Need Titration Study?

[PaulaO2]

It would be far more expensive to do the sleep study vs just pay for a machine. It's not like sleep apnea goes away or gets better with treatment.

[codger]

Are you paying for the machine yourself? I was under the impression most insurances required a new sleep study when you got a new machine.

Suz

Suz,

I am on Medicare which helps pay for a new CPAP every 5 years. My last machine lasted a little over 2 years (2 year warranty had expired) and it cost Medicare and I together about $2000. My personal share was about $1,000.

Since the warranty has expired, the new machine is on me. I went online and bought a machine, humidifier, extra humidifier (because it was cheap), and a software/hardware package that will let me monitor my APAP results for $650. The machine has a 5 year warranty and the humidifier has a 3 year warranty. I bought the extra humidifier as a replacement should I need one ($50). Hopefully my new system will give me at least 5 years service.

Even if Medicare would pay for a new machine, it is cheaper for me to pay out of pocket rather than to let the equipment supplier overcharge medicare and myself.

Codger

[JJJ]

Even if Medicare would pay for a new machine, it is cheaper for me to pay out of pocket rather than to let the equipment supplier overcharge medicare and myself.

I figured the same thing. I had the PRS1 from the DME as prescribed by my doc for only a little over 20 days when I found the same machine on a local Craiglist for $300. The used machine had only about 100 hours on it. I snapped it up and returned the DME's machine. My copay on the DME machine was around $25 a month, so it didn't take long to come out ahead.

But even if buying my own machine had cost a little more I would still have done it. It's great not having to deal with the insurance and DME paperwork. I place great value on my personal freedom and independence.

[PaulaO2]

I am on Medicare. I got a new machine last year. I did not need a sleep study, just a new prescription.

[archangle]

My cpap crashed and I went back to my doctor for an Rx for new machine.
I had read about auto Cpaps and Dr wrote RX for APAP with pressure range 8-12. He also scheduled a new sleep titration study.

I have had 3 sleep titration studies in the past. It is my understanding that the new APAPS (I bought a Devilbiss Intellipap Auto) will automatically adjust pressure by raising and lowering pressure as apnea events occur.
I hate sleep studies, and although the study produces lots of scientific data, the only result is that a CPAP is set at a pressure numerical value.

Do I need another titration study? Won't the Intellipap find the pressure ranges that are best for me. Hasn't the Dr done me a disservice by limiting the pressure ranges on an automatic machine?

No, you shouldn't simply set the auto machine to run the full pressure range.

You'll start every night with too low of a pressure. The machine will start at the minimum pressure every night, and you have to have some breathing problems before it will auto up and find the right pressure. You may be uncomfortable until it adjusts. Many people with poorly adjusted APAPs end up feeling suffocated for part of the night. Then every time you get up to go to the bathroom, you have to start over.

The other risk is that the machine may "run away" and go to too high of a pressure. Some people find they need to limit the maximum pressure on their CPAP machine.

More modern APAP machines are better at this than they used to be, but it's still a good idea to set a narrower pressure range, especially the minimum pressure.

Modern CPAP machines record data on pressure and breathing and allow you to tell what the right pressure is by checking your actual treatment in the home.

Unfortunately, the DeVilbiss is not the best machine to allow you (or your doctor) to monitor your therapy. A ResMed or Phillips CPAP gives you much better data for about the same price.

The DeVilbiss is still a fairly good machine, but you're missing important data you'd have with the right ResMed or Philips machine. You have to pay extra to get the $100 module that lets you get the most data from your DeVilbiss machine. Even then, the DeVilbiss doesn't give you the data that the ResMed or Philips machine does. If you have problems, you simply don't have as much data.

Without that module, you can use their smartcode, which gives you access to some limited data about your therapy, including the AHI numbers.

You may luck out and get good therapy and good AHI numbers with the DeVilbiss without needing the extra data capability above checking the smartcode.

There is some possibility that the sleep study will find something you won't find out otherwise, but your doctor is mostly helping his fellow members of the medical mafia. Most doctors are at least 10 years behind on understanding what you can do with the right CPAP machine. A good modern CPAP machine is like having a mini sleep study every night.

Doctors need to learn to use the capabilities of modern CPAP machines and they can give better and cheaper therapy to their patients with fewer in lab sleep tests.

[codger]

Archangle,

I appreciate the pointers. You said:


"No, you shouldn't simply set the auto machine to run the full pressure range.

You'll start every night with too low of a pressure. The machine will start at the minimum pressure every night, and you have to have some breathing problems before it will auto up and find the right pressure. You may be uncomfortable until it adjusts. Many people with poorly adjusted APAPs end up feeling suffocated for part of the night. Then every time you get up to go to the bathroom, you have to start over.

The other risk is that the machine may "run away" and go to too high of a pressure. Some people find they need to limit the maximum pressure on their CPAP machine."

I think my new machine "ran away" last night because I had reset the max pressure from 12 to 16.
And after years on CPAP with a ramp commencing at 7, I think setting the minimum pressure at 7 or 8 will work out fine for me......no need for a ramp on the APAP. It will be interesting to see how things work out.

Codger