Replies to This Discussion

Permalink Reply by Melinda Hertel on October 20, 2009 at 3:21pm

Hi, Renee. I'll start with the humidifiers because that's the easiest: ResMed is discontinuing the H3i. The H4i is almost the same. I would definitely get a humidifier. It's not natural for the airway to have dry air blowing into it. People who live in more humid environments might be able to get away with not using a humidifier, but I wouldn't recommend it on a permanent basis. If you don't like it, you can always stop using it, but at least you have it.

As far as machines go, some people do better with APAP, but some people do worse. ResMed's products are fabulous--our personal favorite. With ResMed's APAP you can switch it into plain CPAP mode if you don't do well on APAP. As far as the Autoset II and Vantage go, the Vantage is just the older version. The Autoset II is a bit quieter.

The Elite II is the best for straight CPAP since it records AHI, leaks in the mask, etc. The Escape has EPR, the Compact does not. All of ResMed's II series are quieter than before. The only benefit to the earlier models is probably a price reduction. But, if you are billing insurance, that really shouldn't matter unless your DME company is only concerned about their profit margin.

I hope that helps--if you have any more questions, please feel free to call 877-392-7270. I am a CPAP user and work with a sleep specialist.

Melinda Hertel

• ▶ Reply

Permalink Reply by sleepycarol on October 20, 2009 at 6:29pm

I would try for the Resmed Autoset II. I haven't had any experience with the Resmed brand, but an auto has advantages over a straight cpap. You have more options/control over your therapy. If you gain weight, loose weight, etc. you can have the doctor work with you to figure out if your pressure has changed. Some people do better with an apap -- others don't. If you happen to be one that doesn't do well on apap -- that apap can run in straight cpap mode.

I use the M series apap with c-flex and like the flexibility that the apap options supply.

Depending upon where you live, and if you plan on traveling would be a factor in the humidifier. I personally do not like the intergrated humidifiers and prefer one of the Fischer and Paykel stand alone humidifiers. They allow more flexibility and the HC150 has ambient tracking. The water chamber is a tad larger as well, which is nice on a night when you want to sleep in.

• ▶ Reply

Permalink Reply by Dan Lyons on October 20, 2009 at 7:50pm

I am a Resmed user and very happy to be one.

In so far as your insurance coverage, it makes no difference to them which machine you get, they pay the same. Their billing codes are the same for CPAP or APAP. The DME makes more money when the sell you the low-end equipment.

You want humidified air. No question.

If it is me, getting a machine, I would get the RESMED, S8 AutoSet™ II with Easy-Breathe & the Humidaire 4i.

• ▶ Reply

Permalink Reply by Jan on October 20, 2009 at 9:27pm

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 20, 2009 at 9:48pm

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 Judy on October 20, 2009 at 11:25pm

You do NOT want and should REFUSE a Tango, Compact or Escape. They can provide NO USEFUL (to you or your doctor) data.

The only integrated, heated humidifier the S8s can use is the Humidaire 3i to the best of my knowledge, altho an upgrade kit can give it the capacity of a 4i. It is my understanding that the only integrated, heated humidifier that can be used w/the the S8 IIs is 4i integrated humildifier. I could be wrong on this as I've had no experience w/the S8 IIs. You CAN use a stand alone, heated humidifier such as the F&P HC 150 if you choose.

Most xPAP users really appreciate a heated humidifier and many couldn't successfully use an xPAP w/o a heated humidifier. You can always turn it off and use it as a passover humidifier. Or not use it at all if you are one of the few who do better w/little to no additional humidity.

It depends on how much battle you are going to have to do to get an APAP and whether the battle is worth it to you. An APAP is nice but its the full data capabililty that is the important issue in my opinion.

As far as insisting on a Resmed - local DME providers tend to do the bulk of their device business w/one particular manufacturer and in doing so they get bulk prices so they are more willing to negotiate a fully data capable CPAP instead of a bare bone CPAP if you're willing to accept the brand they do the most business with. They are less likely to "deal" if they have to special order a particular brand for you if that isn't their major brand.

That is one of the reasons I always suggest calling your insurance, asking what local DME CPAP providers they are contracted with and then SHOPPING those provider options.I

• ▶ Reply

Permalink Reply by Mary Z on October 21, 2009 at 10:01am

One other consideation is your particular Sleep Doc's preference. My Doc deals with one DME provider and only uses the ResMed machines. Because he trusts the DME provider and the machines and uses them exclusively they have developed a good working relationship and the Doc always gets what he wants from the DME provider and he knows the machines inside and out. Lucky for me I like the DME and the Doc. I get good service from people I trust without having to shop around. The Doc and the DME are available to me and responsive to my needs. I realize this is not always the case. We just happen to have a good fit here. My first Doc did not take me seriously, made pressure adjustments without telling me and then made the next appointment for six months later (would tell me everything was fine leading me to believe the last settings were the correct ones). The new Doc makes adjustments every six weeks as needed. Probably when we get things settled I won't see him as often, but right now it's great to be followed closely.

Good luck, keep us posted,

Mary Zimlich

• ▶ Reply

Permalink Reply by RockRpsgt on October 21, 2009 at 10:19am

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 Judy on October 21, 2009 at 10:30am

I thought if they accepted Medicare they couldnt charge extra. But maybe that is only Medicare patients. I don't think so tho. I think it holds true across the spectrum.

• ▶ Reply

Permalink Reply by RockRpsgt on October 21, 2009 at 10:41am

I don't know Judy. I am just as much asking for info as I am giving my opinion on the matter.

Judy said:

I thought if they accepted Medicare they couldnt charge extra. But maybe that is only Medicare patients. I don't think so tho. I think it holds true across the spectrum.

• ▶ Reply

Permalink Reply by Neal Buckner, LRCP on October 21, 2009 at 1:00pm

Let me put my two cents in here. If you can. Get the Resmed Autoset II with the H4i. The date collection on this unit is far more superior than all the rest. All of the Resmed APAP's have the best adjustment algorythm. If just straight CPAP is all your insurance will pay for then use the S-8 elite. Again the best data collection program.

Suggestion on the interface. If you go with the APAP and don't know where your average pressures are going to end up then go with a nasal mask at first. Using nasal pillows with pressures above 11 or 12 cmH2O can be quite uncomfortable and cause more irritation that it's worth. Then once you have had the APAP for a while and a compliance download shows your 95% pressure levels are less than 12 cmH2O then consider going to the nasal pillows system. But if you have had a titration done and a set pressure has been prescribed and it's less than 12 cmH2O then, by all means give the nasal pillows a try. ResMed makes the Swift LT for her. Nice system. Strong enoough for a man, but made for a woman. lol

Neal Buckner, LRCP

• ▶ Reply

Permalink Reply by Renee on October 21, 2009 at 5:59pm

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

▶ Reply to Discussion

• ‹ Previous
• 1
• 2
• 3
• Next ›
• Page