First-time equipment- is Resmed good quality?

I just got my results from titration, doctor said that I sleep OK when on my sides, but out of 8.6 hrs I spent 2.7 hrs on my back and had respiratory disturbance index of 33.7. So, I got a call today from a home provider medical supply company, wanting to make an appointment for me to pick my equipment up. My health insurance pays 100% for necessary medical devices, so I asked the provider what eqpt to expect. He told me that the doctor prescription says "basic CPAP" with a humidifier, so the guy told me that they will probably supply a Resmed Escape machine w/humidifier. Is this a good machine, should I ask for something different, or? I do a lot of sleeping on my sides, wfor what it's worth, and plan to use a nose-only mask, not a full facemask. Thank-you very much for any helpful advice that you can provide regarding the equipment that they are planning to furnish me and bill my insurance company.

Best advice is to research it, and cpap.com is a good place to do that (so is cpaptalk.com)... make sure that you're getting a data capable machine. One that will record events and not just compliance. Anything less than that if you have a problem, you'll end up back needing another study or having the doc guess at what the problem could be.

Now I'm not getting into which company is better, just advocating for at minimum a data capable machine.

Because I don't use Resmed, I don't always get these right, but there are 3 standard CPAP's for Resmed... which is which, somebody else will have to chime in.

One's the Elite, one's the Escape and one's the Compact (and that's not counting the Auto).

One has full data, one has compliance data only (hours used) and one has no data. The one you want is the full data one (unless you can persuade them to give you the Auto, which is even better).

You'll probably want EPR if you go with Resmed. Respironics calls it CFLEX or AFLEX. It's a pressure relief function, and will make adjustment to the new setup easier, especially if your pressure is higher.

Simple solution....don't sleep on your back. I duct tape a slow pitch softball to the back of my night shirt...keeps me off my back. Unfortunately though I still have some apnea on my side.



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Resmed is one of the leading CPAP manufacturers. I liked my Resmed S8 Elite so well when I decided I wanted a backup xPAP and I wanted an AutoPAP I bought the Resmed S8 AutoSet Vantage. I've never regretted either one.

However, your DME supplier tipped his hand. You do NOT want the Resmed S8 Compact or S8 Escape. You want the Resmed S8 Elite w/EPR. Get a copy of your equipment order (script) from the ordering doctor BEFORE you make the appointment to see the DME supplier. IF the order does state just "a basic CPAP" ask that the order be changed to specify a Resmed S8 Elite. Autos are NICE to have, but they generally aren't necessary.

Most equipment orders are pretty general, leaving it up to the DME supplier which CPAP to provide. CPAPs are billed to insurance by HCPCS (insurance) code. ALL CPAPs from straight, bare-bones, no data to fully data capable autoPAPs are billed and reimbursed at the same rate and the same HCPCS code so the DME supplier makes more profit providing a bare-bones straight CPAP than if they provide a fully data capable autoPAP or anything in between. This DME has already drawn a line in the sand which means you will have a rough time convincing them to provide and Elite and almost no chance of getting them to provide the Vantage autoPAP.

Before making an appointment w/this DME supplier I would also call my insurance company and ask them what local DME suppliers they are contracted with. Hopefully, you will have the option of more than just this one.

I would approach both the doctor and the DME suppliers this way: w/o a fully data capable CPAP your doctor has no way of evaluating your therapy, if you run into problems and adjustments need to be made, w/o that data there is no way of knowing what the problem is and what adjustments need to be made. You are sure your doctor would insist on having the data to KNOW rather than to have to make adjustments by guess or by gosh or by putting you thru another expensive titration study.

If your insurance allows you the option of more than one local DME supplier don't be bashful about approaching the others and even pitting one supplier against the other if necessary to get a fully data capable machine. Another DME supplier may be able to offer a Respironics CPAP instead of a Resmed. Respironics in the other leading CPAP manufacturer. IF they offer a Respironics you would want to insist on the Respironics M Series Pro w/C-Flex. Do NOT accept ANY Respironics w/a Plus in the name, and even w/the Pro you need to insist that it is the M Series Pro. If it is a pre-M Series then it MUST be the Pro II. Another DME supplier might offer a Puritan Bennett and they are a good CPAP also - BUT - again, not all PBs are fully data capable and I'm not sure of the PB models that are fully data capable. Check them out at cpap.com so you know which is. The nice thing about the PB fully data capable xPAPs is that their Silverlining software is easy to purchase if you decide you would want software for yourself. The ONLY drawback to the Puritan Bennetts is that to my knowledge none of them offer any form of expiration pressure relief. This can be important to many patients, especially if they have a fairly high pressure, but a lot of us elect not to use expiration pressure relief so that feature is more important to some than to others.

director373 wrote:I just got my results from titration, doctor said that I sleep OK when on my sides, but out of 8.6 hrs I spent 2.7 hrs on my back and had respiratory disturbance index of 33.7. So, I got a call today from a home provider medical supply company, wanting to make an appointment for me to pick my equipment up. My health insurance pays 100% for necessary medical devices, so I asked the provider what eqpt to expect. He told me that the doctor prescription says "basic CPAP" with a humidifier, so the guy told me that they will probably supply a Resmed Escape machine w/humidifier. Is this a good machine, should I ask for something different, or? I do a lot of sleeping on my sides, wfor what it's worth, and plan to use a nose-only mask, not a full facemask. Thank-you very much for any helpful advice that you can provide regarding the equipment that they are planning to furnish me and bill my insurance company.

Ask them for a better machine ... if they give you ANY excuses, tell them you are not interested in doing business with them and that you will find another DME that is more cooperative.

Demand (not ask), that you be given an APAP machine ... your cost is the same regardless and an APAP can be set to CPAP pressure if that is what works best for you.

The business of xPAP equipment often leaves the uninformed and/or sleep deprived to become financial victims for some DMEs.

Best of luck.

I would get a Respironics m Series with A-Flex machine.

Get a Resmed machine and you can have warranty problems, if you have a problem with your current DME (many do) and you go to another DME who is not a Resmed dealer they will void your machine warranty.

Respironics will honor your warranty no matter what DME you go to.

There was a thread on that very thing just the other day.

I have a Respironics Remstar Pro M series w/HH CPAP only. I also have a ResMed S8 Autoset with H3i HH. I like the S8 the best as it seems to be more accurate in keeping the settings intact day after day. The Remstar Pro is an ok machine but not up to the standards of the ResMed. JMHO. jim

The Resmed Escape machine w/humidifier. Is a good machine, no matter what others are telling you. I have this machine and it is perfect. Who needs data to read every day when you can tell when you wake up in the morning if the machine is working for you or not!!! LOL! It is quiet and operates as it should --a straight CPAP. My pressure is only a 7 --not sure what yours is----but you can make up your own mind which one you'd like best for your health.

Carrie

Get a machine that has enough options (including breathing relief), records nightly data and the software that interprets it so you can tell how your therapy is doing. The easiest to understand is the Respironics software.

Respironics has all their eggs in one basket with the Auto with A-Flex.

At some point, you're going to wonder how your therapy is working and if your machine doesn't have the capabilities to tell you.....the next options get very expensive.


Den

Any machine with a humidifier is better than nothing but I agree with Slinky.
I have a ResMed Elite S8 and I really like it. Even without the software and card you have access to lots of information on how your therapy is working.

director373 wrote:My health insurance pays 100% for necessary medical devices, so I asked the provider what eqpt to expect. He told me that the doctor prescription says "basic CPAP" with a humidifier, so the guy told me that they will probably supply a Resmed Escape machine w/humidifier. Is this a good machine, should I ask for something different, or?

The "Escape" is a very basic cpap machine. Blows one straight pressure all the time, with no pressure relief feature to make exhaling easier. Also doesn't have a feature to provide "efficacy" data about your treated AHI, leaks, etc., in the machine's LCD window.

If I had to accept a resmed machine and it had to be a straight cpap, I'd want at least the Elite, which does have both those features.

With your great insurance coverage, I'd shop around among DMEs (home health care stores) in your area. You might find that the providers your insurance will accept for reimbursement purposes are many. They all want your business, so you have the upper hand for the moment. When they get your name on the dotted line, things can change.

You might also want to check with your insurance company to see if they would reimburse should you decide to buy your equipment from an online DME, like cpap.com. If so, your choices widen considerably since an Rx that has the word "cpap" on it is also good for buying an "autopap" if you so chose.

Personally, if I were going to get a straight cpap machine, it would be:

Respironics M series Pro with C-Flex
Puritan Bennett 420G
resmed Elite with EPR

I prefer autopaps, since they are two machines in one...can be used an an autopap varying the pressure as needed, or can be used as a straight cpap machine if that suits you better.

To buy an autopap online, all the Rx has to say is "cpap."
To buy an autopap from a bricks and mortar DME, you'd need to get your doctor to change the prescription to "autopap" and state a range of pressures (like 6 - 15 cm H2O.)

The autopap I'd want is:

Respironics REMstar Auto with A-Flex M series.
I'd not get the integrated humidifier for an M series machine.
Instead, I'd get the separate Fisher & Paykel HC 150 heated humidifier. Works great with any brand/model of machine.

Resmed use to be the best.
No more
Something happened to weaken them the past two years. First the online price increases. Why attack the uninsured if you care about the patients?
The Liberty is the first time I have ever seen Resmed knock off a product (the Hybrid, which came from the little Innomed/Respcare family and is a better product) and with the huge recall of the S8's along with the easy breakage of the Liberty and Quatro masks, put's them behind Respironics now is my book.
Some even say the Bravo is as good or better than the Swift II (at 87.00, no less) and it will be interesting to see what the CPAP.com product challange shows. It's great how CPAP.com brings these new products out for everyone to see there are alternatives to price controlling companies like Resmed.

neverbetter wrote:Resmed use to be the best.
No more
Something happened to weaken them the past two years. ... The Liberty is the first time I have ever seen Resmed knock off a product ... and with the huge recall of the S8's along with the easy breakage of the Liberty and Quatro masks, put's them behind Respironics now is my book.

This is misleading. Respironics has had their share of Recalls and their M Series humidifer tank leak was just the latest. In addition the M Series humidifier is still its weak leak. It is poorly designed. Resmed's masks have generally been the largest selling masks. There isn't a mask out there that hasn't been a disaster for some users. Masks are an intensely individual item.

Snoredog wrote: ... Get a Resmed machine and you can have warranty problems, if you have a problem with your current DME (many do) and you go to another DME who is not a Resmed dealer they will void your machine warranty.

Respironics will honor your warranty no matter what DME you go to.

There was a thread on that very thing just the other day.

Another rather misleading statement. The post Snoredog is referring to is thread that "I" started. ONE online CPAP manufacturer made the statement that Resmed would not honor their warranty under that circumstance. That online DME has since removed that remark from their website. If you go to the Resmed website and READ their recent policy change (01 Oct 06) there is no such threat. Furthermore, personal experience SINCE that policy change, IF a local DME supplier for whatever reason will not handle a warranty problem, Resmed will see to it that it is taken care of anyway.

Wulfman wrote: Get a machine that has enough options (including breathing relief), records nightly data and the software that interprets it so you can tell how your therapy is doing. The easiest to understand is the Respironics software. ...

Well, just as beauty is in the eye of the beholder, so isn't the understanding of data provided by the Resmed and Respironics software. Frankly, having used both the EncorePro w/MyEncore software AND the Resmed AutoScan and ResScan software I find the Resmed software data easier to grasp and understand and it CERTAINLY was easier for a non-nerd such as myself to install and use!

There is a definite bias in this forum to the Respironics xPAPs. Many of us, including myself, resent that recent (01 Oct 06) marketing decision but it appears to be paying off for them since we are finding more and more Resmed users in the forum. Which I, for one, am glad to see. Hopefully there will be a more balanced assessment of xPAP brands in the future. There are very few Puritan Bennett xPAP users here, but those that have them LOVE them.

Frankly, all three brands are excellent xPAPs and each has their strongpoint and each has their weakpoint.

You have to go to an autoPAP before Respironics' strongpoint becomes apparent: their A-Flex available in both straight CPAP "and" auto modes. Their weakpoint is their humidifier tank design.

Resmed's strongpoint is their easy to access efficacy and usage data via their easy to read, good size LCD screen. A simple button press. Versus the unplugging/plugging, button press of the Respironics access.

Puritan Bennett's strongpoint is their easy to use Silverlining software. Their weakpoint is the lack of expiration pressure relief in any of their xPAPs.

All three brands provide excellent basic CPAP therapy.

There is a lot of stress here on autoPAPs and they definitely have their advantages, moreso for some than for others. I purchased one out of pocket. And since autoPAPs are more expensive than straight CPAPs it makes sense if the opportunity is there to have your insurance pay for the autoPAP and if you opt at a later date to self-purchase a backup xPAP, you can save yourself some money by purchasing just a full data capable CPAP. Frankly, if you are going to encounter one huge battle to get an autoPAP I don't think it is worth the battle. Just my opinion.

IF one has good insurance coverage w/little or no copay, AND you have the option of a good local DME supplier I don't agree w/the popular recommendation to buy online. There are definite advantages to having a GOOD local DME supplier ESPECIALLY for first-time xPAP users. I say that having excellent insurance coverage and encountering a BAD local DME supplier at first and then finding a GOOD local DME supplier.

I will reiterate that the current local DME supplier sounds dubious. I have NEVER heard of an equipment order stating "basic" CPAP. I strongly question that remark by this DME supplier and would most definitely want a copy of the actual equipment order in my possession to see for myself. I'm willing to bet the price of a data card there is NO specific reference to a "basic" CPAP in your equipment order. I would definitely check w/your insurance to find if you have the option of several, or at least one other, local DME supplier.

Good luck and Happy PAPping!

Just goingoff of personal experience here, so take it as you wish. If I were you, I would either get the ResMed s8 elite or the Autoset Vantage. Whatever you do, don't let them give you an s8 Compact. It's a low-end machine, which is fine for some. But in my experiences is not made with the same quality as their higher end machines. I did a two-week trial with the Autoset Vantage and then was switched to the Compact. I was so displeased that I made aramgments to have the machines switched out the very next day. This is more dificult than refusing the machine in the first place would have been. If the DME folks want to come to your house to set it up, make sure you have already worked out what machine they will be bringing with them beforehand and make it clear that you will not accept a machine that does not meet with your satisfaction.

Hope you don't have as much trouble as I did!

Slinky wrote:Frankly, having used both the EncorePro w/MyEncore software AND the Resmed AutoScan and ResScan software I find the Resmed software data easier to grasp and understand and it CERTAINLY was easier for a non-nerd such as myself to install and use!

I'm as non-nerdy as can be. I've used the software extensively from all three major manufacturers.

Silverlining (Puritan Bennett) is my favorite. Encore Pro is a very close second. Even easier is the EncoreViewer software that patients can buy now (replaced Encore Pro as far as being able to buy it.) EncoreViewer is a piece of cake, both to install and to understand, and gives all the detailed therapy data that Encore Pro gave.

The most unhelpful software, imho, was resmed's Autoscan. It's a good thing resmed made averages available in the LCD window because the confusing way their Autoscan software marks hypopnea info on the nightly details graph was pitiful. If averages are all a person wants to see, the resmed LCD is fine. But if a person wants to really see the details about their treatment, Respironics EncoreViewer software and Puritan Bennett's Silverlining software are the way to go...again, imho.

Slinky wrote:You have to go to an autoPAP before Respironics' strongpoint becomes apparent: their A-Flex available in both straight CPAP "and" auto modes.

As was their C-Flex in earlier autopaps. Pressure relief during exhalation while being able to use an autopap in auto mode is no small consideration for many people. So far, Respironics is still the only manufacturer that offers any kind of exhalation pressure relief (C-Flex and A-Flex) in an autopap working in auto-titrating mode.

Slinky wrote:Their weakpoint is their humidifier tank design.

I agree that the M series humidifier is very weak. Fortunately people can choose to get a great standalone humidifier (F&P HC 150) to work with any machine. The resmed H2i humidifiers I used were weak, too...imho. Barely could heat the water at all. Had to use the highest heat setting to get the same amount of heated humidification that any of the other brands' humidifiers put out at the midpoint heat setting.

Slinky wrote:Resmed's strongpoint is their easy to access efficacy and usage data via their easy to read, good size LCD screen.

I agree there. Respironics definitely missed the boat by presenting only weekly and monthly averages shown on their LCD, and not including the overnight one-night info.

Slinky wrote:A simple button press. Versus the unplugging/plugging, button press of the Respironics access.

If you're talking about how to see the averages in the LCD window, you don't have to unplug/plug the Respironics machines to access that info. Button pushing is all it takes to view the averages in the LCD window with Respironics' machines too.

If you're talking about accessing the therapy setup menu (clinical menu) yes, it's more convenient to hold down a couple of buttons without the unplug/plug in routine.

However, if preventing accidental access to the clinical menu is of any importance at all, the Respironics routine is safer, imho. I can picture a child playing around pressing buttons and accidentally holding down the two right on top that get into resmed machines' setup menu. Accidental access would be almost impossible for a child to do with a Respironics machine since the two buttons have to be held down while the machine is being plugged in. It's pretty unlikely a child would accidentally get into a Puritan Bennett machine's clinical menu either.

Slinky wrote:All three brands provide excellent basic CPAP therapy.

I agree there...absolutely!

Slinky wrote:There is a lot of stress here on autoPAPs and they definitely have their advantages, moreso for some than for others. I purchased one out of pocket. And since autoPAPs are more expensive than straight CPAPs it makes sense if the opportunity is there to have your insurance pay for the autoPAP

In agreement again. I'd add that much of the leaning toward autopaps here is because of their versatility. Two machines in one, since any autopap can be used as a straight cpap.

Slinky wrote:Frankly, if you are going to encounter one huge battle to get an autoPAP I don't think it is worth the battle. Just my opinion.

In my opinion, it is worth the battle to try to get an autopap. Again...it's two machines in one.

Slinky wrote:IF one has good insurance coverage w/little or no copay, AND you have the option of a good local DME supplier I don't agree w/the popular recommendation to buy online.

Two big "if's" there that have to both be in place at the same time. As you said..."AND." But yes, "if" both those IF's are there, the local DME is fine.

Slinky wrote:I will reiterate that the current local DME supplier sounds dubious. I have NEVER heard of an equipment order stating "basic" CPAP. I strongly question that remark by this DME supplier and would most definitely want a copy of the actual equipment order in my possession to see for myself. I'm willing to bet the price of a data card there is NO specific reference to a "basic" CPAP in your equipment order.

I agree. Most likely the prescription (the doctor's order) doesn't have the word "basic" anywhere on it. I'd say that's the DME's idea of what an Rx for "cpap" means because that's what the DME wants to give you...one of their least expensive models...to maximize their profit.

Slinky wrote: I would definitely check w/your insurance to find if you have the option of several, or at least one other, local DME supplier.

Excellent advice!!!