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New User: CPAP vs Auto-PAP
#1
I was just titrated this week, and I have a pressure setting of 9.

From talking with the tech at the sleep clinic (Doctor? It'll be a month if you want to talk to them) my prescription is for a straight CPAP, not an Auto-PAP, with humidifier. I've got to talk to my insurance and supply house to figure out what I can get covered.

Should I be pushing for an APAP, or should I just use the CPAP and monitor my AHI on a regular basis and complain if it's high?
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#2
An Apap machine can be used in Cpap mode if that's necessary, but will allow for re-titration or other modifications as conditions change in the future. By specifing just Cpap, he has created a situation where the DME can give you a junk machine that does not do anything more creative than pump air.

So yes. Call the doc and ask for a written prescription specifying a fully data capable Autoset machine.
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#3
I would push for a humidifier at least, and also an auto machine as well. The auto machines are capable of being set for a strait pressure as well as auto. I have a Resmed AirSence10 Auto set and I really like this machine as it is fully data capable so you can monitor you progress to treatment. I would ask your doctor to change the scrip. After all you have to live with this machine for probably the next 5 years or until your insurance pays for a new one. Also you and your insurance pays for it so you should get what you want. I did.
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#4
The problem with the titration studies, is they represent just one unusual night that is used to find the most effective pressure to stop events. That pressure can, and does change with changes in weight, health and other factors. Even a simple cold. The CPAP pressure is usually the 90th percentile pressure (the pressure you were at or below 90 % of the time while being effectively treated.) Having an APAP that is set based on the titration means you get the most effective treatment, and flexibility to
have the pressure change as needed. It also lets you sleep at lower pressures that are adequate 90% of the time.

Some people do great on CPAP, but others are more comfortable and do better on auto CPAP. You only get one machine, and an APAP is a CPAP with more flexibility. Which one should you have?
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#5
So just got off the phone with the Respiratory Therapist at the Medical Supply House: They exclusively use the PR System One Auto w/ Humidifier, which is the exact machine I was looking at requesting.

I'll just have to watch what settings they're using, and talk to the therapist about using a range instead of a fixed pressure.
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#6
Good job. It's a good machine for you. The pressure details can be worked out later as you see what your needs are.
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#7
Imoretti,
I went through the same thing. My Doctor wrote a script for a CPAP, but thanks to "lurking" about here, I knew what to ask for and called my doc and asked for an Auto CPAP. The only thing you may want to call back and make sure you are getting a humidifier with heated hose, or they will just give you a regular humidifier. It makes a difference on your comfort level.
Don't worry if they don't have the pressure set correctly, just come back here and someone will guide you. Good luck.
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#8
(05-22-2015, 12:28 PM)lmoretti Wrote: I was just titrated this week, and I have a pressure setting of 9.

From talking with the tech at the sleep clinic (Doctor? It'll be a month if you want to talk to them) my prescription is for a straight CPAP, not an Auto-PAP, with humidifier. I've got to talk to my insurance and supply house to figure out what I can get covered.

Should I be pushing for an APAP, or should I just use the CPAP and monitor my AHI on a regular basis and complain if it's high?

If you are in the US, INSIST upon an auto-pap with humidifier. Why should make do with old technology? An Apap will do both cpap and apap and when/if your needs change, you can switch out to an apap. In addition, the apap gives you more information so that you can assist in your therapy. Also, don't forget to get a copy of the script. Not all masks and options are likely available at your DME and you might want to buy a different mask from an online place. When you see the doctor, it's easy enough for him/her to print it out and sign it. If your doc asks why, just say that you might become unhappy with your DME and switch someplace else - you wouldn't have to bother the doc for another prescription for supplies.
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#9
(05-22-2015, 02:18 PM)lmoretti Wrote: So just got off the phone with the Respiratory Therapist at the Medical Supply House: They exclusively use the PR System One Auto w/ Humidifier, which is the exact machine I was looking at requesting.

I'll just have to watch what settings they're using, and talk to the therapist about using a range instead of a fixed pressure.
Sound good and maybe they're good on their words but might be a good idea for the doctor to specify the exact machine on the prescription so they're bound legally to dispense the machine of your choice, many people get duped (keep a copy for yourself, never know when you need it)

The prescription should say something like this: PR System One Auto w/ heated tube humidifier model # 560, heated tube, pressure range 7-11, mask of choice, etc .... and "dispense as written"

Find out about replacement schedule here is a wiki guide but check with your insurance
http://www.apneaboard.com/wiki/index.php...6_Medicare
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#10
Hi lmoretti,
WELCOME! to the forum.!
It's great to hear that you will be getting an APAP machine.
Much success to you as you start your CPAP journey.
trish6hundred
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