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CPAP or APAP?
#1
Folks,

First and foremost, I want to thank all that responded to my earlier insurance question. The plethora of information I received was overwhelming and I cannot thank you enough. The welcome's I received were outstanding!

So since the last post, I've found out through the DME that I have an Airsense 10 Elite CPAP ready to be picked up on Monday. The pressure was mentioned to be 6.

So another question I have surrounds the machine, specifically a CPAP vs an APAP. I do appreciate the difference, and was wondering if it would be worth pursuing the latter, as many other contributors seem to prefer the APAP.

I'm not sure if CPAP/APAP is ordered by the doctor, or if the insurance company decides, or what options I have in the matter.

As always, your wise council is appreciated.

Thank you again...


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#2
All regular CPAP machines have the same insurance codes. This includes CPAP and APAP. Bilevel and ASV machines have different codes.

With the same insurance codes, the insurance company pays the same amount, no matter the machine. So they pay the DME the same for an Autoset as they would an Escape. Of course, the DME gets a better profit selling you the Escape (a non-data capable brick of a machine) so that's what they try to dump off the most.

An Elite and an Autoset are both equally great machines except for the "auto" difference. If your insurance is willing to pay for it, my suggestion is to go for the Autoset. You can run it in regular CPAP mode or in auto mode, whichever you or the doctor feel the need for. Your doctor may not like autoPAPs. Some docs are not up-to-date on the research and are still against them. You can just tell him you run it in CPAP mode and pacify him that way.
PaulaO2
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Breathe deeply and count to zen.

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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#3
I am really glad that I lucked out and got a DME that gives the Autoset as the standard! I say luck, because I did not find this forum until after I had already gotten it. That said, I am thankful that the autoset will treat me with just enough but not too much pressure, and that it will respond to need and I don't have to go through having a high AHI for a couple of weeks to get more pressure. my charts show me running most of the time at a comfortable 8 to 10, but there are a couple of times a night that it goes to 12 or 13, and if I was on 10 or 11, those would probably be events. The lower pressure for the times I don't need more is more comfortable, by far. Count me as someone who would push for an autoset.
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#4
(12-19-2014, 12:04 AM)SD50 Wrote: I'm not sure if CPAP/APAP is ordered by the doctor, or if the insurance company decides, or what options I have in the matter.

Unfortunately, there's often no clear answer to that question. Your best bet is to convince the doctor to prescribe the APAP. Then the insurance company and the DME can't try to screw you out of it.

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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#5
(12-19-2014, 12:04 AM)SD50 Wrote: I'm not sure if CPAP/APAP is ordered by the doctor, or if the insurance company decides, or what options I have in the matter.
I think ... you decide .... you,re the boss ... you pay the bills and keep them in business
you tell the doctor what machine you want, the doctor write the prescription for that machine and also specify in writing "dispense as written" so you get exactly that machine

as for insurance, insurance don't care about CPAP/APAP discussion and only care about compliance that you're using the machine something like 4 hours or more per night 70% of the time in 30 days period

anything gives more, has to be better

APAP is like two machines in one:
1st option: CPAP, constant pressure
2nd option: APAP, auto adjust if needed

CPAP can do only 1st option but not the 2nd option
down the track when you've gained enough experience and confidence, you'll appreciate the 2nd option

[Image: AirSense10_AutoSet.jpg.CROP.thumbnail.453X343.png]
model name displayed below "AirSense 10"
don't take the machine if does say "CPAP"
CPAP model is not full data capable machine
Elite, AutoSet, and AutoSet for Her are data capable machines

Air 10 CPAP = fixed pressure machine but not full data machine
Air 10 Elite = Air 10 CPAP + full data capabilities
Air 10 AutoSet = Air 10 Elite + Air 10 AutoSet = 2 machines in one
Air 10 AutoSet for Her = Air 10 AutoSet + AutoSet for Her = 3 machines in one











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#6
If the DME is willing, I would always take a data-capable device with the autoset feature. If you decide not to use those features, fine but they are there if you need them.
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#7
Hi SD50,
I would get the AutoSet.
It can be set to straight CPAP or you can use the AutoSet feature. This way, you have two machines in one.
Good luck to you.
trish6hundred
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#8
simple answers. Get an auto. No reason at all except DME profit to get a brick straight cpap or even a data capable straight cpap.

Go to doc and get him to write your script for an auto. Does not make a hoot in you know where what the DME is willing to do or not.
If that doc wont write a auto script go to a different Doc. You GP can write the script now that youve been diagnosed.

If the DME kicks go to a different DME. Do not accept a brick cpap machine or anything less than an auto machine.

Auto can run either way and youll have to live with this machine for 5 yrs before insurance will replace it.


Did I say GET AN AUTO???????????????????????? Oh I forgot get the climateline hose or if a PRS1 auto aflex get the heated hose to start with. Youll only wish you had later if you dont.
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#9
Demand an APAP and stick to your guns, if the DME doesn't want to give you one tell them you'll find one that will. There are many suppliers out there and one of them wants your business. There is no question you want the APAP, period, the end.
If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
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#10
(12-19-2014, 12:47 AM)DariaVader Wrote: I am really glad that I lucked out and got a DME that gives the Autoset as the standard! I say luck, because I did not find this forum until after I had already gotten it. That said, I am thankful that the autoset will treat me with just enough but not too much pressure, and that it will respond to need and I don't have to go through having a high AHI for a couple of weeks to get more pressure. my charts show me running most of the time at a comfortable 8 to 10, but there are a couple of times a night that it goes to 12 or 13, and if I was on 10 or 11, those would probably be events. The lower pressure for the times I don't need more is more comfortable, by far. Count me as someone who would push for an autoset.

I had the same dumb luck. The sleep center somehow came up with an Rx for a constant 17 cm-H2O. The DME gave me a ResMed S9 AutoSet. After one night, I found this forum and grabbed the ResScan software to see my results. My AHI has pretty much always been below 1 per hour so I contacted my nurse-practitioner after 3 weeks and put the machine in AutoSet at a very conservative 15/17. I've since backed it off to 14/17 and swapped from a nasal mask to ResMed P10 nasal pillows. I should probably back it off a bit more but my results are so good that I stopped pulling out the SD card to look at them and just hit the Info button on the machine when I turn it off in the morning to see the AHI number.

I can't imagine not having a data-capable AutoSet machine. I don't see how you'd ever get your pressure settings dialed in.
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