Have mild sleep apnea, and sleep therapy center question

[kconan]

Hello, I've been reading through the board on-and-off the last year or so and appreciate all the helpful information here.

  I've known that I have some level of sleep apnea, as I don't feel well rested from sleep and the last few years and my wife has mentioned she's heard me sometimes gasping for breath in my sleep.  I've got a Philips DreamStation BiPAP, from my Mom who passed away back in February, and bunch of attachments and accessories for it.  

  So about a month ago I went to a Sleep Center place near me that has mostly good, seemingly legit reviews.  They gave me an at-home test, which I did and got a full nights sleep with no issues.  I returned the test equipment, and then the next week their admin calls me and tells me that I have sleep apnea and wants to sell me a CPAP.  So I told her that I wanted to talk to a doctor, and so she set that up and I talked with the doc.  He said I've got mild sleep apnea, and went over sleep interruptions and how much mine was over normal.  I showed him my BiPAP, and he said I could use it.  The next week I go back the sleep center with my machine.  They bumbled and fumbled around a bit remembering which patient I was (outside of the doctor I've not been impressed), and then they looked over my BiPAP and then said I either needed to do a study there at their location or get an Auto-CPAP "to find my numbers".  

  I explained that I have a BiPAP with a CPAP only mode...Are there some CPAP starter settings, or why not use the Auto-BiPAP?  They held firm on Auto-CPAP or their in-house study, and said that I don't need a BiPAP.  They want to sell me a Philips DreamStation Auto-CPAP for 1500 bucks.  I told them I would think about it.  It bothers me to buy the same f'n machine that I have, but in CPAP rather than BiPAP form.  They called me earlier today while I was on a work call, and then e-mailed me asking for my decision.

  Are they trying to rip me off?  Are they correct that I need an Auto-CPAP?  Can "finding my numbers" be done without them?

  I appreciate any thoughts / advice, thanks!

[Sleeprider]

It's a rip-off because your machine not only does CPAP, it does auto CPAP. Let's skip what won't work and just set it up for success. We are going to use the BiPAP Auto mode but not use all the pressure support. With an adequate range between EPAP min and IPAP max, the machine is an Auto CPAP. BUT, BiPAP is a good thing, and don't let them tell you otherwise. My recommendations are to setup as follows:
Mode: BiPAP Auto
EPAP min 6.0
Max Pressure 14.0
PS min 2.0
PS max 2.0
BiFlex 1
The pressure support simply allows for inhale pressrue to be 2-cm higher than exhale. This reduces flow limitation, treats hypopnea and makes everything oh so much more comfortable. In CPAP terms, you get an Auto CPAP with pressure of 8 to 14 with exhale pressure relief of 2. This will work great and we can fine-tune to make it perfect.

Be sure to reset all the patient data and insert a SD card that has been formatted to FAT 32 or just deleted. Let's show the thieves what can be done with a BETTER machine.

[Sleeprider]

Just FYI, Supplier #2 SecondWindCPAP will sell you a brand new unopened box with at superior Resmed Airsense 10 Autoset CPAP and heated Climateline tube for $538. Tell these thieves to take their Philips CPAP and shove it.

[SarcasticDave94]

That's my sentiment too. BTW mixing DMEs and Dr. McDuck's in a seemingly one stop shop is almost always 2 amigos in cahoots to bill you for their Princesses cruise ship yet taking you "for a ride" on their trash barge. Conflict of interest IMO. And ResMed is a much better machine for most.

[Sleeprider]

I think it's important to add, you need a copy of your diagnostic study and prescription. You are under no obligation to purchase equipment from the clinic or their affiliated DME, but the prescription and diagnosis makes you a free-agent to spend your, or your insurance dollar, at the place you choose. It sounds like the doctor you spoke with is a professional and wants you to have appropriate therapy. His advise you could use the BiPAP was correct. BiPAP is frequently used for obstructive sleep apnea, but it can be difficult to persuade insurance to pay the higher cost compared to CPAP. It is clinically more effective and is still "positive air pressure" (PAP) therapy. Don't be frustrated with the marketing. Get the diagnosis, sleep study copy and prescription you are entitled to under HIPAA. https://www.hhs.gov/hipaa/for-individual...index.html

[kconan]

Thanks SleepRider, appreciate your advice overall and I'll try out those settings very soon and post results in the proper format for any opinions on tweaking.  Also, good call on asking for my sleep study.

  I agree totally that pairing a doctor with a "retail shop" that also sells devices is scam-ish...I mean, it felt gross to me when they went right from my diagnosis to "hey let's get you a pricey CPAP!"  I've just asked them for my sleep study results.  If I get any nonsense in return, I'll remind them of my rights and mention that I intend to write a Google Review.

[SarcasticDave94]

There ya go, keep swinging!

[ICEMAN]

It's a rip-off because your machine not only does CPAP, it does auto CPAP.  Let's skip what won't work and just set it up for success.  We are going to use the BiPAP Auto mode but not use all the pressure support.  With an adequate range between EPAP min and IPAP max, the machine is an Auto CPAP.  BUT, BiPAP is a good thing, and don't let them tell you otherwise.  My recommendations are to setup as follows:
Mode: BiPAP Auto
EPAP min 6.0
Max Pressure 14.0
PS min 2.0
PS max 2.0
BiFlex 1
The pressure support simply allows for inhale pressrue to be 2-cm higher than exhale. This reduces flow limitation, treats hypopnea and makes everything oh so much more comfortable.  In CPAP terms, you get an Auto CPAP with pressure of 8 to 14 with exhale pressure relief of 2.  This will work great and we can fine-tune to make it perfect.

Be sure to reset all the patient data and insert a SD card that has been formatted to FAT 32 or just deleted.  Let's show the thieves what can be done with a BETTER machine.

I have been doing some procrastination some time, with Randomly selecting interesting Threads, to then read up and amazed with some of the quality ,working factual knowledge, say  such as the above response's and to assist and giving such helpful, encouraging, knowledgeable, detailed information to option's to action original queries.