Resmed H4i versus Fisher & Paykel HC150

Hello,

I think this is my first post, though I have been lurking here for a while. I have a question for the forum and maybe need some support. I have been on CPAP therapy for about five years. When I first started treatment I got put on a CPAP with a pressure of 12. I have been very compliant since I realized how much better I could feel. However, I have continued to gain weight which seems to have caused my numbers to go up. Recently I did another sleep study with a new doctor (my previous doctor's office had less convenient hours and I felt that they were very slow to work with). I like my new doctor and am getting pretty good service from the clinic. I definitely went up in required pressure. I am at 14 on my side and 17 on my back. My doctor has recommended that I switch to BiPAP and I have agreed.

When I got the new diagnosis from my doctor, we discussed a temporary solution for my therapy. We agreed to change my existing CPAP to a pressure of 16 while working on getting my insurance to pay for the BiPAP which would be set at a range of 10-20. Thanks to the information found on this forum, I went home that night and set the machine to 16 myself (instead of bringing it to the clinic three days later). Now, my doctor has ordered me an S8 VPAP Auto 25 BiLevel machine through his clinic's DME. That is nice because I wanted auto and data-capable features; My doctor actually recommend it too before I could bring it up.

When I first started therapy I had trouble finding a comfortable mask. I actually came to this forum and got some help finding a mask that worked. I have been using the Activa ever since. Now I really want to try the Activa LT. During my sleep study I used the Mirage Micro (which was way to small for my face and leaked a lot). I really liked the features that it had, though, which are the same on the Activa LT. That isn't a problem, this clinic stocks the Activa LT and will let me try different sizes.

My problem started when I tried to order the humidifier that I want. I saw lots of positive reviews for the Fisher & Paykel HC150. However, when I tried to ask for a different model humidifier (than the Resmed H4i), the lady suggested that anything other than the H4i would be incompatible (different interfaces) and that you have to use humidifiers of the same brand as the machine. Well I politely told her that I understood that to not be true and asked her if I could send her some product literature. Then she backtracked a bit and tried to suggest that stand-alone humidifiers were not heated - only cold. Again I politely disagreed. Again she parried saying that the machine that they ordered came with a humidifier. I pressed her again to admit that she could at least sell the machine without a humidifier. She did agree but told me that they won't sell any humidifiers that were not the same brand as the machine. She told me that I could buy it online (out of pocket instead of through my insurance). I found this conversation frustrating and disappointing, but, in fairness, I got the impression that she knew nothing about the heated stand-alone humidifiers that are on the market.

But on the other hand, I hate it when I know more then the pro's do or when I feel like they are trying to pull one over on me. So, here is my dilemma. Until recently, I was debating whether or not I should get the H4i or the HC150 anyways. When I upped the pressure on my CPAP, I immediately started to suffer some serious dry throat and sinuses. I maxed out the humidifier and it is now decently better (though not completely gone). I have been getting a lot of rain-out most nights since. I decided to get the HC150 because of the the ambient tracking feature, in the hope that it would reduce the rain-out. I am now faced with the question of whether or not I should use the DME at my doctor's office. I could walk away and find another DME. That would mean additional delays, though, because I'd need to get my paperwork faxed over and would need to start the ordering process from scratch. Also, I am not certain that I won't get the same kind of run around with another DME. I could get the BiPAP from my doctor's DME but refuse to accept the H4i humidifier. That would allow me to find another DME that could special order the HC150 humidifier for me. But I would still have to wait for it because there is no way I could use the BiPAP without humidity. Or I could just decided to use the H4i humidifier. That would give me the option of paying for the HC150 out-of-pocket some time down the road when I can afford it.

So... long story short... my question is two part: Do you think that there is much of a benefit in getting the HC150 over the H4i, and what would you do in my situation?

Thanks in advance for your support.

Steve

To be kindly honest, It would be a PITB if DME's had to sell mix n match machines humidifiers if the machine comes with a designed integrated humidifier.

Yes the HC150 is arguably better than a 4i but it isn't integrated & while many of us here have done our own mix n match with one, I feel it is unreasonable to ask DMEs to start providing them in a mix n match way without some guarantees the mix won't create problems let alone mess up the costing.

The 4i is perfectly adequate for the job. The HC150 is really a personal choice but not a necessity.

So while I agree with your desire to have the HC150, I think it is pushing it to expect DMEs to start doing a mix n match.

I sympathize & maybe you can get them to do it & maintain the fee structure. Down to how lucky you get.


Good luck

DSM

Hard to tell from your description whether the representative didn't know what she was talking about, or just didn't want to enter into the discussion.

To be fair, she is right (from one point of view, though wrong from another) in saying that anything other than the manufacturer's humidifier is "incompatible". She is right in the sense that NO ONE, not ResMed nor F&P, will assert formally that the units ARE compatible. On the other hand, there's no reason to conclude or to presume that they are NOT compatible. It's just that neither company has done the research to PROVE that they ARE (or are not) compatible. Why should they enter into that expensive process? They understandably WANT you to purchase and use their own equipment.

You might want to read the thread, viewtopic.php?t=39828 (to which I contributed information and thoughts) which discusses humidifier compatibility.

My OPINION and recommendation (as a user of a ResMed blower and a F&P humidifier): Take the ResMed system with the 4i. It is not a bad unit, it is adequate for most users, and it is more convenient for travel. You can purchase the F&P HC150 at reasonable cost from https://www.cpap.com or from http://www.cpapauction.com or on eBay. (While Ambient Tracking is a nice feature, it is not a cure-all for rain-out. It is only a room temperature sensor - NOT a humidity sensor - which will decrease the water temperature as room temperature drops.)

Possibly - I am not sure - if your physician will certify at a later date that the 4i is inadequate for you, and write a prescription and a letter of medical necessity for a more efficient humidifier, you may be able to ALSO get the F&P unit from your DME under insurance. (My own DME provides me with a new F&P humidifier chamber every 6 months under my insurance, even though they did not provide my F&P heater.) Good luck.