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Many times newly diagnosed patients do not have a clue about what type of cpaps and machines there are. If you were like me, in a sleep deprived state of mind, you really do not know what questions to ask the doctor and the DME.

There are many machine and mask options out there. I suggest when you meet with your sleep doctor that you are armed with plenty of ammo to get the best available equipment that you can afford. When I say this, I do not necessarily imply that you need the most expensive machine and mask available -- just one that best suits your needs!!

There are bare-bones machines. These machines usually do not have any "creature" comforts such as ramp, exhale relieve, and a few do not have humidifiers. These machines can provide good therapy if you are sure of your pressure needs and do not need nor want any comfort features. These are usually fine for those that are uninterested in their data and if both patient and doctor are sure of the pressure requirements needed to keep your airway open. You can usually pick these machines up for a few hundred dollars new on online.

A step above the bare-bones machines are those that provide ramp and exhale relieve. The M series Plus machine is in this category. As well as the entry level machines from other manufacturers. These machine do not provide any useful data except for compliance (meaning the amount of time the machine is used). The M series Plus has a "smart card" but do not be fooled into thinking it is recording anything but compliance data. These machines can provide adequate treatment as well.

The above machines allow the DME's to increase their profits as insurance codes pay by one code -- doesn't matter if the machine is a no frills machine or the top of the line machine. These machines are good for those that are uninterested in their therapy or where money is an issue. They can provide adequate treatment. They are also great for back up machines.

A data capable machine is one that offers an overview of your nightly statistics. Your doctor and you can read your reports with the optional software and determine if your therapy is optimal. It is my opinion every user should have a data capable machine to allow monitoring of your therapy. If problems are encountered it is easier to pinpoint trouble areas and work on those. These machines typically offer creature comforts and provide excellent therapy. They are more expensive in the initial setup -- but insurance companies are billed by the same code so if you are using insurance coverage it doesn't matter which machine you get -- a data capable or a bare bones -- they will get paid the same amount. Software is optional and insurance does not cover that particular cost. Along with the software you will need a card reader so that the computer can read your card. The software and card reader can typically be purchased as a bundle on line. If you do not want the expense of the software DME's should be willing to download your information and provide you with a print out. Many DMEs will do this for free -- some will charge a small fee.

I can not suggest strongly enough to do your research on the different machines and get the one that best suits your needs -- do not let a DME tell you which machine is the best -- that is your decision with the help of your doctor.

Views: 123

Replies to This Discussion

Sleepycarol, good report, one thing that would be good is to talk to some of these data capable machines like who makes them and what models are out their for both cpap and bipap
I'll speak up in support of the Resmed xPAPs!!!! They are compact and lightweight and consist of only 3 parts: the xPAP itself, the integrated heated humidifier and the humidifier water tank. They can't be beat for ease of access to, or for the amount of, data available via the LCD screen. Now, not all Resmeds are fully data capable - but -

The Resmed S8 Elite w/EPR and just released in 2008 Resmed S8 II Elite w/EPR are their fully data capable straight CPAPs w/up to 3 cms of expiration pressure relief and Ramp times up to 30 or 45 minutes (I forget which).

The Resmed S8 AutoSet Vantage and just released in 2008 Resmed S8 II AutoSet are their fully data capable auto PAPs (APAPs). Both can be used in straight CPAP mode or in auto mode. The S8 has EPR only in CPAP mode, the S8 II has EPR in both CPAP and in auto mode. They also have the flexible Ramp and Settling times.

The released in January 2008 Resmed VPAP Auto bi-level and the released in July 2008 Resmed VPAP Auto 25 bi-level are fully data capable, can be used in straight CPAP, bi-level and bi-level auto mode, and have the flexible Ramp and Settling times. In addtion they have multiple "comfort options".

All of the S8 IIs have the new EasyBreathe technology.

The data availble via the LCD screen includes the Efficacy Data, i.e. the 95th Percentile of Pressure and Leak, the AHI, AI and HI for the previous night and the compliance data, i.e. number of hours used that night, number of hours used since start of therapy, number of nights used and number of nights since start of therapy AS WELL AS the averages of the same efficacy data for the previous 1 week, 1 month, 6 months and 1 year.

The ResScan software and cable reader are intended for professional use only but can be purchased from some online DME supplier w/o prescription. The software further enhances the summary and detailed data and produces reports for downloading and printing. ResScan v.3.4 or above is needed for the Resmed S8 IIs unless one has Vista on their 'puter. ResScan v.3.5 or above is needed for those having Vista on their 'puter. ResScan 3.7 is the latest version. The ResScan software is not compatible w/Macs unless the Mac is capable of running Windows based software.
As a DME provider, it has been my experience that even the most bare bones CPAP device always includes a Ramp feature. Not all ramps are the same, though. For example, ResMed devices automatically start at the minimum ramp pressure, whereas all other brands require a seperate button press to enable the ramp. The patient can set the amount of time the ramp takes on a ResMed device (as limited by the provider), however, the patient cannot control the ramp start pressure with ResMed devices. With Respironics devices, the provider sets a fixed amount of time that the ramp lasts, but the patient has control over the ramp start pressure.

To make things even more confusing, when ResMed devices with AutoSet capabilities are set to automatically adjust, there is no ramp feature. Instead, they have a "settling time" period, wherein the device stays at the minimum set pressure for a patient-controlled amount of time before the algorithm is activated that allows the pressure to rise as needed. Respironics Auto-Adjusting devices have a ramp feature that is independent of the minimum pressure setting.

There are many other brands out there, and each one has its unique set of bells and whistles. A good provider will take the time to talk to you and assess your needs and preferences and colaborate with you on your choice of device.

Does anyone know if Medicaid will pay for a data capable machine?




Medicaid pays so little the local DME providers usually will NOT provide anything more than the most basic of PAPs - unless your sleep doctor actually specifies "access to Leak, AHI and AI". That "might" get you a fully data capable CPAP. Maybe.

Danny G said:

Does anyone know if Medicaid will pay for a data capable machine?




Thanks, I'll also ask this in the Manhattan group. Maybe someone can give me more info there :-)

Judy said:
Medicaid pays so little the local DME providers usually will NOT provide anything more than the most basic of PAPs - unless your sleep doctor actually specifies "access to Leak, AHI and AI". That "might" get you a fully data capable CPAP. Maybe.

Danny G said:

Does anyone know if Medicaid will pay for a data capable machine?




Honestly as a patient I would recommend the best machine you can afford. Humidification is a must but if you have your home thermostat set low you will need a machine with a heated tube otherwise you can have terrible condensation problems.

I don't know how anyone copes with a fixed pressure machine. Unless your pressure is below 8 I don't know how anyone could get to or stay asleep. So I would say fixed only if you cannot afford anything else.

Data capable? Well it is cool to look at your stats and pretend you know whats going on and it can be really helpfull to see why you may have had a bad night and also check how your habits (such as drinking or late nights) affect your sleep quility but really? If you are syptom free who cares about stats. Even if you do have a huge stats print out that you take back to your doctor if your are symptomatic then you will probably have to do a sleep study anyway.

I would say that the biggest thing really is the mask. Shop around like a lunatic for the mask because while the machines offer a rather samish expierience the mask has to be perfect for you. Here price varies wildly and you may find a cheepy that is just perfect for you but find the right one and worry about the price later. Don't hessitate to be as difficult and picky with suppliers as you possibly can. Try and talk them into trial use and issist that any mask that you do bye is correctly fitted and works at your highest pressure. Remember that sitting up in a chair is not a fair representation of how your mask will perform. Insist on lying down and putting yourt head on a pillow with the mask running at your max pressure. At the verry least put your hand up to the side of your face to squash the mask and simulate what a pillow will do. If your supplier cannot accomodate you in the reguard find another one. This is your life and the ten minutes of embarrasment that you spen being pushy or lying on the floor with a pillow to see how the mask performs far outwiegh the awfullness of a bad mask. I have never delt with a mask tech/supplier who is actually a user of CPAP and frankly I think that many have no idea of how a masks real nature only shows through at high pressure, lying down, crushed up against a pillow.

Last off is the right pillow. A CPAP pillow can be fantastic and compared to the price of all the other kit is a relatively small cost.


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