When to upgrade machine?

[Jerzasnore]

I did a sleep study just over 5 years ago and ever since I've gotten my Philips Respironics Remstar I've used it every night.  I was diagnosed with severe apnea and my machine pressure is set to 5 (not sure the measurement).  Prior to my machine I would snore very loud (like I was cutting down a forest) and with my machine I don't snore at all.  Anyway, since it's been 5 years I'm wondering if I need an upgrade or if I should keep what I have.  Currently I do not use software but would really like to see what's going on.

So... has there been an advance in technology to warrant a new machine?

[Sleeprider]

You don't mention whether you have the System One Auto DS560), Pro CPAP (DS460) or the brick (DS260). The answer to your question is "before it breaks". You should be making arrangements for a replacement now. The expected life of most machines is 5-years, and it is not uncommon for them to go 7 ore even more, but you don't know when the failure will occur. By replacing now, you have a backup in the event of a malfunction.

If you have great insurance, get your doctor to prescribe a replacement. You should do what you can to obtain physical copies of any sleep studies and past prescriptions you have had. It is not uncommon to be required to take another sleep study when you can't document past diagnostic studies. If your insurance has high copay or deductible, remember that you can get a new Dreamstation Auto DSX500T11 with heated humidifier and heated hose for about $360 on Amazon, or the Resmed Airsense 10 Autoset for about $100 more. No need to fall for the overpricing at most brick and mortar suppliers. Online supplier costs for auto CPAP averages $800 to $900 with your prescription.

If your current machine is data capable, download the free #Sleepyhead software. I highly recommend you get one of the above auto machines. Your current prescription of 5 cm pressure is very low, and it would not be unexpected that it may have changed. Getting an auto CPAP ensures you are getting the pressure you need when you need it.

[Jerzasnore]

Wow... that's a ton of info.  Thanks for the quick response.

I'm not sure which System One I have and will check when I get home.  It was a basic issue from the place where I got the sleep study done; no one explained whether there were differences in the machines; they seemed more concerned about the masks.  I only know that it has an sdcard in it but that probably doesn't tell you anything.  It came with the humidifier section but there was just too much condensation in my mask for me to continue using it so I took it off and now I'm learning about a heated hose to stop that problem.

I have blue cross blue shield so I'll check and see but didn't want to make another appointment before 'talking' with people with experience since I'm basically clueless.  In your opinion is the Resmed airsense 10 worth the $100 more than the dreamstation?

I'll try the sleepyhead software if the card has any data on it.

Thanks again.

[Gideon]

The card will have data, at least compliance data.  Check the model number to see if you have detailed data.

The ResMed Autoset responds faster to events than the Phillips Respironics model.  Both models, once dialed in, will treat your apnea.  In general we consider the Auto machines to be better machines.  IMHO the ResMed is worth the extra $100, but as I said the PR equivalent will also work well.



Current acceptable in Production Machines (ResMed and Philips Respironics, the 2 most popular manufactures)

• ResMed AirSense 10 AutoSet (best choice) (E0601) with HumidAir™ Heated Humidifier (Fixed CPAP, Auto CPAP)
  
  
• ResMed AirSense™ 10 Elite CPAP Machine with HumidAir™ Heated Humidifier (37205) (E0601) (Fixed CPAP)
  
  
• Philips Respironics DreamStation Auto CPAP Machine (DSX500x11) (Not all DreamStation Models, Check SN on bottom, bricks look the same) (Fixed CPAP, Auto CPAP) (best choice)
  
  
• Philips Respironics DreamStation CPAP Pro (DSX400x11) (Not all DreamStation Models, Check SN on bottom) (Fixed CPAP)
  
  
• Current Machines to Avoid
  

• ResMed AirStart™ 10 CPAP Machine with HumidAir™ Heated Humidifier (all models, 37201) (Lack of full data capability)
  
  
• ResMed AirSense™ 10 CPAP Machine with HumidAir™ (37015, 37203) (Lack of full data capability)
  
  
• Philips Respironics DreamStation CPAP (DSX200x11) (Not all DreamStation Models, Check SN on bottom) (Lack of full data capability)
  

Fred

[Sleeprider]

Jerzasnore, in my opinion the Resmed is worth the extra because the Autoset has a faster response than the Philips Auto, and the pressure relief is like bilevel with up to 3 cm of pressure reduction in exhale, while Philips gives you up to 2 cm momentarily during breathing transition. It is more machine for the money.

With a BC/BS plan, you will be paying at least 20% plus deductibles, and must use in-network providers. It is reasonable to assume you will have at least two doctors appointment to obtain the prescription and follow-up on treatment, and much more if they ask for a sleep study. The equipment costs from an in-network provider could be $1500 to $1800. As you can see, your co-pay alone just for equipment can be as high as self-financing the best machines on the market, and with a provider, you don't know what you'll get. You got junk the first time, and if you hang here, you won't get stuck again.

[Jerzasnore]

I just called the docs office to schedule an appointment for this Wednesday so we'll see what they say.

My current machine is the DS150 if that means anything.

[Sleeprider]

The DS150 is 3 generations old now and was replaced by the 60 series, and later the Dreamstation series. It is a fixed CPAP that does not provide ANY efficacy data, but only produces the hours of use. Please be sure to request an Auto CPAP for your next machine. The justification is that it has been over 5-years since your last study and your pressure needs may have changed. An auto CPAP can do that without the cost and inconvenience of a sleep study, and report the results. You should express your preference for the Resmed Airsense 10 Autoset. Based on your success using CPAP and previous diagnostic study, your doctor should be able to prescribe exactly what you want at your appointment.

[Jerzasnore]

Awesome.... thanks to everyone in this thread for all the help. I WILL be requesting the Resmed Airsense 10 Autoset even though the lady I spoke with said they now prescribe the Dreamstation but she did say if I wanted to buy a machine elsewhere I will have that option. I did not see this unit on amazon so if anyone has a link for a decent price a pm would work for me.

Thanks.

[Sleeprider]

They are not consistently available on amazon, and we are not permitted by Rule #3 to post links to commercial and DME sites.

There was one there briefly. Right now they would be available from Supplier #2 and all other listed suppliers. I would just follow up with the in-network providers. There is nothing wrong with the Philips Dreamstation Auto, and compared to what you had, it's a BMW vs a K-car (1980s Chrysler). The Resmed is just a step up.

Good luck with your appointment, and I'm sure they will take care of you. Ask any question that come up, and we will try to give you an honest and useful answer.

[Homerec130]

I just hit the 5 year point on my machine, PR BiPAP auto SV Advanced 950P, and had the discussion with my sleep doc. We could get a new one one now which would require a new sleep study (no big deal). The issue comes that in about a year I will change insurers (Medicare as primary) and if I want support for a machine I already own, I would still need another sleep study and then they would determine if my machine would be supported or not, regardless of the age. Oh, and get this, as I am a continuing user, I have to have 18 months between the two sleep studies before they will authorize it or accept the results. I would also have to change DME's as I am in an area with the messed up preferred providers and would lose the great one I have now. My DME provides hardware support and lets my doctor handle all the rest of the stuff including compliance reporting. I just bring my latest sleepyhead report with me each time I see him. Luckily, I would be able to keep my sleep doc and we already have a plan in place for when I make the transition between insurers, both of which are federal (TriCare and Medicare).

Homer