Issues with shipping CPAP machines to Taiwan - Any advice?

[WWu777]

Thanks Dormeo.

Ok I will download Oscar. Is it user friendly? Even for those who aren't technically oriented?

Does Oscar work with all CPAP machines? How is it different than the software that comes pre-installed in the CPAP machine? Is it any better? If so in what way? Shouldn't the program in the CPAP machine be sufficient?

I got a few other questions but I'll start a new thread for it as you suggested.

Thanks.

Update: Ok I posted my additional questions in a new thread here:

http://www.apneaboard.com/forums/Thread-...-questions

[Gideon]

Thanks Dormeo.

Ok I will download Oscar. Is it user friendly? Even for those who aren't technically oriented?
You may not understand how to interorut that data without help, but the install and use are very straight forward.

Does Oscar work with all CPAP machines?
No.  the OSCAR Help Wiki list compatible machines, if you have any questions just ask http://www.apneaboard.com/wiki/index.php/OSCAR_Help
How is it different than the software that comes pre-installed in the CPAP machine? Is it any better? If so in what way?
It goes into much more detail, you can think of it as being a Sleep Lab test every night without all the wires, and of course some of the data.  OSCAR can drill down to examine each and every breathe that you took for the entire night if needed or just provide the summary overview.  It's the details that make the big difference, that is how many of us can tell what is actually happening through the night.

Shouldn't the program in the CPAP machine be sufficient?
If all you want to do is what just get some kind of treatment yes.  If you want yopur treatment to be optimized, no, you need the detail that OSCAR provides.

I got a few other questions but I'll start a new thread for it as you suggested.

Thanks.

[GuyScharf]

Does Oscar work with all CPAP machines? How is it different than the software that comes pre-installed in the CPAP machine? Is it any better? If so in what way? Shouldn't the program in the CPAP machine be sufficient?

OSCAR is software installed on your computer.  It examines data recorded on a SD card by your CPAP machine.  It does not alter anything on the machine itself.

While some CPAP machine manufacturers offer an app for your phone or computer that reports some data from the machine, those apps are extremely limited in what they offer.  They usually have just enough information to indicate whether you are in compliance with insurance requirements but not enough information to judge the efficacy of the treatment.  Manufacturers may also have a program available that shows detailed data like OSCAR does, but OSCAR organizes the data for better comprehension.  And installing some of those detailed programs from manufacturers can be difficult.

And as Bonjour said, there is a list of supported machines on the OSCAR Wiki.

[gooseegg]

I hope so, because it's a pain in the butt to go to the hospital here and find a sleep specialist. There's a language barrier, and plus the closest sleep center is far away from me too. I'd have to bother my parents to drive me there, since I don't even have my own car here. So I'm looking for a way to use this thing without needing assisting from nurses and sleep specialists. What do you all think?

I disagree about how much of a pain in the butt it is to go to the hospital here in Taiwan for a sleep specialist. Well, at least in Taipei. Over the past 20 years, I have been to 3 specialists - NTUH in the beginning (when you could book a sleep test the same day and few other hospitals here had sleep labs), TMUH 8 years ago where they have a small but comfortable sleep lab, and TPEVGH where I had my most recent sleep test 2 years ago.

There was a 6 month waiting list for the TMUH sleep test. I had been living away from Taiwan for 5 years and had not had a test during that time, so I was surprised at how much more popular OSA diagnosis had become. I went for the test because I was experiencing more bloating and wondered if there was something wrong with my set up. The doctor there only confirmed that the therapy was "working" so I did not make any adjustments.

After 5 years, the gas problems only worsened and I decided to get another test to see what was wrong with my therapy. I had been using Auto CPAPs on their Automatic setting for about 10 years at that point. Since I had moved to Beitou, I got a referral to sleep specialist at VGH (I am pretty sure had I simply walked up to the information desk, I could have gotten the same referral). The sleep lab at VGH was not as pretty as the ones at NTUH and TMUH, but the specialist I met (I'll post his name when I find it again) was great. I only had to wait 2 months for my test at VGH, btw.

He pointed out to me that the automatic pressure function was not helping my apnea and suggested I change my setting to a fixed pressure. He also pointed out several anatomical issues that contributed to my type of apnea. At that time, I had also figured out how to get my data from my machine (S9 AutoSet for Her) and plug it into SleepyHead, so he also used that to explain some of the issues I was having with my autosetting. Oh, and he explained it all in comfortable, excellent English (the doctors I saw at the 2 other hospitals over the year also spoke fluent English). Switching to the fixed pressure was an immediate improvement. Since the switch, I have largedly kept my AHI below 4, usually closer to 2. Most importantly, my bloating subsided - not 100% but it was a dramatic improvement.

Btw, I can also confirm your experience shopping for CPAP machines in Taiwan and the Philippines. Minimum prices are indeed US$ 2,000 for machines that we can buy online for 500 to 700. And I discovered the customs duty problem the hard way when I was rushing to buy a portable CPAP for a camping trip I was planning and the machine was held up in customs. Up to that point, I ordered CPAP machines from US websites without incident, tax, or delay. So, the tax bill (I forget how much it was) was a shock. I ended up paying DHL extra to forward the unit to a friend in HK, and I picked up the machine later on (for the camping trip, the event organizers arranged for me to use an extension cord to a nearby outlet).

Another time, my F30 mask ripped and I did not have a backup. So, I visited the offices of the authorized Resmed importer near Yongchun MRT station in Taipei. The sales person was kind and sympathized with my plight, but did not discount the mask I bought - she noted that their prices are indeed very high, and I should have asked a friend to bring them back from the US. I had a similar experience in Manila - I forgot my mask (but not my machine!) and visited the showroom of Quality Sleep Philippines near Makati Med. Like in Taipei, they were sympathetic but did not give me a discount.

[WWu777]

Hi gooseegg,
Yes it's true that many doctors here in Taiwan speak decent English. But I hate dealing with the receptionists and info desk girls and the customer service staff who answer phones. They don't usually speak English, especially down south where I am. Also the signs and info boards here are all in Chinese too. I am not in an international city like Taipei. 

Remember the city I'm in is not cosmopolitan like Taipei, so there are very few English speakers and hardly any foreigners here. It's very alienating down here, you are lucky you're not here. Unless you have a wife here or family here, you will be very alienated and lonely in southern Taiwan, because the locals seem to have zero interest in meeting new people or making new friends, no matter how extroverted or outgoing you are. I feel like a ghost here, like I don't exist, which I can't stand. You know what I mean? It's nothing like Philippines or Thailand or SE Asia. Totally different world and vibe here. It's more like Japan here than China. Super repressed and restrictive, no self-expression allowed, so you can't be yourself. Perfect example of how the social culture can take away your freedom, not the government, something Americans don't understand because to them, freedom is defined by government control and voting/democracy. 

Even the couchsurfers here have no interest in meeting up, they all want to be left alone. And most of the foreigners here are withdrawn and shy too, like they are afraid to talk to anyone, as if they've become "Taiwanized" and no longer like regular normal foreigners. They are nothing like the western expats in Philippines I hang out with everyday. You know what I mean? 

Plus even when you do meet people here, it's hard to connect with them, because there's almost nothing to talk about, and nothing in common, hence no chemistry or connection. The people here are on a totally different zone/wavelength. Not broad minded at all, very few or no interests, not much to say, very bland, devoid of personality and soulless. Very sad. You know what I mean? At least America has beautiful nature and landscapes and the folks in small towns are friendly. I've found that many foreigners here feel the same way, but are afraid to tell anyone about it, because to talk about feeling lonely/alienated carries a negative/loser stigma and is not politically correct either. 

Sorry for the rant and complaint, but I can't get used to this super repressed culture after living in the Philippines and Russia for so many years. Feels like the Twilight Zone here. How do you adjust to it? Don't you ever feel alienated and lonely here too? Do you feel any social connection at all? Or is it just me? lol

Anyway, sorry for going off topic here. Maybe we should discuss this by PM?

So you go to Manila too? Yeah I noticed the high price of CPAP there too. It's even worse there for prices because in the Philippines, any product of decent or foreign quality gets jacked up high because the reseller wants to make a big profit of it. The greed in PH is insatiable. A lot of places also charge us extra just for being a foreigner for no reason, as a sort of unofficial foreigner fee/tax. It's happened to every expat there that I've talked to.

Now regarding the sleep test, yes they do have it here at a hospital near me, but I was told that the waiting period would be weeks or months. So there's a long waiting list for it. Plus I already had one in 2016. Normally you don't need another one right? How often do you take a sleeping test in a hospital? 

I'm sure there are home kits that can do sleeping tests too, but they are very expensive. I heard that OSCAR might be able to do somewhat of a sleep test at home too. Have you tried that? Can that take the place of a hospital sleep lab?

[WWu777]

Supplier #2 has a lot of experience shipping machines overseas, and has some of the most competitive prices anywhere.  That is SecondWindCPAP (do not use the internet link name).  Look up their site on the #Supplier List and either call or email for an estimate.  They can pretty much tell you all the costs.  You did not specify what brand and model of machine you are seeking.  A Resmed Airsense 10 Autoset from Supplier #2 will be $599 open box or a new Autoset for Her is $729.  There are also less expensive "gently used" machines with a warranty.

Diagnosis of sleep apnea technically requires a sleep study with home test unit or clinical PSG.  You might be able to use a night camera or observer to see if you stop breathing, but those are certainly not ideal diagnostic tools.  The machine above can show you your treated results, but even with minimum pressure, obstructive sleep apnea is usually improved.  In addition, apnea is not the only problem.  Very shallow breathing (hypopnea) and respiratory effort related arousals (RERA) are also very disruptive to sleep. Snoring is also a strong indicator.

Wow Supplier #2 (SecondWindCPAP) seems to have the lowest prices I ever seen for a CPAP machine. What's the catch? How do they afford to price their CPAP's less than other suppliers? 

Btw, does #2 or #1 on that list mean that #1 is the best supplier in some way? How is that list ordered? From best to worst? If so, in terms of what?
 
I think I will either go with Airsense 10 or the XT Auto Travel CPAP.

Btw, I see a lot of Airsense 10 devices on their page. Are they all the same? Are they all Auto CPAP?

Also, what is a ClimateLine Air Tube that comes with some of the Airsense 10's? It looks like a special hose that can keep some humidity inside of it? How does that work?

Thanks.

[jaswilliams]

The number associated with a supplier on our supplier list is purely arbitrary #1 is no better than #35 there is no catch with Supplier #2 they provide excellent new and lightly used machines

There are many different models of Resmed machines in the Airsense and the Aircurve model ranges so be careful that you are comparing like for like.


I would recommend a Resmed Airsense Autoset for Her unless you need a specialist machine

[JJJ]

Also, what is a ClimateLine Air Tube that comes with some of the Airsense 10's? It looks like a special hose that can keep some humidity inside of it? How does that work?

Machines designed in the past five years or so have an electrical connection at the output where your hose connects. This supplies electricity to hoses that contain a heating wire down the length of the hose. You can use a regular hose without the heating wire (like I do), in which case you get no heating of the air as it travels down the hose. If the air in your bedroom is normal room temperature the heating in the hose will do little or nothing for comfort - its purpose is to eliminate condensation (not provide additional humidity), which is a problem for many people. The average humidity where I live runs around 40-50% year 'round, so I never need a heated hose. Many people live in climates where the humidity can get to 80% or more, and they can wake up with a hose that has a loop of water in it, because the air cools enough as it travels down the hose that the humidity condenses out. In the past people living in areas of high humidity had to arrange their hoses without loops, and so the machine was the lowest point, thus any water from condensation would run back to the humidifier tank on the machine.

[Sleeprider]

The function of a heated tube is to keep the wall of the tube warm, and prevent condensation. It does not warm the air. If the room temperature is not significant cooler than the air from the humidifier outlet, condensation will not be an issue. An inexpensive fleece CPAP tube liner can greatly reduce the potential for condensation by providing a layer of insulation that has the benefit of also being more comfortable. I use both, and got my first heated tube from a company in Australia in 2008 before they were available from the CPAP manufacturers. All CPAP machines use a standard 22 mm diameter outlet and will work with standard unheated tubing or the proprietary connectors for the heated tube.

[WWu777]

A few quick questions.

1. Are all CPAP machines able to be plugged into both 110v and 220v outlets? Some regions use 220v outlets. Like Europe and Russia for instance. If I am there, can any travel CPAP safely use that outlet? If not, which ones can use both and which ones can't? Is there a list of which ones can use both 110 and 220? Can the Airsense 10 be used on 220v outlet?

2. On the website of Supplier #2, Second Wind CPAP store, some of the machines are used and some are refurbished. What's the difference? Which is better? I would imagine refurbished may be better since it has been worked on and modified to be as good as new right? 

3. Supplier #2 has Z2 and Z1 Travel CPAPs which are very small, almost the size of a Coke can. Wow. They start at only $260 too. Wow what a steal! (I'd post the link here so you can see them, but links aren't allowed it seems) The Z1 being an older model is cheaper of course. Is it ok to just get the Z1? What are the pros and cons of that device? Have any of you tried it?

4. The Z2 and Z1 also use a blue sponge humidifier that recycles your own moisture back to you. Is it ok to use that kind of humidifier long term for everyday use, even when you're at home? 

Thanks.