Newbie; good DME experience

Hi All,

I suspected sleep problems (based on how I feel plus comments from my wife), so I went to a Sleep specialist (M.D.). I am in my mid-40's. He checked me out and ordered a sleep study. I expected to come to a sleep center for the full works, but instead got a call from Sleep Management Solutions (SMS) where they set me up with a home sleep study (Philips).

I got myself all wired up (feeling like Capt. Picard of the Borg when I tried to sleep), and had my night's sleep; sent the machine back in the morning. A week or so later got in touch with my Dr. and he confirmed that my study confirmed OSV, but a mild case (with a number of "8" whatever that means).

Since then I found CPAPtalk and have been scouring the forums reading up on peoples' experiences (I am an engineer by trade so I like to learn all I can before going into something new). I wanted to know the questions to ask and the things to watch out for (both good and bad). I was especially interested in the various DME experiences - it looks like people have the whole range of experiences with their DME's, both good and bad.

SMS sent over a person to my home to set me up with an xPAP machine, and I can honestly say that it was a very good experience. I didn't sense any technobabble BS (I have a good BS detector), and she actually asked me what I have heard/read about CPAP, and what my expectations were (especially about the type of mask I may be interested in). I didn't feel bamboozled or steered into anything - she answered all of my questions honestly. She will be keeping in touch with me to make sure any problems I have are resolved.

I was pleased to see that the machine I was given is a very good one, with lots of features and monitoring ability. I had my first night with the APAP machine last night, and overall it was not too bad - I was able to sleep, but in the morning I found my nasal area (skin surface) felt a little weird most of the day. That's probably because I am not used to having a mask on my face. I did wake up once during the night with an "OMG I'm suffocating!!!" feeling, but that was temporary.

I asked my wife if the APAP machine noise bothered her; she said on the contrary - between the fact that I wasn't snoring up a storm, plus the machine's gentle hissing, she actually slept well.

So I am hoping for continued good experiences (while recognizing that there may be temporary setbacks).

-- Steven

EXCELLENT!!!

Sounds like you're a duck (one of those people who takes to CPAP therapy like a duck to water), but if you do run into any difficulties you have a good, data capable machine to see what's going on. You were very fortunate with your DME.

Janknitz wrote:EXCELLENT!!!
... you have a good, data capable machine to see what's going on.

I see you have the same machine. I've seen reference to "SleepyHead" software on this forum; is that what I would use to check my performance (based on the data on the SD card)?

-- Steven

Yes, Sleepyhead and Onkor are open source software programs written by members of this board to help people view their data. I bought Encore Viewer before these two options became available, so I haven't used them, but many others have. They are still "alpha ware", but provide a lot of information your geeky heart should love.

You should consider yourself luck to get a data capable machine right off the bat from the DME. I tried to talk my sleep doctor into an APAP for me first machine. He explained that getting the pressure right was more important and I would be fine with a fixed pressure CPAP. What he didn't tell me was that the DME gets paid a flat amount by your insurance company to supply a machine and will always give you a cheaper machine because there's more profit there.


The following is probably too much information for most, but is relevant.

Sounds like your "8" number is your pressure prescription. It is measured in centimeters of water (CM H2O). That means your machine can produce an air pressure that will displace 8 centimeters of water in depth. I've actually done that to check my machine calibration. You find a metric ruler that you can tape to your hose (with mask removed). The zero end should be even with the end of the hose. Fill a clear container that is deep enough to allow the ruler to be inserted past your prescription number in centimeters. Mine is 9. I inserted the ruler all the way to 12 with the machine running. As I slowly lifted the ruler, the hose started bubbling into the water right at the 9 centimeter point. That assured me my machine was producing the right pressure.

DaveLP wrote:Sounds like your "8" number is your pressure prescription.

From what the technician said, the 8 referred to the number of apnea events in an hour - does that make sense? (it was acually 7.9, but she rounded it)

I checked my machine this morning and it said that the 90% pressure it used was 6 cm H20. The machine starts out at a minimum of 4.

-- Steven

You have very mild apnea if your untreated AHI is 8. "Normal" is considered to be anything less than 5. So for you to get an APAP machine for treating such mild AHI, you either got incredibly lucky with your choice of DME's (some actually care about the treatment their patients receive), or your doctor (i.e. if the prescription called for that machine) or the DME figured out pretty quickly that you have done some research and would insist on the best machine. Some people with severe apnea (anything over 30 is considered severe, but we've seen people with AHI's over 100!) only get a data-less brick straight CPAP machine because the DME wants to maximize profits and newly diagnosed people don't know enough to ask for a better machine.

The PR S1 Auto is a very good machine. It delivers great therapy, it's quiet and easy to use for treatment. It's not so easy to access data (you need software to see what people with ResMeds can see right on their backlit, color screens on their machines), but it's good data when you do access it. You don't have all the options for heated hose, slim hose on a PR S1 either. But there's nothing wrong with the PR S1 auto, it just doesn't have all the bells and whistles. A Ford, not a Cadillac.

I had no choice of machines because of my HMO situation, but overall I'm quite happy with the PR S1. It delivers good therapy, and night after night, that's what really matters.

You have choices on what software you wish to use.
Examples here. viewtopic.php?f=1&t=64906&st=0&sk=t&sd= ... re+options

Thanks for the info.

Tell us more about the home sleep test. Did they wire you up and send you home, or give you a box of stuff?

Did you have wires in your hair? A band around your chest? Wires elsewhere? Did the mask have any wires or anything odd about it? Was it a full face or nasal mask? Did you notice what model the machine was? Any kind of phone line connection or wireless? Anything else of interest. Geeky minds want to know.

It's interesting that they started with a home sleep test and gave a data capable machine to a newbie instead of trying to screw him with a non-data machine. Maybe someone's getting smart.

chrissv, mind telling us who your insurance is with? I'd be interested in what the insurance company paid for the test, too.

However, look at the rules here: http://www.sleepmanagementsolutions.com ... alForm.pdf

Looks like they make it difficult to get an in-lab sleep test.

By the way, does your PRS1 machine have a modem or the wireless antenna on the back?

archangle wrote:Tell us more about the home sleep test. Did they wire you up and send you home, or give you a box of stuff?

They sent me a well-put-together kit for the Philips Alice PDx home test system. I wired myself up. They had an instructional DVD that I watched beforehand, and I found a youtube video of it here: https://www.youtube.com/watch?v=EaOMGfj-YYU
It was super easy to do, very idiot-proof; my only complaint is that the medical tape holding down the O2 sensor wire on my arm took off a layer of hair!

archangle wrote:Did you have wires in your hair? A band around your chest? Wires elsewhere? Did the mask have any wires or anything odd about it? Was it a full face or nasal mask? Did you notice what model the machine was? Any kind of phone line connection or wireless? Anything else of interest. Geeky minds want to know.

Check out the video for those answers. The machine was a Philips Alice PDx Portable Diagnostics Recorder. It was quite geeky! Like I said, I felt like a Borg when I was done. But it worked. No phone line - it had an embedded SD card in it, that they apparently extracted once I sent the machine back.

archangle wrote:It's interesting that they started with a home sleep test and gave a data capable machine to a newbie instead of trying to screw him with a non-data machine. Maybe someone's getting smart.

The comment I got from the SMS rep is that since the insurance company didn't have to shell out tons of $$$ on an in-lab sleep test, they are more willing to go for the high end xPAP machine. Plus. the home test may not have been as accurate as an in-lab sleep test, but it confirmed enough of an OSA problem that the APAP machine could adapt to the correct setting for me. No complaints so far!

archangle wrote:chrissv, mind telling us who your insurance is with? I'd be interested in what the insurance company paid for the test, too.

I have Tufts Health Plan (HMO) through my employer. I should also mention that all of the test, equipment, masks, replacements every 6 mo., etc. is paid for 100% with no co-pays. I know - I'm lucky there.

archangle wrote:By the way, does your PRS1 machine have a modem or the wireless antenna on the back?

Yes, it has a cellular modem + antenna on it. The SRS rep said that they would use it to monitor my therapy (and compliance) for a few months, and then I'd send the modem back (they gave me a SASE for the modem).

This conversation has been very educational - thanks for everyone's comments and questions.

-- Steven

Interesting, thanks for the link.

Looks like most of the stuff from an in lab sleep test, but no EEG or EKG. Probably a really good place to start, but I hope they don't make it too hard to get an inlab sleep test if it's needed later.

Be sure to keep track of the cover that goes over the hole the modem fits into.