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Data capable CPAP machines...how do they work?
#11
I think some of us, myself included, focused on "how does it work." We missed the point of the question which was "how to tell my sleep Doc why I need a fully data capable machine for my loaner period instead of the brick S9 Escape I was given."

I assume, since the OP is in Canada that a sleep study was not done; a loaner is being used for a trial period to see if PAP is effective.

Best answer I can think of to the above question is to ask the doctor how the trial will be evaluated with a machine that does not collect efficacy data.
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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#12
@justMongo I have had a sleep study in the lab, then an appt with the sleep doc, then another overnight sleep study this time using CPAP and now a loaner machine for 8 (10 weeks in my case due to scheduling issue) til I go back to see the sleep doc. Not sure why the 8 (10) weeks until I go back to see him UNLESS he was going to use the data a machine would provide him to make a better more precise prescription for CPAP. So without data, I don't know why they wait so long to write a script.
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#13
For me, it was:
1) See the sleep doc
2) Sleep lab study to determine if apnea present
3) See the doc to be told I have apnea; schedule another sleep study to titrate therapy.
4) Sleep lab titration.
5) See doc and he writes Rx.
6) Go to DME and get machine. I was originally given a brick.

Seems like the Rx should have been written after your second study. Perhaps it was; and only transmitted to the people who provided the loaner machine.
The 10 weeks sounds like a routine follow up visit where the doc asks, "cate1898, how have you been feeling?"
Logic dictates that machine data cannot be factored into a tweak in Rx -- there will be no data.

The Canadian Health system is abstruse to me.
Who pays for the machine you will have after the loaner?
If you pay a large portion, then select the machine you choose after studying the various types, makes, models.

best wishes on your CPAP journey.

Mongo

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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#14
(09-13-2015, 02:42 PM)cate1898 Wrote: ... I don't know why they wait so long to write a script.

cate1898,

My guess is to establish a pattern of compliance.

Here in the U.S. a lot of insurance plans will rent a machine for some period of time to establish that the patient can tolerate the therapy and to demonstrate they will actually use the machine before the plan will buy one.

U.S. Medicare has established a standard for compliance at 4 hours per night on 70% of nights during a consecutive 30 days anytime during the first 3 months of initial usage. I think in addition to that a face-to-face review with a doctor is required to establish that the therapy is effective for the compliant patient.

What you describe would satisfy similar criteria (i.e two months on a loaner followed by a face to face meeting with the doctor to write the prescription).

A compliance requirement is one reasonable explanation for not spending the money to purchase a machine up front.

Saldus Miegas
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#15
(09-13-2015, 04:33 PM)justMongo Wrote: The Canadian Health system is abstruse to me.
Not, according to Michael Moore https://en.wikipedia.org/wiki/Sicko

As for bricks, I lost counts of how many people in US given a brick by their DME, just the DME can make few lousy dollars at their expense
Australia is different matter, at times people choose basic machines, APAP are very pricey and hardly any competition among the big players

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#16
I have a pretty forward thinking sleep doc, and a 100% DME Insurance policy which I am so grateful for when hearing other people's stories! My story went so smoothly and no thanks to me who didn't find this forum until after hosing up!

  1. Primary Care Doc sends me to Sleep Doc
  2. Sleep Doc does his exam and asks a lot of epworth questions. Orders in-home study.
  3. Home Study shows moderate apnea (even though I didnt sleep much)
  4. Doc sends orders for APAP to a DME that is In-Network for my Insurance
  5. They call me and schedule me to attend a class (where I and 5 others all receive a machine, do a mask fitting and choose a mask and receive instruction on cleaning) The DME gives everyone an S9 Autoset no matter what their Rx.
  6. 30 day check up with Sleep Doc - as required by Insurance
  7. 8 mo Sleep Doc Checkup - next will be in a year.

The part that kinda burns me is that the DME is charging the Insurance a monthly rental fee of $190 per mo. $35 of that is a monthly fee for the H5i humidifier... what a ripoff! However, the Insurance company allows it, so they do it Dont-know Not sure when the rental ends, I started this routine last November!

My 34 yr old son also has apnea... as soon as I began researching it I knew he did! I got him to get a referral to the same sleep clinic I used. He got a different MD, but similar forward thinking... She set him up for a home test after a first appt that must have gone much like mine, and he turned out to have very severe apnea with O2 desats below 70% and an AHI of 102. Deducting the time he was clearly awake (upright, and no events) puts it at 120. They didnt screw around with that one... Doc read his results late on a Saturday night, and by Tuesday his new DME (not the same as mine, different insurance) had the machine he requested with my help in his hands.

The home study with APAP instead of titration seems to be the latest trend, and Insurance companies are beginning to "prefer" it. The In-lab studies cost way more than the difference between CPAP and APAP. Son has medicaid - even they went for it. Canada probably will too, eventually. Its more cost effective!
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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#17
justMongo mine was almost the same as yours:

1) See the sleep doc
2) Sleep lab study to determine if apnea present
3) See the doc to be told I have apnea; schedule another sleep study to titrate therapy.
4) Sleep lab titration.

4B: Wait for call from DME approx 10 days after sleep lab titration where I asked for a data capable machine and was given a brick BUT JUST AS MY LOANER

5) THEN WAIT 8-10 WEEKS TO See doc WHO WILL NOT KNOW IF THERE TRULY IS COMPLIANCE AS HE WILL NOT HAVE ANY DATA AND THE PATIENT COULD LIE; and he writes Rx. (I think it will be more like you said: cate1898, how are you feeling?)
6) Go to DME and get (or order?) machine. WHICH I PLAN TO GET ResMed AirSense 10 Elite

About the cost....The machines here in Ontario have government regulated prices-the DME cannot charge anything different. The Elite I want to get is $860 and the Govt of Ontario (ADP) will pay 75% which is $645, leaving me with a bill of $215. I have private insurance who will pay up to $1000. for CPAP supplies once I have gone thru ADP allowance of $645. It is a very small percentage of people that qualify for APAP machines up here. I've heard around 3% and the rules for prescribing one is very strict and even if doc prescribes that the govt will want documented proof that it meets all requirements. If I choose to get an APAP, I am totally on my own as I cannot use my $1,000 private insurance until after I have used up the Govt ADP allowance of $645. They've got quite a racket going up here. So I'd be out of pocket about $1160 for an APAP I believe, and I still then would have to buy heated hose if req'd, mask and anything I needed. Free healthcare has it's drawbacks bigtime!!
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#18
(09-13-2015, 05:27 PM)cate1898 Wrote: THEN WAIT 8-10 WEEKS TO See doc WHO WILL NOT KNOW IF THERE TRULY IS COMPLIANCE AS HE WILL NOT HAVE ANY DATA AND THE PATIENT COULD LIE

The escape will give compliance data - just nothing more useful.

The problem here, of course, is bureaucracy. It takes a while to get the "machine" to change it's ways even when there is clearly a better (and cheaper) way

I wish you had a data capable machine. It makes me angry on your behalf that you are being jerked around the block while the govt machine plays its game.
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum
Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه
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#19
Thanks DariaVader. I'm more disappointed than angry to be honest. Wish I had tons of moolah and could just go out and buy my own!
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#20
I'll add that some vendors make arbitrary 'comfort' settings that just don't work for everyone. Respironics has what they call 'Flex' which is designed to enhance tolerance - but not everyone likes what it does. Having a smarter machine with open controls to allow the user to make adjustments to these 'comfort' settings is an important method to gain compliance.

Regarding Nyquist --- no, before that we'd have to discuss the central limit problem and whether or not breathing really is periodic in the first place.
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