[Equipment] Is buying used CPAP machines ok?

[Sheepwrecked]

My CPAP machine died Christmas Eve.  ?
My sleep study was done so many years ago that my doctor won’t help me to get a new machine until I have another sleep study. For reasons I’d rather not go into, I refuse to do an in hospital sleep study  I called my insurance to see if they covered home study’s and they said yes. Called my doctor and told them I wanted them to request a home sleep study for me.  They keep telling me that insurance won’t cover it. Insurance keeps telling me that the doctor only requested a hospital study. It’s starting to look like I may have to get a “prescription” online or something....

10 days without a CPAP Machine and I was getting desperate. I found a CPAP Machine on Craig’s list, bought it, and changed the settings to mostly match my old machine.  

IF I manage to get a sleep study done, can I get it programmed since I wasn’t the original owner and didn’t buy it through the medical supply store? The machine is nice with only 10 hours used and has lots of gizmos and gadgets that my old machine didn’t have.

[Gideon]

Welcome to the Apnea Board Forum.  We can and will help you with all things apnea.

At the top of this page, in the middle of the black banner, you see "CPAP Setup Manuals", click that  Depending on your machine you will be led to a direct download or direction to email and request a manual. That is a manual process with a person reading the email and responding.  The manual will provide direction on how to input the settings.

That said many here manage their CPAP (many flavors) without the assistance of a medical team.  I don't use a doctor for managing settings, only to get a prescription and that so that my purchases will be covered by Medicare or insurance. 

We can help you to program your machine.  But we will need to know what machine you bought and what your settings are.

We can help you to titrate yourself and do so without a sleep lab.  If we see something that requires a sleep lab we will let you know.

First question.  What machine did you get and what are your settings.  What do you know about your apnea?  And finally, how do you feel?

We typically use Sleepyhead software (free) and a data-capable CPAP machine.

Fred

[Sheepwrecked]

My new machine is a REMstar Pro C-Flex+ System one.
My old machine was so old that as far as I know it just had a setting of 8.5.  This was back when I didn’t know you could adjust anything.  
When my original machine died, I bought a used REMstar Pro C-Flex +. I set it for 8.5 and played around with a few other settings until it felt comfortable and I felt rested. 

On my new machine, I set it on the “A-TRIAL” mode which was the only mode where I could set it from 8 to 12.   But then it added 30 days.  I don’t know that happens when 30 days is over. There is no ramp time (my preference). I removed the humidifier and heated hose.  (I get hot too easily). 

Does that info help?

Thanks!

[Sheepwrecked]

At this time I can’t download Sleepyhead. I don’t have a computer, I only have a tablet and mobile device.

[big_dave]

Here is the info from the provider's manual. After the 30 days, it will set itself to the A-Check Pressure, which is either a predetermined fixed pressure, or the 90% pressure measured by the Auto-Trial. The machine only allows 30 days of Auto-Trial, which is intended for at-home titration, although the Auto-Trial can be reset a limited number of times by resetting the machine.

The machine is below the 90% pressure 90% of the time, and above it 10% of the time.

• Min A-Trial Days - This screen allows you to adjust the duration of the Auto-Trial phase in number of days. You can set this to “0” or “3 to 30” days. If you select “0”, you will disable the Auto-Trial phase and go straight into the Auto-Check phase. The default is 7 days. The number of usage days that have elapsed will be deducted from the 30 day maximum for the device. This screen only displays if AutoIQ mode is available and enabled.
• A-Trial max- This screen allows you to modify the maximum pressure setting during Auto-Trial. You can adjust this setting from the Auto-Trial Minimum pressure setting to 20 cm H2O. This screen only displays if AutoIQ mode is available and enabled.
• A-Trial min- This screen allows you to modify the minimum pressure setting during Auto-Trial. You can adjust this setting from 4 cm H2O to the Auto-Trial Maximum pressure setting. This screen only displays if AutoIQ mode is available and enabled.
• A-Check Pressure– If AutoIQ is available, this screen allows you to adjust the Auto-Check phase starting pressure. If Auto-Trial phase is enabled, you can choose the 90% pressure setting determined from Auto-Trial, or you can adjust this setting from 4 to 20 cm H2O. If Auto-Trial phase is disabled, this screen allows you to only adjust the pressure setting from 4 to 20 cm H2O if AutoIQ mode is enabled.

[Sheepwrecked]

Gosh! I hate to sound like a dummy..... but I assume my machine has the AutoIQ although I didn’t see that mode or setting anywhere. I adjusted the settings from 8 to 12.
Should I change this or leave it?

[big_dave]

A-Trial is the same as AutoIQ. Based on your previous 8.5 setting, 8-12 seems like a good starting point, although you may want to increase the max if the pressure hits 12 and stays there.

[Fats Drywaller]

At this time I can’t download Sleepyhead.  I don’t have a computer, I only have a tablet and mobile device.

In addition to the clinician's manual (or provider's manual), there's also the basic user's guide for the DS460. Did you get a paper copy of that with the machine? If so, never mind. If not, you can download a PDF of it from a web site and print that, but you would need to enlist the help of a friend or relative who has a computer and a printer. Here's a google search string to use (either of the first two hits will do it, and the second one is official, from Philips):

filetype:pdf philips ds460 user manual

[OpalRose]

My new machine is a REMstar Pro C-Flex+ System one.
On my new machine, I set it on the “A-TRIAL” mode which was the only mode where I could set it from 8 to 12.   But then it added 30 days.  I don’t know that happens when 30 days is over. There is no ramp time (my preference). I removed the humidifier and heated hose.  (I get hot too easily). 

Does that info help?

Thanks!

Hi Sheepwrecked,
Your machine is a RemStar 460 Pro Cpap.  This is not an Auto Cpap, but you can use the ATrial feature for a limited time with a pressure range. The machine will detect the best or 90% pressure reading and set it back to a straight pressure mode.  Here is a brief description of the modes available on your machine.

Auto-Trial Mode delivers breath-by-breath Auto-CPAP therapy for up to a total of 30-days. At the end of the Auto-Trial period, the device will automatically transition into the CPAP-Check mode at the pressure the patient was at or below 90% of the trial period time. (Note that Auto-Trial mode is for temporary use only and must be used for a minimum of 3 nights to be effective. The REMstar PRO is NOT an Auto-CPAP Machine.)

CPAP-Check Mode checks on the user every 30-hours to determine if therapy pressure is optimal. If not, it automatically adjusts the nightly fixed CPAP pressure by 1 cm H2O (with maximum upper and lower limits of 3 cm) to obtain an ideal pressure.

Straight CPAP Mode is for use when therapy with no changes or checks is preferred. In straight CPAP mode the REMstar PRO will not make pressure checks or adjust therapy levels although normal therapy data will still be tracked.

[Sleeprider]

One other possibility is that you have the System One 50 series, which is the generation before the 60 Series. Your model number would be DS450xx for the 50 series and DS460xx for the 60 series. The 50 series does not have AutoIQ or the ability to support a heated tube.

If I may suggest, your doctor is not listening to you and you need to change tactics. If this is a specialist, talk to your primary care doctor. He can write a prescription based on your historic record of sleep apnea and prior use of a machine. If he is willing to do this, request that he write the script for a Resmed Airsense 10 Autoset CPAP, heated humidifier and heated tube and patient's choice of mask with patient self-titration for pressure. The Resmed machine is easy to set and much more effective than most stuff out there. It has an integrated humidifier.

If it is your primary doctor that is insisting on a new hospital sleep study, just find a doctor that listens to you. That's B.S. There is absolutely nothing to be gained by re-diagnosing an individual already known to have sleep apnea, and modern auto CPAP machines make titration studies unnecessary, particularly for anyone that has already successfully used a CPAP. Ask your insurance if you even need a new diagnostic study, home or clinical, since you have been using CPAP for many years. If they will accept an order for a replacement CPAP, your life is a lot easier. With that said, Medicare generally requires a diagnosis ordered by a physician prior to approving CPAP for the first time. Private insurance varies a lot. If you self-finance, the lowest prices for new equipment are at Supplier #33.