CPAPtalk.com

Peppilappu wrote:Seems like all the manufacturers are rating their machines in DB. Well that is meaningless. You need a DBM (Decibels per meter in distance) rating which specifies exactly how far from the machine the measurement has been taken.

dBm is a measurement referenced to specific signal level, NOT decibels per meter!

Peppilappu wrote:The S8 Auto EPR unit is rated at 24DB. Again, worthless but impressive it its measured at 1 meter. (24DBM)

Sound Pressure Level (SPL) meaurements for all purposes (not just the noise level of CPAP kit) are commonly measured at a distance of 1 metre from the sound source, so the Resmed measurement is certainly NOT worthless, and is in fact reflects best practice in sound level meaurement.

peppi wrote: I'm not one for government intervention but this is one issue I'm hoping the government will step in and stop.

US or Australian government?

billbolton wrote: dBm is a measurement referenced to specific signal level, NOT decibels per meter!

Typically dBm is deciBels compared to milliWatt as reference power.
deciBel is 1/10 Bells = lg(pwr/refPWR).

Measuring at a distance of one meter is useless to me here in the U.S., since I listen from three feet away.

As someone else posted somewhere (how's that for a reference), there is an ISO standard for measuring the sound level of xPAP machines. As long as the manufacturer's all follow it, their numbers should be comparable, if not perfect.

This from Respronics site:
A-Flex is designed to work with our clinically proven auto CPAP algorithm to improve
comfort even more by matching pressure delivery to the patient’s entire breathing
cycle. Like C-Flex, A-Flex provides flow-based pressure relief at the beginning of exhalation. Like Bi-Flex, A-Flex softens the pressure transition from inhalation to exhalation to provide additional comfort in an auto-CPAP mode. The pressure profile mirrors the patient’s breathing, and with the auto algorithm intelligence, it will respond to the patient’s therapeutic need throughout the sleep session.


Its pretty well described on their site. It looks like its an "auto mode" for the exhale cycle.

jnk wrote:Measuring at a distance of one meter is useless to me here in the U.S., since I listen from three feet away.

Duhhh.

1 meter = 3.28083989501 ft

Izzat .280929851 ft < really > gonna make that much difference?

I'm sure you were pulling our leg ... yes you were ... I hope.

Arizona-Willie wrote:

jnk wrote:Measuring at a distance of one meter is useless to me here in the U.S., since I listen from three feet away.

Duhhh.

1 meter = 3.28083989501 ft

Izzat .280929851 ft < really > gonna make that much difference?

I'm sure you were pulling our leg ... yes you were ... I hope.

Hey, it made as much sense as the other complaints!

Hi Peppi,

We're glad you were able to find our S8 Vantage at a price which was competitive with lesser brands. We appreciate your search for our S8 Vantage Autoset - There may be less expensive products in the market; however, we believe the quality and comfort offered by our solution are the best value on the market.

We recently revised our Internet Policies, providing a better experience for shoppers that choose to source our products over the web. We're not sure the source of the mis-information presented to you, but rest assured that we are committed to ensuring our products are available via reputable Internet medical device suppliers and brick and mortar HME's alike. Further, we won't compromise on the quality of our products, or the quality of the service you receive from retailers when purchasing our products. We have strict guidelines regarding the proper information to display, after sales service, educational support, warranty information, follow up service and support staff to ensure that your ResMed product purchase is pleasurable, and to help you remain compliant with your therapy.

Thanks for your patronage, and we look forward to providing years of successful therapy to you.

Sincerely,
Gil Ben-Dov

Vice-President Commercial Operations , ResMed Corp.
9001 Spectrum Center Blvd, San Diego, CA 92123

Gil.Ben-Dov wrote:Hi Peppi,

We're glad you were able to find our S8 Vantage at a price which was competitive with lesser brands. We appreciate your search for our S8 Vantage Autoset - There may be less expensive products in the market; however, we believe the quality and comfort offered by our solution are the best value on the market.

We recently revised our Internet Policies, providing a better experience for shoppers that choose to source our products over the web. We're not sure the source of the mis-information presented to you, but rest assured that we are committed to ensuring our products are available via reputable Internet medical device suppliers and brick and mortar HME's alike. Further, we won't compromise on the quality of our products, or the quality of the service you receive from retailers when purchasing our products. We have strict guidelines regarding the proper information to display, after sales service, educational support, warranty information, follow up service and support staff to ensure that your ResMed product purchase is pleasurable, and to help you remain compliant with your therapy.

Thanks for your patronage, and we look forward to providing years of successful therapy to you.

Sincerely,
Gil Ben-Dov

Vice-President Commercial Operations , ResMed Corp.
9001 Spectrum Center Blvd, San Diego, CA 92123

Hello Gil,

Welcome to the forum.

I was wondering if you are the person who wrote this article:

http://crmguru.custhelp.com/cgi-bin/crm ... faqid=1761

If so, I'd like to "borrow" one of the lines in it (although somewhat out of context) to make a point.

"This approach has proven to be highly valuable and successful for companies of all sizes, small to large."

The point being that it is highly beneficial for the manufacturers to visit these forums and engage directly with the actual consumers/customers/users of their products. An "informed" consumer/user is by far more successful with this therapy than those who are kept in the dark. "Education" is a big key to using this equipment and making it work properly. The success/failure rates for this therapy are NOT acceptable.

Thank you for your post.

Best wishes,

Den

Gil.Ben-Dov wrote:We recently revised our Internet Policies, providing a better experience for shoppers that choose to source our products over the web.

Thank you for participating on this message board, Gil.
You mention recently revised Internet Policies. I wonder... is it now possible for someone who lives in Canda and who has a CPAP prescription to order a ResMed CPAP machine online from cpap.com and have cpap.com ship the machine to the buyer in Canada?

Wulfman wrote:
I was wondering if you are the person who wrote this article:

http://crmguru.custhelp.com/cgi-bin/crm ... faqid=1761

If so, I'd like to "borrow" one of the lines in it (although somewhat out of context) to make a point.

"This approach has proven to be highly valuable and successful for companies of all sizes, small to large."

The point being that it is highly beneficial for the manufacturers to visit these forums and engage directly with the actual consumers/customers/users of their products. An "informed" consumer/user is by far more successful with this therapy than those who are kept in the dark.

The problem is: it's probably more profitable to be closer to the doctors than to the patients, and the more patients can do by themselves,
the less they are paying the doctors to do it.

As a long time CPAP user but also a DME company Coordinator I read with morbid fascination the comments on this topic. Let me give you some industry backgroud on this topic. All CPAP supplies and equipment can only be supplied in most states with a valid prescription from a physician. Yet many people were selling CPAPs and supplies on sites like E-Bay without the required RX. Second, compliance to sleep therapy is terrible. The estimates are that 60% fail to comply with sleep therapy. This means that a lot of money for equipment and supplies are wasted and the person who has OSA (obstructive sleep apnea) is now going untreated. Their is a certain skill set necessary to setup the equipment and accomplish a good mask fit. There is follow up to iron out any issues with the mask or humidity. Insurances are requiring compliance data before payment will be made to the DME company. Reputable DME companies will hire Respiratory Therapists to handle sleep therapy patients as they have the specialized training to do these tasks. Medicare is requiring companies to become accredited before they can provide these types of services. All this is to insure that you, the patient, get positive outcomes from your sleep therapy. How can this be done by purchasing a CPAP from the internet? How can you be sure the settings are done according to the RX? How was the CPAP mask fitted? What happens if there is a problem with the unit or the mask? Will the internet provider be there to help correct these issues?

The intent of manufacturers like ResMed, Respironics, etc. was to remove their products from the internet in hopes that this prevents their products from being sold without an RX and that patients with OSA would use DME companies whose goal is to help patients comply with their therapy needs. The intent was never to gouge the patients for more money. Increased compliance was the ultimate goal.

This being said, I too have run into the DME company that has little to no expertise in sleep therapy and have got into this line of business as a supplement to other lines of business such as oxygen and diabetic supplies as their is correlations among these types of patients. So, as a guideline let me offer some suggestions:

1. Use only an accredited DME company.
2. Use only a company with a Respiratory Therapist on staff.
3. If the mask fitting takes less than 30 minutes be wary of the skill of the fitter.
4. Make sure the company has a professional relationship with your physician. (Our RTs constantly inform the prescribing physicians about any problems with their patients.)
5. Ask about mask replacement programs. Usually masks can be replaced free of charge within 30 days if it is not working out.
6. Look for companies that use ONLY auto CPAP devices with compliance monitoring capability. These have ALL the capabilities your physician would prescribe without having to buy a different CPAP. As was mentioned they are all billed as E0601.
7. Look for in network providers with your insurance as this will save you money.
8. Be patient and overcome any mask issues and you will sleep like you did as a child.

leejgbt,

Welcome to the forum.

In a "perfect world", that list may be just fine. Unfortunately, we don't live in a perfect world. The vast majority of those who are diagnosed with Sleep Apnea (obstructive or otherwise) are usually too sleep-deprived to be able to know what to research with regard to this therapy. They get herded through a "money making machine" and are kept in the dark about everything. How many users do you think out in the rest of the sleep apnea world have the original copy of their prescription and a copy of their sleep studies? How many were given the opportunity to shop around for various brands and types of machines, masks, etc. How many even know what the make and model of their machine and mask are? How many know that there are data-capable machines? (that includes the doctors and DME staff, too.) How many are told that they can't (read aren't supposed to know) access the data on a data-capable machine or that the data is wrong or meaningless? How many haven't even met their doctors? How many are flat-out lied to by the doctors and DMEs? How many insurance provider staff are clueless about the equipment and the therapy? How many get resistance from family members for using their machines? How many are now out of work and with no insurance to pay for the over-priced sleep studies and equipment through the normal channels?

There are many, many more problems that the users of this therapy face. We've seen these stories over and over again on this forum. Fortunately a fortunate few DO find their way to the Internet forums for help, but the vast majority don't......and we know what happens to far too many of them.

There's only ONE number on MY list:

1. Take control of YOUR own therapy!


Den

leejgpt

Thanks for posting guidelines for using DME's for Sleep Disordered Treatment. Although I think you offer some excellent information the biggest aspect I see lacking is DME criteria of communicating with the patient and working with the patient as a team verses something "to do to the patient." Also to assume the only mechanism of successful treatment of OSA is via a DME is not necessarily valid. The point missed is many OSA patients seek alternatives to DME attempting to correct DME experiences and obtain many of the treatment outcomes you noted. A goal of compliance may not be the same as an obtained goal of successful treatment. Personally, I became a "non compliant" OSA patient in 2003 after an initiating my own sleep study and treatment. I view my "noncompliance" as a self fulling prophecy of the respected sleep clinic and DME I was using at the time. The sleep clinic documented negative compliant remarks when I had hand surgery and was unable to assembly the humidifier/gear for a couple of weeks. The DME disregarded my mask needs, the fact my furniture was being ruined by a leaky product, billing nightmares, 5 minute review toss in a bag and figure it out on your own approach. Again, at my OWN INITIATIVE, I resumed treatment of my OSA. I immediately found the DMEs to be extremely unwilling to team with me, lacking of insight I was an informed consumer, suggested dishonest sales practices (double dipping), provided incorrect information including speaking to what my physician restrictions would be to promote equipment with a greater profit margin, no show of schedule appointments and more billing aggravation. I currently attribute my compliance to my own initiative/persistence in securing my equipment which started through "internet education" reinforcement of clinical software (internet obtained), having a sleep doctor who knows how to team with a patient and limited DME involvement. I don't think DME's have an ultimate patient experience advantage over the internet at this time. I'm sure there are some exceptions out there, but if compliance is based on DME experience and expertise, why is compliance such an issue!!!! Think about it.......and provide an excellent patient focussed service to the OSA customers in your DME business.
elg5cats