Preparing for a new machine (5-year mark)

Hi, everyone! I hope all of my fellow apneics are doing well or at least trying to stick with therapy (if you're new to it).

In February 2014, I will be hitting my five-year anniversary on xPAP therapy which means...

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... I will be elligible for a new machine. My HMO covers 50% of the cost (it used to be 80%... bastards). What can I expect when it comes time for a new one? Do I need another sleep study after five years? I have lost about 30 pounds frmo when I started but hope to lose another 30-50. Luckily, I have a great DME rep. I'm just trying to get all my ducks lined up.

Thanks!

Jonah looked so adorable; I miss his cute little smile.

Since you currently have an old machine and a fairly high pressure, I would consider a new sleep study. I just had one and was surprised to find I now had complex apnea.
I would have happily settled for an S9 Autoset which I was actually fighting for when I discovered the complex apnea.
I now have an ASV machine which I am starting to get used to.
I would recommend a new sleep study just to get enough info to be sure I knew what I wanted.

tattooyu wrote:Hi, everyone! I hope all of my fellow apneics are doing well or at least trying to stick with therapy (if you're new to it).

In February 2014, I will be hitting my five-year anniversary on xPAP therapy which means...

dun dun DUNNNNNNNNNNNNNNNNNNNNNNNNNN

... I will be elligible for a new machine. My HMO covers 50% of the cost (it used to be 80%... bastards). What can I expect when it comes time for a new one? Do I need another sleep study after five years? I have lost about 30 pounds frmo when I started but hope to lose another 30-50. Luckily, I have a great DME rep. I'm just trying to get all my ducks lined up.

Thanks!

I am thinking about the same thing although my time is a year or so from now.

By that time my weight will have moved some 50 pounds (about 30%) from the last time my Doc moved my pressure.

I have been using CPAP for ten years with only the first sleep study done.

So in about a year I suppose I will be doing a sleep study. If they still find OSA I will request a simple dumb brick CPAP (I plan to add the flow data monitoring myself). What I do NOT want are any of those crazy unnecessary sleep disturbing "clear airway sensing" pulses!! I think my sleep quality will improve considerably when they are gone!!!

I have found that I do just fine with no humidifier and since I can see that "what grows in there" may not be good I am likely to stay that way.

I hope to establish a machine for home and one for on the road. The one at home I hope to have with a one night capable battery backup capability.

If they do not find OSA I will invest in home PSG supplies. I do not think that OSA is the same any day. What they find at the lab may very well not be true at home.

One more thing the weight loss is very long term for me. I do not believe that it is good to change your weight by more than 8% per year. Too many toxins and other changes. Not enough time spent working to change the things which brough on the weight. It takes time to learn to eat well. It takes time to train the body to have more muscle and be used to a lot more use.

i'm wondering if it might actually be cheaper to buy one from one of our regulars who sells new machines here - i bought a new respironics ASV 950 for WAY less than 50% of the price offered by online sellers ( DME's prices are usually way above those)

I'm going to send an email over to my DME rep with a few questions. He's actually a stand-up guy.

johnthomasmacdonald, I'll PM you on that other option.

chunkyfrog, you don't like my beautiful visage?

Aww, you're cute too.
Now I know where Jonah got his stunning good looks.

It's unlikely that you will need another sleep study. That isn't normally needed when a person gets a new machine. You would need to check with your insurance company to be sure.

Now you are a handsome young man but cute kids trumps handsome young men any day of the week.

chunkyfrog wrote:Aww, you're cute too.
Now I know where Jonah got his stunning good looks.

Pugsy wrote:It's unlikely that you will need another sleep study. That isn't normally needed when a person gets a new machine. You would need to check with your insurance company to be sure.

Now you are a handsome young man but cute kids trumps handsome young men any day of the week.

Awwww shucks!

Now the question is: ResMed S9 or Respironics System One? I'm used to ResMed, so I'll probably stick with that, but is there any reason one might trump the other?

Since you are used to the ResMed's way of doing things I think I would suggest staying with that brand...though they did change the algorithm a little but it was an improvement and I doubt you will notice any difference in actual breathing.
You know I have had a chance to use both machines and in all honesty since the PR S1 now has a heated hose....it's a toss up.
Before the heated hose..the Climateline was a significant pro IMHO.
Since insurance is going to pay the same and you are going to have to pay the same no matter which machine...I would stick with ResMed unless you just like to experiment and want to see what the other side is like.
Minor pros and cons with either but none are deal breakers.
The humidifier hose placement on the PR S1 is a definite advantage. Resmed still has it in the back but you are used to that anyway so likely not a factor.

They are both great machines and both do a great job..they just go about the job a little differently so while they each take a slightly different road...they both get there.

I think that most people would do just fine with either one. Now if you were footing the entire bill yourself...save some money and get the PR S1. There are a few people who do seem to prefer one brand over another for various reasons.
If the DME happens to have both brands so you could try the PR S1 just to see if you might like it better...wouldn't hurt to take advantage of it but most DMEs don't have those sort of trials available. Most of the time they stock only one brand but if you don't ask the answer is always "no".

I am first to admit I am new to this entire self educating and self treating for apnea. Which considering I am a certified wilderness 1st responder and most of my life educted myself on everything I had a vested interest. To the point of currently holding 57 state, federal and trade licenses. Until left out in the cold by a couple of sleep doctors my current situation with work and trying to be a full time home health care provider for my wife I never really took any time to learn about my apnea.

While I have griped about the price of our health insurance ($2,100 per month for 2 people) i have learned from sites like this I have a good deal. 4 fully paid sleep lab visits this year thus far and they buy a new machine 100% of cost every three years I am learning I have a great deal. When I wrecked my motorcycle my primary care physician requested an out of state orthopod and they didn't blink. Super doc rollex into state with one case of titanium rods, plates, screws, etc and a case with his own tools. When I started my business I met with a reputible insurance agent and told him I wanted the best health, liability, building, contents, workmans comp, vehicles and all. It is expensive but have never regretted having good insurance. These high out of pocket most folk I hear talk about would probably cover a better policy but cant be sure. Only bad insurance issue I ever had was when rear ended by a lady text messaging and did not see the red light or me stopped for it. She had one of those wonderful state minimum insurance policies. Since the accident was caused by a negligent driver my health insurance xid not pay for 1st 30 days medical bills and her coverage didnt even cover the first day but my vehicle insurance did kick in 5k in medpay funds. Before the 1st 30 days went by and my insurance kicked in I was presented a bill from the hospital for 75k. Once my insurance company contacted hers they said had lost all contact with their client and when we found her they would be bappy to show up in court. 2 years later after chasing her around the country I just paid the bill. Now all my vehichles have 50k in medpay to protect for that. Wben I hit the deer on my motocycle my insurance paid every dime.of th 1/4 million meds bills from time paramedics scraped me off the pavement till medical transport delivered me home 2 weeks later.

With the cost of my new ASV machine having to.ante up half the cash myself would suck. In 2.5 years diagnosed been to sleep la 7 times. 4 this year and doctor said once i settle info new macbine a couple weeks will stick me back in 1 more time this ysad. My theory is if you pay for good insurance then use it. Get your studies and your new equipment. Now that I see the state of medicare I will probably keep private insurance for life. I dont want some government employee telling me what procedures I or my wife dont qualify. If I want to roll into the emergency room for a hang nail so be it. The crazy thing is we got letters this hear saying our current insurance plan is no longer allowed by obamacare. Because we meet the current 7.5 year grandfather clause we get to keep keep it but starting in 2014 we have to pay $140 per month per policy holder luxery tax because the vovernment has ruled it unfair to have our plan. If we modify our coverage it has to be into a government approved plan. I cant add any new employees into this plan, I have to give them crap for insurance. Put a man into a high risk job and have to give him cut rate benefits. Hopefully if one gets hurt on job I can still take good care of him through our caddilac workmans comp plan. Rant off.

Pugsy wrote:Since you are used to the ResMed's way of doing things I think I would suggest staying with that brand...though they did change the algorithm a little but it was an improvement and I doubt you will notice any difference in actual breathing.
You know I have had a chance to use both machines and in all honesty since the PR S1 now has a heated hose....it's a toss up.
Before the heated hose..the Climateline was a significant pro IMHO.
Since insurance is going to pay the same and you are going to have to pay the same no matter which machine...I would stick with ResMed unless you just like to experiment and want to see what the other side is like.
Minor pros and cons with either but none are deal breakers.
The humidifier hose placement on the PR S1 is a definite advantage. Resmed still has it in the back but you are used to that anyway so likely not a factor.

They are both great machines and both do a great job..they just go about the job a little differently so while they each take a slightly different road...they both get there.

I think that most people would do just fine with either one. Now if you were footing the entire bill yourself...save some money and get the PR S1. There are a few people who do seem to prefer one brand over another for various reasons.
If the DME happens to have both brands so you could try the PR S1 just to see if you might like it better...wouldn't hurt to take advantage of it but most DMEs don't have those sort of trials available. Most of the time they stock only one brand but if you don't ask the answer is always "no".

I'm thinking along the same lines as what you posted. However, my S8 AutoSet II has the hose in the front, not the back.



I can't imagine it would be that difficult to get used to, but I'm not sure my side table can accomodate the S9 OR the PR S1. The cubby is narrow but deep, so my S8 fits perfectly. I'll have to measure. I can't wait for the ClimateLine. Have they fixed the issue with them going out frequently?

And, as always... thank you, Pugsy.

I totally forgot about the S8 hose junction placement..sorry.

Yes, they seem to have fixed the issues with the ClimateLine hoses wanting to tear easily. Some people still prefer to add a little vet wrap at the junction to the coupling. I used mine for 14 months though without any added support and I didn't have any issues but then I didn't mess with it much either. Some people feel the need to remove the hose and clean it every day and it's like anything else..the more you mess with things the greater the chance of something tearing. My hose is lucky to get washed once in 6 months. I don't think I ever washed my ClimateLine.

The S9 and the PR S1 machines are about the size of a good size novel. Dimensions are listed on the spec page so you can get an idea just how much of a foot print they have. They are going to be a bit larger overall compared to your S8 in terms of length and width but I think probably shorter in terms of height. I have only seen the S8 on the shelf at the DME though...haven't had a chance to put it side by side with the newer models. So I am just guessing a little here.

I didn't have any issue with the hose being in the back but then I used a M series machine for 2 years with the hose in the back.
The swivel connection on the top of the PR S1 is a nice "pro" but like I said before...minor pros and cons but none or deal breakers.

A fairly reliable source close to me said a little birdie told them that ResMed will have a new machine out in 2014. That was all the information they had. If that's the case, I may want to wait until the new machine comes out, even if that's after my five-year anniversary. Last time, I got the S8 Autoset II and then the S9 came out right after! No, sir. I don't want that to happen again.

However, new machines might also have new kinks that haven't been worked out. Still, I think I'd like to have the newer machine.