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Hello! New Member, Just Woke Up!!!
#1
Hi Guys,
New member here. Glad to find such a helpful place.
A little background. I am a 65 yo retired Pharmacist who suffered from severe sleepiness, mountain dew addiction, anxiety and depression for atleast 50 years....
I was too busy to learn about sleep apnea, thinking all my problems were "I must be real lazy dude". No MD or other provider suggested a sleep problem untill just recently.

Now I have focused my internet studies on Sleep apnea, between naps, and I have become obsessed with getting this situation worked on.

I have started an at home titration study on Oct 7 2016, using a loaner, Respironics System 1/ 160 which was provided for free by the Sleep MD's office.

I was starting to feel much better with more energy and focus.

Then it happened.... They took back to nice auto adjustable cpap and said I get my own machine.. I was delighted to finally get started on my own machine when I realized they were giving me the Dreamstation CPap "Brick" dumdum machine.

I used the brick last night, with a fixed rate of 12 cm and had a horrible night, couldn't keep either of my masks from leaking until I cranked down the straps so tight on the Dreamwear nasal I was having bad pain on my nasal septum??. the other device I tried was a Resmed Airfit F10 which i had previously purchased, having tried one during my titration loaner period. The new F10 was very difficult to get a good seal at 12cm and I cranked to straps so tight my neck hurt real bad.

I finally came here to read and research.

I did not like or want the brick Dreamstation CPAP with no auto.

The MD's office said that they will not provide a Dreamwear Auto or Pro, as was suggested as good machines in the your cpap wiki. The Sleep MD staff said They will give me a prescription for CPAP and I could shop around if I didn't like their offer.

They did say I could return the brick machine and not be charged for it.

I have Medicare with an Aetna Senior supplement, Plan G and was hoping to have a better machine covered.

Have any of you with medicare been able to get approval for an Auto CPAP for your first machine???

Will the DME providers try and bill for a better machine for me?

I can survive without the CPAP indefinately, since it is time for my winter nap!!! anyway.

Thank you in advance for any tips you may share on how to get a better machine covered.

Inhome test details follow:


I completed an inhome sleep study on 9/21/16 with scores of:
Total record time: 487 min
OA: 11
Mixed ap: 5
Central ap: 77
Hypop: 41
AHI: 17.1/hr
Mean heart rate: 63.5
avg O2 sat: 91%
Diagnosis: Moderate Central Sleep Apnea

Scotty

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#2
I was lucky. I knew nothing when I started. I did not choose my PAP but I got the Resmed S10 auto set and Medicare pays 80%. My DME has the worst national reputation but locally, I have had nothing but good service. Like I said I was lucky. Don't accept anything but what you want. It is hard enough to get these things to work and you will fall madly in love with it so you should get something you like.
HuhDont-knowI am an accountant so any advice given here is not medical. If I give any financial advice, you can take it to the bank. However, you will have a hard time cashing it in. Okay
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#3
They've given you an improper machine for your diagnosis. Central Apnea should be treated with an ASV machine.

Now, Medicare may require you to fail on CPAP (meet compliance, but not reach AHI goal) before approving a different machine.


BTW: Welcome
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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#4
Hi scotty,
WELCOME! to the forum.!
I wish you good luck as you start your CPAP journey.
Hang in there for more responses to your post.
trish6hundred
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#5
Thanks for your replies.
the machine they sent me home with isn't even listed for sale anywhere!
DreamStation DSX 200H11.

I fear this machine does not record any sleep statistics, only compliance.
Does that sound right? The manual says only the Pro and the Auto Modles record AHI, PB, and ???

How can they make any adjustments if there is no cpap sleep cycle data??? How can I prove I need to move to a better machine?

Scotty
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#6
Scotty, unfortunately, the DSX200X11 is the bottom of the line fixed CPAP with no efficacy data. If at all possible, return the machine and ask for the Auto or Pro CPAP. The price of each of these is not much different, but the features and data are very different. You may need to ask your doctor to prescribe AUTO cpap to get what you want. Auto CPAP will track your success or problems, and changes pressure automatically to match your changing needs due to sleep stage, position or health. You deserve a better machine, and should not have to accept this to pad the profit of your supplier. Without data, if you have problems, you will need another expensive sleep study to troubleshoot what the auto CPAP can fix or report for free.

Talk to your doctor, and get the change. You could use a pressure of 10-14 and get much better treatment than a fixed pressure of 12 with no feedback. Lack of feedback and motivation is the biggest cause for failure in sticking with this therapy. Get it for the data. You will fail at any CPAP machine due to your complex apnea. You need the data to prove it is a failure and move toward what you really need, which is ASV.

It is possible you were given this piece of crap machine because they know you will fail on it. Don't wait to complain. You are having central apnea and are not treated on that machine. You should have been titrated for ASV from the beginning.
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#7
Welcome Rip Van Winkle... glad you just woke up. Congrats

Welcome


Now, go back to sleep. Sleep-well

Cheers,
Steve Coffee
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#8
Welcome to the forum scotty! Glad to hear you have educated yourself about the machines and their differences. If your sleep doc will write a script for an auto machine, even if all you need is a fixed pressure, go for the auto as it can also run in fixed mode. Good luck choosing your new machine and keep us posted!
APNEABOARD - A great place to be if you're a hosehead!! Rolleyes

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EVERY ACCOMPLISHMENT BEGINS WITH THE DECISION TO TRY!
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#9
Hi Scotty. Welcome to the Apnea Board. JustMongo and Sleeprider are sending you in the right direction. " return the machine and ask for the Auto or Pro CPAP", " You may need to ask your doctor to prescribe AUTO cpap to get what you want", "They've given you an improper machine for your diagnosis. Central Apnea should be treated with an ASV machine. Now, Medicare may require you to fail on CPAP (meet compliance, but not reach AHI goal) before approving a different machine". You are going to have to jump through some hoops to get the proper treatment for your diagnosis. The proper machine (ASV) will usually only become available when you fail using the best that Auto adjusting cpap machines can do. Get a proper prescription and find a new DME that you can work with. Talk with the DME about your diagnosis (Diagnosis: Moderate Central Sleep Apnea). Make sure that the DME understands the Medicare protocol for getting an ASV machine. By the way an ASV machine will also easily treat the Obstrutive Apneas that you have mixed in with your Centrals. On the other hand a standard CPAP madhine will usually make the Centrals much worse. Oh, and this one is most important. Find a new Sleep Doc. You may have to travel. I finally went to my University Medical Center to find a sleep Doc that understood Central Apnea. Finally, post your results once you get on a data capable machine. Good luck.

Rich

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