I just received my first quarterly CPAP parts resupply shipment from Apria and honestly I'm a bit confused. I've only been using the machine for a little over 3 months and this is what they shipped me (after a $60 copay):
(1) New P10 frame with no headband
(1) New ClimateLineAir hose
(5) New P10 Nasal cushions
(6) New air filters
Let's start off with the filters. How often should I be changing them? I've used the same one since I got the machine and when I took it out it didn't look particularly dirty. I know they should be changed, but I'm confused as to why they sent me 6 for a quarterly shipment.
For the cushion, I get that after a while it might start to loosen up but they sent me 5 of them! That seems excessive, no?
Then there's the frame, which doesn't seem to be anywhere in need of replacement. How often should that realistically be replaced?
Finally, the ClimateLineAir tube. Mine still seems nearly-new in condition, and while I'll keep this one as a spare it seems particularly wasteful to throw it away after a mere 3 months!
I'm thinking of cancelling the resupply orders or "maintenance package" or whatever Apria wants to call it. I want to make sure I swap out key parts when their life span is over so I get optimal therapy, but this just seems wasteful and unnecessary. Can anybody give me some advice on what is the smart thing to do here?
According to the insurance schedule, you are expected to replace your pillows every 2 weeks, to me, that is "overkill," when I could make a set of pillows last for several months. I had a heated hose for 2 years or better before I threw it out and when I did, it showed no sign of wear.
They sent you that many filters because I think they expect you to change them every 2 weeks, again, to me it is overkill since I have an air cleaner which cuts down on the dust a lot and I don't have any pets so I don't have that to worry about.
I'm not suggesting that any body follows my schedule, I just think that some of this is overkill to downright wasteful.
Most of this depends on you and your environment.
They tend to go with near the worst case because they don't want someone, anyone, follow their guidelines and have a problem.
I find that with the filters if I take it out every couple of weeks and flick it good with my finger that they clean up pretty well, and yet I can see a little "puff" come off the filter.
If you wash your hose and mask regularly then they last, if not you want to change them out to keep "stuff" from building up inside.
As for the frame, I tend to get up multiple times a night and take the mask off. I have noticed that the clip no longer stays on as well.
I am collecting my backup/replacement stash. Not exactly sure when I will stop. I have no idea what the future will bring and I have gone without insurance before, I do not want to have to pay for supplies out of pocket, so therefore the stash.
If I thought for even a second that the insurance company's would even feel sorry for me if I lost my insurance and could not afford them, then I might not build up a stash. Am I going to have 100 masks, no, but right now I have 3.
It would seem that everyone in the CPAP industry is incentivised to overservice. From a framwork perspective it seems to be driven by what Medicare will agree to cover. If Apria or whatever DME can oversupply within those guidelines then the greater is their revenue - pretty simple.
P10 frame: change every year or two (I guess)
Climateline hose: not for many years
P10 cushions/pillows: I rotate 2 pillows on alternative nights (and wash) for 6-9mths before I change them. So 3 to 4.5mths a pillow
Air filter: once every 6mths (Sydney air and home enviro is not so dusty)
In my case I have to pay full ride for everything so other than having paid for many masks I now don't use I am pretty frugal. That said if I notice a degradation in performance I change items.
Some people swear they get greater leaks when their pillows are over 2 wks old. I have never seen that myself. The 2wk timeframe was set by Medicare from, what I suspect was strong lobbying from the CPAP companies (Resmed, Respironics) as Medicare cut their profit margin on their machines compared to other markets (USA vs rest of world). It's really whatever you feel comfortable with in regards to changeover times.
I would tend to look at it from a different perspective. I think the majority of users of anything tend to not follow instructions, taking care of anything, cleaning anything and if they are not given replacements they will either use it until it makes them sick or just stop using it.
CPAP has a 60% failure rate (not used) and this is about typical for most things. Remember an IQ of 100 is the middle of the population so 50% of the world population is below 100. Nice people, but perhaps they might not always understand or follow instructions.
The people that inhabit forums like this are not the norm.
So much about supplies depends on your environment and how rough/gentle you are on equipment. Much of the throw-away claim due to 'bacteria' is nonsense for MOST. You are washing this stuff regularly and you do not exist in a sterile environment. Once you have spares, put a hold on your resupply until you actually need stuff. Except for air filters, nothing needs replacing unless you see you are having a problem.
I noticed that less air is coming out of my P10 after 7 months of almost continual use. I'm going to try some other cleaning methods (water pik for teeth has been recommended). If that doesn't work, I could see this as an annual replacement item.
Climateline hose - I currently have 2 heated and 2 non-heated (the non-heated bought on ebay when I briefly had a used machine). Some people get cracks in theirs because the hose rubs against stuff, kids break it, you roll on it, dog chews it etc.. Otherwise, I see no reason to replace it. I had to replace my brother's hose every other year because the ends would crack. No icky stuff inside the hose ever, BUT that may differ in your environment.
Nasal cushions. Mine last about a month or so; then I boil for 5 minutes, let dry and they work another month before one side or the other starts collapsing or leaking. Basically, replace when you start getting leaking problems and boiling no longer resolves that. Good to have extras. My cat ran off with one drying on the counter and you can't prevent leaks with cat chews in plastic.
Air filters - in winter, I find that the filters stay cleaner, but still get cat fur in them. Filters are cheap - replace once a month - more often if they are pretty gray. Insurance/Medicare allow 2 per month - have to change my brother's twice a month in summer because windows/doors are open.
Humidifier - I have one backup. Seals can go bad, you can drop your humidifier, etc. Otherwise no reason to replace IMHO unless you use tap water and have mineralization issues. A coating of mineralization will affect heating which in turn affects humidity. For some people, cheaper to replace the humidifier every year than to get bottled water.
Change filters often and change that hose. I am a big advocate of getting rid of the hose. Why? Because we really cannot clean it well enough. I get a new one, clean the old one, and hang it up. When I get the next one, the old one, and get rid of the oldest one. That way I always have a decent back up. Regular hose (non-Slimline, non-Climateline) is not too expensive. I have one unopened I keep for emergencies. It gets tossed into my suitcase when I travel.
I tend to keep headgear until it is falling apart. Even if they send me a new one, i keep using the old one. Then when I do decide to switch (some times it will stretch faster than other times), I will keep it for backup scavenge it for parts.
Filters should be changed often. I live in an old house with high ceilings, wood floors, 3 dogs, 2 cats, and in a rural area. My filter looks like I run my CPAP off diesel after 30 days. Luckily filters are cheap so I change mine as often as I think of it. Which isn't often enough.
Nasal pillows' lifespan differ. Since there's so little room for movement and adjustability due to size, when they start going bad, they leak like crazy. Even my Nuance will. I know when it is time to change because I can hear myself breathe. Drives me nuts.
Speaking of scavenging, I keep all parts that I can. My DME mails my stuff to me in a rather sturdy box. I have one of them on the shelf next to my CPAP and in there I keep the spares, parts, etc. I clean used parts really, really well; examine under good lighting; and pack in a ziploc bag when absolutely dry. I keep swivels and adapters and frames and pillow sizes I don't use and all that stuff. If my current pillows break, I can go up or down a size until I get a new set.
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My philosophy - keep a backup of everything, except pillows and filters which I keep at least 2 backups. Don't throw things away until their performance has attenuated. For example, there are only two reasons to throw away a heated hose: 1) it has a hole in it, 2) it doesn't heat anymore. P10 pillows last the least amount of time. Once they get too soft and start pushing their way up into your nose too much, throw away and put in a new one. P10 Mask frames - use them until the hose is super stretched out or the exhalation ports don't work properly, which I find happens after about 6 months. Filters - meh, flick them a couple of times to release built up dust. I do think the headgear replacement interval is pretty reliable - after 6 months they are pretty stretched out and move around my head too much.
My insurance has a $500 individual annual deductible and since most years I almost never hit $500. So I just usually buy my own supplies online. So I try to get as much use as possible outta stuff as possible. I changed sleep doctors in November and next thing I know I get a call from a new DME saying they had a script for a new APAP and wanted me to come in to get it and fitted for a mask and other supplies. That was in December so I told them I would wait until after the first of the year so getting the new machine would cover my deductible for the year. So now I am stockpiling supplies and only paying the 20% deductible. The way I see it and others have eluded to is inspect your stuff and replace when needed not by some arbitrary criteria.
(02-21-2016, 12:28 AM)PaulaO2 Wrote: Change filters often and change that hose. I am a big advocate of getting rid of the hose. Why? Because we really cannot clean it well enough.
May I ask you why we can´t clean a hose well enough?
I have been on one hose for 8 years.
Still was like new.