Sorry for the long first post - a lot of details to cover. I live at 8400' in the Colorado Mountains and will be starting BiPap very soon.
I recently completed a sleep study (at a similar altitude to where I live) and met with a doctor for a follow-up a week ago. I have severe SA and my AHI in the sleep study was 95.9 events per hour, my events consisted of 0.4 central apneas, 17.7 obstructive apneas, 3.6 mixed apneas, 74.2 hyponpneas per hour. About half-way through the study they connected me to a CPAP. The study showed elevated AHI until they had me on a BiLevel at 25/19, then my AHI was 7.4 per hour. I even got 49 minutes of REM sleep during the CPAP/BiPap part of the study and felt great the next day - I was a "lucky" one that slept great during the study. I will be using additional O2 at night - the sleep study recommended 4L so we will start there. I recently recovered from severe pneumonia requiring surgery so my O2 requirements might change as my lungs continue to heal.
The doctor first prescribed me a Respironics System 1 BiPAP Pro with Bi-Flex with datacard, heated humidity and pressure set at 25/19. Based upon reading this forum I convinced them to change my order to an Auto machine, which they have done (So now it will be a BiPAP Auto). My concern is this machine and all Phillips machines say max altitude 7500 feet (in their manual). When I met with the doctor I told him my only close DME is Lincare (others would be in Denver an hour+ away) and they told me the previous week they "only" provide ResMed devices and he said he prefers Respironics and that is what the order will specify. I mentioned what I had seen about the altitude issue - ResMed rates to 8500' and Respironics rates to 7500' and he said he would look into it. I asked the doctors office about getting a copy of the order and when I saw it is the Respironics, I emailed back the office about the altitude issue she said the machine will self-adjust (which it will but only up to 7500 feet).
So I am wondering how big of an issue this is and how far to take it, and how to do so. I talked to Lincare about the altitude issue and the person in the local office will submit the paperwork to the "Lincare Bipap person" and state the machine needs to be rated for 8500' and then once they specify the machine she will contact the doctor if it doesn't match his specific request for a Respironics. She said they deal with this frequently. I figure I will let Lincare fight back some and be the "bad cop" now instead of me being a pain to the doctor and challenging him more (unless that is what is needed).
Thanks for all the advice you have provided while I lurked here and learned enough to insist on an Auto Machine.