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Archived SleepyHead Discussions [Q&A Thread from Sep-2011 thru May 2014]
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digidoc664 Offline

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Posts: 16
Joined: Apr 2012

Machine: PRS1
Mask Type: Nasal pillows
Mask Make & Model:
Humidifier: PRS1 heated
CPAP Pressure: 8
CPAP Software: SleepyHead

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Sex: Male
Location: El Paso, TX

Post: #161
RE: SleepyHead CPAP Reporting Software - JediMark
(04-15-2012 01:35 AM)PaulaO2 Wrote:  It could be that your machine only records time used and nothing else. I've tried my useless S9 Escape with SleepyHead and some days were there, others were not. Just guessing here.

We (forum members responding to my post) know that the PRS1 250P only records compliance data. What I had hoped to see on the SleepyHead SW was a way to view the data graphically to learn from patterns and trends. The SH SW works just fine, but SD card data not viewable. As discussed earlier in this thread, I will upgrade equipment to get data I need and view it in the SH SW.
04-19-2012 01:10 PM
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digidoc664 Offline

Members

Posts: 16
Joined: Apr 2012

Machine: PRS1
Mask Type: Nasal pillows
Mask Make & Model:
Humidifier: PRS1 heated
CPAP Pressure: 8
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: El Paso, TX

Post: #162
RE: SleepyHead CPAP Reporting Software - JediMark
(04-19-2012 12:49 PM)SuperSleeper Wrote:  Have to agree with JumpStart here. DMEs (Durable Medical Equipment suppliers) get reimbursed a flat fee (roughly $1500) for dispensing normal CPAP (whether it's a non-data-capable inexpensive model that cost them $500, a data-capable constant-pressure CPAP costing them $700, or an Auto-CPAP costing them $800 - they all use the same medical coding and reimbursement schedule). Nearly all Medical insurance companies must follow Medicare guidelines on CPAP reimbursement, which has the $1500 payment. If they can get you to agree to a low-end $500 model, they will have a $1000 profit. If you (or your doctor) insists upon a higher-end $1000 Auto-CPAP, they make only $500 profit.

They have a vested financial interest in giving you the cheapest CPAP they can find, which maximizes their profit, in other words.

On the so-called "rent to own" system for new Sleep Apnea patients, the only difference is that the costs are spread out over several months to ensure that you're going to be "compliant" with your CPAP therapy. If you don't remain compliant (use the CPAP machine a minimum of 4 hours every night), they will stop paying the DME fees and you will either have to return the CPAP or pay for it out of your own pocket.

There is only one reason why an insurer sees a need to make sure you're compliant with your therapy: it's called cost-control. If you aren't using the machine, they can save money by stopping the "rent-to-own" payments to the DME, thus saving them any future payments towards the cost of your CPAP.

So, for brand-new CPAP users, instead of charging Medicare or the insurance company the full $1500 at one time, it is spread out over several months. Usually, after you have remained compliant for at least 12 months, your insurance company will give the "go ahead" to your DME to charge the remaining balance of the $1500 allotted to them, at which point the CPAP becomes your own property, free and clear.

Quote:Both insurers discount, sometimes rather heavily, what is actually paid against a medical service provider's bill.

Not really. Under the current regulations, they are required to pay $1500 to the DME for your CPAP equipment. They will pay no more than they have to. DMEs can "charge" whatever they please for the CPAP machines, but Medicare or Insurance is only going to pay a max of $1500 for the whole process, no matter what.

Many times what happens is that a DME will "say" that the machine and humidifier, mask, etc. has a list price of $1800 or more. They will send a bill for that amount to the insurance company, knowing full well that the max is going to be $1500. But even though the DME claims the retail price is $1800, the truth is that they probably got the equipment for far less (usually between $500-1000).

If you request a more expensive data-capable or Auto-CPAP machine, many times less scrupulous DMEs, knowing that they will be reimbursed the full $1500 from Medicare or insurance, will go ahead and try to squeeze the additional $300 from the end-user (you), since they can now "claim" that the machine's price was more than just the "basic CPAP model" and your insurance only paid them $1500, so you owe them the extra money (profit) that they lost by not giving you the "basic CPAP machine". This does happen and we've had several members here report that exact same scenario... and apparently, it is legal for DMEs to do this. But there are plenty of DMEs that are satisfied in making the somewhat smaller profits involved in selling you a data-capable or Auto machine. (taking the $1500 from insurance, and paying for a $900 machine, giving them a $600 profit, instead of a $1000 profit if they had given you a low-end CPAP). Some DMEs are out to get as much cash as they can, and will "put the squeeze" on the patients to come up with more cash.

If you want a data-capable machine, or an Auto-CPAP, there are MANY DMEs out there who are willing to give you one and accept the $1500 payment from Medicare or insurance and be satisfied with that. If your DME insists that you must pay them additional money (for a machine that is already being paid for via Medicare or insurance), RUN out the door and go to a DME that isn't so greedy, or buy one online from one of the online DMEs (which usually have much lower prices). But if you buy online, make sure your company has a procedure in place for reimbursing you for your online purchase.

Don't let the Insurance companies or the DMEs bamboozle you - they are for-profit businesses... with emphasis on the profit. Their primary interest as a company is to maximize income while minimizing costs. They may claim to have your best interest at heart, but the truth is that they are simply wanting to have you remain compliant with your CPAP so they can maximize their own profits. Plain and simple. The faster you realize this, the better off you're going to be and the less you'll get taken advantage of.

And, of course, it's better to realize all this BEFORE you start dealing with a particular DME. (not always possible, I know). Because once you accept a particular DMEs rent-to-own agreement, you're locked into that DME for that period of time, unless you can convince the insurance company that they are committing fraud or not providing adequate service or proper equipment.

My comment on discounting was meant to apply to all medical procedures, office visits, therapy, etc. So, I greatly appreciate the specific information you have provided on the relationship between the DME and insurers.

I know (and have addressed with both insurers) that I can purchase equipment for much less than they will pay to DME. And was told essentially what you have reported, just in fewer words ("we appreciate your concern, but we will do it our way!").

The dilemma of how best to upgrade is being resolved as I write.

Thanks for your knowledgeable input to this discussionThanks.
04-19-2012 01:24 PM
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digidoc664 Offline

Members

Posts: 16
Joined: Apr 2012

Machine: PRS1
Mask Type: Nasal pillows
Mask Make & Model:
Humidifier: PRS1 heated
CPAP Pressure: 8
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: El Paso, TX

Post: #163
RE: SleepyHead CPAP Reporting Software - JediMark
(04-19-2012 11:29 AM)JumpStart Wrote:  
(04-18-2012 10:32 PM)digidoc664 Wrote:  Their concern is not primarily economic, but assurance that procedure is necessary. Both ensure that any interaction with medical professionals meets standard guidelines and that no fraud is being perpetrated.

Wow. If you believe that, lets talk about some ocean-front property I have in Arizona. :grin: The ONLY interest insurance companies have is related to making a profit - everything else is secondary. They are, by definition, a for-profit company, organized as such and answering to shareholders seeking just that. The issue of whether a procedure is necessary is, again, profit oriented - if the procedure is not required, not necessary (in their opinion) or not covered under their guidelines, they don't pay for it, and hence don't waste money and therefore make a greater profit. And there is nothing wrong with that model, as long as you understand the motivations involved. It is generally called capitalism.

(04-18-2012 10:32 PM)digidoc664 Wrote:  So, upgrading to more effective equipment will amount to a small increase in cost to them in order to ensure my medical needs are being met and monitored appropriately.

They don't care what your needs are, as long as you follow their guidelines for payment. Insurance companies are among the most detail oriented businesses in the world. If you, as an insured, have bad breath, and their formulary requires a payment of X for your variety of bad breath, then you will (in most cases) receive that payment, either directly or made on your behalf to a provider of some sort. Sometimes, of course, they need a *nudge* to make that payment.

If things work out for your benefit, great. You selected (or acquired, depending on the insurance) insurance which meets your needs. Don't, however, attribute their actions as seeking benefits for you, or any altruistic motive. They are merely following their written contract to provide certain services in return for the money or benefits they receive from insuring you. And you occasionally have to "push" to insure that they do, in fact, follow that contract!

And don't rely on them to look out for you. They have no interest in doing so, nor should that be expected of them. They are not in that business.

In my specific case, insurers will pay more than 3 times the price for which I can purchase equipment and accessories. My out-of-pocket co-pay is about 7% of what CPAP will cost insurers. It is that which I addressed with them and was told, nicely, "git along li'l dogie, we're running the ranch!"
04-19-2012 01:33 PM
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SuperSleeper Offline

Administrators

Posts: 9,961
Joined: Feb 2012

Machine: PR System One REMstar Auto (DS560)
Mask Type: Nasal pillows
Mask Make & Model: ResMed Mirage Swift II
Humidifier: none
CPAP Pressure: 12.5 - 18.5 cmH20 (auto range)
CPAP Software: SleepyHead

Other Comments: Have diabetes Type II

Sex: Male
Location: Illinois, USA

Post: #164
RE: SleepyHead CPAP Reporting Software - JediMark
(04-19-2012 01:24 PM)digidoc664 Wrote:  The dilemma of how best to upgrade is being resolved as I write.

I hope you get this resolved... I really do.

Here's how you upgrade:
Pack up all your CPAP equipment, lock stock and barrel, and walk into your DME's office and demand that you get a fully-data-capable CPAP machine in exchange for the low-end machine they forced upon you. Be nice at first, but if they don't agree to give you a decent data-capable machine, tell them that YOU KNOW that they were being well-compensated for their efforts and that you don't appreciate them giving you the lowest-end, non-data-capable CPAP machine they have just so they can make more profits. Let them know that you are an INFORMED CUSTOMER who will TAKE ACTION and become a THORN in their flesh if you aren't satisfied.

Ask to speak to the manager if necessary. Make a nuisance of yourself. Tell them you will complain to the insurance company about their poor service. Tell them you will file a complaint with Centers for Medicare & Medicaid Services (CMS) (who regulates the DMEs whether they are dealing with Medicare or private insurance companies) asking them to investigate the DME's refusal to provide you with adequate equipment.

There is no reason why a DME who is (as you say) getting more than 3 times the "market price" for a CPAP machine should not also provide YOU with a data-capable CPAP machine. That's simply absurd.

This may not apply to you of course, but I just don't understand why more people don't speak up when being financially and medically abused like this. It's because of these issues that we all have higher Medicare taxes to pay and higher private health care insurance premiums to pay. We're all in this together, and we ought not to let a DME to increase the cost of health care for the rest of us.... we can prevent that from happening by acting as individuals to stand up to the DMEs (and insisting that we get what WE paid for).

Can you tell I'm PO'd at the DMEs today?? Too-funny It's because I've had three emails this morning complaining about how 3 DMEs treated 3 customers like peons. I'm sick and tired of it, as you can probably tell. Cool

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.

04-19-2012 02:08 PM
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digidoc664 Offline

Members

Posts: 16
Joined: Apr 2012

Machine: PRS1
Mask Type: Nasal pillows
Mask Make & Model:
Humidifier: PRS1 heated
CPAP Pressure: 8
CPAP Software: SleepyHead

Other Comments:

Sex: Male
Location: El Paso, TX

Post: #165
RE: SleepyHead CPAP Reporting Software - JediMark
(04-19-2012 02:08 PM)SuperSleeper Wrote:  
(04-19-2012 01:24 PM)digidoc664 Wrote:  The dilemma of how best to upgrade is being resolved as I write.

I hope you get this resolved... I really do.

Here's how you upgrade:
Pack up all your CPAP equipment, lock stock and barrel, and walk into your DME's office and demand that you get a fully-data-capable CPAP machine in exchange for the low-end machine they forced upon you. Be nice at first, but if they don't agree to give you a decent data-capable machine, tell them that YOU KNOW that they were being well-compensated for their efforts and that you don't appreciate them giving you the lowest-end, non-data-capable CPAP machine they have just so they can make more profits. Let them know that you are an INFORMED CUSTOMER who will TAKE ACTION and become a THORN in their flesh if you aren't satisfied.

Ask to speak to the manager if necessary. Make a nuisance of yourself. Tell them you will complain to the insurance company about their poor service. Tell them you will file a complaint with Centers for Medicare & Medicaid Services (CMS) (who regulates the DMEs whether they are dealing with Medicare or private insurance companies) asking them to investigate the DME's refusal to provide you with adequate equipment.

There is no reason why a DME who is (as you say) getting more than 3 times the "market price" for a CPAP machine should not also provide YOU with a data-capable CPAP machine. That's simply absurd.

This may not apply to you of course, but I just don't understand why more people don't speak up when being financially and medically abused like this. It's because of these issues that we all have higher Medicare taxes to pay and higher private health care insurance premiums to pay. We're all in this together, and we ought not to let a DME to increase the cost of health care for the rest of us.... we can prevent that from happening by acting as individuals to stand up to the DMEs (and insisting that we get what WE paid for).

Can you tell I'm PO'd at the DMEs today?? Too-funny It's because I've had three emails this morning complaining about how 3 DMEs treated 3 customers like peons. I'm sick and tired of it, as you can probably tell. Cool

Quote:There is no reason why a DME who is (as you say) getting more than 3 times the "market price" for a CPAP machine should not also provide YOU with a data-capable CPAP machine. That's simply absurd.

Best reason is that doctor's prescription specifies what equipment is to be provided for the specific treatment they want to create. DME made it clear that prescription on file is only for the PRS1 DS250P model. So, in their scenario, I'm obliged to return to the sleep center, meet with staff (never even seen the prescribing physician!), review compliance data and probably schedule another night of wired study to ensure I get what I would like. Everyone makes more money (from insurers) while I waste time. No simple phone calls, here.

My solution is a little more direct, involves only my Primary Care Physician (a good guy!), a form, and maybe money from my own pocket. Once I complete this process, I should be able to make whatever adjustments are necessary for future needs, as well.

Those of you responding were not supposed to strike terror in the heart of a new CPAP userDielaughing- I wanted "quick" advice, but got treated as a "newbie" and flooded with angst.Oh-jeez

I have appreciated others taking time to inform me of the mine field, and especially appreciate GUB for providing a way to verify why I was having a problem. I'm not happy with my planned solution, but it's workable and hopefully, less wasteful of limited resources, mine included.

Not being able to trust health care providers is only recently becoming a new concern. No one on this forum has engendered a sense of trust in these providers. I have taken responsibility for my own health needs for some time, now, and do ensure I get quality service or I move on. This CPAP process is one I cannot escape (and live!), but I am not happy about the constraints. What will it be like when I have to give over my care to some assisted-living environment in the future? That prospect seems grim.

Okay, let's end on a positive note. The surgical repairs to my skeleton have been very effective. The soft-tissue surgeries have also been effective and long-lasting. My physical therapies have been helpful and instructive of how to best modify my behavior. I have sufficient income. I am married almost 48 years to the only woman who has ever loved me unconditionally. (Maybe my mother did when I was very young.) My son and his family are loving and generous. My closest friends respect me and seek my advice. And a Father in Heaven and his precious Son, the Lord Jesus, love me unconditionally.
(This post was last modified: 04-19-2012 07:02 PM by digidoc664.)
04-19-2012 07:00 PM
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SuperSleeper Offline

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Posts: 9,961
Joined: Feb 2012

Machine: PR System One REMstar Auto (DS560)
Mask Type: Nasal pillows
Mask Make & Model: ResMed Mirage Swift II
Humidifier: none
CPAP Pressure: 12.5 - 18.5 cmH20 (auto range)
CPAP Software: SleepyHead

Other Comments: Have diabetes Type II

Sex: Male
Location: Illinois, USA

Post: #166
RE: SleepyHead CPAP Reporting Software - JediMark
(04-19-2012 07:00 PM)digidoc664 Wrote:  My solution is a little more direct, involves only my Primary Care Physician (a good guy!), a form, and maybe money from my own pocket.

Well, I was trying to save you from having to unnecessarily spend more of your own money out of pocket, but heck, if you're well-off enough to throw your own money at the problem and ignore that the DME is unethically extracting money from your pocket, that's your decision to make, I guess. Bigwink Too-funny

My comments are more for the newbies who might be reading this. They need to know that they shouldn't allow a DME to push them around (especially after they paid for their own insurance)-- they should expect some degree of good service and a decent machine from a DME, especially since the DME is getting handsomely paid for their "service".

Apnea Board is really more of a "patient empowerment" website and forum. We take control of our own treatment, and we don't like it when we're being taken advantage of by those in the medical professions. (nor do we like it when other fellow patients are being taken advantage of). Most medical professionals don't participate in unethical behavior, but far too many of the DMEs do. We tend to inform people and give information about how "the system" actually works, so that patients go into the "medical battlefield" fully equipped to walk away without being a casualty of that system.

Quote:Those of you responding were not supposed to strike terror in the heart of a new CPAP userDielaughing- I wanted "quick" advice, but got treated as a "newbie" and flooded with angst.Oh-jeez

You must realize that although you may be a veteran CPAP user, we have many more newbies reading these threads who need to be warned against the practices of unscrupulous, profit-driven DMEs. Nothing wrong with profit, but too many times uninformed patients believe their DME to be an altruistic do-gooder who puts the needs of the patient above their own financial interests-- when the truth is that they seldom do any such thing.

Also, it's important to know that we springboard from one issue to another around here and seldom stay completely "on-topic". SHa_biggrin5

In any case, good luck with your CPAP issues, digidoc. Coffee

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.

04-19-2012 07:37 PM
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Sleepster Offline
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Posts: 4,988
Joined: Feb 2012

Machine: ResMed AirCurve10 VAuto
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: HumidAir and SlimLine Hose
CPAP Pressure: MaxI 13.6 | MinE 5.2 | PS 4.4
CPAP Software: ResScan SleepyHead

Other Comments: Diagnosed Nov 2011. Conquered aerophagia.

Sex: Male
Location: Houston, Texas

Post: #167
RE: SleepyHead CPAP Reporting Software - JediMark
(04-19-2012 12:49 PM)SuperSleeper Wrote:  If you request a more expensive data-capable or Auto-CPAP machine, many times less scrupulous DMEs, knowing that they will be reimbursed the full $1500 from Medicare or insurance, will go ahead and try to squeeze the additional $300 from the end-user (you), since they can now "claim" that the machine's price was more than just the "basic CPAP model" and your insurance only paid them $1500, so you owe them the extra money (profit) that they lost by not giving you the "basic CPAP machine".

I don't see how they can get away with this. My insurance company sends me an EOB (Explanation of Benefits) that shows how much the provider charged my insurance company, how much the insurance company "allows", how much the insurance company paid to the provider, and how much I'm expected to pay the provider as a co-pay or whatever.

I had to pay something to the DME for my original CPAP, and then less than 30 days later when the doc changed it to a BiPAP I had to pay an additional amount.

BTW, I originally had an option for a less expensive CPAP that was not data-capable. I opted for the more expensive one, not because I knew anything about the significance of data capapbility, but because it was the only one the DME had with him in his truck. (My doc had put in a stat order only just that morning, and the DME came to my house that afternoon with the machine).

The doctor is an ENT surgeon with whom I've had a long history, and developed a relationship of trust. The DME was chosen by him. These are all things that go against the conventional wisdom, but hey, whatta ya gonna do when you're in the throws of OSA and are scared, scared, scared?

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.
04-19-2012 09:28 PM
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greatunclebill Offline

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Posts: 549
Joined: Feb 2012

Machine: Respironics System one Auto A-Flex
Mask Type: Full face mask
Mask Make & Model:
Humidifier: System one
CPAP Pressure: 8-12
CPAP Software: SleepyHead EncoreViewer

Other Comments: quattro fx full face

Sex: Male
Location: L.A. (Lower Alabama)

Post: #168
RE: SleepyHead CPAP Reporting Software - JediMark
(04-19-2012 09:28 PM)Sleepster Wrote:  I don't see how they can get away with this. My insurance company sends me an EOB (Explanation of Benefits) that shows how much the provider charged my insurance company, how much the insurance company "allows", how much the insurance company paid to the provider, and how much I'm expected to pay the provider as a co-pay or whatever.

it's not about them getting away with something. my tricare prime insurance is basically like your insurance. plus we have no deductible and low co-payments. not all insurance is like this. some have high deductibles, yearly caps and all kinds of stuff like the patient paying above and beyond bills. remember the poster whose insurance allowed full price for used machines. it comes down to what the employer offers or what insurance the person can afford if there is no employer insurance plan.

alot of these insurance stories are a reality check for me who had free medical care in the military and now pay so little.
04-19-2012 09:47 PM
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pssnn Offline
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Posts: 136
Joined: Mar 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal pillows
Mask Make & Model: Swift FX
Humidifier: H5i
CPAP Pressure: 14 - 18
CPAP Software: ResScan SleepyHead

Other Comments: Quattro FX + Swift FX

Sex: Male
Location: Missouri

Post: #169
RE: SleepyHead CPAP Reporting Software - JediMark
(04-19-2012 02:08 PM)SuperSleeper Wrote:  Can you tell I'm PO'd at the DMEs today?? Too-funny It's because I've had three emails this morning complaining about how 3 DMEs treated 3 customers like peons. I'm sick and tired of it, as you can probably tell. Cool

Hey Big SS,
Not to worry, This forum IS empowering and empowerment is the antidote to crappy DMEs.

"Goodnight Chesty wherever you are!"
04-19-2012 10:39 PM
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pk6301 Offline

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Posts: 31
Joined: Mar 2012

Machine: Respironics System One Model 550
Mask Type: Full face mask
Mask Make & Model:
Humidifier: Respironics
CPAP Pressure: 6-20
CPAP Software: SleepyHead EncoreViewer

Other Comments: cms 50D Plus

Sex: Male
Location: Erie, Pennsylvania

Post: #170
RE: SleepyHead CPAP Reporting Software - JediMark
I Finally !!! got the sleepyhead software to run correctly, I have to use it on my old dusty and crusty desktop which is about 9 years old.. The software does not like my new spiffy 32 bit netbook running Windows 7.. I tried running the software as the administrator, it gives me the Stats fine, it gives me the daily on the left side fine, but it does not give me any of the graphs.

Someone once asked me how I adjusted to CPAP so well--I thought for a moment and said I had two choices CPAP or DEATH..The choice was easy..
04-20-2012 09:56 PM
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