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New member question: Did my DME give me a used machine?
Hi to all,

I'm new to the forum, but a long-time cpap user.

I recently upgraded to a Resmed S9 Autoset after years of using a Respironics Sleepeasy. The respironics was 5yrs old & getting loud, and I also thought it would be good to get a new sleep study after 5yrs.

The DME originally gave me a Resmed S9 Escape, but thanks to the helpful posts here, and some back-and-forth between Dr/sleeplab/DME, I exchanged for the S9 Autoset.

However, after examining my "new" cpap machine today, I'm questioning how old it is. Under menus Info>Service>Run Hrs shows 3452. I remember checking the S9 Escape, and found zero hours for this field.

I could understand a few hours, even 40-50 if it was tested and returned, but 3452, if correct, is 1-2yrs use. The DME told me the warranty was 2yrs, but appears as if a good chunk of this time has already been used. I will certainly call them to question the hours, but was wondering if this type of situation is common.

Also, on a related note, my machine is set to range from 4-20 cmH2O. As my fixed pressure was 12 cmH2O, does this sound typical? I was expecting a tighter range around the 12 cmH2O. The script I received did not specify a range, so I'm in D.I.Y. mode, like much of the rest of this process so far!

I have requested the clinical manual and analysis software to better educate myself, but would also welcome any feedback on the use hours and rate setting on my new cpap.

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The machine you got has a year and a half of hours on it already. It's fine, but if this a**h*le told you it was new, I'd go back and throw it in their teeth. They are getting rid of a very used machine and there is no way to know how many patients it has been used by.

You should set the auto machine to 10 cm minimum pressure, and let the maximum go to 20. It will only go as high as you need, but you will have a higher AHI if the minimum is set too far below your theraputic pressure. We allow a little bit of pressure relief with an auto unless it disrupts your sleep. You really don't want a lot of pressure change during the night or you'll wake up exhausted.
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Hi pickettj86,
WELCOME! to the forum.!
It sure sounds like you got a "used" machine. Call your DME and ask about that and if the answer isn't to your satifaction, you might want to take it back.
Hang in there for more suggestions and much success to you as you continue your CPAP therapy.
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If you went in there under the impression you were getting a NEW machine , I'd run it back in there and get the new one, Why would they lead you on like that ,We all know they have a 5 year life expectancy (per insurance payouts) so If there giving you a 1.5 - 2 year old machine as a new one I'd say NO! (maybe for 1/2 price if it was coming out of your pocket) I'm assuming your insurance is paying for most of it?
anyway good luck hope you get a good result.
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Yes, definitely used. The current user's hours can be erased but the total machine hours cannot.

As for the pressure, my suggestion would be to set it to a range of 8 - 16. Starting out low-ish will make it easier to tolerate. Let it run like that for at least 10 days to gather data. Unless you see you are regularly hitting 16 every night (which means you'd need to raise the max), or not going over 10 (which means you may need to drop the min), leave it alone.
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I'd eject the DME immediately and find a better one.
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I can't even believe how many times DME's pawn off used machines to their customers. I know because it happened to me too, except I was asked to pay an upcharge because it was an auto machine! When I realized it was at least 1 year old already, I took it back and made a stink.
They did replace it with a brand new one.
Take that machine back, you have to live with it for at least five years.
Tell them you won't accept any machine that isn't new.
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Thank you for all the helpful responses. After reviewing the clinical manual and forum posts, I did narrow the pressure range, and adjust display, reporting and EPR settings.

1st use resulted in an ahi index of 0.6 - very pleasing. I don't have a baseline for comparison, as my previous machine was a "brick", but I felt well-rested. I'm going to leave things alone for a couple weeks, until I better understand the software packages.

The sleepyhead software is really impressive - much more user-friendly than the ResScan. It was interesting to see the ebb and flow of pressures throughout the sleep cycle - validated the extra effort to get autoset vs elite.

Now for the entertainment - my conversation with DME rep:

I let the rep. know the unit worked great, but questioned the run hrs. of 3452 - wondered if it was a used machine. The rep. got a bit defensive, and told me their policy was that since I used my machine and exchanged it, I would get a used machine in return.

I pointed out that I originally specified a unit with diagnostic data collection, and called within 2 days to request an exchange when I discovered that they gave me a "brick". Furthermore, the additional hours on machine were due to waiting for the therapist's availability. Finally, the approx. 50 hrs I put on the original machine were a long way from the 3400 hrs on the exchange machine.

At this point the rep. sawed off the tree branch they were sitting on by telling me that I had used the original machine for 13 days, and put MORE than 50 hrs on it. Now fallen to the ground, the rep. found a shovel and began digging themselves a hole, telling me that they had no idea how I would have gotten a machine with that many hrs; they did not keep them around that long, and they did not know anything about the hours being that high.

The brevity ship has already sailed on this rant, but know that the rep also insinuated the run hrs didn't matter because the machine had a two-year warranty. Sigh.

I felt they had run through their entire repertoire, so I threw down a rescue rope by offering to call the insurance company, sleep lab, Dr office, ResMed and their boss for help. With all those experts involved, surely the serial number of the machine could be tracked, and this mystery solved...

"We" decided an exchange for a machine with <200 run hrs would be the best way forward.

caveat emptor
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Yep....... Your results are great!

..and I like that you have been so helpful to the DME so that they may grow and improve the quality of their business. Indeed, as our Pres might say, this has been a "teachable moment" for them.

Good job.
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Good results all around! You should be a diplomat.
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