[CPAP] New to CPAP - Where Do I Start?

[USKiwi]

I have been diagnosed with Sleep Apnea and need to use a CPAP machine. I am still waiting on the company to call me for the setting up of the machine etc. I am new to this and would like any advice you 'more experienced' people can give me. I have no idea what to expect with the company coming with the machine. Do I get a choice on what machine? If so what recommendations do you have. What about long distance travel. I have a trip which includes a 14 hour direct flight on Air New Zealand. Any tips? Thanks for reading.

[SuperSleeper]

Hi USKiwi, welcome to Apnea Board!

One of our Master Members (Archangle) made this page on which machines to avoid and which are good ones:

http://www.apneaboard.com/wiki/index.php...ne_Choices

The answer is absolutely "yes"-- you do have a choice on the machine. Some people will try to tell you otherwise, but they are wrong. First, do your research on which machine you want, then get your doctor to write the prescription for that specific machine make and model.

Basically, Medicare and insurance reimburses the DME (Durable Medical Equipment provider) a flat fee (usually around $1500) to issue you a CPAP machine and accessories (such as a mask, filters, humidifier, etc). The DME would rather you take a cheap low-end machine that cost them $600, so they can pocket the remainder (1500-600= $900 profit). If they give you a higher-end data capable machine that costs $1000, they only make $500 (1500-1000) for instance.

Medicare and insurance doesn't care. The billing codes are all the same for CPAP, whether it's a standard CPAP, Auto-CPAP, non-data-capable or fully-data-capable. They pay the same to the DME no matter what.

Make sure you get a fully data-capable machine, even though a DME may try to "bamboozle" you into accepting a low-end "brick" (machine that doesn't record data) so that they can make more profit off you. Remember this: Many DMEs have no problem lying to you in order to make more profit. Do not sign for a low-end machine - if you sign for it, that's it, you're stuck, generally. If the DME provider you're sent to doesn't agree to give you the machine you want, threaten to walk out the door. Then, they will usually comply with your wishes, because some profit is better than no profit. But even if they don't give you want you want - you can go to another DME supplier usually - and don't have to use the one the doctor or sleep center sets you up with. Threaten to walk out the door if they don't give you want you want - YOU are the customer, and YOU are in control, not them.

Also, try to get an Auto-CPAP machine (APAP). They can be set in standard CPAP mode (one pressure all the time), or if need be, can be operated in Auto mode, where the machine adjusts pressures automatically as your needs change (which they will). If your doctor wants you to have a standard CPAP rather than an Auto-CPAP, remind the doctor that Auto-CPAPs can be set to operate in standard CPAP mode, but still offer the option of auto mode if needed in the future. Medicare and insurance reimbursement cost for CPAP or Auto-CPAP are the same, but the Auto-CPAP offers far more options for you in the future.

Many folks here get the ResMed S9 AutoSet or the PR System One REMstar Auto or the newer PR System One Series 60 REMstar Auto. All 3 are very good machines and are autos with full data capability. Additionally, if you go to our Private Files and Links area, you can download (for free) either the ResScan software or the SleepyHead software for your personal computer to view charts and graphs that are useful in analyzing your data to see if your treatment is effective. You can then make small adjustments to obtain a lower AHI.

Here's another link on how to properly adjust pressures:

http://www.apneaboard.com/adjust-cpap-pr...re-on-cpap

Also, once you get your machine, you can request the free Clinician Setup Manual for it, which will give you more insight into how your machine operates and will give you the ability to get into the Clinician Setup Mode, if you wish to do that. Here's the page for that:

http://www.apneaboard.com/adjust-cpap-pr...tup-manual

Also, ask questions as you go here on the forums. We're here to help!

[trish6hundred]

Hi USKiwi,
What SuperSleeper said.
There is a wealth of information on this board, HAPPY READING!
Best of luck to you with your CPAP therapy.

[Dawei]

Welcome, USkiwi! Hope you will have the opportunity to do some fast reading to absorb the info from SuperSleeper and the link to machines to look for and those to avoid by Archangle.
About your upcoming trip home, I doubt you'll be able to do anything CPAP-wise on the long flight. There are threads on this board about alternate power sources for when the power goes out on land requiring batteries, inverters and that sort of thing, but I have seen nothing about using CPAP on an aircraft. When you reach Kiwi-land, your new machine should (hopefully) be able to handle the 240volt power there. I just checked the power adapter for my ResMed S9 Autoset, and it shows it can handle an input of either 120v or 240v @50 or 60 cycles. So, if your new machine can also handle an input voltage of either 120 or 220-240, all you'll need in NZ is a plug adapter to handle the transition from a U.S. plug type to an NZ one.
Just one P.S. to what has already been posted for you; a data capable machine records info during each night that your doc as well as you can examine to see what's happening with your therapy. Without a data capable machine and using one that only records the number of hours of use (we call them "bricks"), neither you nor your doctor know if therapy is effective and if the machine is set to the correct pressure for your needs at that point in time. The only quick way to learn that with a brick is to conduct another expensive sleep study.

[jdireton]

Kiwi,

Welcome to the board, we're glad to have you here. Super has pretty much covered the basics. You will have other questions. Just post them here and we'll try to give you good advice.

Be patient, but be firm. We hear stories every day about medical equipment providers who lie to their clients, stating that this or that is your only option. It is frustrating, but again, we can help you out.

Best of luck with your treatment. I can say that almost everyone benefits greatly in the long run. We're here to help if we can.

[zonk]

Do I get a choice on what machine? If so what recommendations do you have.

yes you get to choose any DME from insurance approved list
make sure your doctor specify the machine on the prescription and write dispense as written
also get a copy of the prescription for yourself to keep

my recommendation goes to one machine only ... Resmed S9 Autoset
better and more useful display of data on screen and supported by Resscan and SleepyHead software

It is vitally important to find a mask that fits properly and is comfortable to wear
everyone is different. choose the option works best for you
find out about 30 days mask return from DME and insurance replacement schedule

[USKiwi]

Thank you for all your replies. I got the call from the DME this afternoon and I blasted them with questions. I have an appointment for next week at their office. I found out my insurance covers 100%. I looked on the DME website and they do have the machines you have all recommended and the customer service rep says I have the choice of machine and equipment up to $1500 covered by insurance and any more I pay myself. Now its time to do research

[TheWerkz]

What about long distance travel. I have a trip which includes a 14 hour direct flight on Air New Zealand. Any tips? Thanks for reading.

Hi USKiwi,

It sounds like you have a great insurance plan with Aetna! (from your previous post)

I can't add anything to what SuperSleeper already told you regarding which machine to get but, if you're going to travel Internationally more than once you should see the approved CPAP devices listed on Air New Zeland here: http://www.airnewzealand.com/special-ass...pment#cpap

While flying, if you don't want to purchase a $300.00 battery pack to be able to use any CPAP device that's approved by TSA and Air NZ, then out of the top rated CPAP's on the market in SS's list you're down to just 1 option, the ResMed S9 AutoSet (the same one I have too), Air NZ will provide a 115v power outlet after you follow their procedures, prior notification and filling-out their medical necessity forms.

According to their website, their 12 volt in-seat power is NOT to be used with any CPAP device, so, a voltage converter wouldn't be allowed, in this case you'd use their provided "medical outlet" with the regular power supply you always use with the S9.

You can also carry-on your CPAP bag without counting against your maximum allowed carry-on baggage limit since it's a medical device.

I would have used my CPAP back when I flew to OZ 5 years ago, but that was 6 months before I bought my CPAP, it's a long 15 hour flight from LAX to SYD and I was jet-lagged, fortunately the return flight is an hour shorter thanks to the jetstream.

One final note on CPAP and flying, it's not recommended to use the humidifier while flying since turbulence can cause the water in the humidifier to splash back into the flow generator, this can kill the flow generator and then you're stuck without CPAP until you can get it replaced! I've already killed one machine just by bumping it with my foot and causing the water to splash into the flow generator, and it wasn't even running at the time - live and learn.

Good luck!

Ren

[zimlich]

Others have answered your questions so I'll just say welcome.
Mary

[Sleepster]

I looked on the DME website and they do have the machines you have all recommended and the customer service rep says I have the choice of machine and equipment up to $1500 covered by insurance and any more I pay myself. Now its time to do research.

I've been on CPAP therapy for a little over a year. I lucked out by getting a decent DME who provided me with a data-capable machine. I had to pay more for it, but it was worth it.

I've discovered that the two most popular brands among the knowledgeable folks I've met here and on other forums are ResMed and Philips Respironics (PR). Each has it's pros and cons, but if I were you I'd ask for the ResMed S9 Autoset. Make sure it has the removable water tank that you can wash out.

That's pretty much it, as long as you have simple obstructive sleep apnea and there are no complications you should be good to go.

Your next hurdle is getting a good-fitting mask. This is harder because there are so many and what works well for one person may not work well for another. Do your research on this, contact your DME and ask them which mask they recommend you start with and why. Usually it's normal to have to switch masks at least once within the first month, and then again later on as you find your comfort zone.

If you get overwhelmed or discouraged just remember that CPAP therapy is your best bet for living a full life free of sleep deprivation, high blood pressure, heart attacks, or strokes.