Intro! + Rant! + Rage-quit my DME, what should I buy?
Hello! I've been lurking in denial for a while, figured it was about time to actually create an account.
The TL;DR is that I absolutely hated dealing with my DME's business practices so much that I got my physician to call in a "stop therapy" order with them, and returned my AirSense 10 AutoSet after about 60 days of use. I'm now in the position where I need to buy a machine out of pocket (ouch), and while I'd prefer to pay less money, I'm okay with paying more if it means that I get a machine that is more "future-proof" in case it turns out that I need something more capable. The ResMed AirSense 10 AutoSet seemed to be doing an ok job for me according to Sleepyhead but I still felt extremely un-rested (more on this below). I'm an extremely light sleeper and while the exhalation pressure wasn't intolerable, it was a distracting annoyance. I'm wondering if it would be worthwhile to spend an extra kilobuck for the AirCurve 10 VAuto - that's a huge bump up in price! Based on my reading, it does everything that my APAP but has higher adjustability for exhalation pressure? (Even having read several FAQs I'm still struggling to understand the nuances between APAP and BiLevel with the automatic adjustments.)
VERY long story...
I'm a 52yo male, 6'3" 225#. At peak career with poor work/life balance in tech industry at a dying company, its all downhill from here. 
I've been struggling with apnea for years (first diagnosed about 10 years ago with "moderate" SA, can't recall the numbers), but resisted therapy because I told myself that quitting booze and getting more exercise would eliminate it. No such luck. My lack of sleep was finally reaching a point where I was barely functioning and impacting work, so I finally decided to bite the bullet and go do whatever was necessary. HA! As if it were that easy - little did I know that everybody from my doctor's practice to the sleep lab to the DME to my insurance company had basically weaponized mediocrity for profit. This then intersected with one of my (many?) idiosyncrasies, that I generally don't answer my phone, and any voicemail that isn't transcribed to text is ignored. I get so many spam/scammer calls that it's just unusable. If a call shows up from a repeatable number, fine, I'll whitelist it, but otherwise they go straight to VM.
After waiting nearly three months for my appointment, I got in to see my highly rated sleep doctor (Berkeley, CA). Nice guy. Seemed promising. Prescribed an at-home sleep study. Warning sign #1... he said "you might need to keep calling them to get onto their calendar". Indeed, it did. When I finally got an appointment with them, went in, and learned that they'd rescheduled me. They'd "tried to call".
Updated appointment is three weeks later. The guy who gave me the demo on how to use the equipment had his spiel down, but crikey, it was excruciating. He was clearly most used to explaining things to elderly people with mild dementia, not highly caffeinated startup execs with meetings to get to. Anyway, I do the study. It took three weeks to get the results after many, many calls to the sleep clinic, and then multiple messages to the doctor. (I first requested my appointment in August 2018. Got results in January 2019.)
Results... "severe", 36 events per hour. He prescribes CPAP. Tells me his office will reach out with info. They never did. I left a voicemail after a couple weeks, no reply. I got busy at work, and forgot to follow up again.
After another couple weeks, I realized that I'd received a dozen voicemails (comically transcribed) from "unknown caller":
“Hello this is ___ your healthcare this message is to confirm that we have received an order for equipment your order is not ready at this time we are verifying your information to get your order ready there is no reason to return our call you will receive a call from an ____________ representative within the next five business days thank you for being the best part __________…”
“Hi my name is Ellen from opera _____ _____________ on ___ like __ ______ us message is for Rachel _____ ________ if you think you're adorable medical equipment if you wish you could call us please give us a call back at this number ____516-5408 thanks for being the best part of off ___ house for have a great day…”
“Hi my name is Allen from ______________________________ on that occurred in line ____ message is for _____ ________ if you see guardians are durable medical equipment if you ____________ called just give us a call back at this number um 800-516-___ thank you for being the best part of I'll __ has _____ have a great day…”
(Those are C-n-P straight off my phone! Well done, Siri. I particularly like "adorable medical equipment.)
Keep in mind, I've had no interaction with anyone regarding how the process of getting CPAP equipment works, I don't know at this time what a DME supplier is, I don't know anything. Just a bunch of messages that I suspect has to do with my CPAP but I'm not sure, and I find it strange that I haven't received anything in the mail or gotten info from my doctor.
I was out and about one day, go another unknown caller at about the same time that these voicemails seemed to appear, and decided to answer. The caller mumbles from a script "this is ___ from ____ and we need to verify your information for your medical equipment..." Okayyyyy.... "please verify your full name?" "who are you intending to call"? Uhhh, (he reads back my name). "What medical equipment are you referring to?" He says... "I'm not sure, let me check..." and then proceeds to list off a bunch of things, the make and model of the CPAP machine, the mask, the tubing, etc. Then he says "Uh... CPAP equipment?" I say ok, yes, I'm expecting to get a CPAP machine, but who are you and what company do you work for?" He tells me, and "Can you verify your address for shipping?" "Shouldn't you have that? I'm not comfortable providing information to people that call me." He then gives up and says "do you live at (address)?" I say yes. He then asks for me to confim my social security number. I say "HELL NO, why do you need that?" and he says "for the credit application for the equipment rental."
Ok, so I know you guys have been through this and it probably wasn't unexpected for you, but I naively thought, y'know, I'd get a bill for a machine, the insurance would pay part of it, my high deductible would take it in the shorts, just like my many-thousand-dollar ER visits. Expensive but.. done. Not a rental. WTF. And the whole scripted dialog was so.. buzzwordy, and one-way, uninformative. Nobody has told me what the hell I'm getting, yet someone is talking in circles using vague terms and saying "need to this" and "it's important to that". I'm a reasonably sharp person, and was getting dazed by this call. I can't imagine how an easily confused elderly person would react... it felt like that's literally what they do, try to bamboozle old people into getting into payment plans for services.
I said "I'm not interested in renting equipment. How do I just... buy it?" He said "uhhh.. I'm not sure, that's not my department, you can call 800-XXX thank you for being the best part of ____" and hung up on me.
I was fuming after this conversation, and didn't call. More voicemails were left, same as the prior ones.
A week later, a box showed up on my doorstep. I opened it. It contained a ResMed AirSense 10 Auto. I was pretty P*ssed off, but on the other hand... here's a CPAP machine, I'm desperately tired, and I didn't have to do any credit application, so I stupidly assumed that maybe I'd won. HA HA HA. But anyway, I set it up, start using it, go through the usual n00b struggles, search for whether there's a way to reconfigure it and whether there's a different way to get data off it than MyAir... and find this forum, and Sleepyhead. More details on my therapy below, but lets get through the administrative hell first.
During my first month of usage, I continue to get twice-daily voicemails from the DME from random numbers and unknown caller, and finally I get one where they say to contact their billing department immediately or else my account will be sent to collections. Sigh. I call in, they tell me I owe $$$, and that my contract with them says XYZ. I say I've never agreed to any contract, never seen any contract, etc. They go WTF, and escalate me to their manager, who isn't in the office, so it goes to voicemail. I leave a message. Another generic voicemail, then a VM from the manager. I call them, I say I haven't ever seen a billing breakdown, a letter, any description of what I'm paying for, etc. She says she'll make sure that I'm sent one. A week later, I get a bill in the mail, finally! Note that they were already threatening to send me to collections at about Day 35. The bill does not have any kind of breakdown. I request a breakdown. A week later, I get one mailed. It's SOOOO inflated, it just makes me mad. After insurance, I still owe $480 for some unknown portion of the machine + supplies. I don't know how long it's going to be until it's paid off. They're charging $250 for the "humidifier". I look it up, you can order it for like $20. The markup is insane. The therapy isn't working great (see below), I grumpily decide F this, I want out. I contact my sleep doctor at the beginning of March, tell him I want 1) to get off this DME ASAP, and 2) send me a prescription so I can just order something online. After leaving several more messages for him, I hear back mid-June, he says he's issued a "stop therapy" to the DME. A while later, related, but not obviously to me, my security camera goes off while I'm at work, there's some random dude standing at my door with a clipboard. Next day, same dude, at my door, with clipboard. My wife is a little freaked out by this. This isn't the kind of place where you just answer your door when some random dude is at the door. Another day, now it's a different random dude. He calls and leaves a voicemail... he's from the DME, there to pick up the equipment (!) Just... showing up? WTF. Alright, I could keep going, you get the picture. You had the picture. Instead of letting Random Dude pick up the equipment, I make an appointment to return it myself. I tell them its pretty f'ed up to just have someone showing up at my house, and I'm told "we scheduled a pickup appointment for you." "How would I know this, I haven't spoken with anyone?" "We would have left a message." Natch.
Good riddance.
Writing down my whole grumpy reaction to them makes me feel prematurely crotchety. But hey, I'm partially grumpy because I'm getting crappy sleep. So:
The AirSense 10 Auto was theoretically doing ok for me by the numbers, I was getting AHI 1.7 - 2.5ish. But still not feeling rested, sometimes feeling worse than when I didn't do CPAP at all. I was only getting about 5 hours of sleep and would still wake up several times during the night, feeling wired and jittery. It felt like my pulse was racing and my BP was high, but I'd measure them and they were totally fine. So strange. I'd had a sneaky suspicion that I have both sleep apnea and some sort of undiagnosed anxiety disorder... and that respiration events during the night can trigger some sort of misplaced adrenaline dump into my system. But... even with AHI way down, I'm still getting these jittery wakeups where it takes me 30-60 minutes to settle down afterwards. By morning, I'd be all congested (my allergies?) and would need to rip the nasal mask off to breathe at all. I'm sure I can work through these issues, I just had returned the machine before I'd really gotten into dialing things in.
My plan is to buy a new machine plus try a full-face mask for when I'm in allergy mouthbreather mode. I was also getting some large leaks out my mouth (which my wife hated, because I was basically blowing a windstorm directly at her!) so I've gotten some lip tape. I have a whole lot of facial hair going on, so I'm not sure how this will work out.
I'm leaning towards the AirSense 10 Auto again, but per my TL;DR at the start, I'm wondering if it would be worthwhile to invest in the AirCurve 10 VAuto. It's an unpleasantly large amount of money, but since I don't have to argue with a DME, I kinda want to get the best thing that makes sense. I also intend to go all-in with Sleepyhead and datalogging and tweaking, might as well have fun with it, I figure. I have an old Zeo and a Withings sleep pad, so I like the "quantified self" aspect of this.
Advice on the machine? I'll be back with therapy updates once I get up and running again.
Thanks in advance!
The TL;DR is that I absolutely hated dealing with my DME's business practices so much that I got my physician to call in a "stop therapy" order with them, and returned my AirSense 10 AutoSet after about 60 days of use. I'm now in the position where I need to buy a machine out of pocket (ouch), and while I'd prefer to pay less money, I'm okay with paying more if it means that I get a machine that is more "future-proof" in case it turns out that I need something more capable. The ResMed AirSense 10 AutoSet seemed to be doing an ok job for me according to Sleepyhead but I still felt extremely un-rested (more on this below). I'm an extremely light sleeper and while the exhalation pressure wasn't intolerable, it was a distracting annoyance. I'm wondering if it would be worthwhile to spend an extra kilobuck for the AirCurve 10 VAuto - that's a huge bump up in price! Based on my reading, it does everything that my APAP but has higher adjustability for exhalation pressure? (Even having read several FAQs I'm still struggling to understand the nuances between APAP and BiLevel with the automatic adjustments.)
VERY long story...
I'm a 52yo male, 6'3" 225#. At peak career with poor work/life balance in tech industry at a dying company, its all downhill from here. I've been struggling with apnea for years (first diagnosed about 10 years ago with "moderate" SA, can't recall the numbers), but resisted therapy because I told myself that quitting booze and getting more exercise would eliminate it. No such luck. My lack of sleep was finally reaching a point where I was barely functioning and impacting work, so I finally decided to bite the bullet and go do whatever was necessary. HA! As if it were that easy - little did I know that everybody from my doctor's practice to the sleep lab to the DME to my insurance company had basically weaponized mediocrity for profit. This then intersected with one of my (many?) idiosyncrasies, that I generally don't answer my phone, and any voicemail that isn't transcribed to text is ignored. I get so many spam/scammer calls that it's just unusable. If a call shows up from a repeatable number, fine, I'll whitelist it, but otherwise they go straight to VM.After waiting nearly three months for my appointment, I got in to see my highly rated sleep doctor (Berkeley, CA). Nice guy. Seemed promising. Prescribed an at-home sleep study. Warning sign #1... he said "you might need to keep calling them to get onto their calendar". Indeed, it did. When I finally got an appointment with them, went in, and learned that they'd rescheduled me. They'd "tried to call".
Updated appointment is three weeks later. The guy who gave me the demo on how to use the equipment had his spiel down, but crikey, it was excruciating. He was clearly most used to explaining things to elderly people with mild dementia, not highly caffeinated startup execs with meetings to get to. Anyway, I do the study. It took three weeks to get the results after many, many calls to the sleep clinic, and then multiple messages to the doctor. (I first requested my appointment in August 2018. Got results in January 2019.)Results... "severe", 36 events per hour. He prescribes CPAP. Tells me his office will reach out with info. They never did. I left a voicemail after a couple weeks, no reply. I got busy at work, and forgot to follow up again.
After another couple weeks, I realized that I'd received a dozen voicemails (comically transcribed) from "unknown caller":
“Hello this is ___ your healthcare this message is to confirm that we have received an order for equipment your order is not ready at this time we are verifying your information to get your order ready there is no reason to return our call you will receive a call from an ____________ representative within the next five business days thank you for being the best part __________…”
“Hi my name is Ellen from opera _____ _____________ on ___ like __ ______ us message is for Rachel _____ ________ if you think you're adorable medical equipment if you wish you could call us please give us a call back at this number ____516-5408 thanks for being the best part of off ___ house for have a great day…”
“Hi my name is Allen from ______________________________ on that occurred in line ____ message is for _____ ________ if you see guardians are durable medical equipment if you ____________ called just give us a call back at this number um 800-516-___ thank you for being the best part of I'll __ has _____ have a great day…”
(Those are C-n-P straight off my phone! Well done, Siri. I particularly like "adorable medical equipment.)
Keep in mind, I've had no interaction with anyone regarding how the process of getting CPAP equipment works, I don't know at this time what a DME supplier is, I don't know anything. Just a bunch of messages that I suspect has to do with my CPAP but I'm not sure, and I find it strange that I haven't received anything in the mail or gotten info from my doctor.
I was out and about one day, go another unknown caller at about the same time that these voicemails seemed to appear, and decided to answer. The caller mumbles from a script "this is ___ from ____ and we need to verify your information for your medical equipment..." Okayyyyy.... "please verify your full name?" "who are you intending to call"? Uhhh, (he reads back my name). "What medical equipment are you referring to?" He says... "I'm not sure, let me check..." and then proceeds to list off a bunch of things, the make and model of the CPAP machine, the mask, the tubing, etc. Then he says "Uh... CPAP equipment?" I say ok, yes, I'm expecting to get a CPAP machine, but who are you and what company do you work for?" He tells me, and "Can you verify your address for shipping?" "Shouldn't you have that? I'm not comfortable providing information to people that call me." He then gives up and says "do you live at (address)?" I say yes. He then asks for me to confim my social security number. I say "HELL NO, why do you need that?" and he says "for the credit application for the equipment rental."
Ok, so I know you guys have been through this and it probably wasn't unexpected for you, but I naively thought, y'know, I'd get a bill for a machine, the insurance would pay part of it, my high deductible would take it in the shorts, just like my many-thousand-dollar ER visits. Expensive but.. done. Not a rental. WTF. And the whole scripted dialog was so.. buzzwordy, and one-way, uninformative. Nobody has told me what the hell I'm getting, yet someone is talking in circles using vague terms and saying "need to this" and "it's important to that". I'm a reasonably sharp person, and was getting dazed by this call. I can't imagine how an easily confused elderly person would react... it felt like that's literally what they do, try to bamboozle old people into getting into payment plans for services.
I said "I'm not interested in renting equipment. How do I just... buy it?" He said "uhhh.. I'm not sure, that's not my department, you can call 800-XXX thank you for being the best part of ____" and hung up on me.
I was fuming after this conversation, and didn't call. More voicemails were left, same as the prior ones.
A week later, a box showed up on my doorstep. I opened it. It contained a ResMed AirSense 10 Auto. I was pretty P*ssed off, but on the other hand... here's a CPAP machine, I'm desperately tired, and I didn't have to do any credit application, so I stupidly assumed that maybe I'd won. HA HA HA. But anyway, I set it up, start using it, go through the usual n00b struggles, search for whether there's a way to reconfigure it and whether there's a different way to get data off it than MyAir... and find this forum, and Sleepyhead. More details on my therapy below, but lets get through the administrative hell first.
During my first month of usage, I continue to get twice-daily voicemails from the DME from random numbers and unknown caller, and finally I get one where they say to contact their billing department immediately or else my account will be sent to collections. Sigh. I call in, they tell me I owe $$$, and that my contract with them says XYZ. I say I've never agreed to any contract, never seen any contract, etc. They go WTF, and escalate me to their manager, who isn't in the office, so it goes to voicemail. I leave a message. Another generic voicemail, then a VM from the manager. I call them, I say I haven't ever seen a billing breakdown, a letter, any description of what I'm paying for, etc. She says she'll make sure that I'm sent one. A week later, I get a bill in the mail, finally! Note that they were already threatening to send me to collections at about Day 35. The bill does not have any kind of breakdown. I request a breakdown. A week later, I get one mailed. It's SOOOO inflated, it just makes me mad. After insurance, I still owe $480 for some unknown portion of the machine + supplies. I don't know how long it's going to be until it's paid off. They're charging $250 for the "humidifier". I look it up, you can order it for like $20. The markup is insane. The therapy isn't working great (see below), I grumpily decide F this, I want out. I contact my sleep doctor at the beginning of March, tell him I want 1) to get off this DME ASAP, and 2) send me a prescription so I can just order something online. After leaving several more messages for him, I hear back mid-June, he says he's issued a "stop therapy" to the DME. A while later, related, but not obviously to me, my security camera goes off while I'm at work, there's some random dude standing at my door with a clipboard. Next day, same dude, at my door, with clipboard. My wife is a little freaked out by this. This isn't the kind of place where you just answer your door when some random dude is at the door. Another day, now it's a different random dude. He calls and leaves a voicemail... he's from the DME, there to pick up the equipment (!) Just... showing up? WTF. Alright, I could keep going, you get the picture. You had the picture. Instead of letting Random Dude pick up the equipment, I make an appointment to return it myself. I tell them its pretty f'ed up to just have someone showing up at my house, and I'm told "we scheduled a pickup appointment for you." "How would I know this, I haven't spoken with anyone?" "We would have left a message." Natch.
Good riddance.
Writing down my whole grumpy reaction to them makes me feel prematurely crotchety. But hey, I'm partially grumpy because I'm getting crappy sleep. So:
The AirSense 10 Auto was theoretically doing ok for me by the numbers, I was getting AHI 1.7 - 2.5ish. But still not feeling rested, sometimes feeling worse than when I didn't do CPAP at all. I was only getting about 5 hours of sleep and would still wake up several times during the night, feeling wired and jittery. It felt like my pulse was racing and my BP was high, but I'd measure them and they were totally fine. So strange. I'd had a sneaky suspicion that I have both sleep apnea and some sort of undiagnosed anxiety disorder... and that respiration events during the night can trigger some sort of misplaced adrenaline dump into my system. But... even with AHI way down, I'm still getting these jittery wakeups where it takes me 30-60 minutes to settle down afterwards. By morning, I'd be all congested (my allergies?) and would need to rip the nasal mask off to breathe at all. I'm sure I can work through these issues, I just had returned the machine before I'd really gotten into dialing things in.
My plan is to buy a new machine plus try a full-face mask for when I'm in allergy mouthbreather mode. I was also getting some large leaks out my mouth (which my wife hated, because I was basically blowing a windstorm directly at her!) so I've gotten some lip tape. I have a whole lot of facial hair going on, so I'm not sure how this will work out.
I'm leaning towards the AirSense 10 Auto again, but per my TL;DR at the start, I'm wondering if it would be worthwhile to invest in the AirCurve 10 VAuto. It's an unpleasantly large amount of money, but since I don't have to argue with a DME, I kinda want to get the best thing that makes sense. I also intend to go all-in with Sleepyhead and datalogging and tweaking, might as well have fun with it, I figure. I have an old Zeo and a Withings sleep pad, so I like the "quantified self" aspect of this.
Advice on the machine? I'll be back with therapy updates once I get up and running again.
Thanks in advance!
on California sales and they shipped for free.
maybe more out of pocket as compared to buying local.
Kind of the polar opposite of what you went through with your DME.
