order Resmed from Australia when in HK, without the reservations imposed in ordering from the U.S?

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Pugsy
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Re: New to CPAP - Advice from experienced users would be welcomed

Post by Pugsy » Mon Feb 13, 2023 9:07 am

Julie wrote:
Mon Feb 13, 2023 8:57 am
I wonder if he could order Resmed from Australia when in HK, without the reservations imposed in ordering from the U.S?
I dunno but I doubt it. ResMed enforces the "can't ship outside your country" policy on all the online sellers (places like cpap.com) and then there are the Hong Kong restrictions. Just not long ago someone posted about the restrictions and taxes for importing cpap stuff. It's not an easy hurdle at all.

Of course there is secondwindcpap.com who aren't bound by those restrictions and who won't require a RX for international sales but one has to also check with customs and the importing side of Hong Kong rules/regulations.
There are places in the world where it isn't so easy to just order a cpap machine and have it delivered.
Japan, Spain and Brazil also have some hurdles when importing cpap goods.
The VAT that Hong Kong may add to importing could really eat up any money savings when buying online out of Hong Kong.

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earlvillestu
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Re: New to CPAP - Advice from experienced users would be welcomed

Post by earlvillestu » Mon Feb 13, 2023 10:52 am

Pugsy wrote:
Mon Feb 13, 2023 9:07 am
ResMed enforces the "can't ship outside your country" policy on all the online sellers
Imperfectly, apparently. I bought a new AirSense 11 (with an Rx) from sleeplay.com last May. When I tried to install MyAir I got the message that the serial number of my machine was not supported in the United States. I did not pursue it further, since OSCAR doesn't care about such nonsense, and it renders MyAir essentially useless.

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Pugsy
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Re: New to CPAP - Advice from experienced users would be welcomed

Post by Pugsy » Mon Feb 13, 2023 11:28 am

earlvillestu wrote:
Mon Feb 13, 2023 10:52 am
Pugsy wrote:
Mon Feb 13, 2023 9:07 am
ResMed enforces the "can't ship outside your country" policy on all the online sellers
Imperfectly, apparently. I bought a new AirSense 11 (with an Rx) from sleeplay.com last May. When I tried to install MyAir I got the message that the serial number of my machine was not supported in the United States. I did not pursue it further, since OSCAR doesn't care about such nonsense, and it renders MyAir essentially useless.
There are always people willing to "break" the rules or heck, maybe they don't have the same rules because it depends on if they are buying from ResMed and have signed the contract with ResMed that prohibits shipping outside the domicile of the seller.

That contract impacts the wholesale price that these places pay for the ResMed products or might even affect how the seller can even get ResMed products to sale.

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If you want to try the Eclipse mask and want a special promo code to get a little off the price...send me a private message.

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Miss Emerita
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Re: New to CPAP - Advice from experienced users would be welcomed

Post by Miss Emerita » Mon Feb 13, 2023 12:42 pm

You also asked about masks. If you breathe through your nose during the day, you can try a ResMed P10 nasal pillow mask, which is as minimal as a regular mask can be. Get one with the fit pack, which includes small, medium, and large pillows so you can try them all.

Another option, if you can get regular supplies for it in Hong Kong, is the Bleep mask, which has no straps. Instead, it has "ports" that stick onto your nose. You attach the rest of the mask to the ports. The old-style Bleep, which I prefer, has plastic ports that you click the mask onto. The new-style Bleep has a magnetized attachment.

If you tend to breathe through your mouth during the day, you'll need a full-face mask, which inevitably will have more headgear.
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Re: New to CPAP - Advice from experienced users would be welcomed

Post by Janknitz » Mon Feb 13, 2023 2:18 pm

Suggest you do some research to find out if ResMed machines can legally be obtained directly in Hong Kong or shipped there from the US or Australia.

If you cannot buy locally, perhaps you can find someone to ship you a used machine from those countries, but be aware that you have to get it through your customs in Hong Kong and pay any duties or other taxes owed. Or, if you can travel to a country where they are available, that's another option.

Respironics machines are not as good (and pay attention to the recall issue) but it's better than continuing to let your apnea go untreated. Snoring is one thing, what is happening to your body from untreated apnea is quite another. Sometimes you have to let go of the perfect and accept the good to avoid bigger problems in the end. Your wife has been putting up with your snoring for years. Sounds like it's your turn to tolerate a few more decibels of sound from a CPAP rather than let your apnea remain untreated.
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zonker
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Re: New to CPAP - Advice from experienced users would be welcomed

Post by zonker » Mon Feb 13, 2023 2:46 pm

want to follow up on what miss e said regarding the p10 mask. i would suggest you go to cpap.com, NOT to buy but to look at masks there. there is a bewildering array of masks. seeing them there might give you an idea of just want you may want.

also, they have some reviews of the masks so you could maybe get some idea of what people like or don't like about a particular product.

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Respirator99
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Re: New to CPAP - Advice from experienced users would be welcomed

Post by Respirator99 » Mon Feb 13, 2023 7:57 pm

Sleeplay.com will sell outside the US as (I believe) will 1800CPAP.com.

If you are a member of SleepHQ community you can get a coupon to purchase an Airsense 10 Autoset from Sleeplay for US$499. Definitely worth looking into, and the saving would more than pay for a SleepHQ subscription.
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Slobdiddy
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Re: New to CPAP - Advice from experienced users would be welcomed

Post by Slobdiddy » Tue Feb 14, 2023 12:54 am

This is absolutely brilliant advice - thanks so much to you all!!

Buying from the US is no problem as I have a freight forwarder. However, I have found an advert locally for the "RESMED AIRCURVE 10 VAUTO" on sale at USD1375 locally. Looks the same as the one for USD1776 on cpap.com. Is there an older model of this same machine with the same name or is it likely to be the same one as on cpap.com? Looks like it has lots of features so if you guys on the forum think it's a good model then I will buy it.

Now for the next question, which is what else do I need? Is this just tubing , mask and a cleaner? (And are these all a standard fitting and so can I use different manufacturers for the mask and machine?). I would like a mask that is lightweight, comfortable, and able to deliver enough pressure for a very loud snorer. Again product specific recommendations would be awesome if that's ok.

Once I have all the kit, I promise to post an update on whether my forum-assisted approach has been a success!

Slobdiddy
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Re: New to CPAP - Advice from experienced users would be welcomed

Post by Slobdiddy » Tue Feb 14, 2023 1:17 am

Thanks to Miss E and Zonker - P10 and no mask Beep approach looks good.

But as someone who moves around a lot at night, I can see that a solution with the tubing plugging in at the top of the head may make sense. Would the Philip's DreamWear Nasal CPAP Mask with Headgear be the lightest solution that has a top-of-head attachment? Would this work with the Resmed CPAP machine?

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Respirator99
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Re: New to CPAP - Advice from experienced users would be welcomed

Post by Respirator99 » Tue Feb 14, 2023 4:03 am

The Resmed VAuto operates similarly to the Autoset, though there are some important differences. The Autoset will vary the pressure (within preset limits) throughout the night, adapting to your changing needs. There is a setting called EPR - exhale pressure relief - which lowers the pressure slightly as you exhale. Many people find this improves their comfort considerably. On the VAuto, the machine again varies pressure as required. The exhale pressure is called EPAP and the inhale pressure is IPAP. The difference between EPAP and IPAP is called pressure support (PS). EPAP + PS = IPAP. This is the biggest difference - on the Autoset, EPR is limited to 3 cmH2O. while on the VAuto it can be up to 10 cm. The VAuto has a number of secondary settings relating to the timing and shape of the flow curve. For ordinary obstructive sleep apnea the Airsense 10 Autoset is perfect for most people. The VAuto gives additional options, mainly for people who need higher pressures. Unless you have any indication that the more sophisticated machine is required, then the Autoset should be sufficient. And it's a lot lower cost.

Generally speaking, masks are interchangeable between different types of machine. Eg you can use a Philips mask on a Resmed machine or a Resmed mask on a Philips machine. The exceptions are some small travel machines which have specific masks.

Hoses come in two types - standard and heated. In general, standard hoses will fit all masks and machines. Heated hoses are specific to the make & model of machine and are not interchangeable. The heated hose prevents condensation, which can cause water to blow into the mask - an unpleasant sensation also referred to as "rainout". Your machine should come with a hose in the kit, but check with your supplier.

Regarding cleaning, soap & water is all you need. Do NOT get an ozone or UV "cleaner" - they are a waste of money and may void the warranty on your equipment.
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