DOC WOULD NOT PRESCRIBE AUTO C-FLEX

Is this true ? - do doctors really charge $500/month to rent out a machine that can be bought for the same price from cpap.com ?

This is worrisome. If this is what your doctor charges then it seems plausible that such a doctor might become seduced by the value of the treatment rather that the value to the patient.

I haven't gotten the bill yet, but that's what my insurance said the sleep clinic billed for one month's rental PLUS a one-time fee of about $200 for, uh, think it was called accessories (which consisted of a funnel, a 6 foot hose and two tiny samples of lubricant lotion).

Strongly suspect you are right about seduction by profit.

[Runaway AUTOs are stilll regarded as problematical & doctors still have to consider the potential for medical litigation by disgruntled patients.]

I'd really like to know the basis for this statement. Is there any paper or publication or study that supports this statement? [/quote]

fstanmyre wrote:[Runaway AUTOs are stilll regarded as problematical & doctors still have to consider the potential for medical litigation by disgruntled patients.]

I'd really like to know the basis for this statement. Is there any paper or publication or study that supports this statement?

[/quote]


Actually there was a thread on this issue just a few days back. I can't remember the thread (RG was there & added some input after I posed some questions on a related aspect). Those comments came from someone who was a regular here but is no longer. Their prior postings were being aired.

Also I have discussed this indepth with the RNHS Sleep Studies clinic staff (our country's foremost such clinic) as I had been told by them to avoid autos & after reading a lot here I bought one then went back and discussed with them why they were opposed to them. I was then told that there was one specific brand that they believed had a problem (I won't name it other than to say it wasn't RemStar).

I believe it is true to say that there are mixed opinions on AUTOs and that some reservations I have heard about may relate to specific brands. As to a scientific or research paper on the topic ! - I haven't written one

Cheers

DSM

gracie97 wrote:
I haven't gotten the bill yet, but that's what my insurance said the sleep clinic billed for one month's rental PLUS a one-time fee of about $200 for, uh, think it was called accessories (which consisted of a funnel, a 6 foot hose and two tiny samples of lubricant lotion).

Strongly suspect you are right about seduction by profit.

Re the $US 500 per month. Reason I asked is that I was offered a RemStar Plus with Heated humidifier for rental here in Sydney, via a local RemStar supplier, for $AUD150 per month (min 2 months - no masks). $AUD150 = $US112.50. This seems more reasonable allowing that the same units cost double the US price here. Also I don't get that money back through health insurance here - they are very light on rebates for OSA gear.

Cheers

DSM

Re the $US 500 per month. Reason I asked is that I was offered a RemStar Plus with Heated humidifier for rental here in Sydney, via a local RemStar supplier, for $AUD150 per month (min 2 months - no masks). $AUD150 = $US112.50. This seems more reasonable allowing that the same units cost double the US price here. Also I don't get that money back through health insurance here - they are very light on rebates for OSA gear.

If you'd rented that machine, your rental cost have come out to little more what my out-of-pocket, after insurance cost is: My insurance will pick up $400 (80%) and I'll pay the other $100/month.

Suppose the REMstar costs twice as much in Australia because of import expenses?

Well, after a brief discussion and request to my GP he prescribed an APAP for me and I got my Remstar APAP about a month ago. I was not worried about 'runaway' pressures since my sleep lab suggested pressure was 23. I had been using a bpap for a couple of months and had actually been getting pretty good results - AHI near or below 5 most nights. (I found a Bipap setting of 18/16 worked very well). But after all the discussions here, I was hoping that the Apap would allow me to spend a good part of the night at a lower/more comfortable pressure.

I must say the Apap has been a disappointment for me. With a setting of 10 to 20, it spent all night at 10, only briefly (minutes) upping the pressure to 10.5. And my AHI was in the high 20's. so I changed the setting to 15/20 - same result. I have gone to a CFlex setting of 18 and my AHI is running around 15 now and it reports exceptionally high snore indexes..

Someone suggested on this forum that the Apap algorithm may not function properly for users that require higher setting. It sounds like that may be the case for me. In a ny case there is certainly no sign of runaway pressure.

As for most things in life, there is no single solution that works for everyone. I called my GP last week and asked for a script for my old Bipap and I've had a call from the DME to set up an appointment.

You "haven't written one"??????? In other words there aren't any? I think we have to be a little more careful with statements about runaways and law suits. Don't get me wrong, I also have questions about apap but I thought you might have had a little more substance behind your statements. Maybe somebody else does?

For those who have questions about apap vs cpap, Google "apap vs cpap studies". Here is just a few of them.

http://thorax.bmjjournals.com/cgi/conte ... uppl_3/S49

http://ajrccm.atsjournals.org/cgi/conte ... 163/6/1295

http://ajrccm.atsjournals.org/cgi/conte ... 163/6/1295

http://64.233.179.104/search?q=cache:ij ... dies&hl=en


http://www.google.com/search?hl=en&lr=& ... tnG=Search

fstanmyre wrote:You "haven't written one"??????? In other words there aren't any? I think we have to be a little more careful with statements about runaways and law suits. Don't get me wrong, I also have questions about apap but I thought you might have had a little more substance behind your statements. Maybe somebody else does?

_________________

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

Hi Stan,

Actually the issue I raised was calling doctors liars on hearsay evidence !
(esp when they are not present to defend themselves) I apologize if that irked you.

Also I am happy to supply you with the name & phone number of the sleep clinic staff member who publicly warned us against buying AUTOS - I don't think she personally has written any scientific papers on the topic but she does work closely with some professors who specialise in respiratory issues.


Keep smiling


Cheers

DSM

Send me her name and phone no. I'd be very interested in talking to her.

Stan,
Thanks from the rest of us for taking the time to pursue this! Please let us know what you find out when you talk to dsm's:

...sleep clinic staff member who publicly warned us against buying AUTOS.

Very curious to know if this turns out to be a knee-jerk response from another uninformed/misguided RT, or if it is based on actual scientific data.

Three cheers!

Ooops! Sorry! I see it is Fred (not Stan). My apologies!

fstanmyre wrote:Send me her name and phone no. I'd be very interested in talking to her.

Stan,

Will forward her name & phone via PM. I too will be interested in how she explains it to you.

One other point worth mentioning before too much more confusion sets in, there is a difference between the concept of AUTO OSA therapy and the way particular companies implement that concept. I doubt that many of us doubt the concept. I do believe there are concerns in how some companies have implemented the concept. This sleep clinic person did and will focus on concerns as to how some companies are implementing the concept. Her remarks were made to an audience of people participating in a one month sleep clinic study. Just wanted to set the scene and the salient facts for your conversation.

Cheers

Doug

Anonymous wrote:Stan,
Thanks from the rest of us for taking the time to pursue this! Please let us know what you find out when you talk to dsm's:

...sleep clinic staff member who publicly warned us against buying AUTOS.

Very curious to know if this turns out to be a knee-jerk response from another uninformed/misguided RT, or if it is based on actual scientific data.

Three cheers!

Hi anonymous (or is it stan )
Re scientific studies. Do you have any that show that most brands of AUTO have no problems and that sleep clinics/specialists can be confident in recommending them.

Just wondering If so I'll happily withdraw any issues I raised and will appologise for raising them.

Cheers

DSM

dsm-- it is Fred (as signed in his post) not Stan.
Again, Fred, our apologies to you.