Heading in for my titration tonight

Any recommendations?

Confession time I had a sleep test 10 years ago and didn't do anything about it. At the time the AHI was 34. I have recently lost about 48lbs and counting and this time the AHI was 20.8 so I guess that is good but still need the machine. Still have more weight to loose as well another 50 or 60 anyway.

I have high deductible insurance so the question of using a DME or buying online is big one for me. Anyone just do the fitting themselves using the online guides? Or do I really need to go to a DME at twice the price?

Do I buy the machine online and the mask at the DME.

Thoughts????

nappinginatree wrote:Do I buy the machine online and the mask at the DME.

It is often useful to use a DME for mask trial purposes because finding the right mask can be a challenge.
It depends on the DMEs mask swapping policy...if it's liberal then use them. If it is stringent 1 mask swap no matter what then don't use them.
DMEs are free to set up their own in house "rules".
Mask manufacturers typically offer 30 days for each trial...DMEs often just say 30 days period. That 30 days being 30 days from the first day of supply.
Once you find a workable mask...you can always buy online to save money.
If you have looked at masks and have an idea what you think you might like...let me know. I might have something. I have a few masks that have been donated that were past experiment failures. Not used much and with enough life remaining to at least try something to see if it is possibly something you might like.

If we were at the beginning of the calendar year there might be some advantage to letting the cost of the machine apply towards the deductible for the rest of the year but at this time of year...odds are you won't be incurring a whole lot more expenses and the savings could be significant. Do the math.
Also remember to compare what a DME might want to supply (a non data machine) vs what you can get online..machine of your choice without hassles and battles.

Does the combination of your Sleep Study, your Titration Study AND the machine & supplies still NOT exceed your deductible?

Advantage of using your insurance is that the insurance will DEEPLY discount both items. Of course, the DISadvantage of those discounts might be that you will not meet your deductible.

Since you waited 10 years anyway, had you been able to wait another 3 months that would have put everything in the same year.

And even if the Sleep Study, the Titration, AND the machine & supplies would still not have met your deductible, it should at least have put a big dent in it.

Our year runs with our fiscal year which is June. The way our insurance works is we have a 5200 deductible my employer puts in the first 2400. I suspect if what they tell me at the sleep center is correct the sleep study will be about 2500 for both nights. I assume the machine and everything that goes along with it will be about 1000 so I am still shy of the deductible by a good bit I think we have 550 towards it now so probably still 1000 short or more.

Most of the DMEs I called today said 30 day swap but did not indicate how many times you could do that. One did say that they try to keep that to one time.

The markup on those things is astronomical so while I understand the hassle with swapping I would think they would have to do several to even come remotely close to the cost.

ETA: I absolutely have to have good data reporting for compliance reasons for a medical certificate.

Boy, that is some sucky insurance!
I'd cancel the titration (probably too late for you), and get a good APAP.
I retitrated with my Autoset, and found the lab had set me 2-3 cm too high.
As for your proof of compliance, do you ABSOLUTELY have to go through the DME?
The summary data from my software should be good for your doctor to sign off on.
All cpaps have compliance data--but most of us need more.

I don't have to go through the DME. I am looking to start flying again and need the compliance data for a 3rd class medical. So long as the machine can produce it. I would like to have the detailed data. I have been looking at the Devilbiss autoadjust as it seems to have everything I need but also isn't completely high end cost wise like the S9. Also since I do camp quite often 12v system will work well with a simple battery set up.

At this point I will see how it goes with the test tonight maybe they will have a mask that works and I can use that as a baseline.

I use the Autoadjust as my travel machine; and I can't detect any differences in therapy.
Some of the numbers are a little different, but it all feels the same.
It's nearly as quiet as the Autoset, and made in the good ole USA. --with a 5-year warranty!
You may need to get the module and software so you will have more data to take your doctor (or the FAA)
(ignore the price shown; if bought at the same time, accessories are usually discounted.)
https://www.cpap.com/productpage/devilb ... ystem.html
We can also direct you to links to the clinician's manual (free).

Hi Napping Even though your insurance puts a lot of it on you, have you checked to see if they insurance negotiates some kind of discounted price with DME's? For me, the negotiated price makes them competitive with online sources plus you have somebody face to face to work with. I too camp a lot. Respironics machines are 12V so it makes it easier than say a ResMEd that needs an inverter. I use a drycell, deep cycle marine battery and get 4 nites without recharge.

Well I made it through the second night. Not too bad actually I slept much better(I thought so anyway).

Observations:

I am a mouth breather so getting used to the nose mask was a bit of a pain. Had an urge every so often to take a deep breath with my mouth. The whole not being able to open your mouth and take a breath is a bit frustrating.

I also felt at times like I had to work to exhale against the pressure so that was a little annoying. I understand the newer machines can lower pressure on exhale guessing the one they use there doesn't.

The nasal mask they used gave me a sore on my nose. I tried adjusting it several times but with all the other wires I couldn't get it just right.

It did make my ears pop a little.

For the last half hour or so I tried a full face mask and liked it but it has it's own quirks (cheeks puffing up). Thinking I will need one of each anyway for those times when I am stuffed up.

I had a fairly vivid dream that my mask was filling with water and I was having a hard time getting it off. Shortly after that I woke up to go to the bathroom. Not sure what that means.

I will check with the insurance company again today to see if they have any negotiated agreements. They are a pain to work with.

If mouth breathing is your thing, you might try the Fisher-Paykel Oracle 2 oral mask.

Take a look at my post:

viewtopic.php?f=1&t=63139&p=589683&hili ... hs#p589683

It might give an idea about how to cope with the issues related to this mask.