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Any advice on talking my Dr into the Auto machine?
#1
I did read the thread on "Do Sleep Doctors hate APAP machines?"
From what I've read here on the board, it seems that "auto" is the way to go.
I'll be doing my follow up Dr visit (after BiPAP titration study) tomorrow.
I was told by the Respitory Therapist that I'll be getting a Respironics System One BiPAP machine. From what I've been able to find, they only seem to come in "Pro" or "Auto" versions. It looks like either is very good.
The points I've found that may help me sway my Dr are that I only was able to sleep a few hours (3) and maybe, that I have noticed that I seem to become congested every night - possibly due to allergies (pressure required may change).
What do the Drs seem to think determines the "need" for "auto" machines?
Thanks!
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#2
Good luck with the follow-up just tell the doc what to write on the prescription after all you pay him to look after your health care. Sometimes doctors are not aware that the insurance pay the same amount for either machine so they prescribe the lessor machine to save money for patients and insurance. For the congestion I recommend Neimed sinus rinse, its a god send for congestion relief.
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#3
Thanks and I'll look up the Neimed sinus rinse!
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#4
If I was in that position then I would just tell the truth. Well, at least my truth, which is that I have a curious nature and I like to be involved in my own therapy. Ten years ago after having my first sleep study I got a perscription for a CPAP. I talked to the Doc about an auto CPAP, and he said I didn't need one. Not really knowing how to counter him, I let it drop and decided to just go with a CPAP. I met with the local DME but was not comfortable with them. They seemed a bit shady, didn't give me direct answers, and I didn't trust them. I went online and found that I could buy an auto machine with a CPAP prescription, so I ordered a Resmed Autoset Spirit. I don't know if the online retailer was breaking the law at the time selling an auto machine with a CPAP prescription. Now it appears that a prescription needs to be quite specific.

I used that machine for nearly 10 years, but had to replace it a couple of weeks ago due to worn out bearings. Over that period of time I watched my numbers and made adjustments as I saw fit. I lost a lot of weight one time and was able to reduce the pressure. I've watched the numbers change based on various criteria, such as my fitness level, stress level, seasonal allergies, and alcohol consumption. Watching the numbers and making changes has kept me interested in my own therapy, and it has given me confidence that my OSA is properly treated.
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#5
I think "AUTO is the way to go" is not the best way to go. Some people respond better to straight CPAP, or bilevel.
Although since most AUTO machines can be used in CPAP mode that is almost a moot point. But, AUTO is not an inherently better mode of treatment. If it were that's all doctor's would prescribe.

That said, if you want an AUTO have your rationale prepared for your doctor. If you can present solid reasons for that prescription I think you will get what you want
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#6
(06-17-2012, 05:58 PM)johns019 Wrote: I was told by the Respitory Therapist that I'll be getting a Respironics System One BiPAP machine. From what I've been able to find, they only seem to come in "Pro" or "Auto" versions. It looks like either is very good.
The points I've found that may help me sway my Dr are that I only was able to sleep a few hours (3) and maybe, that I have noticed that I seem to become congested every night - possibly due to allergies (pressure required may change).
What do the Drs seem to think determines the "need" for "auto" machines?

First of all, not all doctors are aware of just exactly what an "auto" machine is. There are auto servo ventillator (ASV) machines that are needed by patients with sleep disordered breathing conditions that are more complicated than simple obstructive sleep apnea. Many doctors might think that when you inquire about an auto machine, you're talking about an ASV machine.

Since you're getting a BiPAP machine, make it clear to the doctor that the Auto BiPAP is only 5% higher in price (roughly $100 more for a machine that costs almost $2000) and that you are not asking about the BiPAP Auto SV Advanced machine. And that the Auto BiPAP can be placed in regular BiPAP mode at fixed inhalation and exhalation pressures.

If you don't mind the few extra dollars, there's no reason you shouldn't be able to get the Auto BiPAP. On the other hand, there is no reason you shouldn't be happy with the BiPAP Pro. That's the machine I have, and I'm perfectly happy with it. I can't help wondering, though, what things would be like if I had the Auto!
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
Although an APAP (Auto-CPAP) is not ideal for everyone... I will say that I wholeheartedly believe that it is the best option for the vast majority of OSA patients.

SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.



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#8
I am about to get mine today - I cited the fact that I have a lot of allergies and frequently get colds,
my doctor had written the RX for 9-10cmH2O so they will give me the auto machine locked into CPAP
mode and then change it if the doctor agrees to auto mode.. (or if I try it on my own <evil laughter>)

Have a great week! Smile
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#9
(06-17-2012, 05:58 PM)johns019 Wrote: I did read the thread on "Do Sleep Doctors hate APAP machines?"
From what I've read here on the board, it seems that "auto" is the way to go.
I'll be doing my follow up Dr visit (after BiPAP titration study) tomorrow.
I was told by the Respitory Therapist that I'll be getting a Respironics System One BiPAP machine. From what I've been able to find, they only seem to come in "Pro" or "Auto" versions. It looks like either is very good.
The points I've found that may help me sway my Dr are that I only was able to sleep a few hours (3) and maybe, that I have noticed that I seem to become congested every night - possibly due to allergies (pressure required may change).
What do the Drs seem to think determines the "need" for "auto" machines?
Thanks!

IMHO, Sleep Doctors do NOT like Auto CPAP simply because they just do not want to be bothered with the additional information those machines provide nor with you knowing that additional information.

If it were me, I would just tell the Sleep Doctor that "I" want an Auto CPAP. The most additional information I would provide is that I expect to lose weight in the near future & need a pressure range that will accomodate that (as oppossed to 1 single pressure). If you do not need to lose weight, find some other reason.

I believe that Auto CPAP is the way to go.
Don't let the Sleep Doctor dictate otherwise!

Stewart
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#10
Just as an FYI... if your current sleep doctor doesn't want to write a prescription for APAP, just go do another doc who will.

You don't need to be a sleep doctor to write a script for CPAP or APAP... any type of doctor can write the prescription. Just have them write the prescription for the specific brand and model of CPAP you want, with the pressure range, and check the box that says "no substitutions".

SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.



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