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Permalink Reply by Nat Pike on July 1, 2009 at 9:38am

"Congratulations" on your diagnosis. Welcome to the club, so to speak.

First of all, I hope your insurance would pay for at least SOME of your machine. Check, because it's not the kind of information they volunteer. I was lucky when I was diagnosed in that my insurance fully payed for a rent-to-own situation. I now outright own my machine, which is nice.

Every online retailer I've ever used for equipment has disappeared by the next time I needed equipment, which is disconcerting to say the least. I recently needed a new mask, and went to a local Wright & Filippis location. They were very helpful, and also helped me discover that my current insurance covered things my last sleep doctor said they wouldn't cover! Unfortunately, they appear to be pretty regional to Michigan without any retail section online (their site is at http://www.firsttoserve.com/), but maybe their helpfulness can extend to them helping you find a good online source.

I have a heated humidifier which I now almost never use. But it really does help in the winter when the air is really dry and I find myself waking up all dried out. A passive humidifier doesn't appear to be much better than no humidifier. So of course the heated ones are way more expensive, and often not covered by insurance. Not to be glum.

A machine with a ramp feature is nice to have, especially when getting used to using one, or getting used to a new, higher pressure setting. I've been using my machine so long that I don't turn the ramp-up feature on anymore. i want my pressure immediately so i can just go to sleep. But when I started, it was invaluable. I was at 16cm and starting at that suddenly was very uncomfortable.

I hope someone can tell you a reliable online supplier, especially if it's one that can help with insurance issues!

But most of all, getting started with CPAP or BiPAP therapy can be rough and take some time to get used to. Please don't give up if it is, as it really makes a difference over time!

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Permalink Reply by RockRpsgt on July 1, 2009 at 10:10am

Welcome to sleep guide.

first I would call your insurance company and find out which machines they will pay for. this might narrow things down for you.

Buying a CPAP machine is alot like buying a car. You have to pick the one with the best options and price for you. Remember that you are the only one that it has to work for.

fully data capable machines are nice. These will allow you to download the data from your machine giving you the option to evaluate you therapy whenever you want. Also as you become more educated with the PAP treatment it will give you more options down the road. i really like the Respironics Pro M Series. The Resmed S8 is also a very good machine. If not one of these specific machines I would suggest one by one of these companies as they are the 2 best.(In my opinion anyway).

The newer machines will come with all of the options that you have mentioned, but I will do my best to explain or break them down for you.

Humidifier-This is a must have option. The humidifier controls the dryness of the air being blown into your nose or mouth. This can affect your throat, sinuses, or cause water to drip down the hose and into your mouth, nose, or face. Very annoying. This is a comfort setting and will need to be adjusted accordingly.

The flex option which is called Cflex on a CPAP machine is another must have. This option makes it easier for you to breath. Specifally exhale. It lowers the pressure slightly as you breath out. this is also a comfort setting.

Ramp- Professionly the verdict is still out on whether or not this option is very beneficial to PAP therapy. This is an option that allows you to start out on a lower pressure and slowly raise to your prime pressure. This allows some people to fall asleep easier. If you use this option I would suggest that you do not exceed 20 minutes as it could allow apneac events that affect your sleep onset.

you also have 2 treatment options. Straight CPAP or auto CPAP. Both of the machines I mentioned above offer both of these options. Straight CPAP would mean that unless you used the ramp option your pressure would stay at 12cmwp. With an Auto PAP your pressure floats on a set range say 11-13cmwp. This can be beneficial if your breathing is worse in one position over another. As a sleep tech I prefer a straight PAP, but once again that is only my opinion. You have to choose the options that you are going to be comfortable with. The object is better health FOR YOU not me.

As far as masks go I am probably not the right one to give advice as my use of them is kind of in a one night stand situation. For clinical use I like the options given by the Resmed masks. I believe them to be a great introductory mask. I will tell you to try as many as you are given the option to try. When fitting a mask you should put it on sitting or standing upright. You should then lie down on your back and adjust it. The object is to keep the comfort level high while keeping the leak level low. Then you should roll to your left and right sides and make more adjustments. Once again comfort high leak low. Honestly Shariq you might go through 20 masks before you find one that works for you.

I will tell you that when PAP therapy works it gives you back time in your day. Not time like in hours, but time via energy. pleaser don't waist it or give up on it. Good luck I hope I have helped. i am sure there are more post to come. Sorry guys if I made any mistakes.

Rock

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Permalink Reply by sleepycarol on July 1, 2009 at 11:04am

Welcome,

I notice that you are from another country. I am unsure what type of medical coverage your country has and options available to you. By purchasing on line a few tips would be -- make sure you are dealing with a reputable dealer, make sure you know what you are ordering before actually ordering, ask questions prior to ordering (once you find one that interest you - read the reveiws are ask questions here if necessary) and research your options.

If you purchase it on line you stated it could be shipped to any city in the USA. How is that possible? The USA is a huge country. Of course I realize that you may have relatives or friends that could take shipment for you and then forward it to you.

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Permalink Reply by Shariq on July 1, 2009 at 2:44pm

Hi all,

Thank you for the welcome and the advice Nat, Rock, and Carol. :)

I do not have any insurance so this will be coming out of my pocket.

Has anyone used a website called: www.cpap.com ?
I have been reading on this site and was just curious if anyone has used them and are they reliable.

@Rock: The mask is a concern for me too... unfortunately I will not have the opportunity to try a few out... that is why I have to make the best educated guess I can.

@sleepycarol: Yes, I have friends who could help out with shipping it to me... I mentioned that to convey that it does not matter if the retailer/website ships international or not.

Shariq

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Permalink Reply by RockRpsgt on July 1, 2009 at 5:54pm

Sorry Shariq I did not notice that you were not American. That is what I get for assuming. LOL sorry Russ.
I would go with the Resmed masks just for the adjustment options. Get a full face and a nasal mask as the 2 of them will help in your therapy.

Shariq said:

Hi all,

Thank you for the welcome and the advice Nat, Rock, and Carol. :)

I do not have any insurance so this will be coming out of my pocket.

Has anyone used a website called: www.cpap.com ?
I have been reading on this site and was just curious if anyone has used them and are they reliable.

@Rock: The mask is a concern for me too... unfortunately I will not have the opportunity to try a few out... that is why I have to make the best educated guess I can.

@sleepycarol: Yes, I have friends who could help out with shipping it to me... I mentioned that to convey that it does not matter if the retailer/website ships international or not.

Shariq

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Permalink Reply by amott1973 on July 2, 2009 at 10:41pm

Hi Shariq,

I have used cpap.com. Not for a machine and mask, but for accessories, and it was handled very nicely. I know they've been around for at least the last 4 years since I was diagnosed in 2005. I believe you will still need a prescription from your doctor for the machine itself, although I don't think you will for the mask.

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Permalink Reply by sleepycarol on July 2, 2009 at 10:44pm

I voice a thumbs up for www.cpap.com as well. I have gotten supplies from them and they arrive promptly and packaged securely.

If you want to pay extra, they do have mask insurance available and is recommended if you are unsure what size you take. They do have a guide to help with sizing as well.

Good luck!!

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Permalink Reply by Judy on July 3, 2009 at 12:35am

Ack!!! Nat! Wright & Filippis???? Certainly can't be the Saginaw office you are talking about!!! Or they must have a different RRT!! The one I had to deal w/was "less than truthful" and/or dumb as a rock and too dang lazy to bother reading the Clinicians Manual and couldn't or wouldn't get past the Quick SetUp Guide if her life depended on it. I had to print out the Medicare replacement schedule and parts coverage and shove it under her nose to get a replacment cushion and swivel for a mask my cat damaged. She tried to tell me Medicare wouldn't pay for the part(s) I needed. Told me Medicare wouldn't pay for my doctor scripted nebulizer ..... I switched DME suppliers ASAP. And most if not all insurances WILL pay for a humidifier, in fact most if not all will pay for an integrated, heated humidifier.

I would vouch for cpap.com as a great online DME supplier, also cpapworksllc.com - and Daniel Levy who posts here has a CPAP supply business. His is a fairly new online business but he sure has been great and helpful here and doesn't tout his online supplier status in his posts - just shares good advice.

And, Rock, I HAVE to correct you about calling your insurance company, do NOT discuss brand or model, etc. CPAP w/your insurance! Insurances pay by HCPCS code NOT by brand and model! Better you don't discuss brand or model at all w/them. What you DO want to ask your insurance is what local DME suppliers they are contracted with!!!. And about DME benefits, copays, deductables, annual limits; CPAP outright purchase, rent to own (capped rental).

And the Resmed S8 Compact and Escape and the Resmed S8 Escape II are NOT fully data capable altho yes, they do provide good therapy. Nor is the Respironics REMStar M Series Plus fully data capable. You are right tho, the Respironics M Series Pro IS fully data capable as is the Resmed S8 Elite and S8 Elite II. The key words are PRO and ELITE for full data capability. Neither the Pro nor the Elite are APAPs. I know Rock meant that both Resmed and Respironics offer both straight CPAPs and also APAPs but wanted to clarify that.

C-Flex and A-Flex are Respironics' proprietary names for their expiration pressure relief. EPR is Resmed's proprietary name for their expiration pressure relief.

I am NOT picking on Rock Hinkle when I make these clarifications. He is one of our most valuable members!!!!!! But he is a sleep tech and not a DME RT so he hasn't had as much experience w/the various brands and models of xPAPs and their options as a DME supplier's RT would - yet. From what I know of Rock Hinkle he'll be learning most all of them before he retires!! He has that kind of interest and curiosity and caring for his patients.

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Permalink Reply by RockRpsgt on July 3, 2009 at 3:21am

Thanks Judy.

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