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ONLINE home testing?
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SuperSleeper Offline

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Post: #31
RE: ONLINE home testing???
Ah, Nila.... looks like Netskier answered you while I was typing all that. At least you got a couple of perspectives on the subject. Smile

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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 05:31 PM
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greatunclebill Offline

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Post: #32
RE: ONLINE home testing???
wow.... i went from totally clueless to totally overclued. thank you very much for this.

you're correct about bipap/bpap now that i understand it. my old second generation respironics cpap with c-flex says bipap on the bottom of the machine. of course i knew it wasn't what i thought was bipap and had read that bipap was a respironics name. i wondered about that.
03-20-2012 05:38 PM
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nila Offline

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Post: #33
RE: ONLINE home testing???
Thanks you guys!! And especially supersleeper, for that detailed explanation Smile.

So, there is nothing that is both a true BPAP and an APAP?

I think I am going to end up needing an inspiration pressure of around 10 and an expiration pressure as close to 0 as possible. So, I guess that means I will have to forgo the benefits of APAP Sad.

I guess it also means I will have to have one machine for the test and another for my permanent machine. Which makes me lean even more towards renting, rather than buying the test machine.

What terms should I use with the DME folks, in order to get a machine that can be used for a home test? My doc will write the prescription tomorrow, but only if I can tell her the exact machine I need. What are the specifications and/or models I should ask for?

I understand the S9 is the best, but what if they don't have that one?

Thanks again Smile.
03-20-2012 06:09 PM
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SuperSleeper Offline

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Machine: PR System One REMstar Auto (DS560)
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Post: #34
RE: ONLINE home testing???
(03-20-2012 06:09 PM)nila Wrote:  Thanks you guys!! And especially supersleeper, for that detailed explanation Smile.

So, there is nothing that is both a true BPAP and an APAP?

I think I am going to end up needing an inspiration pressure of around 10 and an expiration pressure as close to 0 as possible. So, I guess that means I will have to forgo the benefits of APAP Sad.

I guess it also means I will have to have one machine for the test and another for my permanent machine. Which makes me lean even more towards renting, rather than buying the test machine.

What terms should I use with the DME folks, in order to get a machine that can be used for a home test? My doc will write the prescription tomorrow, but only if I can tell her the exact machine I need. What are the specifications and/or models I should ask for?

I understand the S9 is the best, but what if they don't have that one?

Thanks again Smile.

Nila, no you don't have to forgo an Auto when using BPAP... many newer BPAPs are also auto-BPAPs (that vary the pressure according to your needs, but still maintain a pre-set variance between your exhale and inhalation pressures). For instance, if you set the pressure differences at 8 cmH2o, the machine will always deliver an IPAP and EPAP differential of 8. Say you set the IPAP and EPAP range at 8 (as I just said), and the auto part of the machine determines your pressure needs to be at 12, it would set the exhalation (EPAP) level at 4. Most machines will not go below 4.0 on the pressure, however, so if it determines the needed pressure is 10, your exhale pressure is still going to be 4.0. Let's say the auto-BPAP determines that to punch through some apnea events, your pressure needs to be temporarily at 15... well then, given the above settings, your exhale pressure would be 7.0. (15 - 8)

Now, the auto-BPAPs are very expensive. The PR System One REMstar BiPAP Auto with Bi-Flex and the S9 VPAP Auto BiLevel machines both retail for just under $2,000.

If I could get any machine I wanted, I would probably get one of the above machines - they have the greatest number of options and can basically be operated in any mode(s) that the lesser-cost CPAPs and APAPs can operate in, plus BPAP and auto-BPAP.

But, I settled for an S9 AutoSet, which is about $1,100 cheaper and does a very good job for me since I don't need BPAP.

I will say that if you're planning on insurance paying for an auto-BPAP, getting the prescription for an auto-BPAP is easy compared to getting insurance or Medicare to pay for it. I'm not sure on what the requirements are, but I'm pretty sure that insurance and Medicare has specific standards and considers auto-BPAP only if "medically necessary". You'll have to ask your insurance provider what documentation is needed to make that determination.

If you're paying for it yourself, then you'll have no issues other than getting the script and buying one online or locally. (online is going to be cheaper, generally).

But if you do go that route, you're going to have to do a TON of reading in the Clinician Setup manual of an auto-BPAP, because there are a lot of settings that must be set properly and some of them interact with each other to produce (sometimes) "unintended consequences". So, plan on spending a while reading up on the proper operation of any auto-BPAP machine.

Hope this helps!

Smile

SuperSleeper
Apnea Board Administrator
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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 06:24 PM
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nila Offline

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Post: #35
RE: ONLINE home testing???
Oh, thank you, I am starting to feel like I understand stuff now, and am a bit more prepared for my doc appointment. <my smilies get deleted, but there should be one here>

Going back over the thread, I see this:

Quote: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.

...so I guess that means any APAP from Resmed or Respironics should work for the initial test.

Ok. Whew!

I am so grateful for the handholding. I am used to being on the other end of that <smiley>.
03-20-2012 06:36 PM
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SuperSleeper Offline

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Machine: PR System One REMstar Auto (DS560)
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Post: #36
RE: ONLINE home testing???
(03-20-2012 06:36 PM)nila Wrote:  ...so I guess that means any APAP from Resmed or Respironics should work for the initial test.

Nila, whoever is going to set up the home sleep test for you will undoubtedly have certain requirements... I'm not sure how those home tests work, exactly, so you need to talk to them on whether they can use your existing machine or they provide one themselves for the test.

SuperSleeper
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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 06:45 PM
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SuperSleeper Offline

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Posts: 9,971
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Machine: PR System One REMstar Auto (DS560)
Mask Type: Nasal pillows
Mask Make & Model: ResMed Mirage Swift II
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CPAP Pressure: 12.5 - 18.5 cmH20 (auto range)
CPAP Software: SleepyHead

Other Comments: Have diabetes Type II

Sex: Male
Location: Illinois, USA

Post: #37
RE: ONLINE home testing???
Also, if your titrated pressure is 10 cmH2O, I'm not sure you'll need BPAP... even using a standard CPAP or APAP, if your pressure is 10 and you set the EPR at 3, your exhalation pressure will be 7, which is very, very low.

If you can't breathe out against a pressure of 7.0 something is wrong, in my opinion. Many times it's just a matter of "getting used to" breathing out against slightly higher pressure. The time period for getting used to CPAP pressure is usually a week or less, at those kinds of pressures.

If it's a matter of getting to sleep with the slightly higher exhalation pressures, you can set most CPAPs to "ramp up" from 4.0 to your prescribed pressure over time (usually for up to 30 minutes) so you can fall asleep easier without experiencing the higher pressure in the first few minutes of "sleepy time".

SuperSleeper
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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 06:49 PM
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nila Offline

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Post: #38
RE: ONLINE home testing???
(03-20-2012 06:49 PM)SuperSleeper Wrote:  Nila, whoever is going to set up the home sleep test for you will undoubtedly have certain requirements... I'm not sure how those home tests work, exactly, so you need to talk to them on whether they can use your existing machine or they provide one themselves for the test.

It looks like it will have to be my primary care doc, who knows nothing about apnea. She will write the prescription, but I will have to be the one who tells her which machine to prescribe.


Quote:Also, if your titrated pressure is 10 cmH2O, I'm not sure you'll need BPAP... even using a standard CPAP or APAP, if your pressure is 10 and you set the EPR at 3, your exhalation pressure will be 7, which is very, very low.

If you can't breathe out against a pressure of 7.0 something is wrong

Oh, yes, something is very wrong.

I have a bad injury to my midback/diaphragm area. I can only stand or sit up for about 5 minutes per day. It's been 25 years and it has not healed. One theory is that apnea may play a part in the difficulty healing, along with a congenital problem with connective tissues and childhood exposure to dioxin.

My doctors are still trying to determine exactly what is preventing healing of that and other injuries. Treating my apnea is part of figuring it out and getting me back on my feet.
03-20-2012 07:40 PM
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SuperSleeper Offline

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Machine: PR System One REMstar Auto (DS560)
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CPAP Software: SleepyHead

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Post: #39
RE: ONLINE home testing???
Nila, might want to be careful-- I'm not sure that an insurance company will accept a "home sleep study" by a primary care doc who is not certified to operate home sleep tests, at least when it comes to the higher standards that apply when trying to get insurance to pay for an auto-BPAP machine.

If it's simple CPAP, all you should need is the script from the doc, but on high-end CPAPs like BPAP, pretty sure you need more documentation, which would include a full sleep study to determine the medical necessity.

You might want to check first to see if your insurance provider will accept that type of study done by your doc, if you plan on going the auto-BPAP route.

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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 07:49 PM
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Netskier Offline

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Post: #40
RE: ONLINE home testing???
(03-20-2012 05:31 PM)SuperSleeper Wrote:  Ah, Nila.... looks like Netskier answered you while I was typing all that. At least you got a couple of perspectives on the subject. Smile

I am glad you did; I learned from your post.

I do think that BPAP is poor acronym, that is not particularly easy to guess its meaning, or figure it out while encountering it for the first time. I think I will try to use BiPAP or even better Bi-PAP which really suggests Bi-Level PAP.

My age is none of my mind's business. --- Netskier
03-20-2012 08:26 PM
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