Newbie - which auto CPAP machine?!

Vlad - Who is ResScan software available from for free? wrote:

Lizistired wrote:There are several threads on this.
There are some advantages to the PRS1 550:
The hose attaches on the top and swivels, on the S9 it comes out the back and has to do a sharp 90 deg turn where hoses tend to fail. Not a deal breaker but something to consider.
PRS1 has separate on and off settings for auto start & stop. The S9 has one setting that controls both. I like auto on for convenience but if I take the mask off in the middle of the night I don't want the machine to turn off because I won't hear it blowing and put the mask back on. So I can't use "smartstart".
Resmed ResScan software is readily available for free, easy to use. The color LCD screen is bright and clear and gives you more information than the black and white PRS1 screen. Now that Jedimark has made "sleepyhead" available that isn't such a big deal.
Style: S9 is silver and has a fat Bose look and the PRS1 is earthtone but kind of bulky looking, though I don't think the footprint is really any bigger. I only mention this because I know some people care way too much about decor.
I love my S9, but they are both good machines. Others know more about the difference between the S9 EPR and the PRS1 A&C flex, exhale relief.
But really, you will be happy with either one.
I think PR has a 60 model now but we haven't heaqrd much about it yet, so I can't comment on that.

Where can I get a free ResScan software?

viewtopic/t80020/Resmed-S9-Software.html

I am new into my therapy night #9 tonight and i have the resmed s9 autoset my 1st machine and i love it i am not going to lie! I also have a full face mask which i found works better for me my aHI numbers have been amazing with my autoset/mask combo

OK -- I am going to 'wake up' the topic.

I am in the same boat -- literally just diagnosed the other day with mild sleep apnea and now have to decide on a machine.

The info given thus far in this thread on machines has been very helpful and it seems the money is on the Resmed and the Respironics Auto models. However, I was wondering if anyone had an opinion on the clinical efficacy of the DeVilbiss Intellipap Auto model? The DME supplier that my sleep testing company works with said they usually recommend the DeVilbiss line to patients. They can special order Repironics models -- however if they do they can't be returned to test out a different model.

I am leaning toward the new Respironics One 60 with the heated tubing option and/or the DeVilbiss. I promised myself I would try to get a US-made machine if possible and those two are the only choices out there. The Resmed is a great machine, but ...imported

I have a BCBSIL PPO that covers 80% of the DME allowed network charges. When buying these models with insurance, does the end price vary with the machine chosen or do all APAPS/CPAPs models get reimbursed at the same flat rate by the insurer/patient?

Because one thing is for sure -- the Devilbiss may not have some of the bells and whistles of the other models, but even with the add-on humidifier and optional data module, it's cheaper, at least online.

Now if in the CPAP DME world, the insurance pays the exact same amount for Brand X, Y, or Z CPAP or APAP, and I will have the same co-pay, then I may as well pick the better model regardless of MSRP. Because my co-pay will be identical. Is this what happens when buying a CPAP with insurance?

Has anyone ever negotiated the amount billed for a machine with a DME provider to match the online prices? Or do the DME people simply max out the contracted rate from the insurer without giving a choice? Because if I can negotiate a DeVilbiss Auto from a DME at $600, it will cost me less of a co-pay than another machine retailing at $1,000.

Also, finally, are there any newer clinical studies out there published on more current machines? Everything I have found has been on very old, obsolete APAPs.

Thanks!!!!

Spektor wrote: Has anyone ever negotiated the amount billed for a machine with a DME provider to match the online prices?

It's doubtful that you can do this. There likely are behind the scenes regulations that require the billed amount to be the same for all people. Especially if the DME is a participating provider with Medicare. Medicare would clean their clocks if they found out that a DME was selling a machine to someone at a lower price would be offered to a Medicare patient. I think that is a big no-no.

The only problem I have with Devilbiss machines is the lack of wave form data. It doesn't gather it.
I also don't particularly care for their software and the way it does present the data that it does gather but that is my own preference.
Since I tend to be data oriented...I want the most data I can get and that includes waveform. Is it a deal breaker?
Probably not but since there are other machines out there that also do a great job and are well thought of brands...then I tend to prefer them.

For what it's worth, I have both machines, the S9 Autoset and DeVilbiss Intellipap which I use at my wife's house when I'm there (long distance marriage [careers, kids, elderly parents]). The Intellipap is the equal of the S9 Autoset, in my experience. If you want to record data, they will both do that, but the data capabilities of the S9 Autoset are superior to that of the Intellipap. However, all the fiddling around with data isn't for everyone, and paying twice the price of an Intellipap just for data capabilities that you may not be interested in might not be worth it to you.

If you have your pressure setting from your titration study, you can use that level, minus about 2 cm pressure to set as the minimum pressure and that's all you need. Either machine will take it from there, and with the lights out you won't know the difference between the machines. I think there's far more variability in choice of masks than there is in machines. Any automatic machine will do essentially the same thing. The Intellipap is a good one.

Pugsy wrote:

Spektor wrote: Has anyone ever negotiated the amount billed for a machine with a DME provider to match the online prices?

It's doubtful that you can do this. There likely are behind the scenes regulations that require the billed amount to be the same for all people. Especially if the DME is a participating provider with Medicare. Medicare would clean their clocks if they found out that a DME was selling a machine to someone at a lower price would be offered to a Medicare patient. I think that is a big no-no.

The only problem I have with Devilbiss machines is the lack of wave form data. It doesn't gather it.
I also don't particularly care for their software and the way it does present the data that it does gather but that is my own preference.
Since I tend to be data oriented...I want the most data I can get and that includes waveform. Is it a deal breaker?
Probably not but since there are other machines out there that also do a great job and are well thought of brands...then I tend to prefer them.

Not Medicare -- its Blue Cross/Shield of Illinois private PPO plan. Yeah I just figured hey, I know what the retail price of this box is on the internet, you guys have a reimbursement rate of way more than that, so will you cut me a deal and take less, so my co-pay is less? I asked BCBS if I could buy the machine online for cheaper and then send them the receipt to reimburse me -- noooooooooooope. They said basically I had to use a participating provider DME to get BC to pay the full 80% -- even if BC is getting hosed on the price compared to online vendors. Only in America....

And back to the machines, so then from a patient standpoint, does the DeVilbiss Auto "feel" the same breathing in and out as the more expensive machines? Is it equally "comfortable" to a patient? I hear so much about patented algorithms and expiration relief and sensors and response to apneas time, etc. it's all so daunting.

Maybe it will be the heated hose that does it for me.

I probably should test drive all of them. Make the damn DME people let me do it. I guess all things being equal, if my insurer will only pay a fixed fee for any machine and if I cant get the DME to cut my end co-pay cost on a DeVilbiss, I should just follow the crowd and go with one of the Cadillac models.

Any news in the grapevine when DeVilbiss will have its own super deluxe Cadillac model? Hopefully soon.....

Pugsy wrote:
The only problem I have with Devilbiss machines is the lack of wave form data. It doesn't gather it.
I also don't particularly care for their software and the way it does present the data that it does gather but that is my own preference.
Since I tend to be data oriented...I want the most data I can get and that includes waveform. Is it a deal breaker?
Probably not but since there are other machines out there that also do a great job and are well thought of brands...then I tend to prefer them.

If you get the optional data module for the DeVilbiss, does it then track this data?

Thanks!

Spektor wrote:If you get the optional data module for the DeVilbiss, does it then track this data?

No, it isn't a matter of the software not showing the waveform...it is the matter of the machine not gathering that particular data point.

Look on this page for the software examples..pictures on the left..click on each to enlarge. This will give you an idea what that software shows.https://www.cpap.com/productpage/devilb ... ystem.html
FWIW...I hear the Intellipap is a great machine. I have never tried it though so I can't compare it to anything.
It isn't a crap machine by any means just because it costs a little less. It is an excellent machine.
Will one algorithm work better for you than another? Unknown. While there are some people who might do better with one over an other I think that most people will do just fine with any one of them. I happen to own both a Resmed S9 and a Respironics PR S1 bilevel pressure machine. Minor pros and cons with either but none are that big of a deal. I get excellent therapy and feel the same with either.

Now go to this link and look at this software report. While this is from a high dollar machine the basics are there and you get the data shown when you use Respironics software....ww.healthcare.philips.com/pwc_hc/main/h ... _Guide.pdf

I prefer the way the Encore reports are presented visually over the Intellipap software. You might be totally happy with the way the Intellipap software presents the data it collects.

Being new and if a Respironics machine has to be ordered it is very likely that the 60 series will be supplied and SleepyHead won't work with it just yet. It is being worked on though. You can look at the User Guide for SleepyHead to see what that software looks like. It offers a lot more data and things you can do with it over the brand name software.

Hi Spektor,

I am a disgruntled Intellipap owner. Let me qualify what I am about to say by noting that I am probably in the minority on this board regarding this machine so keep that in mind. Here goes.

If your therapy goes well, then I imagine that the Devilbiss is a great machine. But when it doesn't, as mine hasn't, the lacking the data that Pugsy talks about is frustrating. Of course, I don't know if that would make a difference but it would sure be nice to have as much information as possible to figure out what is going on.

Also, as someone who had to return my unit to cpap.com for service, please check how your DME handles warranty issues. Since Devilbiss will not do a straight exchange unlike Resmed, (viewtopic.php?f=1&t=80249&p=739583&hili ... om#p730033), I either have to rent a machine from cpap.com or buy another backup unit.

Since I was pretty unhappy with the unit, I was considering buying another one anyway. But personally, I find that philosophy very troubling since a customer would be without a unit for 3 to 6 weeks if they don't have the resources to get another one.

Good luck with your decision.

49er

Was your problem caused by the machine or is the Intellipap not capable of overcoming it? Does the Intellipap not account for your type of apnea with its algorythms etc?

Yeah -- I'm set to talk to the DME people today about deciding on a machine.

My big question now is I have called about three places and asked what models they carried and if I can test drive them before deciding. I was rather surprised that no one I spoke to said they carried both DeVilbiss and Respironics, and no one said they allowed test driving the equipment before buying. That was rather surprising. You apparently just have to pick one then you're kind of stuck with it.

Hi Spector,

You're asking some good questions for which I don't have a good answer. I am now wondering if I had a machine that was totally defective because of a just concluded conversation with a cpap.com rep. I am reconsidering buying another machine as I would like to give this machine one more shot.

But then there is getting a quick replacement which has been the customer service experience from hell.

Too bad there isn't a Herz or Avis of cpaps so a potential customer could test them out.

You might want to read this thread thread and look for the post by McDover, a trusted machine salesman about what this person recommends regarding machines.

viewtopic/t81487/Considering-a-Fisher-a ... -Icon.html

Good luck.

49er

Spektor wrote:Was your problem caused by the machine or is the Intellipap not capable of overcoming it? Does the Intellipap not account for your type of apnea with its algorythms etc?



Yeah -- I'm set to talk to the DME people today about deciding on a machine.

My big question now is I have called about three places and asked what models they carried and if I can test drive them before deciding. I was rather surprised that no one I spoke to said they carried both DeVilbiss and Respironics, and no one said they allowed test driving the equipment before buying. That was rather surprising. You apparently just have to pick one then you're kind of stuck with it.

49er wrote:Hi Spector,

You're asking some good questions for which I don't have a good answer. I am now wondering if I had a machine that was totally defective because of a just concluded conversation with a rep. I am reconsidering buying another machine as I would like to give this machine one more shot.

But then there is getting a quick replacement which has been the customer service experience from hell.

Too bad there isn't a Herz or Avis of cpaps so a potential customer could test them out.

You might want to read this thread thread and look for the post by McDover, a trusted machine salesman about what this person recommends regarding machines.

49er

Ha yes! Well that was my next question -- can one 'test drive' different machines before deciding on one to buy. The DME people my sleep test people sent me to (turns both are owned by same people.....) want me on this DeVilbiss machine and can only get me a Resmed or Respironics by special order. Doable but cumbersome. They say they are not able to let me test out one machine versus another one. I asked if I could borrow a DV machine for a few days then try out a Respironics to compare. No, not allowed. May be possibly be able to rent out a loaner DV but not another brand. Well that would be pretty pointless.

So I have been on the phone with Respironics and then their local Chicago sales rep and he gave me some other local DME people to contact that may do better for me.

I've honestly never heard of a business that is so restrictive. If I can return underwear that don't fit me well, or even an electric toothbrush, for the amount these machines cost, a person should be able to test them out before buying -- or at least give a satisfaction guarantee to return the unit for a full refund within a certain time period.

[/quote]
Ha yes! Well that was my next question -- can one 'test drive' different machines before deciding on one to buy. The DME people my sleep test people sent me to (turns both are owned by same people.....) want me on this DeVilbiss machine and can only get me a Resmed or Respironics by special order. Doable but cumbersome. They say they are not able to let me test out one machine versus another one. I asked if I could borrow a DV machine for a few days then try out a Respironics to compare. No, not allowed. May be possibly be able to rent out a loaner DV but not another brand. Well that would be pretty pointless.

So I have been on the phone with Respironics and then their local Chicago sales rep and he gave me some other local DME people to contact that may do better for me.

I've honestly never heard of a business that is so restrictive. If I can return underwear that don't fit me well, or even an electric toothbrush, for the amount these machines cost, a person should be able to test them out before buying -- or at least give a satisfaction guarantee to return the unit for a full refund within a certain time period.[/quote]

Definitely try other DMEs. It sounds like your current wants to do as little work as possible instead of helping you find the best machine for your needs.

Yup, it is a pretty restrictive business.

49er

The test drive issue is ostensibly an issue of hygiene, since these are medical respriratory devices. But in reality, it's just too much trouble for the DME's.

My HMO (Kaiser) regularly gives patients Respironics Auto machines for week long home titrations. The machines are used over and over again, and obviously they have the ability to clean them well enough that it doesn't violate any regulations regarding the re-use of medical equipment. Each patient gets a brand new hose, filters, and a mask for titration. They don't give you a humidifier for the home titration--apparently those are a bigger pain to clean and the tanks would have to be replaced between patients--those are costly.

So theoretically, a "try before you buy" plan could work, but the DME has NO incentive to do it--it's troublesome and cuts into their profit margin, even if they end up with a stock of returned machines (i.e. from people who don't meet the compliance requirements or who give up too soon).

F&P and DeVilbiss machines do not currently record airflow waveforms at all.

The data capable S9 and PRS1 machines record airflow waveforms. While apnea event recording and categorization is a good thing, there's no substitute for looking at the actual airflow waveforms to have a picture of your breathing.

In my opinion, you and your doctor are flying blind trying to treat without airflow waveforms.