Is it worth fighting for an APAP vs. a CPAP?

ambar · Post by **ambar** » Fri Mar 31, 2006 4:27 am

My titration study at Stanford resulted in a prescription for a CPAP at 10cm pressure (AHI on the diagnostic study was 33). According to the fine folks at billmyinsurance.com, I cannot get an APAP through them unless the prescription specifically calls for one. I specifically discussed APAP with the resident at Stanford in the consult I had before the titration, and she was very down on APAP (the summary is "the technology doesn't work as well as they say it does.") It appears that their clinic policy is to prescribe CPAP, or BiPAP for people who need very high pressures. I'm trying to get the prescription adjusted, but it's become a game of phone tag that I simply cannot win (the latest excuse was that the doctor had been out of town). I talked to my GP today and she "doesn't feel comfortable" writing the prescription -- even accused me of trying to duck the specialists -- I really went off the handle at that one (and she is normally a very cooperative doc).

Don't tell me to front the money and go through cpap.com -- that's $1k I don't have and can't risk BS/BC screwing up on the reimbursement.

I'm pretty pissed because the morning I woke up after the titration is the most awake I have felt in AGES, and I want to get this show on the road.

Suggestions? Keep after them or give in and get the non-auto for the sake of starting therapy already?

I haven't even STARTED sleeping with a mask and I'm already frustrated to the point of tears. Arrgh!

TerryB · Post by **TerryB** » Fri Mar 31, 2006 6:21 am

My personal preferance is CPAP with C-Flex or equal. I got an auto and it was initially set to auto with C-Flex. I was disturbed by the variations in pressure when the machine decided to increase pressure. The mask seal efficiency was also less reliable with the low pressures. So now I have 12 cm CPAP with 1 CM C-Flex.

TerryB

wading thru the muck! · Post by **wading thru the muck!** » Fri Mar 31, 2006 6:32 am

ambar,

No need to get so frustrated. APAPs are useful machines for many of us, but the benefits of an APAP over a CPAP at 10cm are likely to be very minimal in the short term. Some here have reported that APAPs don't seem to work for them. Some very knowledgeable people have the data to show that CPAP worked better for them than APAP. I personally chose to get an APAP, but don't feel as though you are doomed to failure if a CPAP at 10cm is what your Doc thinks you need.

I'm not saying give up the fight... just don't feel as though you failed if you are not able to convince your Doc.

ozij · Post by **ozij** » Fri Mar 31, 2006 7:17 am

Keep after them or give in and get the non-auto for the sake of starting therapy already?

Absolutely. You felt great after the titration night, so they may be right about your pressure.

Wader practically took the words out of my mouth....

O.

sleepylady · Post by **sleepylady** » Fri Mar 31, 2006 1:40 pm

You could try talking to your specialist again and state all the valid reasons why you would prefer a CPAP over an APAP. Remind them that this machine can definitely be set as a CPAP. You might want to search for other threads about justifying APAP's to the doctor. I believe we just had a thread about it a couple of days ago.

I agree with Ozij that you should definitely start treatment as soon as possible. For me, I started on CPAP and really tried to get it to work, but after upping the pressure and still having problems I called my doctor to see if she'd write me a script for an APAP and she did. Personally, my APAP works better than the CPAP did AND they had me set at a higher pressure than I'm at most of the night. One thing in my favor was the fact my insurance likes to make monthly payments for 10 months. In that time if my doctor switches me, I can then get a different machine and don't have to start the rental period again. You may want to see how your insurance handles the purchase of CPAPs.

Best of luck and let us know what happens.

Melinda