Replies to This Discussion

Permalink Reply by Renee on October 21, 2009 at 6:12pm

Hello Melinda,

Thank you for taking the time to write and for all the valuable info you have provided.

After reading thru and deciphering all the feedback I have received, I would like to let you know what I have decided. As you recommended, and knowing that throat tends to get dry, I will be using a humidifier and will be ordering the H4i or the Fischer and Paykel - F&P HC 150 W / ambient tracking ( although I don’t know what ambient tracking is ? ) and the F & P HC 150 has a water chamber that is a tad larger as well, which is nice on a night when you want to sleep in..

As for the xPAP – 1st choice - S8 AutoSet II with Easy-Breathe – newer, little quieter – and depending on insurance: 2nd choice - the S8 Elite II w/EPR – best for straight CPAP, best data collection program, records AHI, leaks in the mask, etc. –- and the H4i – ResMed Heated Humidifier

And I had wanted to use the smallest mask possible, so nose pillows, BUT Neal gave me a wake-up (hey, that’s a sleep pun!) and let me know that using nasal pillows with pressures above 11 or 12 cmH2O can be quite uncomfortable and I am to start out at 18 cmH2O so I am now reconsidering my choice of mask.

If you have any thoughts, could I ask for your ideas on the: Mirage Activa LT (small); Mirage Activa; Mirage Micro (slender design for improved field of vision); Mirage SoftGel (soft & one durable frame is compatible with both Mirage SoftGel and Mirage Activa™ LT cushions); Mirage Vista (good for reading – doesn’t attach to forehead); Ultra Mirage II?

I do thank you for all the advice you have already provided.

Best,
Renee

• ▶ Reply

Permalink Reply by Renee on October 21, 2009 at 6:21pm

Hello Carol,

Thank you for offering your thoughtful advice.

From all the great info I have received, I am thinking of ordering: 1st choice - S8 AutoSet II with Easy-Breathe – newer, little quieter – and depending on insurance: 2nd choice - the S8 Elite II w/EPR – best for straight CPAP, best data collection program, records AHI, leaks in the mask, etc. –- and the H4i – ResMed Heated Humidifier or the Fischer and Paykel - F&P HC 150 W / ambient tracking ( although I don’t know what ambient tracking is ? ) and the F & P HC 150 has a water chamber that is a tad larger as well, which is nice on a night when you want to sleep in.

And I had wanted to use the smallest mask possible, so nose pillows, BUT Neal gave me a wake-up and let me know that using nasal pillows with pressures above 11 or 12 cmH2O can be quite uncomfortable and I am to start out at 18 cmH2O so I am now reconsidering my choice of mask.

If you have any thoughts, could I ask for your ideas on the: Mirage Activa LT (small); Mirage Activa; Mirage Micro (slender design for improved field of vision); Mirage SoftGel (soft & one durable frame is compatible with both Mirage SoftGel and Mirage Activa™ LT cushions); Mirage Vista (good for reading – doesn’t attach to forehead); Ultra Mirage II?

Thank you for all your help and support.

Best,
Renee

• ▶ Reply

Permalink Reply by Renee on October 21, 2009 at 6:29pm

Hello Dan,

Thanks for taking the time to reply to my posting and for sending along your advice.

From the limited communication that I have had with my DME, I think I may be amongst the lucky ones who has a good partner . . . a little time, equipment and service will tell. I thought I’d let you know what my plans are at this point – gained from all the great info I received on SG: 1st choice - S8 AutoSet II with Easy-Breathe – newer, little quieter – and depending on insurance: 2nd choice - the S8 Elite II w/EPR – best for straight CPAP, best data collection program, records AHI, leaks in the mask, etc. ( BUT, of course, as you mentioned insurance coverage should make no difference – so likely the S8 AutoSet II ) –- and the H4i – ResMed Heated Humidifier or the Fischer and Paykel - F&P HC 150 W / ambient tracking ( although I don’t know what ambient tracking is ? ) and the F & P HC 150 has a water chamber that is a tad larger as well, which is nice on a night when you want to sleep in.

I had wanted to use the smallest mask possible, so nose pillows, BUT Neal gave me a wake-up and let me know that using nasal pillows with pressures above 11 or 12 cmH2O can be quite uncomfortable and I am to start out at 18 cmH2O so I am now reconsidering my choice of mask.

If you have any thoughts, could I ask for your ideas on the: Mirage Activa LT (small); Mirage Activa; Mirage Micro (slender design for improved field of vision); Mirage SoftGel (soft & one durable frame is compatible with both Mirage SoftGel and Mirage Activa™ LT cushions); Mirage Vista (good for reading – doesn’t attach to forehead); Ultra Mirage II?

Thanks again for your time and help.

Best,
Renee

• ▶ Reply

Permalink Reply by Renee on October 21, 2009 at 6:40pm

Hello Judy,

Thanks for taking the time to think thru my query and for all the important info you provided.

I looked back thru my notes that I made while talking with the DME rep on the phone about what to expect to receive and I notes include the C-Series with disposable water chamber. But I have read your reply and I will be changing the order. I will have no difficulty getting ResMed equipment because that’s the DME does provide that. Having considered all the great advice I got in response to my posting, I thought I’d let you know what I’m thinking of ordering: 1st choice - S8 AutoSet II with Easy-Breathe – newer, little quieter – and depending on insurance: 2nd choice - the S8 Elite II w/EPR – best for straight CPAP, best data collection program, records AHI, leaks in the mask, etc. –- and the H4i – ResMed Heated Humidifier or the Fischer and Paykel - F&P HC 150 W / ambient tracking ( although I don’t know what ambient tracking is ? ) and the F & P HC 150 has a water chamber that is a tad larger as well, which is nice on a night when you want to sleep in.

I had wanted to use the smallest mask possible, so nose pillows, BUT Neal gave me a wake-up and let me know that using nasal pillows with pressures above 11 or 12 cmH2O can be quite uncomfortable and I am to start out at 18 cmH2O so I am now reconsidering my choice of mask.

If you have any thoughts, could I ask for your ideas on the: Mirage Activa LT (small); Mirage Activa; Mirage Micro (slender design for improved field of vision); Mirage SoftGel (soft & one durable frame is compatible with both Mirage SoftGel and Mirage Activa™ LT cushions); Mirage Vista (good for reading – doesn’t attach to forehead); Ultra Mirage II?

Thanks again for your time and help with this and all the support you offer on SG.

Best,
Renee

• ▶ Reply

Permalink Reply by Renee on October 21, 2009 at 7:03pm

Hello Mary,

Thank you for your reply and your prospective.

I am really glad to hear about the relationship that you have developed with your doctor and DME provider. I truly believe that with my health care providers that the relationship is an ABSOLUTELY key, essential element to good treatment and health. Although it has been hard, I have changed doctors when communication and respect were not fundamental to our relationship and have ALWAYS found out that it was the right decision. So good to hear about your experience. Thanks for sharing it. And thanks for your kind offer that I keep you posted.

My Best,
Renee

• ▶ Reply

Permalink Reply by Neal Buckner, LRCP on October 21, 2009 at 7:04pm

You're very welcome Renee,

In my experiance with higher pressure like 18 cmH2O the Activa LT is the best option wiht a chin strap. It seals very nicely and the flexiblity design in the cushion is superior to the rest. And, like you mentioned, the frame is the same as the new Mirage soft gel so changing out the cushion (which most insurances will pay for monthly) is a breeze. I would strongly discourage you from going with the nasal pillow system given your pressure prescribed. Sinusitus and rhinitis is very uncomfortable. With regards to the humidifier the H4i that comes with all the ResMed S-8 machines, also has ambient tracking. They just don't advertise it. I would suggest staying with the ResMed line when it comes to matching up the blower to the humidifier. Reason: ResMed's software is very intelligent and sensitive to what's called dead space (The amount of space that needs to be filled between you and the blower.) It calculates every single cubic centimeter and provides perfect pressure adjustments. changing the humidifier to another brand can change the effectiveness of the S-8 machine and give false data.

For all intents and purposes the S-8 Elite with EPR is more than adequate for your application. Even though I set everyone up on an Autoset II. I do that for basically one reason. We all change as we age and as we gain or lose weight the pressure requirements change. With the Autoset I am able to change my patients over to APAP without having to stock loaner machines to do a new titration. Bottom line, it saves my company money to set my patients up on a more expensive machine. The company you may be going through might not have the same philosophy.

Try not to let your experiance at the sleep lab dictate your acceptance of CPAP therapy. They get a little sterile and cold over time because thay are data collectors and patient emotional comfort doesn't always come first.

You have done a lot of homework and I know you will do just great. I wish more of my patients were more pro-active like you.

Good luck!

Neal

Renee said:

Hello Neal,

I am so glad that you have put your two cents in - this is really valuable. I have been reading thru the replies to my post and have received extremely important info from several people and I am really grateful.

From all the great info I have received, I am thinking of ordering: 1st choice - S8 AutoSet II with Easy-Breathe – newer, little quieter – and depending on insurance: 2nd choice - the S8 Elite II w/EPR – best for straight CPAP, best data collection program, records AHI, leaks in the mask, etc. –- and the H4i – ResMed Heated Humidifier or the Fischer and Paykel - F&P HC 150 W / ambient tracking ( although I don’t know what ambient tracking is ? ) and the F & P HC 150 has a water chamber that is a tad larger as well, which is nice on a night when you want to sleep in.

BUT you have brought a whole new quandary to me . . . I am not forward looking to xPAP therapy – might have to do with my experience in the sleep study – or it may just be that it is just an inconvenient, uncomfortable, obtrusive experience that one must get used to tolerating. That said, I had so hoped that I would be able to use the smallest mask – so just the nose cushions with a chin strap (which is what the doctor at the sleep study also recommended – but I am not comfortable with the place where I had the sleep study and am switching to another place for follow-up and continued treatment). But I digress . . .

You mentioned that using nasal pillows with pressures above 11 or 12 cmH2O can be quite uncomfortable and I am to start out at 18 cmH2O. So hmm . . . I had been planning to try the: Swift LT for her, Swift LT, or the Mirage Swift II. Now your email has sent me back to the drawing board, but better to find out now before the rep arrives with the 3 little nasal pillow masks in tow. So, I am thinking now that, perhaps, I should start out with a fuller mask and I’m wondering if I could ask your thoughts on the: Mirage Activa LT (small); Mirage Activa; Mirage Micro (slender design for improved field of vision); Mirage SoftGel (soft & one durable frame is compatible with both Mirage SoftGel and Mirage Activa™ LT cushions); Mirage Vista (good for reading – doesn’t attach to forehead); Ultra Mirage II.

I really do thank you very much – your advice and support is invaluable.

Best,
Renee

• ▶ Reply

Permalink Reply by Neal Buckner, LRCP on October 21, 2009 at 7:08pm

The billing code for an APAP and CPAP are exactly the same and in most cases the cost to the DME is only about a $50 difference between a straight CPAP and APAP. I agree with Dan. You were taken for a ride and should file a complaint.

Neal

Jan said:

I just got an apap and the dme asked me to pay the difference between the straight cpap which the insurance company would pay for and the apap. I agreed to do this. Is this the way it works most of the time?

• ▶ Reply

Permalink Reply by Dan Lyons on October 21, 2009 at 7:44pm

Criminal fraud is the obtaining of funds or tangible item(s) thru the usage of deception, false information or misdirection.

There is but one coding for both machines. The insurance industry standard is that they pay the same, for a CPAP as the do for an APAP. Thus the only variable is the patient’s plan and/or co-pay.

Based on the information to which has been brought to light, I would be willing to say Jan was the victim of an all to frequent and very much so illegal act perpetuated upon an unknowing patient.

I will agree that the CPAP unit(s) cost the DME less than the APAP unit(s), but the DME is reimbursed at high percentage of his costs on the CPAP and less on the APAP’s, thus the DME’s motive.

The DME agreed to this payment plan when the signed their agreement contracts with the insurance company. They knew full and well the reimbursement amounts up front.

The DME, in an illegal move through the fraudulent pretenses, is now attempting to shake down cash from the patient to increase their profits.

The DME’s motive is greed – period, plain and simple.

For that reason, Jan is now jus another victim of a crime, based on the information she shared. It is grounds for an investigation to be conducted. Jan is but the first person to which has questioned the DME’s actions, but I can assure her, that she was not the first and she won’t be the last.

It is up to law enforcement, state insurance commission and/or the attorney general’s office, to determine, thru a criminal investigation, the extent to which they should pursue this unscrupulous DME.

It is the responsibility of each and every person/patient to watch the industry and keep them honest. If we don’t, each of use will be is Jan’s shoes.




Rock Hinkle said:

Dan I am not arguing with you, but I would like you to explain to me why you see this as fraud. I don't see it that way. Don't you have to cheat, hide, or falsify the info to the customer, or the ins. company to get a fraud charge. In any other buisiness the cost difference would be put on the customer. Not saying i agree with the practice, but it is a buisiness. As of right now fully data capable is an option not a requirement. If you were purchasing a car you would typically pay more for the cd player or sun roof. Just my opinion.

Dan Lyons said:

Congratulations, I do believe you have been gotten by DME greed.

I would be demanding a refund and talking to the insurance commissioner’s office for my state, filing a fraud complaint.


Jan said:

I just got an apap and the dme asked me to pay the difference between the straight cpap which the insurance company would pay for and the apap. I agreed to do this. Is this the way it works most of the time?

• ▶ Reply

Permalink Reply by Renee on October 21, 2009 at 8:19pm

Hello Neal,

Ooooh, OK, Neal, I’m going to move on up to a larger Mask – you kill-joy you. And, yes, sure makes sense to get the H4i and match the ResMed equipment compatibility. From the limited communication I have had thus far with my DME provider, they have seemed to be very cooperative so I am going to contact them with the expectation of them being agreeable to providing the Autoset II – but I appreciate the full grounding you have provided.

And, if I’m not asking too much, what do you think of your 1st choice – the Activa LT with a chin strap vs the Mirage Vista (good for reading – doesn’t attach to forehead) ? And, lastly, I wouldn’t have thought of using a chin strap other than with nasal pillows. Does the Activa LT just cover the nose? Thank you.

The sleep study center, itself, that I went to, was the problem. I found the techs to be quite good. I haven’t groused about it but here goes . . . on my 1st night, I was in an office with a Murphy bed and the left side of the bed contained a cabinet which apparently held supplies because the techs came into my room, turned on the light and sorted thru the closet throughout the night to find items they needed. Also there was no air circulation and it was too warm. After the tech opened the windows, it got cooler but still warm enough to sleep without any sheet or blanket and still no air circulation. On the 2nd night, I was in a smaller room with a smaller bed, but there was a fan and I had time to adjust the direction and speed while waiting for the tech, so even though the bed was smaller – especially with the equipment in it – the temperature and air circulation was better and the techs didn’t need to come in and out throughout the night to find supplies. BUT what bothered me the most was such a simple thing – the beds had plastic covering on the mattresses – but NO sheets ! They had only a VERY thin piece of cotton material that was laid across the TOP of the mattress. It was the same size as the length and width of the mattress so it did not go down over the sides, top, bottom of the mattress. And so as soon as you sat on it for the tech to hook you up, the material started to bunch up and then as the tech placed the equipment under the pillow, the material pulled down from the top – and then as you laid down – well, that was it – the material just shriveled up under you ! So, throughout the night, your whole body, especially your arms and legs were partly on a damp plastic mattress or tangled up in a pile of crumpled up cotton fabric. (Since I had been reading the SG forum and thought it was important to find out ASAP out my OSA, I remained with the same sleep center for the 2nd test – but I wish I had thought to take a sheet from home for my 2nd night.) Needless to say, I didn’t sleep much either night for a whole assortment of reasons.

But, now, I’ve got a starting point and I also have an appointment for Nov. 2 with another sleep center that was recommended on SG and I am hoping to switch there for continued testing and treatment.

I appreciate your compliment about my being proactive. Feels very good to receive your support. And, in kind, I hope you will know how very much your communication with me has helped me in many ways.

My Best,
Renee

Neal Buckner, LRCP said:

You're very welcome Renee,

In my experiance with higher pressure like 18 cmH2O the Activa LT is the best option wiht a chin strap. It seals very nicely and the flexiblity design in the cushion is superior to the rest. And, like you mentioned, the frame is the same as the new Mirage soft gel so changing out the cushion (which most insurances will pay for monthly) is a breeze. I would strongly discourage you from going with the nasal pillow system given your pressure prescribed. Sinusitus and rhinitis is very uncomfortable. With regards to the humidifier the H4i that comes with all the ResMed S-8 machines, also has ambient tracking. They just don't advertise it. I would suggest staying with the ResMed line when it comes to matching up the blower to the humidifier. Reason: ResMed's software is very intelligent and sensitive to what's called dead space (The amount of space that needs to be filled between you and the blower.) It calculates every single cubic centimeter and provides perfect pressure adjustments. changing the humidifier to another brand can change the effectiveness of the S-8 machine and give false data.

For all intents and purposes the S-8 Elite with EPR is more than adequate for your application. Even though I set everyone up on an Autoset II. I do that for basically one reason. We all change as we age and as we gain or lose weight the pressure requirements change. With the Autoset I am able to change my patients over to APAP without having to stock loaner machines to do a new titration. Bottom line, it saves my company money to set my patients up on a more expensive machine. The company you may be going through might not have the same philosophy.

Try not to let your experiance at the sleep lab dictate your acceptance of CPAP therapy. They get a little sterile and cold over time because thay are data collectors and patient emotional comfort doesn't always come first.

You have done a lot of homework and I know you will do just great. I wish more of my patients were more pro-active like you.

Good luck!

Neal

Renee said:

• ▶ Reply

Permalink Reply by Neal Buckner, LRCP on October 22, 2009 at 1:32am

The Activa mask only goes over the nose. So using a chin strap is a good idea to get started. You might find that after you have been on CPAP for a while the need to open your mouth will go away. The OSA sufferers brain programs itself to know what sleeping position and jaw position is the most successful at getting any kind of sleep. Once you start using CPAP the brain will start a "re-programing" process. First will be the adjustment to having something on your face. It's not natural to have something on our face when we sleep. At the same time our brain recognizes a certain level of airflow and depth of breathing as being a normal breath. Once you place air pressure to the upper airway the brain tends to make you think you aren't getting enough air where in actuality the gas exchange in the lower airways is actually better. Try sticking your head out the car window while driving 50 mph. Or ride on a motorcycle with an open face helmet and no faring. The sensation and result is the same. At first it feels weird like you can't catch your breath. But the longer you ride or have your head out the window the easier it gets because the brain registers the CO2 levels as staying normal and in some cases improved. Your "ventilation" is good. Once you get past that initial adjustment it becomes second nature and even gets to the point of your subconscious triggering anxiety if you don't wear your mask at bed time. Just like the way it was programmed to make you feel more comfortable to lay on your side to sleep and open your mouth to breath now.

I digress. Yes use a chin strap to start. Or a full face mask if that doesn't work. Then once you have become comfortable and compliant. Then see if you can graduate to a simple nasal mask. As far as the Vista mask goes. It's a good mask. But keep in mind that, although mask may look cool, it doesn't mean it will work for you. Everyone's face is different. Have the DME bring several options. Personally I have had more success with the Activa than the Vista on my patients. But again, everyone is different. So try a few. And don't let the DME provider fool you into thinking that you are stuck with a mask. ResMed and Respironics both have a 30 day mask guarantee. If for any reason the mask you initially get set up with doesn't work. Either due to seal or discomfort, to include pressure sores and skin irritation, they will replace that mask with the DME company at no cost. So you have the option to change your mask.

The goal is to make you,the consumer and patient, comfortable so you will use and benefit from the PAP therapy.

Neal

Renee said:

Hello Neal,

Ooooh, OK, Neal, I’m going to move on up to a larger Mask – you kill-joy you. And, yes, sure makes sense to get the H4i and match the ResMed equipment compatibility. From the limited communication I have had thus far with my DME provider, they have seemed to be very cooperative so I am going to contact them with the expectation of them being agreeable to providing the Autoset II – but I appreciate the full grounding you have provided.

And, if I’m not asking too much, what do you think of your 1st choice – the Activa LT with a chin strap vs the Mirage Vista (good for reading – doesn’t attach to forehead) ? And, lastly, I wouldn’t have thought of using a chin strap other than with nasal pillows. Does the Activa LT just cover the nose? Thank you.

The sleep study center, itself, that I went to, was the problem. I found the techs to be quite good. I haven’t groused about it but here goes . . . on my 1st night, I was in an office with a Murphy bed and the left side of the bed contained a cabinet which apparently held supplies because the techs came into my room, turned on the light and sorted thru the closet throughout the night to find items they needed. Also there was no air circulation and it was too warm. After the tech opened the windows, it got cooler but still warm enough to sleep without any sheet or blanket and still no air circulation. On the 2nd night, I was in a smaller room with a smaller bed, but there was a fan and I had time to adjust the direction and speed while waiting for the tech, so even though the bed was smaller – especially with the equipment in it – the temperature and air circulation was better and the techs didn’t need to come in and out throughout the night to find supplies. BUT what bothered me the most was such a simple thing – the beds had plastic covering on the mattresses – but NO sheets ! They had only a VERY thin piece of cotton material that was laid across the TOP of the mattress. It was the same size as the length and width of the mattress so it did not go down over the sides, top, bottom of the mattress. And so as soon as you sat on it for the tech to hook you up, the material started to bunch up and then as the tech placed the equipment under the pillow, the material pulled down from the top – and then as you laid down – well, that was it – the material just shriveled up under you ! So, throughout the night, your whole body, especially your arms and legs were partly on a damp plastic mattress or tangled up in a pile of crumpled up cotton fabric. (Since I had been reading the SG forum and thought it was important to find out ASAP out my OSA, I remained with the same sleep center for the 2nd test – but I wish I had thought to take a sheet from home for my 2nd night.) Needless to say, I didn’t sleep much either night for a whole assortment of reasons.

But, now, I’ve got a starting point and I also have an appointment for Nov. 2 with another sleep center that was recommended on SG and I am hoping to switch there for continued testing and treatment.

I appreciate your compliment about my being proactive. Feels very good to receive your support. And, in kind, I hope you will know how very much your communication with me has helped me in many ways.

My Best,
Renee

Neal Buckner, LRCP said:

You're very welcome Renee,

In my experiance with higher pressure like 18 cmH2O the Activa LT is the best option wiht a chin strap. It seals very nicely and the flexiblity design in the cushion is superior to the rest. And, like you mentioned, the frame is the same as the new Mirage soft gel so changing out the cushion (which most insurances will pay for monthly) is a breeze. I would strongly discourage you from going with the nasal pillow system given your pressure prescribed. Sinusitus and rhinitis is very uncomfortable. With regards to the humidifier the H4i that comes with all the ResMed S-8 machines, also has ambient tracking. They just don't advertise it. I would suggest staying with the ResMed line when it comes to matching up the blower to the humidifier. Reason: ResMed's software is very intelligent and sensitive to what's called dead space (The amount of space that needs to be filled between you and the blower.) It calculates every single cubic centimeter and provides perfect pressure adjustments. changing the humidifier to another brand can change the effectiveness of the S-8 machine and give false data.

For all intents and purposes the S-8 Elite with EPR is more than adequate for your application. Even though I set everyone up on an Autoset II. I do that for basically one reason. We all change as we age and as we gain or lose weight the pressure requirements change. With the Autoset I am able to change my patients over to APAP without having to stock loaner machines to do a new titration. Bottom line, it saves my company money to set my patients up on a more expensive machine. The company you may be going through might not have the same philosophy.

Try not to let your experiance at the sleep lab dictate your acceptance of CPAP therapy. They get a little sterile and cold over time because thay are data collectors and patient emotional comfort doesn't always come first.

You have done a lot of homework and I know you will do just great. I wish more of my patients were more pro-active like you.

Good luck!

Neal

Renee said:

• ▶ Reply

Permalink Reply by TR on October 22, 2009 at 2:09am

I feel the humidifier does help in the winter or in a dry climate. My mouth seems to stay moist if I use the humdifier in these situations. Also drink plenty of water during the day this will help keep your mouth moist as well. Really if the ari is not dry then I have had no issues not using the humidifier option on my Bi-Pap machine. The Bi-pap worked well for me because when I breathed out I was not breathing against the strong airflow like I was with the CPAP machine I tried out for a week or two. I also used a full face mask due to a deviated septum in my nose which closes up when I breathe in with a NOSE mask. I use the RESMED fullface mask, it adjusts nicely and I have also purchased a long hose so I can move around in bend without yanking my bi-pap machine all over the place. This really helped! sleep studys are the best and really only good way to adjust your settings on any machine. A respitory or sleep apnea doctor should be the only one making these adjustments.

Tim

• ▶ Reply

Permalink Reply by Renee on October 22, 2009 at 10:06am

Hello Tim,

Thanks for taking the time to reply and thanks for the tips, especially to drink water during the day, which is good for a whole lot of reasons and the simple, yet important, idea of getting a long hose.

And I am also appreciative for your thoughts because, although I am starting out with CPAP/APAP, my doctor thought that after I go in for another sleep study, I may be switching over to Bi-Pap myself – but I didn’t realize how that could be a benefit. Also I have a partially deviated septum, so I am glad that you mentioned that as well. I have a consultation on Nov 2 with a different sleep study center than where my initial testing took place so I thank you very much for all mentioned because now I think I will be able to make full use of the visit to take care of so many issues that I wouldn’t have known to inquire about had you not shared your experience with me.

Thank you for all you valuable advice and suggestions.

Best,
Renee

Tim Rupe said:

I feel the humidifier does help in the winter or in a dry climate. My mouth seems to stay moist if I use the humdifier in these situations. Also drink plenty of water during the day this will help keep your mouth moist as well. Really if the ari is not dry then I have had no issues not using the humidifier option on my Bi-Pap machine. The Bi-pap worked well for me because when I breathed out I was not breathing against the strong airflow like I was with the CPAP machine I tried out for a week or two. I also used a full face mask due to a deviated septum in my nose which closes up when I breathe in with a NOSE mask. I use the RESMED fullface mask, it adjusts nicely and I have also purchased a long hose so I can move around in bend without yanking my bi-pap machine all over the place. This really helped! sleep studys are the best and really only good way to adjust your settings on any machine. A respitory or sleep apnea doctor should be the only one making these adjustments.

Tim

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