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Doctor will only prescribe cpap

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jkeith +0 points · 4 months ago Original Poster

I brought up prescribing APAP over CPAP with my doctor. He was rather adamant against it. He likes to review the data himself and adjust if needed. But, he wouldn’t budge on APAP. I’ve had a cpap machine in the past, worked fine (until I knocked it over with water in it). Just trying to do the best possible thing for myself.

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Sierra +0 points · 4 months ago Sleep Innovater

I think using a good APAP like the ResMed AirSense 10 AutoSet is the best way to go. It is actually less than $100 more expensive than the CPAP Elite. If you can find a good deal on line you may be able to get it for virtually the same price. I also like to use SleepyHead and monitor my own results. That said, in some situations a fixed CPAP pressure can give good or better results than an auto machine. I have now changed my AirSense AutoSet into fixed CPAP pressure mode. But, it would have been difficult to get there without the auto mode and SleepyHead.

The problem with a fixed CPAP machine is that if you cannot put it in auto mode it is difficult and very time consuming to find the right pressure. Sleep labs love to do titration tests to determine the "right pressure", because they make good money doing that. An auto machine does a titration test every night for free, providing you look at the results with SleepyHead.

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jkeith +0 points · 4 months ago Original Poster

I agree, but DME fills exactly as prescribed, he will only write it for cpap not APAP

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bonjour +0 points · 4 months ago Sleep Commentator

It depends on how the prescription is written. If it is by insurance code they are the same. ResMed AirSense 10 AutoSet (best choice) (E0601) (Fixed CPAP, Auto CPAP) ResMed AirSense 10 AutoSet for Her (best choice) (E0601) (Fixed CPAP, Auto CPAP) ResMed AirSense™ 10 Elite CPAP Machine with HumidAir™ Heated Humidifier (37205) (E0601) (Fixed CPAP)

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Biguglygremlin +0 points · 4 months ago Sleep Commentator

Hi jkeith

Are you entitled to a second opinion?

If so request a copy of relevant records and go consult someone else.

If the same situation recurs there might be a valid reason.

If it's an issue of economics offer to pay the difference.

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jkeith +0 points · 4 months ago Original Poster

I can, but it takes a long time to get any sleep appointments around here. I’d almost just prefer to get started as soon as possible.

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Biguglygremlin +0 points · 4 months ago Sleep Commentator

Yes it takes months here too.

When you referred to your doctor I mistakenly thought that maybe a GP could prescribe a machine in which case it would be a simple matter to visit a different one.

I guess the parameters for who can prescribe are set by whoever controls the money for the machine.

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jkeith +0 points · 4 months ago Original Poster

I do wish it were that easy. Guess I’ll just roll with the cpap machine and keep an eye on the data. Decided I’ll go with the Resmed air sense 10 elite. Took me awhile to decide vs the Phillips Respironics

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Sierra +0 points · 4 months ago Sleep Innovater

Yes, I believe the AirSense Elite records detailed data that can be read into SleepyHead. The AirSense CPAP model is more basic and does not.

I think the DME system is misguided in the way they dispense machines. Their first choice is a CPAP, and if that fails then a APAP. It would be more cost effective to just go with an APAP from day one and skip the titration tests.

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jkeith +0 points · 4 months ago Original Poster

The only kicker I saw was you could get the Dreamstation pro that allows you to have APAP more or less for one month at a time to obtain a better number.

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Sierra +0 points · 4 months ago Sleep Innovater

It isn't a sure thing that one will get better numbers with an APAP. They tend to get issued with a fairly wide range between minimum and maximum pressure, with the minimum pressure typically too low. That means each night you have to have some apnea events first to get the pressure up to where it needs to be. And if you are prone to central apneas a higher pressure can make things worse. For those reasons those with an APAP tend to gravitate to a narrow range between the minimum and maximum pressure, if the objective is the best possible results. But, having it in auto mode and then using SleepyHead you can determine what that pressure range is, and when it gets narrow, just switch to a fixed pressure and potentially get even better results. This is the refinement process that essentially eliminates the need for an overnight titration study to determine a pressure.

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jkeith +0 points · 4 months ago Original Poster

Interesting find. I found my old ResMed S9 AutoSet (didn’t even know it was an auto haven’t used it in years). Now I have the airsense 10 elite

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Sierra +0 points · 4 months ago Sleep Innovater

My wife still uses her S9 AutoSet and it works very well for her. If you use the S9 in Auto and SleepyHead to monitor the results you can check to see if the Elite is setup at the right pressure. About the only advantage I can think of for the AirSense 10 over the S9 is that the AirSense 10 has an Auto Ramp feature that I like.

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