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New - Lots of Questions
#1
New - Lots of Questions
Finally got a prescription for a CPAP today. 

Initial study results were 87 apneas 444 hypoapneas 0 RERAs
titration 6 apneas 42 hypoapneas 0 RERAs - most during the ramping up to 13

The prescription is for CPAP 13cm. and supplies

The prescription is written for a cpap will I be able to use it get the ResMed AirSense 10 Autoset? 

What is the likelilhood insurance will cover the Auto when the script is only for a CPAP?

Are there any online suppliers that will deal with insurance directly?

If I opt to buy online instead of through the referred DME will insurance reimburse anything?


I used a full face mask for the Titration and do tend to breathe through my mouth as I have Chronic Sinusitis, should I stick with the full mask or should I try some of the nose pillow masks?

Does the type of hose really matter?

What accessories are really necessary?

How do you try on different masks? do you buy  a couple to see what works?

Thanks for any help!


don't know if the insurance questions are appropriate for this forum - please excuse if not
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#2
RE: New - Lots of Questions
I don't know about the insurance questions but I would try to get an autoset. If having trouble getting one I assume you could try asking doctor to change script to APAP or Resmed Autoset.

Definitely stick with a full face mask if you have nasal issues. F20 is the best one I have found.

Use a climate line heated hose.

All you need is machine, hose and mask. I like to have a spare humidifier tank on hand (~6 month to 1 year), air filters (~3 months or as necessary), spare hose (~ 6 months), spare mask (~ 6 months), spare mask cushion (~ 3 months).
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#3
RE: New - Lots of Questions
The ResMed S10 autoset is a Cpap. Insurance will pay for it at the same rate it will pay on any Cpap. DON’T accept anything else. The supplier may try to give you another ResMed or a Phillips dreamstation because they make more profit from those. AGAIN do NOT take delivery of any other machine ResMed s10 autoset or autoset for her. 

If you insurance will reimburse depends on your insurance. Call them and ask if you have a deductible on a Cpap if you purchase it yourself. I just did it 6 months ago and they paid for everything except the extended warranty I bought with it ($50). Take a look at Supplier #2 on the suppliers list at the top of the site (you can’t put in Commercial sites on this site). They are a very good company. 

Trying different masks and supplies can be done through your supplier whether or not you buy the Cpap from them. Amazon do have some of the masks at a much lower price Especially if you buy it in parts and put them together (ResMed pillows). 

Your ResMed will come with tubing, if you want a heated hose that can be bought through Amazon for much less. I have never had a heated hose in 20 years of use but some people swear on them. Your ResMed will come with a humidifier. Only thing you really need is a mask.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#4
RE: New - Lots of Questions
Ask your doctor to rewrite the script for a ResMed AirSense 10 AutoSet.  The DME will go by what's on the script.  

You have the most power now before accepting a machine.  Once you are issued a machine, it's harder to exchange.

As far as your insurance coverage... call them and ask questions about your coverage, deductibles, etc. so you have no surprises.  Don't believe what any DME tells you.

Don't forget to get a SD card, 2gb to 32gb.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

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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
RE: New - Lots of Questions
Thanks everyone, took awhile to figure out insurance. I appreciate all of the help!
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#6
First Night
Here are the charts for my first night of use. Any advice?


Attached Files Thumbnail(s)
   
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#7
RE: New - Lots of Questions
I would suggest to change your settings 

Autoset instead of straight Cpap 
Min 8
Max 20
EPR 3

That allows the machine to vary its pressure anywhere from 8 to 20 for apnea. It will not raise higher than it needs to treat it. It may never get that high but it can if need be. 

EPR WILL help your flow limits and make much easier to exhale.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#8
RE: New - Lots of Questions
You have significant flow limitations. Usually we suggest increased EPR setting to reduce them but you are already at the max of 3. Higher pressure may reduce them. Were you comfortable with the pressure at 13? If so I suggest you change from fixed pressure to auto with minimum pressure at 12 and maximum at 20. Since you are now at 13 I'm not sure a lower min pressure will help any. The machine will automatically adjust the pressure to minimize your flow limitations and will not go to 20 unless required. If you don’t know how to adjust the settings go here https://www.apneaboard.com/resmed-airsen...setup-info

You can get a copy of the clinician manual by email. Click o the CPAP setup manuals aat the top of this page and scroll down to HOW TO ASK FOR A MANUAL VIA EMAIL.

This change may not resolve the problem. You may need a BIPAP machine which can provide more pressure support (the difference between inhale pressure and exhale pressure). The maximum pressure support available with EPR is 3cm of water. If you make the change please post data again.
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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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#9
RE: New - Lots of Questions
Make sure that the machine you get is new. That means 0 runtime hours on it. I have to assume that they come in a box that has matching serial numbers to the machine. 

I was given a ResMed AirSense 10 AutoSet. It wasn't until I got it home and became enlightened due to this forum, that I found out how to check it's runtime hours. 

Mine was supposedly new, but no box. Mine had 52 hrs. on it from the get go. It's been fine, and no problems at all. If it was a returned model, I would have wanted to know.
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#10
RE: New - Lots of Questions
Nice job so far.

I expected 13 Fixed cpap mode with no EPR.
It sounds like your doctor is trying to work with you. Let's start by trying to work right him.

You have an exceptionally high number of flow limits, and you have RERAs too. The EPR=3 should have cut down the glow limits and I suspect it did. Others have already said this.

I suggest you call your doc and say hey the 13 fixed is not working, I'm feeling bad (describe why), ask since the 13 fixed isn't working what about trying auto mode at 13-20. What do you think?

That last is very important because it says you are not trying to go around him, you are trying to work with him.

There is a good chance you may need a BiLevel such as the ResMed VAuto. You will need a new prescription for that. Increasing pressure with your docs help, you want him on your side and I think he may be one of the good ones. Failing at higher pressures should help justify the BiLevel.
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