need advice from the experts here

hello everyone,

in 2007 i was diagnosed with severe osa. i was on something like 25cm and prescribed a bipap. since then i have lost 50lbs dieting and quit smoking. i have had problems lately with pressure being too high (stomach bloating with pain and feel sleepy all the time) and went to a new sleep center. they of course did a new sleep study and i have the results, they are reccommending 11cm cpap and the sleep tech telling me i should not be on a bipap. my AHI is 89.6.

ok so my first question is

should i let them order the new cpap via the medical supply place or just get it myself from cpap.com? My med supply place sucks really bad, always sending the wrong stuff and if im not mistaken, they jack the prices up on the xpaps and are ripping me off.(the goodnight 425 with humidifier they sold me in 07 total cost was 1600$...my co pay was about 600 for this unit.

I wanted to pick my brand and model and want to get an auto cpap...M Series Auto CPAP with A-Flex is the one my research is comming up with

thanks in advance

Where you get your machine from is not going to change the coarse of your treatment. If you can afford out of pocket costs, no problem. M series auto is a good machine. Good luck to you..

Maybe a dumb question, but why do you need a NEW machine? Can't they just set the biPAP for your current needed pressures?

agree, probably your bipap can be adjusted

I would be skeptical of moving to a CPAP after being on the BiPAP and owning one. Most BiPAP machines can be put into a CPAP mode. So the need to buy a new machine sounds like a new insurance claim rather than being a necessity. A BiPAP at 11cm is still comfortable to use for some people.

Great on the weight loss and smoking cessation, that seems to have really made a great difference.

GReeNeYe wrote:hello everyone,

in 2007 i was diagnosed with severe osa. i was on something like 25cm and prescribed a bipap. since then i have lost 50lbs dieting and quit smoking. i have had problems lately with pressure being too high (stomach bloating with pain and feel sleepy all the time) and went to a new sleep center. they of course did a new sleep study and i have the results, they are reccommending 11cm cpap and the sleep tech telling me i should not be on a bipap. my AHI is 89.6.

ok so my first question is

should i let them order the new cpap via the medical supply place or just get it myself from cpap.com? My med supply place sucks really bad, always sending the wrong stuff and if im not mistaken, they jack the prices up on the xpaps and are ripping me off.(the goodnight 425 with humidifier they sold me in 07 total cost was 1600$...my co pay was about 600 for this unit.

I wanted to pick my brand and model and want to get an auto cpap...M Series Auto CPAP with A-Flex is the one my research is comming up with

thanks in advance

In support of Muse-Incs response...

Can't you run the Bilevel as a CPAP ? - done it myself before.
Just set the bilevel to cpap mode & the pressure as recommended. If you don't get really good results in cpap mode bump up the CMs by 0.5 or 1.0.

Congrats by the way - that weight loss is commendable & dropping the cigs will without doubt extend your life. - good going. No an easy achievement.

DSM

You can narrow the gap between IPAP and EPAP slowly to get used to a constant pressure. Once IPAP and EPAP are the same, you essentially have a CPAP. Or, keep a small difference (1-3 cm) to make your BiPAP similar to a CPAP machine with pressure relief. You can 'bracket' your pressure down fairly gradually to get used to the lower overall pressure. I don't know much about your current machine, but does it give you efficacy data? Data is very useful, especially for people like you who experience big changes in their conditions.

thanks for the quick replies.

my bipap has a unreadable led screen and i dont know how to set the pressures. also to be quite honest, i dont think its ever worked right since it fell off the table and the screen broke. the med supply place checked the pressure and said its at my prescribed pressure and i didnt need it to be repaired so i just left it that way.

they only gave me my new sleep study results and i have a week to go to get the prescription at the follow up visit. its been quite a few months that i feel as if im not getting proper treatment from this bipap. im a wreck already not getting proper sleep and waiting for all this seems like an eternity.

also, what is the down side to ordering my own cpap if any, and does my prescription have to specify auto cpap? i figure an auto cpap will will self adjust if my pressures change in the future.

thanks to all as i really have no one to ask these questions and get a users point of view....

dsm wrote:Just set the bilevel to cpap mode & the pressure as recommended

The bilevel machine GReeNeYe has (PB Goodknight 425) does not have a "cpap mode" according to the Provider manual. If a 425 user starts looking for "cpap mode", there's no such mode setting on that machine.

It can still be set to operate at a single pressure, of course, by setting EPAP and IPAP to the same pressure.

The point is moot, anyway, since GReeNeYe went on to say:

GReeNeYe wrote:my bipap has a unreadable led screen and i dont know how to set the pressures. also to be quite honest, i dont think its ever worked right since it fell off the table and the screen broke. the med supply place checked the pressure and said its at my prescribed pressure and i didnt need it to be repaired so i just left it that way.

So...even after getting into the clinical setup, there'd be no way to see the settings menu.

GReeNeYe wrote:what is the down side to ordering my own cpap if any, and does my prescription have to specify auto cpap?

There's no downside to ordering an autopap for yourself from an online store like cpap.com, if you don't mind paying out of your own pocket for it.

As far as I know, cpap.com still accepts a "cpap" prescription with a single pressure on it for ordering an "autopap" since an autopap is considered an CPAP machine capable of autotitrating. The autopap can be set for "cpap" mode and set for the single pressure on your new Rx. After you receive the machine, you can set it for autotitrating and a range of pressures if you wish. Would probably be a good idea to use it for about a week in cpap mode at the single prescribed pressure to get data about how you do that way, before trying some autotitration ranges.

The M Auto with A-Flex is a very good machine. I like the A-Flex feature very much, but if it turns out you do better with C-Flex instead of A-Flex, you can switch to C-Flex. Or, can turn off both if you do better with neither.

I personally am not fond of the M machine's integrated humidifier. I'd skip getting the integrated M humidifier and get a separate Fisher & Paykel HC 150 humidifier to use with the M machine. But that's just my personal preference.

i cant thank you all enough. i want to be prepared for my follow up visit and request the proper equipment presciption. maybe its because i have never had any major medical problems before this but i feel as if they just want to get my insurance charged for the sleep study and now they are being evasive in truely helping me. i know one thing, this is getting expensive real fast

i read up about the cflex and aflex functions but not sure which one i need but i will ask the doctor when i see her.

thanks again

If you buy the M Series auto with A-Flex, you can try both C-Flex and A-Flex in the one machine (3 settings for each). This machine has both.

You can try them all and see whcih works best for you - or maybe you just want to turn them off altogether! All those options plus the fact that you can run the auto on cpap mode!

I have the machine you like...I agree with rested gal, the water reservoir is too small. Don't bother with it.

Her is what cpap.com needs to let you purchase an APAP machine"

APAP

* Contains one of the following words or phrases "APAP", "AutoPAP", "AutoSet", "Auto CPAP", "Auto Adjusting CPAP", "Self Adjusting CPAP", "CPAP" or "Continuous Positive Airway Pressure" or similar term.
* Contains your physician's contact information
* Contains your physician's signature
* Contains the patient's full name
* Contains your pressure range (Optional, Not Required)

o Example: 4-20 CM/H20
o Example: 4-20
o Example: 6-18 CM/H2O
o Example: 6-18


CPAP prescriptions are accepted for Auto Adjusting (APAP) Machines.


I used a CPAP prescription and purchased an APAP. Be sure to get a card reader and software if possible. Folks on this forum will help you get the clinical manual so you can adjust your pressure.

My original cpap pressure was prescribed at 14. I have set my auto pap at 10 minimum and 16 maximum. It RARELY reaches 13.

Good luck.

Hawthorne wrote:If you buy the M Series auto with A-Flex, you can try both C-Flex and A-Flex in the one machine (3 settings for each). This machine has both.

Hawthorne is right. The Respironics REMstar Auto with A-Flex M series -- you can choose to turn on either A-Flex or C-Flex when using the machine in "auto" mode -- or not use either at all. In "cpap" mode you can use C-Flex or not use it at all. A-Flex is not available in "cpap" mode.

YawnGirl wrote:I have the machine you like...I agree with rested gal, the water reservoir is too small. Don't bother with it.

Her is what cpap.com needs to let you purchase an APAP machine"

APAP

* Contains one of the following words or phrases "APAP", "AutoPAP", "AutoSet", "Auto CPAP", "Auto Adjusting CPAP", "Self Adjusting CPAP", "CPAP" or "Continuous Positive Airway Pressure" or similar term.
* Contains your physician's contact information
* Contains your physician's signature
* Contains the patient's full name
* Contains your pressure range (Optional, Not Required)

o Example: 4-20 CM/H20
o Example: 4-20
o Example: 6-18 CM/H2O
o Example: 6-18


CPAP prescriptions are accepted for Auto Adjusting (APAP) Machines.


I used a CPAP prescription and purchased an APAP. Be sure to get a card reader and software if possible. Folks on this forum will help you get the clinical manual so you can adjust your pressure.

My original cpap pressure was prescribed at 14. I have set my auto pap at 10 minimum and 16 maximum. It RARELY reaches 13.

Good luck.

this is great info, thanks so much. so if im reading you correctly a cpap prescription will allow me to purchase an auto cpap.

one more qestion if you all dont mind. as far as performance and being a quiet machine, the m series is good? because this is the cpap i will be requesing,

thanks

GReeNeYe wrote:

YawnGirl wrote: this is great info, thanks so much. so if im reading you correctly a cpap prescription will allow me to purchase an auto cpap.

one more qestion if you all dont mind. as far as performance and being a quiet machine, the m series is good? because this is the cpap i will be requesing,

thanks

Yes. A cpap prescription will qualify you for an APAP.

I did have a problem with the noise at first, but I placed it on a "library stool" about 10 inches off the ground and purchased a $20 sound machine and don't hear it now. I have never heard the machine you currently have, so I can't compare. Sorry.