RE: Sleep test results. What should I do, now?
Misguided Wrote:I'm with Ang, not getting an Auto-capable machine is silly if you have the option. You can always run in CPAP mode if you need to for some reason.
The DME is not your friend. You are a mark, and they want to make as much money as they can. Knowledge is your best weapon. Knowing things like not to accept a Resmed unit with Escape in the name are important if you want to pay a role in managing your own health.
RE: Sleep test results. What should I do, now?
zonk Wrote:For me i think the problem is that the Escape is not data capable machine which you can not monitor your therapy and optimize your therapy . You can use an Autoset in auto-titrating mode and CPAP mode and all Xpap comes under Medicare E601 code in which the insurance pay a set price regardless what machine the DME gives you .I feel you need to work with your doctor in addressing the issues that you have mentioned trouble concentrating, memory loss and falling asleep in the daytime which it could be not CPAP related .
RE: Sleep test results. What should I do, now?
archangle Wrote:You can buy a brand new PRS1 Auto machine with heated humidifier online for under $700 so don't take much guff off the DME.
Sometimes, you can get reimbursed by your insurance for online purchases as "out of network" providers at a lower percent. Watch out for deductibles.
See if you can talk your doctor into writing you a prescription that specifies a pressure range. Even if it's a small range, such as 8-12 if he thinks 10 is the correct range. That way, the DME has to give you an Auto.
Do not let the DME give you a ResMed S9 "Escape Auto". It collects very little data. If it's an S9, the only auto that is acceptable is the "S9 AutoSet." Check the machine when you buy it to see that it really says "AutoSet" next to the power button.
Do not accept any ResMed machines that are not S9 models. The S9 is so much improved in terms of data collection that it's insane to accept earlier models.
All PRS1 (Philips Respironics Series One) Auto machines record good data. Do not accept any older Respironics models. The PRS1 machines are much improved in terms of data collection.
Do not accept a PRS1 "AutoIQ" machine. It is NOT an Auto CPAP machine. (Long, ugly story.) You want the PRS1 REMstar Auto AFLEX.
If you get a non-auto machine, do not accept any PRS1 "Plus" machine. "Pro" is the good manual PRS1 machine. Do not accept any ResMed "Escape" machine. "Elite" is the good manual model.
Is the DME you're dealing with an "in network" DME? Usually, in the US, an in network DME cannot charge you a different price for different CPAP machines per their contract with the insurance company. If they want you to pay up, ask them to write you a quote or some such.
They don't have to upgrade you to an auto or give you a better model unless it's necessary to fill the prescription. That's why it's good to get the doctor to specify a pressure range.
You really do want a fully data capable machine. The DME will tell you that the Escape or Plus machines record data, but they only record the times the machine is running. The good machines record the number of apenas, the types, other breathing problems and even record waveforms of the airflow you had all night long. If you have a problem, you or your doctor can look at the data and get a clue as to what's wrong. It's like having mini-sleep study data for every night you sleep.
Remember, if it's midnight and a DME tells you it's dark outside, go and look for yourself.
RE: Sleep test results. What should I do, now?
archangle Wrote:zonk,(time=1314922345) Wrote:Another thing get your doctor to specify the type of machine on the prescription for example S9 Autoset with humidifier and dispense as written . Be sure to specify a pressure range, too. Cuts down on the arguments.
Be sure it says "S9 AutoSet", not just "S9 Auto". Then they can't give you an "S9 Escape Auto."
"Philips Respironics Auto" would work, but be sure they don't switch you with an "AutoIQ". Don't leave off "Philips".
RE: Sleep test results. What should I do, now?
Dolla Bill Wrote:Zonk,
The actual defining event for me getting a sleep test was when I went to an ENT because I had a throat problem. Felt like I had a piece of food stuck there. As part of the diagnosis we talked about my sleep apnea. He sent me for a sleep test.
We spent more time talking about my throat. An endoscopy, today, showed very minor problem. So when we talk again, it will now be focused on apnea. I want to learn all about this problem.
I agree that other issues could be here, am having some other tests run. I mentioned that my early experience with apnea included cardio symptoms. These have occurred again when I quit using the CPAP for about three weeks.
So, off to a cardiologist for an EKG and Echo. Next week a stress test. A few other tests I have been putting off. So far everything can be summed up in a statement from the cardiologist, "Bill, you are 'disturbingly normal."
Fatigue, short term memory, trouble concentrating, falling asleep when I sit for more than a few minutes, could be apnea related, or something else.
Thanks for your comments. I am open to suggestions.
Kind regards,
Bill
RE: Sleep test results. What should I do, now?
Ltmedic66 Wrote:If you went to an ENT, I am sure you are looking in to this, but thought I would mention this. That lump in your throat sounds like LPR- laryngopharyngeal reflux. Basically, it is acid reflux that resuls in irritation to your voice box and upper airway. The usual treatment involves lifestyle changes such as avoiding foods that contribute to reflux and drugs that helps to control acid reflux, such as nexium, protonix, or aciphex (there are lots of them these days).
There is an increased risk of having acid reflux if you have OSA. Of course, there are other things that can cause that "lump in the throat", but LPR might be worth investigating.
RE: Sleep test results. What should I do, now?
zonk Wrote:Your sleep test results shows that your AHI dropped from 71.5 to 11.8 per hour on CPAP which is a good result and almost all of them are obstructive which indicate that your OSA is a simple one and your titrated pressure at 11 is happy medium between the minimum 4 and the maximum 20 .
RE: Sleep test results. What should I do, now?
Ltmedic66 Wrote:Steven,(time=1314981459) Wrote:I would not only have the prescription specify a pressure range, but also a very specific machine & humidifier and even a Climateline hose if you choose ResMed.
Decide what you want beforehand & have the prescription written very specifically. Well, there are two lines of thought on this. I just have a "generic" prescription- CPAP at 11cm with heated humidifier and mask of pt choice. This script will serve me for life- I can buy any CPAP or APAP with it.
If you get a very specific script that lists machine, model, mask, and hose, that is exactly what you can get with it. Certainly, this is a good way to go if you have to meet insurance specifications for reimbursement for a certain machine, but I would always recommend having a somewhat generic script for future needs.
Just my 2 cents...
RE: Sleep test results. What should I do, now?
Ltmedic66,(time=1315000112) Wrote:Well, there are two lines of thought on this. I just have a "generic" prescription- CPAP at 11cm with heated humidifier and mask of pt choice. This script will serve me for life- I can buy any CPAP or APAP with it.
If you get a very specific script that lists machine, model, mask, and hose, that is exactly what you can get with it. Certainly, this is a good way to go if you have to meet insurance specifications for reimbursement for a certain machine, but I would always recommend having a somewhat generic script for future needs. If one is in this situation, I would kindly explain these reasons to the doctor and ask them to write two separate prescriptions... one for generic CPAP that will "cover you for life" (that you will keep "on file" for future use if necessary) and then the specific one naming a specific make and model for the insurance company so they will pay for the machine you desire.
Explain to the doc that these days, even if you purchase CPAP masks or a heated humidifier, they require a prescription. In this economy, you may lose your insurance coverage at some point, and need the "generic prescription" to purchase a new CPAP or other accessories than the specific machine you want today.
I'm still using my generic CPAP prescription from 2004, since I have no health insurance - most online DMEs will accept that one, but you're absolutely right - if written "dispense as written" or "no substitutions", by law you can't get any other machine other than the one listed on the script, even if it's no longer manufactured.
Get two prescriptions to cover your bases - best of both worlds. 
Good points, LT.
SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
RE: Sleep test results. What should I do, now?
zonk Wrote:It,s confusing for me what is the point having a prescription for life if 5 years is the norm for CPAP replacement and any GP can write one or even i might have another sleep study in the meantime and my requirement might have changed (BIPAP or ASV) .
Wise man said "If it's midnight and a DME tells you it's dark outside, go check for yourself " 
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