New to the club.. starting my thread for all my questions that are sure to come. TIA!

[freddieku]

My story: 9 years ago when I was younger and concerned with things like partying and traveling and not pulling out a mask when dating a new girl, I was diagnosed with moderate OSA. I rented a machine, tried a couple masks and it just didn't take. Fast forward to now, I'm a 35 year old male, 6'5", 225 and I think my sleeps gotten a little worse. I decided that I should look into this again, used Lofta for an at home test and was shown to have 8.1 AHI and 18.7 RDI. I think that was actually a good night of sleep and my numbers are worse. But, I want to buy a new machine and get started but have a few questions to start.

1) Decided on the ResMed AirSense 10. I was originally told the For Her version was the best but have sense backed off on that. Can anyone give their input?

2) Supplier #1 on the list for instance, I assume all the ones on the list are reputable but some seem to have better return policies on masks which I think will come in handy as I might need to change masks. This seems like sound logic, no?

3) I'm not 100% sure I'm a mouth breather but I'm pretty sure. I drool, have heard recordings of my sleep and it sounds like my mouth is open, etc. I'm fine with a full face mask and think I'd rather that than chin straps and such for the less obtrusive nasal pillow. This sound reasonable?

4) One of the websites I was originally going to go through (cpapdirect) lists the CPAP machine as "with integrated humidifier and heated hose".. I sleep in a cold room, thermostat at 65 so have gathered I think I need a heated hose or I might have "rain" problems. Do I need to buy a heated hose if I buy the ResMed AirSense 10 from say #1 on the supplier list?

5) Other than the CPAP machine, the face mask and possibly the heated hose, what other things do I need to order at the moment? Are those 3 things enough to get started? 

6) The doctor at Lofta recommended 4-20 which from reading seems way too wide.. is there a better guess of what I should set this to? Trial and error?

7) Anything I'm missing here to start in terms of what I've said and presented? I appreciate any help. Sorry for all the questions. From reading, I can tell this place has a lot of great info and as someone with no insurance, I'm trying to do this mostly myself!

8) Oh that last thing made me remember.. all in this will cost $800~ give or take. I'll try like crazy but if this just doesn't work.. is there really only one website that might buy my used machine for $200 and that's about all I can do with reselling?

Thanks in advance. If I missed anything, my apology. Happy to answer any questions!

[Sleeprider]

Check out Supplier #2 for a new-in-box Autoset at $589 with humidifier and slimline tube. Call for a quote for upgrade to heated. You can buy a heated tube on Amazon for $25, so they might just throw it in. I am not as big a proponent of the for her algorithm as others. If you can get it for the same price, then fine, otherwise, I don't see enough advantage to warrant any inconvenience.

Supplier #1 has been used by many on the forum as a reliable source of masks with a 30 day return policy. Great deal until you are certain you have found "that" mask. Whatever you do, always call when buying rather than ordering right off the website. There are discounts and deals that may not be advertised due to minimum advertised price restrictions by the manufacturers. It is almost always better to call and ask if there is a discount available.

Positive pressure therapy often enables nasal breathing, so the need for full face coverage is less predictable than you think. It's an individual decision, but the nasal pillows are obviously much less crap on your face, and allow you to speak, take a drink of water and have other advantages. I have never used anything else,, even with colds or severe congestion. The nasal pillows just clear it up with the direct pressure. YMMV

See note #1 concerning Supplier #2. $589 complete. In a heated tube, I use a fleece tube cover (Snugglehose) which costs about $20. It not only helps stabilize temperature, but is a lot softer on your face and body, and quieter. Based on my many years of use, you can ignore the warnings about use with a heated tube.

Starting pressure, minimum 7.0 with EPR 3 gives you a starting pressure of 7/4. That is bilevel inhale/exhale pressure and with EPR is more likely to prevent flow limits, hypopnea and RERA in addition to apnea. We can dial you in after one night. Anyone that suggests 4-20 is not worth listening to...too many books, no practical experience.

Most resales seem to be on Craigslist. If you're looking for a bargain, check it out. I use the SearchTempest search engine and use the search term Resmed.

Good luck! You're off to a great start by starting here.

[Melman]

Welcome to the forum.
1) The ResMed AirSense 10 autoset is the preferred machine on the forum. The for her version has an additions softer algorithm but lacks none of the features of the standard version. They cost the same. Either should meet your needs.

2) Mask selection is one of the biggest challenge so it makes sense to choose a supplier with a good return policy. I tried several different masks before finding one that ws comfortable and did not leak.

3) I'm a mouth breather and have found that a chin strap is worthless for me. I can breath quite well between my teeth and through my lips with my jaw firmly closed with a chin strap. There is a tongue placement technique that prevents mouth breathing but I've never been able to make it work consistently. That leaves lip taping as the only effective solution for me to use nasal pillows. Some swear by it but it doesn't appeal to me. I'm quite comfortable with the Resmed Airfit F20 full face mask. Mask come in different sizes. Go to the website for the mask you want to try and download the sizing template.

4) At least one of the suppliers sells the machine bundled wit the heated hose.

5) You will need filters for the machine inlet. An SD card 8-32GB is required if you want to use free OSCAR software available here https://www.sleepfiles.com/OSCAR/  It's highly recommended if you want to take full advantage of the forum. Also you should get a setup manual available here https://www.apneaboard.com/adjust-cpap-p...tup-manual  Which will provide instructions on how to change pressure settings.

6) I suggest starting with 7-20 and full time EPR of 2 or 3. A minimum pressure of 4  is too low. Also, don't bother with ramp. It just delays effective therapy.

I hope you find this information helpful. No need to apologize for the questions. We welcome them.

[freddieku]

Stuff

Stuff

Thank you both for your replies! Your knowledge definitely makes me feel a lot more comfortable. 

One quick question, do you feel confident that I’m ok ordering the CPAP machine from any of the listed suppliers? I don’t particularly care which so say I just order everything I need from #1? Also, do you guys refer to them that way as a way of seeming impartial or because it trips up something? Just curious to know how to post going forward.

Thanks again. Hoping to order this soon so it can get shipped today!

[Sleeprider]

The supplier lists consists of vendors that were nominated by the Advisory Members and voted to be included. They are not in any particular order, and while Apnea Board makes no representation about those vendors, they probably would not be there if they did not provide good service and fair deals.

The forum rules forbid any links to commercial entities and DME sales, so the Supplier List is our work around.  You can say the names of places as long as they don't include a part of a link which is why Supplier #1 is particularly prone to resulting in rule infraction notices.  So I can say I bought a Resmed Airfit P30 on Amazon, but including the link is a shortcut to infraction.  It's not unusual to see the notice below on a post.  You should avoid that.

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Moderator Action: Link Removed THIS IS A TEST

To maintain our status as an educational organization, certain types of commercial links are prohibited in this forum.  This is stated in the Apnea Board Rules with details given in the Commercial Links Policy section.

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[staceyburke]

I have purchased 2 used machines fro Supplier #2. One machine had less than 1month use and the other less than ONE WEEK. Cost is much less and they have a year warranty. Great company. They also have “open box” and new for less than any other site I could find.

[freddieku]

Thank you for the explanation and the quick reply!

So, in your opinion, would ordering the air sense 10, a heated hose, and the F20 facemask from Supplier #1 be a good start today? And I can fill in the filters and other options through Amazon or other suppliers as I go?

Anything I’m missing? (I have an SD card)

Thanks!

Edit: sorry, I didn’t see the reply above. Thanks! I’ll look into #2. I’m a little hesitant about used for obvious reasons but since the masks and what not aren’t, I may just be being overly bleh about it.

[Sleeprider]

Supplier #1 will price match, but you need to call. I already quoted a lower price for the Airsense 10 Autoset from Supplier #2 that included the slimline tube, and as I said, I'm sure you can talk them into a heated tube. Supplier #33 is at $597 including a heated tube, filter, carry case etc. Supplier #1 is particularly good for the mask return policy. All in all your plan sounds pretty good, but I would ask them to price match Supplier #33 with the heated tube.included.

[freddieku]

Thanks everyone! I got the AirSense 10, F20 mask and a heated hose. If there's a getting started guide, feel free to point me there, I'd appreciate it. Otherwise, I guess I'll start with 7-20, turn off the ramp and EPR of 2 or 3. I'll grab some distilled water, I guess? Anything else I need to know? Tips or tricks.. things I'm not thinking of? I'll download OSCAR and put my SD card in the CPAP and get started with that too? Oh and does anyone have an opinion on the CPAP pillows you can buy from Amazon? Worth it?

Thanks so much for the help. Get's here by Wednesday night so two more nights of sleep without it :/ but oh well!

[Melman]

You don't really need distilled water. Tap water is acceptable. If you have really hard water you will get deposits in the humidifier which can be removed with vinegar. If you change the water daily and wash the humidifier daily you may have no problem with deposits. Distilled water is no safer than tap water if you're concerned about potential for perfection.