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ONLINE home testing?
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Netskier Offline

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Machine: Resmed S9 Autoset, Mirage Quattro Full-Face Mask, Slimline tube.
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CPAP Pressure: 6-13 cm H20; Ramp OFF.
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Other Comments: Currently studying Reversal of Aging.

Sex: Male
Location: Los Angeles South Bay, about 20 min South of Downtown LA.

Post: #21
RE: ONLINE home testing???
(03-17-2012 01:39 PM)nila Wrote:  Oh -- I thought of another thing Smile.

The local DME companies rent XPAPs. I did call them and ask if they rented machines to test for apnea and they said no, but now I understand that maybe I did not phrase the question correctly.

Is there more than one XPAP machine that can be configured to do a home test? Is there a list somewhere, or are they a particular type of machine? I want to call the DME companies again and see if I can rent one Smile. How would I phrase this question?

Especially, what is the oldest and least state-of-the-art machine that could do the test? That seems like my best bet Smile.

I think that if I know what machine I want and where to rent it, my doc will write me a prescrip on Wednesday.

Thank you folks so much! I am really excited to have hope Smile.

Nila,

I think you want one of the latest APAP machines for running an at-home sleep-test because they are the most data capable. You need a Resmed Autoset machine, or its Respironics equivalent, to run an automated sleep test in your home in a single night, and to get provide enough data for the best possible home sleep test. It would take many nights of experimentation to use a CPAP machine to test a single pressure per night.

I believe that Resmed and Respironics APAPs currently offer the best data collection features; they simply collect more data than the other brands. The more data you collect in your at-home sleep-study, the more informed you and your doctor will become.

I went for the Resmed S9 Autoset because I wanted the quietest machine available so that I could sleep better. Why choose to have your sleep be disturbed by a machine's noise? No point to that. Both of the Consultants at Apria that I spoke with told me that they would choose the Resmed S9 Autoset if they were getting a machine for themselves. I have Kaiser, and they only use Respironics machines, and I had to fight to get a Resmed machine.

I suggest downloading and installing the Sleepyhead software as soon as convenient so that you can begin learning how to use it before you get your machine. That is, I would solve both problems in parallel to save time. I am very impressed with SleepyHead, and expect it to soon exceed the capabilities of Rescan.

I don't know the Rescan software because it does not run on a Mac, so I can not offer to help you with that.

I really do not see the point of renting a machine, if you can just buy one, with your Doctor's prescription, use it for "his study" of your sleep apnea, and then get your health insurance to reimburse you for the purchase. Why waste your money on a rental when it is unnecessary?

Netskier

My age is none of my mind's business. --- Netskier
03-18-2012 12:26 AM
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greatunclebill Offline

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Posts: 549
Joined: Feb 2012

Machine: Respironics System one Auto A-Flex
Mask Type: Full face mask
Mask Make & Model:
Humidifier: System one
CPAP Pressure: 8-12
CPAP Software: SleepyHead EncoreViewer

Other Comments: quattro fx full face

Sex: Male
Location: L.A. (Lower Alabama)

Post: #22
RE: ONLINE home testing???
(03-18-2012 12:26 AM)Netskier Wrote:  
(03-17-2012 01:39 PM)nila Wrote:  Oh -- I thought of another thing Smile.

The local DME companies rent XPAPs. I did call them and ask if they rented machines to test for apnea and they said no, but now I understand that maybe I did not phrase the question correctly.

Is there more than one XPAP machine that can be configured to do a home test? Is there a list somewhere, or are they a particular type of machine? I want to call the DME companies again and see if I can rent one Smile. How would I phrase this question?

Especially, what is the oldest and least state-of-the-art machine that could do the test? That seems like my best bet Smile.

I think that if I know what machine I want and where to rent it, my doc will write me a prescrip on Wednesday.

Thank you folks so much! I am really excited to have hope Smile.

Nila,

I think you want one of the latest APAP machines for running an at-home sleep-test because they are the most data capable. You need a Resmed Autoset machine, or its Respironics equivalent, to run an automated sleep test in your home in a single night, and to get provide enough data for the best possible home sleep test. It would take many nights of experimentation to use a CPAP machine to test a single pressure per night.

I believe that Resmed and Respironics APAPs currently offer the best data collection features; they simply collect more data than the other brands. The more data you collect in your at-home sleep-study, the more informed you and your doctor will become.

I went for the Resmed S9 Autoset because I wanted the quietest machine available so that I could sleep better. Why choose to have your sleep be disturbed by a machine's noise? No point to that. Both of the Consultants at Apria that I spoke with told me that they would choose the Resmed S9 Autoset if they were getting a machine for themselves. I have Kaiser, and they only use Respironics machines, and I had to fight to get a Resmed machine.

I suggest downloading and installing the Sleepyhead software as soon as convenient so that you can begin learning how to use it before you get your machine. That is, I would solve both problems in parallel to save time. I am very impressed with SleepyHead, and expect it to soon exceed the capabilities of Rescan.

I don't know the Rescan software because it does not run on a Mac, so I can not offer to help you with that.

I really do not see the point of renting a machine, if you can just buy one, with your Doctor's prescription, use it for "his study" of your sleep apnea, and then get your health insurance to reimburse you for the purchase. Why waste your money on a rental when it is unnecessary?

Netskier

you can get a bad noisy resmed just as easily as a bad noisy respironics. my wife and i each have a phillips respironics remstar auto a-flex machine. i can hear neither of them. if i get up or she gets up at night we cannot hear the other and don't even know if it is on until we look closer. so i guess they are at least as quiet as yours. and this is 2 seperate machines bought at 2 different times. people can say they are generally noiser. that's fine. but i'm saying from personal experience with 2 of them in my bedroom now, they are pretty quiet, not knowing how quiet others are.

as far as price i know that my pr is much more cheap out of pocket because resmed doesn't allow on line sellers to discount theirs. matter of fact, i bought mine from number 6 in the seller list for $619 which i know is cheaper than the resmed.

do not just buy a machine and then hope to get reimbursed. before you buy something speak with your insurance company to make sure they will reimburse you. my insurance company, for instance, will not reimburse expenses. when i need something the doctor sends them the authorization request and they go to a dme and buy or rent it. they do not deal with on line discounters and do not pay me. all money goes directly from them to the dme. again, make sure you know exactly what your insurance company will allow and pay for before obligating yourself.

perhaps your doctor can ask your insurance company for a one month rental of a machine to test you. i doubt they would do it but he could ask.
03-18-2012 10:23 AM
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Netskier Offline

Members

Posts: 125
Joined: Mar 2012

Machine: Resmed S9 Autoset, Mirage Quattro Full-Face Mask, Slimline tube.
Mask Type: Full face mask
Mask Make & Model:
Humidifier: H5i, but not being used.
CPAP Pressure: 6-13 cm H20; Ramp OFF.
CPAP Software: SleepyHead

Other Comments: Currently studying Reversal of Aging.

Sex: Male
Location: Los Angeles South Bay, about 20 min South of Downtown LA.

Post: #23
RE: ````
(03-17-2012 01:34 PM)nila Wrote:  
(03-17-2012 04:41 AM)Netskier Wrote:  Here's an idea for solving your problem. Ask your doctor to prescribe you a Resmed S9 Autoset with the H5i humifier, or whatever the very latest is, so that he can set it for you to use at home to run your own sleep study under his supervision....

Now, you have an at home sleep study prescribed for you by your doctor, and the two of you can apply for the insurance company to buy your machine for you, by having you submit your proof of purchase to the insurance company.

I just found Resmed S9 Autosets with heated humidfiers made in 2011 for $550 on the Internet.

With this solution, your total cost for sleep test and APAP will be $550 plus a little more for a mask and hose.

Please let me know if this helps you.

Oh, thank you, thank you! This is enormously helpful Smile. May I forward your post to my doc?

Yes you may forward my post to your doctor.

My age is none of my mind's business. --- Netskier
03-18-2012 04:20 PM
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nila Offline

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Post: #24
RE: ONLINE home testing???
Thank you, folks Smile.

And sorry for disappearing for a couple of days -- I misread my small computer screen and posted in the wrong thread here Wink.

Netskier:

Quote:I think you want one of the latest APAP machines for running an at-home sleep-test because they are the most data capable. You need a Resmed Autoset machine, or its Respironics equivalent, to run an automated sleep test in your home in a single night, and to get provide enough data for the best possible home sleep test. It would take many nights of experimentation to use a CPAP machine to test a single pressure per night.

I believe that Resmed and Respironics APAPs currently offer the best data collection features; they simply collect more data than the other brands. The more data you collect in your at-home sleep-study, the more informed you and your doctor will become.

Ok, so any APAP from Resmed or Respironics will be good, with the S9 being ideal?

What data am I going to be collecting? Just needed pressures, or other stuff?

Quote:I really do not see the point of renting a machine, if you can just buy one, with your Doctor's prescription, use it for "his study" of your sleep apnea, and then get your health insurance to reimburse you for the purchase. Why waste your money on a rental when it is unnecessary?

Well, because I could get the machine sooner (this week, I hope), and I am not sure insurance would reimburse me, and the rental fee is $50 for two weeks.

I do have masks and a hose, and I am impatient to try something Smile.

I'll go download software...
03-19-2012 01:23 PM
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nila Offline

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Post: #25
RE: ONLINE home testing???
Hi folks --

I have an appointment for a phone consult with my primary doc tomorrow, so I thought I'd bump this for my prescription/testing questions.

Quote:Ok, so any APAP from Resmed or Respironics will be good, with the S9 being ideal?

What data am I going to be collecting? Just needed pressures, or other stuff?

The other thing I forgot (it is so hard, doing this when I am too sick to remember details right -- but the apnea may be WHY I can't get over the mono) is that, due to a back injury, I can't exhale against pressure for very long.

With a regular CPAP, set on 10, I could do it for less than 5 minutes. So I guess that means I need an APAP that is also BiPAP?

Do BiPAPs vary in what their lowest exhale pressure is, or widest range between exhale and inhale? Is there a comparison chart somewhere, or do any of you good folks happen to know which can produce the lowest exhale / broadest range?

Will any APAP that is also BiPAP work for doing a home test, or are there other requirements?

Thank you so much Smile. I am trying to get up to speed on all this stuff as fast as I can.
03-20-2012 02:47 PM
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greatunclebill Offline

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Posts: 549
Joined: Feb 2012

Machine: Respironics System one Auto A-Flex
Mask Type: Full face mask
Mask Make & Model:
Humidifier: System one
CPAP Pressure: 8-12
CPAP Software: SleepyHead EncoreViewer

Other Comments: quattro fx full face

Sex: Male
Location: L.A. (Lower Alabama)

Post: #26
RE: ONLINE home testing???
(03-20-2012 02:47 PM)nila Wrote:  Hi folks --

I have an appointment for a phone consult with my primary doc tomorrow, so I thought I'd bump this for my prescription/testing questions.

Quote:Ok, so any APAP from Resmed or Respironics will be good, with the S9 being ideal?

What data am I going to be collecting? Just needed pressures, or other stuff?

The other thing I forgot (it is so hard, doing this when I am too sick to remember details right -- but the apnea may be WHY I can't get over the mono) is that, due to a back injury, I can't exhale against pressure for very long.

With a regular CPAP, set on 10, I could do it for less than 5 minutes. So I guess that means I need an APAP that is also BiPAP?

Do BiPAPs vary in what their lowest exhale pressure is, or widest range between exhale and inhale? Is there a comparison chart somewhere, or do any of you good folks happen to know which can produce the lowest exhale / broadest range?

Will any APAP that is also BiPAP work for doing a home test, or are there other requirements?

Thank you so much Smile. I am trying to get up to speed on all this stuff as fast as I can.

i don't know about bipap. i could not breathe against 12 with asthma, asthmatic bronchitis and emphysema even with c-flex. i just couldn't do it. but now with the auto set on 8 - 12 i'm fine thanks in part to the a-flex which is a better technology than c-flex. c-flex gives exhalation relief. a-flex gives inhalation and exhalation relief. the thing is with straight cpap they have to set it to the maximum episode you may have. but the reality is you may go days and never reach that maximum number. i go along at 8 and go up to 9 or 10 or 11 a few times a night but very seldom go up to the 12 that was constant on the cpap. i hope you understand this and i hope it helps you.
03-20-2012 03:10 PM
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nila Offline

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Post: #27
RE: ONLINE home testing???
(03-20-2012 03:10 PM)greatunclebill Wrote:  i don't know about bipap. i could not breathe against 12 with asthma, asthmatic bronchitis and emphysema even with c-flex. i just couldn't do it. but now with the auto set on 8 - 12 i'm fine thanks in part to the a-flex which is a better technology than c-flex. c-flex gives exhalation relief. a-flex gives inhalation and exhalation relief.

Wait, so your APAP decreases the pressure when you exhale? I thought that was what BiPAP was. Am I confused?
03-20-2012 04:27 PM
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greatunclebill Offline

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Posts: 549
Joined: Feb 2012

Machine: Respironics System one Auto A-Flex
Mask Type: Full face mask
Mask Make & Model:
Humidifier: System one
CPAP Pressure: 8-12
CPAP Software: SleepyHead EncoreViewer

Other Comments: quattro fx full face

Sex: Male
Location: L.A. (Lower Alabama)

Post: #28
RE: ONLINE home testing???
(03-20-2012 04:27 PM)nila Wrote:  
(03-20-2012 03:10 PM)greatunclebill Wrote:  i don't know about bipap. i could not breathe against 12 with asthma, asthmatic bronchitis and emphysema even with c-flex. i just couldn't do it. but now with the auto set on 8 - 12 i'm fine thanks in part to the a-flex which is a better technology than c-flex. c-flex gives exhalation relief. a-flex gives inhalation and exhalation relief.

Wait, so your APAP decreases the pressure when you exhale? I thought that was what BiPAP was. Am I confused?
i'm speaking about apap with a-flex, not plain old apap if there is such a thing.

like i said i do not understand bi-pap at all. my rp automatic with a-flex is set to 8 - 12. the a-flex has settings of 1, 2 or 3. i ass-u-me that 1, 2 and 3 are the amount it lowers. so say i am at 10, with a-flex on exhale the pressure will drop to 7, 8 or 9 depending if i set it 1, 2 or 3. its not much but it makes a difference. on inhale it also drops but i dont know how much.

somebody, please explain how bi-pap works or how it drops or whatever it does. i'm clueless.
(This post was last modified: 03-20-2012 04:54 PM by greatunclebill.)
03-20-2012 04:53 PM
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Netskier Offline

Members

Posts: 125
Joined: Mar 2012

Machine: Resmed S9 Autoset, Mirage Quattro Full-Face Mask, Slimline tube.
Mask Type: Full face mask
Mask Make & Model:
Humidifier: H5i, but not being used.
CPAP Pressure: 6-13 cm H20; Ramp OFF.
CPAP Software: SleepyHead

Other Comments: Currently studying Reversal of Aging.

Sex: Male
Location: Los Angeles South Bay, about 20 min South of Downtown LA.

Post: #29
RE: ONLINE home testing???
(03-20-2012 04:27 PM)nila Wrote:  
(03-20-2012 03:10 PM)greatunclebill Wrote:  i don't know about bipap. i could not breathe against 12 with asthma, asthmatic bronchitis and emphysema even with c-flex. i just couldn't do it. but now with the auto set on 8 - 12 i'm fine thanks in part to the a-flex which is a better technology than c-flex. c-flex gives exhalation relief. a-flex gives inhalation and exhalation relief.

Wait, so your APAP decreases the pressure when you exhale? I thought that was what BiPAP was. Am I confused?

The marketing info is confusing. The best APAP machines give you a little bit of BIPAP, and the real BIPAP machines give you a lot of BIPAP.

Bipap gives you two pressures: one for inhalation, the other for exhalation, which can be set quite a bit lower than for inhalation.

The best APAP machines just give you a little of this. For example, my Resmed S9 Autoset can be set to give 0, 1, 2, or 3 cm/H2O less pressure on exhalation than on inhalation. I set mine on three, and I like that. I would use more if I could. The machine reacts pretty quickly. I have stopped inhaling in the middle of a breath, and then exhaled to see what would happen, and the pressure dropped almost instantly. Nice.

The best Phillips Respironics APAP machines do something similar, as GreatUncleBill wrote.

My age is none of my mind's business. --- Netskier
03-20-2012 05:07 PM
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SuperSleeper Offline

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Post: #30
RE: ONLINE home testing???
(03-20-2012 04:27 PM)nila Wrote:  Wait, so your APAP decreases the pressure when you exhale? I thought that was what BiPAP was. Am I confused?

The short answer is "yes" - many newer CPAPs and APAPs can produce lower levels of pressure when you breathe out, using a technology called exhalation pressure relief, which is a CPAP feature that lowers the pressure on a CPAP machine when the patient exhales in an effort to make breathing more comfortable. CPAP machines provide continuous positive airway pressure, making it easier for the patient to inhale, but harder to exhale, so this is a comfort feature, basically.

Exhalation pressure relief generally offers three possible settings: 1, 2 or 3, with each number signifying the number of cmH2O of pressure reduction. (A setting of 1 provides the least pressure relief; a setting of 3 provides the greatest relief).

There are several brand-specific terms for exhalation pressure relief. ResMed uses the term EPR. Philips-Respironics uses the term A-Flex for its APAP machines, Bi-Flex for its BiPAP machines, and C-Flex for its CPAP machines.

Now, bilevel positive airway pressure (BPAP) also called Variable positive airway pressure (VPAP) is a CPAP mode. It delivers a preset inspiratory positive airway pressure (IPAP) and expiratory positive airway pressure (EPAP). BPAP can be described as a CPAP system with a cycled change of the applied CPAP level.

Often BPAP is incorrectly referred to as "BiPAP". BiPAP is the name of a portable ventilator manufactured by the Philips-Respironics Corporation; it is just one of many ventilators that can deliver BPAP.

There are three modes of BPAP:

S (Spontaneous) – In spontaneous mode the device triggers IPAP when flow sensors detect spontaneous inspiratory effort and then cycles back to EPAP.
T (Timed) – In timed mode the IPAP/EPAP cycling is purely machine-triggered, at a set rate, typically expressed in breaths per minute (BPM).
S/T (Spontaneous/Timed) – Like spontaneous mode, the device triggers to IPAP on patient inspiratory effort. But in spontaneous/timed mode a "backup" rate is also set to ensure that patients still receive a minimum number of breaths per minute if they fail to breathe spontaneously.

So, one could say that a CPAP with A-Flex, C-Flex or EPR is actually like a mini-form of BPAP (but the maximum it can reduce exhalation pressure is 3.0 cmH20 of pressure.

BPAPs can be adjusted with a great degree of pressure differential between the exhalation and inhalation pressures - limited only by the machines upper and lower pressure limits - and what setting the patient chooses to use.

BPAPs are generally used when a patient must be on very high pressures to eliminate apnea events... they can go up to 25 cmH20 of pressure and sometimes higher. Standard CPAPs are generally limited to a max of 20. So, as an example... if on BPAP, a patient could set the high end inhalation pressure at 25, and the exhalation pressure at 14, if they so choose. Or set the inhalation at 18 and the exhalation at 10. (a difference of 8 cmH2O, which is not possible with standard CPAP).

SuperSleeper
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www.ApneaBoard.com


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.

03-20-2012 05:20 PM
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