What is the best CPAP machine?

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What is the best CPAP machine?

Postby fjd2006 » Wed Jan 25, 2006 5:37 pm

My insurance (Aetna) will pay for a CPAP machine. I just don't know which one they are going to give me. Does the sleep lab determine what machine you will get or does the patient have a choice? Thanks.
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Re: What is the best CPAP machine?

Postby Daniel » Wed Jan 25, 2006 5:56 pm

fjd2006 wrote:My insurance (Aetna) will pay for a CPAP machine. I just don't know which one they are going to give me. Does the sleep lab determine what machine you will get or does the patient have a choice? Thanks.


How long is a piece of string ?

CPAP machines blow air at a constant pressure...........APAP machines blow air, when they think you need it...........BiPAP machines blow air at one pressure and allow you exhale against a lower pressure.

All very simple, but, if you don't get the right mask it really makes no difference what machine you get...........you will have problems.

Try out as many masks as possible first..........don't even look at machines. There are nasal masks (breath in and out through your nose), Full Face masks which cover your nose and mouth and suit natural mouth breathers and there are Nasal Pillows (silicone bungs for your nostrils through which air is pumped. You should typically try up to 10 different nasal masks, 3 full face masks and 2/3 nasal pillow set ups. Get advice from your doctor or RT. Make the DME supplier earn their money and get fitted properly.

Beware the DME supplier who starts off with 'I know exactly the right mask for you'..........

Best of luck, and don't be afraid to post back.

Daniel.
The untreated Sleep Apnoea sufferer died quietly in his sleep..
Unlike his three passengers who died screaming !


The first 40 years of childhood are by far the hardest
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New York CPAP Suppliers

Postby lssnyc » Fri Feb 09, 2007 11:20 am

Can anyone recommend a reputable CPAP supplier in the New York City area? I live in Manhattan and I am having a very challenging time getting minimal service. Seems like all that they are interested in is making the sell and then good bye.
Just as a side note, I find it interesting that I am refered to as "the patient" during the sells process. I feel more like a customer in a quick and dirty sell.
Thanks.
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Postby hhopper » Fri Feb 09, 2007 3:48 pm

As long as you have a prescription, you can buy a cpap machine on line. Google or Froogle around until you find the best price. Most folks here have Respironics® or Resmed®. The only difference is that a local DME will (if they're good) fit the mask for you and even let you try different masks. You will have to make sure your insurance will cover an on line buy. But if you're payng for it yourself, they are much cheaper on line.
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Postby ArthurAnxious » Fri Feb 09, 2007 4:38 pm

I live in MANHATTAN and am serviced by Promptcare based in Clark NJ, they have absolutely dumb resp. therapists but they deliver eventually and there is one knowledgable person at their headquarters who eventually returns calls. I am insured with Aetna and they willingly provided an auto (Resmed Vantage). My sleep lab offers to prssure them into doing whatever I need. And the sleep lab secretary (order and script writer) is really helpful and an OSA sufferer herself.
Arthur
Sleeping with a curvaceous blonde autoPAP (Resmed autoset). Hope springs eternal.....
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Postby lssnyc » Sun Feb 11, 2007 3:32 pm

Thanks to all for your replies regarding CPAP vendors. Seems like there aren't any that really good/reputable. I just got a Resmed S8 Elite. The humidifier barely seems to work even at the highest level in comparison to my old Fisher Pykel CPAP machine. Is this a common issue for others I wonder? I cannot get a response from my supplier.
Concerning masks, I have been using a nasal mask for the last few years, however, I have recently noticed that I wake up with "foam" around my mouth. As a result I have ordered a full face mask since I suspect that I am now a mouth breather due to chronic sinusitis. Has anyone else experienced this issue? Would the Nasal Pad only mask work? Also, can anyone recommend a good sleep lab in Manhattan? The lab I used to go to is moving to Westchester, north of the city.
Thanks for your feedback.
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Postby CrohnieToo » Sun Feb 11, 2007 4:39 pm

Oh, there are some good local DME suppliers out there. They just seem to be few and far between! *sigh*

I have a Resmed S8 Elite too. I love being able to access my AHI, etc. data on the LED screen via the Advanced patient menu! But, yeah, I'm reading more and more about problems w/the integrated humidifiers (Respironics too) not providing as much heat/humidity as the stand alone humidifiers. I had the loan of a F&P HC 100 stand alone heated humidifier which I only kept at 2-3 and now that I have my replacement Humidaire 3i I "have" to keep it at 5-6!!!

I'll be that foam around your mouth isn't from you mouth breathing, it is from air escaping thru your lips, usually just a minor hole or split between one side or the other of your lips. Makes for "sticky lips" rather than the dry mouth and "cardboard tongue" you get w/mouth breathing. You could try taping your lips or even some PoliGrip on your lips before turning in. The PoliGrip worked great for me.

I use the ComfortLite 2 nasal cushion.
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CPAP Suppliers

Postby lssnyc » Mon Feb 12, 2007 12:49 pm

Thank you CrohnieToo for your suggestions. I really appreciate it. As far as using Poligrip, does it irritate your skin? Also, you stated that there were some good CPAP suppliers, are you able to name them in the New York area. I am having a hard time getting a response from mine. I paid (out of pocket) for an RT to come and fit me for a mask, which doe not fit properly, so currently,I am using my old mask. As a result, the situation seems to be in a holding pattern. Perhaps I should return my new CPAP machine and start all over.

Thanks,
LSSNYC
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Postby ArthurAnxious » Wed Apr 18, 2007 4:51 pm

Did you ever have any luck finding a good DME in NEw York City, or are they all equally lousy, my dear pet enemies at Promptcare are living down to their reputation, except that they do call if the pulmonologist threatens them forcefully. I am thinking of switching to Lincare which the pulmonologist says is much better and having them service me at my office in NJ (where they work).
Arthur
Sleeping with a curvaceous blonde autoPAP (Resmed autoset). Hope springs eternal.....
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Postby CrohnieToo » Wed Apr 18, 2007 7:12 pm

I'm afraid I'm way too far from NY to be of any help regarding a decent DME supplier much less a good one!

You need your script and your sleep study to get a CPAP from any local DME if you have insurance coverage for your equipment and you sure don't want to pay out of pocket from local suppliers!!! If they accept Medicare (and almost all do) they can NOT charge you less than what they get from Medicare.

I've never had PoliGrip irritate my skin or lips. Remember it was developed to be used in the mouth between a denture and the mouth's surface.

As far as mask fitting: I get my best mask fits by my sleep lab MANAGER believe it or not. She uses a CPAP machine set at your pressure and it has the capability of detecting mask fit. She has you don the mask comfortably (with the CPAP running) and adjusts the headgear whilst you hold the mask in that comfortable position whilst checking what the machine says about the fit. When you feel no leaks and the machine indicates excellent fit, she has you lay down on a bed on your back and again checks the machine for mask fit, asks you where you feel a leak, if any, makes any necessary adjustments, then has you turn on one side, repeats the process, if all is satisfactory, then you roll to the other side and go thru the process again. At times she will have you pull the mask just a skosh away from your face for the cushion to fill w/air again (if a nasal cushion and probably a full face mask as well). In addition she told me that a warm mask fits better than a cold one and I've found that to be true as well. I take mine under the covers whilst I watch a 1/2 hour of TV, then put it on, turn off the TV and go to sleep.

Sometimes just raising your eyebrows, twitching your nose or twitching your upper lip will stop a MINOR leak.

Another thing to keep in mind: Respironics, Resmed and Fisher & Paykel will replace to the DME for FREE any of their masks tried by patients that didn't work out if the DME fills out the proper form and returns it to them w/in 30 days.

As for returning your machine: which machine do you have? If it is a fully data capable machine not all DMEs will willingly give you one because they get reimbursed the same amount by insurance for a bare-bones, compliance data only, machine as they do for a fully data capable CPAP. Obviously their profit margin is enhanced by providing as bare-bones machine as they can get away with. Ooops! I missed that you have the Elite!

That Resmed S8 Elite you have is one honey of a machine. I like mine much altho I also now have a Resmed S8 Vantage (autoPAP). Once we find that 'sweet spot' of pressure for me I'll most likely save the Vantage as a backup machine and use the Elite for most nights. So I wouldn't be too quick to return it just 'cause you don't like the DME! On the other hand, IF your insurance is contracted w/several DMEs I'd check w/each of them to see which I liked and felt comfortable w/for my masks, hoses, etc. other than the machine itself. I'm doing that right now. My CPAP DME is such a PITA that I'm counting the days for the next 7 months of rental so I can dump them completely. Meanwhile, since the mask, etc. are outright purchases I get them from a DME supplier also contracted w/my insurance who have been just great and that I am very happy with.

You might also call Resmed about the Humidaire 3i. There are several people who have had their Humidaire 3i replaced for insufficient humidity. If they okay its replacement they will insist that you return it to your DME for the DME to send it in. But the general consensus seems to be that the integrated humidifiers aren't quite so efficient as the stand alones. This isn't just a Resmed problem.
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Postby lssnyc » Wed Apr 18, 2007 11:06 pm

Thanks for the feedback and education. I have been struggling with Arcaidian. I still haven't found a CPAP supplier that I would call reputable. My doctor has recommended a medical supplier in my area on the upper east side of Manhattan that I will use going forward. They are called Care 1 Home Medical. I will let you know how that goes.
Just for clarification, are CPAP machines rented and the rental is paid by insurance/medicare?
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Postby CrohnieToo » Thu Apr 19, 2007 11:06 am

Policies regarding rental or purchase or rental and purchase can vary from insurance to insurance. There's no hard and fast rule.

Medicare does a capped rental for 13 months then the machine reverts to patient ownership.

Some insurances purchase outright immediately. Some insurances insist on a specified rental term (usually 3 months or more from what I've been reading) and then the purchase.
ResScan 3.10 - Resmed S8 ResLink & oximeter
ConTec CMS-50D+ oximeter - Philips EverFlo 5L Oxygen Concentrator
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I do not have insurance coverage on the cpap machine HELP

Postby SCOOTERD » Fri Mar 20, 2009 12:22 pm

I do not have insurance coverage on the CPAP machine. I am newly diagnosed. Since the machine is not covered for me it will all be out of pocket. I feel as if the Doctor and the different providers will not give me enough information to make a decision based on my financial needs and still get the machine so that I may begin my process of living/sleeping basically. Can anyone provide advice on this matter?
I want to do what is best for me without becoming a slave to high prices. I've read here on line is better for those not covered by insurance. What is the best machine, mask, - I need a full I am told since I breathe through my mouth. What are the worst in case they try to sell me a lemon. What are realistic prices on items. It seems I will need a machine, filters, tubing, a mask - the list goes on. PLEASE PLEASE SOMEONE GIVE ME SOME SOUND ADVICE HERE?

THANK YOU :shock:
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Postby CrohnieToo » Fri Mar 20, 2009 2:47 pm

Since the doctor and different providers aren't giving you the information you need to have an idea of what the best equipment for you might be I would first send a WRITTEN request for a copy of the doctor's dictated results (1-2 pages each) AND the full scored data summary report w/condensed graphs (5+ pages each) from both your sleep evaluation study AND your titration study (or did you have a split-night instead of a two night study??) AS WELL AS your equipment order (script). They are part of your medical records and in the USA you have a LEGAL RIGHT to a copy of them under HIPAA. (If you family doctor is cooperative request the copies be sent to him as there usually is no charge to do so and then ask that he give you copies. Sometimes sleep labs will charge you a fee to send them to you but not to your family doctor). I would also ask which mask and what size mask you wore during your titration study. IF it was fairly comfortable and you were able to sleep fairly decently w/it then that would be the best one to ask for. IF it wasn't ..... masks are a VERY INDIVIDUAL thing. My favorite mask could be disaster for you and vice versa.

W/o knowing your needs, but assuming you don't need one of the "special" xPAPs such as a bi-level I would suggest you check out:

1] Resmed S8 Elite II w/EPR w/Humidiaire 4i integrated, heated humidifier
2] Resmed S8 Elite w/EPR w/Humidiare 3i or 4i integrated, heated humidifier
3] Respironics M Series Pro w/C-Flex w/integrated, heated humidifier

or a more expensive auto CPAP:
1] Resmed S8 AutoSet II w/EPR & Humidaire 4i integrated, heated humidifier
2] Resmed S8 AutoSet w/Humidaire 3i or 4i integrated, heated humidifier
3] Respironics M Series Auto w/A-Flex and integrated, heated humidifier
4] Respironics M Series Auto w/C-Flex and integrated, heated humidifier

It is a bit of a hassle to price shop online due to the MAP (minimum advertised price) policies some of the manufacturers have instituted against the online DME suppliers. You either need to call their toll-free number and ask if they have an "unadvertised sale price" on the item you are interested in, or use a "code" they provide, or "add to your shopping cart" to find out what the real price to you is.

Then visit the local DME suppliers, ask which CPAP they recommend, ask the price to you as a self-pay client; ask what your self-pay cost would be for the devices you've checked out online and know the price of, ask how lenient their mask exchange policy is.

Be aware that local DME suppliers price headgear and mask as separate sales, hose is extra over and above the price of the xPAP, humidifier is priced separately, you don't receive the Clinicians Manual only the Users Manual whereas online the headgear and mask are priced as one unit, the hose is included in the price of the xPAP, etc.
ResScan 3.10 - Resmed S8 ResLink & oximeter
ConTec CMS-50D+ oximeter - Philips EverFlo 5L Oxygen Concentrator
PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2.14.0
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Year Diagnosed: 2006

another complication

Postby truckerdad57 » Tue Mar 24, 2009 9:02 am

Another complication can be....

Are you a Commercial Motor Vehicle Operator?

From your posts you did not mention if you were. If you are a CMV operator you will NEED a compliance data recording model like the ResMed S8 models.

As a CMV operator you not only need to deal with the problems if your DME and medical treatment you also need to meet the medical requirements of the Federal Motor Carrier Safety Administration for your DOT Medical Card.

Good Luck
(just a truck driver with sleep apnea)
Co-coordinator Truckers for a Cause Chapter of A. W. A. K. E.
awake.truckersforacause.com
Do not substitute information from here for professional medical advise.
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