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Hello all,

I need some quick help as I need to call my DME back this afternoon. Just to backtrack and give you the whole story...

I currently have a CPAP with a pressure setting at 16 (originally 14). When I discussed the possibility of an APAP with my DME they didn't like that at all. They kept steering me away from them. Since I have insurance, I'm guessing they would prefer to have me on a low-end machine since the insurance will pay the same set amount for either machine.

Anyway, after reading a different thread on this board that had suggestions on how to get your doctor to approve an APAP, I decided to give it a try. After all, when they did my sleep study they had me just sleeping on my back. I DON'T sleep in that position, if at all possible. I'm a tummy and side sleeper. Plus, with an APAP it will allow the pressure to be more accurate so I won't be stuck at a straight 16 if I don't need to be. Well I left a message for my doc asking for a new prescription and she okayed it and called it in to the evil DME.

I had requested a PB 420E. When I just talked to the DME they want to set me up with a Resmed Vantage. Can anyone give me a breakdown on which is the better machine? Are they comparable softwarewise, etc or is one clearly the better machine? I do travel so would like a small and compact machine.

Thanks for all the help.

Melinda

Stick to your request for an APAP...and the 420E is an excellent machine. I've had one for almost 9 months now and love it. I travel about once a month and it's lightweight, has a great travel case and there has been no problem taking it through the airport security.

If you do get the 420E, will your DME also provide the software for it?? IMHO, that's an absolute necessity with this unit. It provides evidence of compliance, can be used to monitor your treatment and can be used to switch from APAP-mode to CPAP-mode and back. Also, be sure to get the heated humidifier. It makes a world of difference.

Good luck!

This therapy WORKS!!!

I also have a 420E and an older model Resmed. As far as the machines go, I think the two you are talking about are probably equal. More people have experience with the 420E because it has been out longer than the Resmed S8.

I don't have the Resmed software, only the Silverlining software that goes with the 420E. And that is pretty nice. I believe it was Rested Gal who said she did not like Resmed's software at all and much preferred the Silverlining and the Encore Pro that goes with Respironics machines.

Does your DME even carry Puritan Bennett? DME's tend to carry only a brand or two, not all the brands. You have the right to use any DME that contracts with your insurance. You might want to put a call into insurance and ask them what DME's they work with in your area. When I called mine, I got a list of 10. Some of those 10 only did oxygen, not CPAP. But I did end up with a choice of several DME's to try. I ended up with the Puritan Bennett 420E because that is the brand the DME carried...that and DeVilbiss.

You might also ask your insurance if you could buy your machine from CPAP.com and then be reimbursed for it. Might end up being cheaper for everybody that way.....Also call Billmyinsurance.com and see if they work with your insurance (that's the sister site of CPAP.com). They have all the major brands of machines and you can take your pick without hassle, as well as buy the software from them. DME's most likely will NOT sell you the software.

Make sure your unit has automatic altitude adjustment and is ready for international voltage as well if you travel. As well as being APAP with software capability....

Good luck!

Jan in Colo.

Howdy,

I run a family of CPAP websites that supports this forum and feel compelled to put in a little plug.

Consider BillMyInsurance.com as an alternative to your DME. They take insurance and let YOU choose the equipment. You can call them toll free at 1-800-266-1575.

Here is a link to the APAP compare chart, which can give you the strait facts on the differences between popular APAPs:

https://www.cpap.com/cpap-compare-chart ... sting-CPAP

Good luck and write back if you need more info!

Johnny

I also found that ALL the DMEs I looked into immediately steered me to the Resmed machines....

Resmed must provide the best pens/post-its/coffee mugs/tshirts/lunches and other promotions to the DMEs. Not sure about their machines; the sleep docs would tell you they're all the same.

(it's easy to become jaded around here

Good going, Melinda, on having your doctor write the Rx that will make your DME give you a machine that may very well let you spend more of your sleep time at a lower pressure than the steady 16 you're stuck with now.

I'm no doctor, but given the kind of pressure you may be looking at as an effective "low" (and unless you particularly need a very small machine) I'd suggest you make the DME order you a Respironics REMstar Auto with C-Flex....even if it means delaying getting the machine and having to go back to your doctor to have the RX written specifically for an autopap with C-Flex.

And don't let the DME try to convince you that the ResMed S8 Vantage also "has pressure reduction when you exhale." ResMed does have "EPR" to reduce pressure on exhalation, but the S8 Vantage cannot use that feature when operating in autopap mode. The Vantage can use EPR only when operating in cpap mode.

The reason I'd advise getting the REMstar Auto with C-flex is...there's no way to know for sure whether you're really going to be able to spend most of your night sleeping at a fairly low pressure on autopap, or whether you'll instead need to set the low pressure up rather close to your new prescribed pressure of 16.

It's very possible that your sleeping position might result in your using a much lower pressure than the study (with you on your back) came up with. Hopefully that's what will happen when you start using an autopap. However, if it turns out that your treatment goes better setting the low up around 12 or 13 or 14, you might find C-Flex to be very welcome relief when you exhale.

The Respironics REMstar Auto with C-Flex can be operated as an autopap with or without C-Flex, if that particular feature doesn't suit you.

If you already have no trouble exhaling against 14, 15, 16, then any autopap should be fine for you.

As Jan mentioned, I do prefer the software that's used with the PB 420E (Silverlining) and the Respironics REMstar Auto with C-Flex (Encore Pro) over the Autoscan software used with ResMed machines. If you get either the 420E or the REMstar auto with C-Flex, send me a PM with your email address.

All that said, you needn't worry much over your choices. Any of the three major brands of autopap will probably do a fine job for you. You've done your homework well! Glad to hear your doctor agreed with your reasoning.

Melinda,

I agree with rested gal...First choice being the REMstar Auto with C-flex. If you get resistance from your DME, take up Johnny on his suggestion to checkout billmyinsurance.com. They will get all the paperwork in order and let you get whatever machine you want... and best of all, if they find out you would be better off buying elsewhere they will tell you that too.

Remember that there is no reason to rush into making a decision you might regret.

I had a similar experiance and now it's starting to tick me off. Been on cpap for about 2 months now. When I went to get my machine from the DME he acted like the one he had in his bag was the only thing there was. My doctor even recommended c-flex on the rx (I'm set at 13) but he acted like he'd never heard of it. He was respiratory therapist so I figured he knew best, right? Now I'm pretty convinced he gave me a)whatever he had lying around (they don't don't even make this model any more - (it's only been two months) and b) whichever gave him the biggest spread on the insurance! Did he think I was stupid and wouldn't check out what he gave me?

Don't get me wrong, it works great so I guess it does the job. But I'm skeptical about the pressure just because the sleep study was on my back (worst possible position) and I usually sleep on my side. But I'll never know because I'm hooked to a "dumb" machine.

I guess I'll have to check my insurance and see what they'll do about swapping if I switch to another DME.

if your script said c-flex and you didn't get it, I'd call the insurance company and tell them you didn't get what was prescribed and you'd like that taken care of immediately.

Thanks to all who responded. I can't tell you how much I appreciate the detailed and quick responses. It is so great to have this site to turn to for research and to ask questions. I find that with all of our combined efforts, we know more than any DME could possibly know. I did mention to my DME yesterday that after looking at reviews and talking to others who have Sleep Apnea, I found my choice was the correct one to go with. After my reasoning, what could she say? She doesn't have this condition so how can she know what works and doesn't?

I ended up choosing the PB 420E. I don't have any problems with exhaling...must be I have big lungs. My second choice was the REMstar Auto with C-Flex. Anyway, when I called the DME I could tell she wasn't happy but she put in an order for the machine. I made sure to tell her I also needed the humidifier and software. It's interesting how they try to steer you to the machine they want saying "I have this in stock and can get you set up right away, but if you want this other machine I'll have to order it." Like I'm going to fall for that one. I've used CPAP for 2 months, I can use it a tad longer for the machine that will work best for me.

xzombie how does your insurance work? Mine "rents" the machine for 10 monthes and then after that time it's mine. In other words, it doesn't matter how many changes to the machine I have in that time...straight 10 monthes and whatever machine I have at the end is mine. I wish they would just let me buy one online since it would be cheaper, but at least they are picking up a portion of the cost and it allows me to find the machine that works for me.

On a side note, I had asked my DME about the Aura mask a couple of weeks ago and she had never heard of it. Interesting how you have to educate DME's isn't it???? Anyway, after the problems I've been having with my current mask I ordered one online from cpap.com and it arrived last night at my boyfriends. Well yesterday she mentioned she had gotten in an Aura mask so I could check it out. I thanked her, but said well I already ordered one. The silence was very entertaining It is interesting that the DME's think we are just going to sit back and take whatever they give us and not be more pro-active in our treatment.

sleepylady, way to go! Good for you sticking to your guns...and getting your amunition here.

One other thing for you to consider: Copay. Do you have a monthly copay that you will be donating to the DME?? If so, you may want to figure out how much the total would be, then check here at cpap.com for the 420E/HH/Silverlining bundle and negotiate with your insurance company for reimbursement if you buy it from cpap.com. Or, maybe even go through billmyinsurance.com and see if it would be less out of pocket for you. Just some thoughts.

This therapy WORKS!!! (even though we have to start it all foggy-headed!)