Advice Wanted: Current CPAP Died - what are my options now?

[iSnooze]

I've had my Respironics System One CPAP since Dec 2011. Almost 8 full years. It finally died today. I have an appointment tomorrow with my GP and will ask for a new sleep study. I was going to do this anyway before my CPAP died because I lost a lot of weight in the last 2 years. 

My current prescription is set at a static pressure of 11.  I still have a copy of that prescription. 

This is where I need some advice. I see 3 options.

1. Should I wait for the sleep study before getting a new machine, not knowing how long that will take?
   
2. Should I use my old prescription and buy a machine Online so I have one in a few days and then adjust it once the sleep study results are in?  (Since this isn't my first machine, I'm comfortable ordering one Online).
   
3. Should I ask my doc to write a new prescription for an APAP, order it on Online and then adjust the settings after the sleep study results are in?  If so, what pressure range should she write on the prescription?
   
4. Is there another option?
   

Here's a bit more information:
I've already lost 130 lbs. I want an APAP because I still have about 40-50 more lbs to lose and will lose it in 12 -18 months  I don't want to be stuck at a constant pressure if my weight loss means that I will need less pressure.

It's been a long, long time since I posted anything here. I'm so happy to see the forum is still flourishing and helping others adjust to using CPAP. I truly believe I would have died from OSA complications if I hadn't found CPAP therapy.

Thanks for the advice and opinions.
iSnooze

[JesseLee]

Congratulations on your health! Way to go!

I have some questions for you.
1) do you have insurance to cover a new machine?

2) Can you wait to get a new machine?

If you answer no to the questions above, your sleep study should still be valid (I think they are valid for 10 years). Thus, you can get your doctor to write you a new Rx and you can proceed to get a new machine.

I recommend Resmed Autoset 10/ Autoset 10 For Her.

If you go for a sleep study, which you may need since you've experienced significant weight loss, you may be looking at a month or more to get you a new machine. It's kind of up to you.

Settings: if you are comfortable at fixed pressure 11, you could probably try auto 9-14 and be fine if not better. Charts would be good to see first before I commit to changing pressure much.

[Gideon]

IMHO No need for the Sleep Study unless you are trying to prove you do not need CPAP (diagnostic study without a machine).  

Get Rx from the Doc for APAP, have him expedite it with the DME for a "tomorrow" pickup
You were on a PR machine, did you use Flex?  If so were you comfortable with it?  (PR and ResMed Flex vs EPR "technically" are the same thing but have a different feel to them)
If the answer is yes you may want a DreamStation Auto Otherwise definitely the ResMed AirSense 10 AutoSet or AutoSet for Her (extra algorithm)

We can easily help you dial it in to whatever pressure/pressure range you currently need.
DownLoad OSCAR as this is the tool that will help, it is like getting a titration study every night, but without all the wires and such.

[Sleeprider]

iSnooze, I think in spite of your weight loss, you are going to quickly miss your old CPAP. A few days from now, you're going to know everything you need, without a sleep study. Your best option is to request a prescription for auto CPAP and self-titration. My choice would be the Resmed Airsense 10 Autoset, because it is much more responsive to indications of obstruction, and prevents apnea rather than responding after the fact. You will probably get to enjoy lower pressure, and you would like EPR. You are familiar with Philips CPAP, so the Dreamstation Auto CPAP would be very similar to your experience with the PRS1, but you will have to set pressure high enough to avoid apnea and hypopnea.

I don't think you will find CPAP is no longer needed. That is a rare occurrence with weight loss, but not unheard of. I personally detest sleeping in a clinic, and think its a waste of time and money. Did your PRS1 CPAP provide data efficacy (model 460) or was it a brick (260)?

[iSnooze]

Thanks all for the thoughtful advice.

I have insurance but will probably pay out of pocket since I still have to pay $1000 deductible for this year. However, I will call them to see what amount they will cover. I know when I first got a cpap it was just slightly cheaper to use the insurance and "rent" the machine for 13 months than to buy it outright. 

I really don't want to wait weeks for a new machine. 

I did use Flex with PRS1. 

I'm attaching a screenshot of my statistics from OSCAR but the last date anything was recorded was March 15, 4 months ago. 

I will ask my doctor for a new prescription for an auto CPAP and self-titration. I have been looking at the two machines you've mentioned and I believe I would prefer the ResMed AirSense 10 AutoSet for Her because it is quieter than the DreamStation Auto. However, either one will be an improvement over the PRS1.

Thanks for the info. I do appreciate it. 

iSnooze

[Sleeprider]

I'm confident you will really like the Airsense 10 Autoset For Her. Good values are available from Supplier #2 and Supplier #33

The Resmed will offer a much more comfortable EPR vs Flex, and should give us a shot at eliminating some of that hypopnea.

[Hydrangea]

Congrats on the weight loss!!!!!

Personally, I've had symptoms of sleep apnea since high school when I was very lean & thin. So I'm not one to buy into the notion many doctors have that weight loss cures sleep apnea. Because of my opinion with that, I'd push for a new machine (an APAP) ASAP, ie: like it's an emergency. (I wouldn't want to be one night without mine.)

You don't need a new sleep study. (Although doing one could be interesting for your own info.) Your doctor should be able to write the same Rx as before, and you can insist that you get an APAP.

[Hydrangea]

Now that I've read your most recent reply, I'd say just buy one out of pocket since you'd have to pay $1,000 as deductible to get one through your insurance.

I bought mine on Amazon. Although if you want to buy through a reputable vendor that will support you if your machine malfunctions, it'd be better to get one from "real" online suppliers. (I was just going for the cheapest I could pay.)

[OpalRose]

iSnooze,
The weight loss is amazing.

There’s also a good chance you would be able to use a lower pressure with that much of a weight loss.

I would go for the AirSense 10 AutoSet for Her. Your doctor should be willing to write a new script.
This way you can avoid a sleep study.

Good luck and Welcome Back!

[DaveL]

iSnooze, I think in spite of your weight loss, you are going to quickly miss your old CPAP.  A few days from now, you're going to know everything you need, without a sleep study. Your best option is to request a prescription for auto CPAP and self-titration.  My choice would be the Resmed Airsense 10 Autoset, because it is much more responsive to indications of obstruction, and prevents apnea rather than responding after the fact.  You will probably get to enjoy lower pressure, and you would like EPR.  You are familiar with Philips CPAP, so the Dreamstation Auto CPAP would be very similar to your experience with the PRS1, but you will have to set pressure high enough to avoid apnea and hypopnea.  

I don't think you will find CPAP is no longer needed.  That is a rare occurrence with weight loss, but not unheard of.  I personally detest sleeping in a clinic, and think its a waste of time and money.  Did your PRS1 CPAP provide data efficacy (model 460) or was it a brick (260)?

Thanks.
Wonderful post.