CPAP Machine List ?

I have seen lot of posts where folks answer NEWB questions about what machines to get and to avoid. Is there a list of these somewhere here? My study is tonight and (as long as I can get to sleep) they are real sure they can start or complete my levels in one study - if so, then having to choose or reject a machine model would seem to coming up really quickly.

Must haves would be: Auto adjust? Ramp up? Humidifier? Computer software and data recording?

I have a very small airway and may require high pressure so may need a special machine (RPAP, I thought they said) which dials down the pressures when I exhale?

Point me to a list or some lists of quality machine with all the feature someone could want,then I could keep that handy when we start looking at equipment.

Thanks!

viewtopic.php?p=307168#p307168

Start with this list

no such thing as an RPAP... there's a CPAP/APAP or BiPAP/BiLevel or an ASV

Don't ask about software of the folks at the study unless you want a lecture. Go off the list above and when you get it, ask here about the software.

Make sure that you get a copy in your hands of the the perscription. It will be useful for a variety of things down the road.

Thanks!

I guess it bi-pap or ASV they were talking about.

All the full data machines on the list are also all recommended and full featured or I do I need to make sure the other features are there and go read reviews of them as well?

It's a list by Rested Gal you are looking for.

• Rested Gal's list of machines that record "full data" and those that don't --
  viewtopic.php?p=307168#p307168

It's a lot to remember so you would do better to print it. You need to spend some time reading and searching. Now is the time to start a notebook - for questions and to list machines or masks to try and generally to make notes in.

Good Luck

dwynne wrote:Thanks!

I guess it bi-pap or ASV they were talking about.

All the full data machines on the list are also all recommended and full featured or I do I need to make sure the other features are there and go read reviews of them as well?

Don't accept obsolete models. Any Respironics machines should be Philips Respironics Series One machines. Any ResMed machines should be S9 machines, not S8. You're paying for a new machine, why not get one?

Many DMEs will try to pawn off an obsolete machine on you. Strangely enough, they charge you the same price for older models as newer models. The older Respironics and ResMed machines require special card readers to get the data, while the newer ones use standard SD memory cards that can be read by almost any computer. The newer models also tend to record more and better data.

Don't let the sleep doctor or sleep lab steer you into using their favorite DME. Get a prescription on paper. Find out who the local DMEs are who are in your insurance company's plan. Ask for the particular machine you want and if a particular DME won't give it to you, try another. That's part of the reason you want your prescription on paper instead of having the doctor fax it to someone. Don't give the DME the original, give him a copy.

It's helpful if your prescription specifies an auto machine with a range of pressures. Then they have to give you an autopressure machine, which avoids many, but not all, of the CPAP machines with little data. Watch out that they don't give you a ResMed Escape Auto. That machine records a lot less data than the ResMed AutoSet.

I like Philips Respironics Series One REMstar (PRS1) Auto with AFLEX or the the Resmed S9 Autoset for auto CPAP machines. PRS1 Pro (NOT the Plus) or ResMed S9 Elite (NOT Escape) for manual CPAP machines.

Absolutely get a prescription for a heated humidifier as well.

If you get a Bilevel(BiPap) machine, try to get a PRS1 or a ResMed S9 model. Avoid any Respironics that says "Plus" or ResMed that says "Escape." (I'm not sure there are Bilevel models like this. I'm not that familiar with the Bilevel machines.)

You probably won't get a Bilevel/BiPap machine to start with. I think most insurance requires you to try and "fail" with a CPAP machine before you can get a bilevel machine.

Look at the machine carefully when you pick it up. DMEs will often tell you they're giving you one model and actually deliver another. They'll try to fool you with "Plus" instead of "Pro", Escape instead of Elite, or S9 "auto" instead of S9 AutoSet. Don't let them give you a "temporary" machine of the wrong type. Wait for the real thing. Even if they do eventually give you the real thing, they'll "accidentally" screw up the billing.

Don't let them push you around. Don't think of them as medical professionals looking out for your own good. Think of them as used car salesmen trying to sell you what generates the most profit for them. You are the customer, not their child. Be polite and friendly, but realize they're in business to make the maximum amount of money off of you.

If you decide you don't need the Auto or the humidifier, you can always turn that feature off.

on the Respironics machines... including the Phillips Respironics machines... there is a Bipap Plus... don't get that one. Get either a Bipap Auto or a Bipap Pro.

on the Resmed machines... they use the term VPAP for their bilevels. You'd be best getting an S9 VPAP Auto if that's the way that you're going.

dwynne,

Janknitz has a great blog with lots of useful information that you need to know BEFORE you start talking with the DME and BEFORE you accept delivery on any CPAP machine. Her blog is at: What you need to know before you meet your DME

And since you specifically ask about software as well as the machine themselves, I thought I'd repost this thing that I wrote a while back for another newbie. It focuses on a subset of the machines in Rested_Gal's list of machines, but her list doen't say much about the software end of things and does still contain some obsolete, but full data machines on it.

And you absolutely do NOT want to accept an older model machine even if it is a full data machine: You'll be using this machine every night for the next 5 years or so, so you doen't want to start out using something that is no longer manufactured.

Important Information About the Four Most Commonly Used Brands of CPAP/APAP Machines

For the four most common brands of xPAP equipment here's what you need to know about their most RECENT lines of machines:

• Full Efficacy Data Machines:
  • Resmed: The S9 Elite CPAP with EPR and the S9 AutoSet CPAP
  • Resprionics: The System One REMstar Pro CPAP with C-Flex Plus and the System One REMstar Auto CPAP with A-Flex
  • Fisher & Paykel: The Icon Premo CPAP and the Icon Auto CPAP
  • DeVilbiss: The IntelliPAP Standard Plus with SmartFlex and the IntelliPAP AutoAdjust with SmartFlex (for which I still need to add information about it's on-board data and what kind of way you download more detailed data to really see what's going on.)

• Only Compliance Data Machines:
  • Resmed: The S9 Escape CPAP with EPR and the S9 Auto Escape CPAP
  • Resprionics: The System One REMstar Plus CPAP with C-Flex and the System One REMstar DS150 CPAP
  • Fisher & Paykel: The Icon Novo
  • DeVilbiss: The IntelliPAP Standard

Important Notes:

1) It is best to hold out for a full efficacy data machine right from the start. As soon as you accept a brick that records only compliance data, you will have a mess on your hands if you later try to upgrade it to a full efficacy data machine. So if a DME contacts you (because the sleep doctor's office sent the script) and makes an appointment to set up the equipment and then shows up with a compliance-only brick of a CPAP, REFUSE delivery of the machine. Yes, they will tell you, "This is exactly what the doctor ordered." But YOU are paying for the machine (through your co-pay and your insurance company's money) and you are under NO obligation to "accept" a machine that you believe will be detrimental to your health in the long run. Politely inform them that you will only accept <fill in list of machines that you find acceptable> and that if they are unwilling or unable to provide you with such a machine, you will take your business to a different DME.

2) The naming of two of the Resprionics System One straight CPAPs is particularly confusing:

• The System One REMstar Pro CPAP with C-Flex Plus IS a full data machine, but
• The System One REMstar Plus CPAP with C-Flex IS NOT a full data machine.

3) Technically the Resmed Auto Escape is not quite a "only compliance data" machine because it does give a minimum amount of data beyond the number of hours used. But not enough additional data for it to be considered a full data machine. If the choice is between the S9 Elite and the S9 Auto Escape, you're better off with the Elite in my humble opinion.

4) On-board Data: Each brand of machine has its own select set of data can be viewed directly off the machine's LCD. The Resmed S9 AutoSet and Elite have by far the best on-board LCD data of any of these machines since their LCDs will let you see all of the following: AHI, AI, CAI (from which you can easily compute OAI and HI); 95% Unintentional Leak rate; 95% Pressure Setting (AutoSet only); and hours used (of course). You can also easily change the reporting period from 1 day to 1 week to 1 month to 3 months and more. The on-board data for the Resprionics System One machines is limited to 7 and 30 averages for AHI (not broken down by type) and 7 and 30 averages for "Percentage time spent in Large Leak." That Large Leak data is useless in my humble opinion----in part because Resprionics leaves the definition of Large Leak undefined and in part because a Large Leak has to last an awfully long time to show up in a 7-day average (let alone a 30-day average). I've used both an S9 AutoSet and a System One BiPAP Auto so I know those machines really well and speak from direct experience. I am not directly experienced with the F&P Icons, but as near as I can tell (based on information in other apnea forums that I read), the on-board data for the Icon has the following data: 1, 7, and 30 day figures for AHI (but not broken down into type), leak rate, and the 90% pressure level and SenseAwake stats for the Icon Auto.

5) Software:The S9 needs ResScan, which can be downloaded for free once you know where to find it. (Search for posts from a forum member named Uncle_Bob since he keeps a link to the ResScan download in his signature.) The System One needs Encore Viewer (which can be purchased for $100 from a variety of on-line cpap supply stores) or Encore Pro (which is sold to DMEs and doctor's offices, but not patients). If you really want Encore Pro, there are torrent sites from where it can be downloaded. There are also two forum members who are in the process of writing free software for analyzing the System One data: Cpapdork's Onkor program is a web-based program that does not require installing anything on your machine; jedimark's SleepyHead can be downloaded as an .exe file for a windows machine and the source code is available for those who want to try to compile it on other platforms. Both Onkor and SleepyHead are still in the early stages of development, so there are still bugs that the authors know they have to work on eliminating, but both programs can usefully provide some meaningful information to the System One users who cannot or do not want to pay for Encore Viewer. The Icon uses InfoSmart, which appears to be aimed at clinics and sleep doctor offices. I have no information about how a user might find and install the InfoSmart software for their Icon machine.

6) Data cards: The S9 and the System One both use standard SD cards for the data. The Icon uses a SmartStick.

dwynne, another thing to be aware of is that the full brand name of the "Resprionics" [sic] System One machines mentioned by robysue is Philips Respironics -- not just Respironics. Respironics (the company) was acquired by Philips a year or more ago. You'll often see the Philips Respironics System One machines referred to on this forum as PR1 or PR System One machines.

robysue wrote:[*]Resprionics: The System One REMstar Pro CPAP with C-Flex Plus and the System One REMstar Auto CPAP with A-Flex
-----
[*]Resprionics: The System One REMstar Plus CPAP with C-Flex and the System One REMstar DS150 CPAP
---
2) The naming of two of the Resprionics System One straight CPAPs is particularly confusing:
---

Here is a link to a page that has videos of some of the better machines with instructions on how they work as well.
http://www.cpaplibrary.com/machines.html
Hope this helps.

Dane

Thanks for all the help and info!

The sleep study went well last night. Got in bed about 10pm and by 11:30pm was getting set up for a mask (yep, I got it bad). Nose pillows would not do and I ended up in a full mask and was still sleeping when the study ended at 6am. Worst cotton mouth ever (by habit I am a mouth breather). Hard to imagine they could changed masks, chin straps, etc and not woke me up (except once). Yep, I got it bad and have falling asleep just about anywhere at any time. Felt a little short of breath for most of the morning, got used to a machine doing all the work all night?

I did not get much else from the tech other that by the morning is was "in the 20's". Waiting for the sleep doc's followup now.

dwynne wrote: I did not get much else from the tech other that by the morning is was "in the 20's". Waiting for the sleep doc's followup now.

While you're "waiting for the sleep doc's followup" you've actually got a whole bunch of things to do.

1) Call your insurance and find out about the following things:

• Coverage of durable medical equipment---xPAP equipment in general. You need to know what your copays for the equipment are going to look like---don't just assume that coverage will be good. Don't assume that coverage will be similar to coverage of prescription drugs. And DO find out if they pay for CPAP machines by code.
• Specifically ask the insurance company about in-network DMEs. The more names of DMEs on the list the better. And see if there are any DMEs that specialize in CPAP equipment in your area and whether those DMEs are "in-network".

2) Start callling DMEs NOW---or rather as soon as you get a list of in-network DMEs. You want to be the one who chooses your DME instead of letting the doctor or the sleep clinic chose the DME for you. You want to find a DME that you are comfortable with. And ideally you want to find a DME that will be happy to set you up with the full efficacy data (auto) machine of your choice---even if all the prescription reads is "CPAP at n cmH2O". So start screening DMEs while you're waiting to here back from the doc since you already know they did a split study on you and only let you sleep for 1 1/2 hours before strapping a mask on your face. You could use this as the first screening question for every DME you call: I have been diagnosed with OSA and am looking for CPAP equipment. If I chose you as my DME, would you be able to provide me with a <machine of your choice> for my first CPAP machine?


3) Continue reading here (and elsewhere) all you can about OSA so that you can go to your followup with your questions about the diagnosis and your CPAP prescription. If you have a lot of questions, write them down so that you don't forget them.

Best of luck

Still have not heard from the sleep doc, and I slept terrible last night (no machine) - so I called and they are out of the office until Thursday, when I have an appointment. I was hoping / thinking I could be snoozing on a machine before then.

I had already talked to insurance about DME and they (BCBS/TN) said I pay until I my deductible, then they pay 80% until I reach out of pocket max. Per robysue's suggestion I did call them back to ask more questions. That is in network, out of net is the same but deductibles and co-pays are doubled. Since I had used my plan $0 so far this year, I had to pay the full amount for the sleep study (over $1,300) but that did eat of most of my deductible and OOP.

They do use codes, it appears, and the deductible / co-pay apply no matter if I am "renting" or buying If they buy, looks like you can't ask for another machine for 3 years. Renting (of course) is on going and always covers machine replacement. They don't seem to have a rule about not doing APAP or BiPAP machines where needed (prescribed), but the DME has to be willing to sell what you want for the price will pay for a model of that code.

They were not much help with picking a DME and suggested I use the locator on their web page. Been there, done that, 114 within 50 miles of home. I just have to call them all and check off the ones that do CPAP and see what then they carry / sell /rent You are correct, a lot of work!

I will not know what type of machine I will need until after the doc visit, but the S9 line looks like my first choice over the PRS1 models either APAP or auto bi-PAP depending on what the doc days. MSRP is about the same, but if I were paying cash the PRS1 models are a LOT cheaper at most online DMEs. They would (I assume) have the same code and would cost me / insurance he same - then I think the S9 models. The DeVilbiss mdel are bargains if paying cash as well.

I called Resmed and got the names of several local DMEs that are on my insurance provider list, then called several of those to talk about equipment. One was really nice and helpful, another was fairly helpful, some others not so much (too busy to answer questions on the phone, perhaps?).

Anyway, to my insurance APAP and CPAP are the same and are paid out at the same price, BiPap is billed and paid higher. The bill $1,400 or so for CPAP or APAP machine and my insurance will pay about $1,000 (no matter what they bill). BiPAP is billed $4,000 or and paid around $2,600. If you have checked online price they are not hurting themselves selling for these prices. They can bill as a sale right off or a 10 month rental (to start). The insurance does not want to buy a new except every 5 years (the machines carry 2 yr or 3 yr warranties). In the case of an out warranty failure then have paid for repairs and even replacements in the past. This is just for the machine, not a mask of other supplies. Insurance will pay for a 1 new hose every month (?!) and a new mask every 3 months. Other suppliers are paid for as needed or reasonable. Anything not written on the script is not included but they can get stuff amended, added and approved later. Like the Resmed heated hose, get that specified on the script and then it is paid for - other wise I pay an up charge for that.

They admitted that since the insurance pays the same by code, they make more if you take a less expensive (them) machine.

They said the PR machines are the most popular because the docs and the DME can read /write / exchange info via the PR web page and can call for changes via that system. The S9 (and others) do have a data card they can read with the right software, but it sounds like the PR system could let me (or the DME tech) upload the info so they doc can see it w/o toting the card around. They seem to be more profitable for the dealers, which would make them tend to push them. One said the factory warranty service or replacement was easier with PR which is why they liked selling them.

One DME had a 30 day mask trial program, the others did not.

Next step is the doctor visit tomorrow...

dwynne wrote: One DME had a 30 day mask trial program, the others did not.

That is BS. They all get it from the mask manufacturer BUT they have to submit paper work. So someone is lying....NO surprise.

As for the data via modem to the doc and DME.... YOU won't see it unless you get a copy from them. To me that causes an unnecessary delay in me seeing my data and I personally would NOT sign-up for that.

Esp. when starting out you will want to see your data daily for about the 1st yr or so. Keep that in mind.

[quote=]As for the data via modem to the doc and DM[/quote]

Encore Anywhere..special modem attached to the back of the machine over the slot where the SD card goes.
Unsure if there is an extra fee. With this DME can check hours of use and gather other data if the machine offers it and they can make changes to machine via the modem.