Newly diagnosed and confused (Canada)

[JO'M]

Hello everyone,

I'm newly diagnosed (end of June), I've had 2 sleep studies, the 1st to confirm sleep apnea and the 2nd (a week ago) to get the level of pressure needed (12). Which was a night of torture and I've been to a DME/RT and have some equipment on a months trial. After a month, I'm to go back to the sleep Dr, he will review the data and write the official prescription.

I have this equipment:

PR REMSTAR PRO C FLEX+ with a heated humidifier
Phillips True Blue Nasal mask - I've used it for 3 nights and so far so good. I am only getting minimal leaks
I also have the ResMed Mirage Quattro full face mask to try out next week.

According to the RT, the incidents have gone from 8.4 down to 4.1 using the cpap, but it feels like the breath is forced and sometime I need to exhale through my mouth to clear all the exhalation.

There was no discussion with the RT about different CPAP machines (I was more than a little foggy at this point), she brought this one out and said that if it looks like I need an APAP, then we would try a different model.

I've been reading all the new user info and links about equipment and I've been browsing cpap.com, the more I read the more I'm confused. It seems like the PR REMSTAR PRO C FLEX+ is an outdated model (?) or a basic model but how do I know what the best manufacturer/model for me is?

It seems like Exhalation relief is important, an alarm? I travel several times a yr to Denver, should I look for one that adjusts for the altitude? The model I have has a SD card but I am hooked up with a modem and the info is sent to the DME.

For Ontario members - How much does the ADP program actually pay? I was told 75% of approved price. But what is the approved price?

help?

[Pugsy]

The PR System One Remstar Pro with CFlex has a model number 450 on the bottom of the machine..it might have DS or Ref in front of it. It is a full data machine and you can used SleepyHead with it...see my signature for links.
It plainly states "Pro" on the machine top. Give it a try and see what you can get.

The PR System One Plus CPAP with CFlex (what you have currently chosen in your profile) has a model number 250 and the only data it offers on the SD card is how many hours you use it.

So please confirm which machine you have first of all.

There is a newer model but barely new that is called the 60 series models. It has a heated hose available that the prior models didn't along with a few other minor things. Those mode numbers would be 460 or 260 respectively.

Your exhale issues could be from the CFlex part of things. Perhaps you need a different setting in the CFlex that would be more comfortable for you. What is your prescribed pressure setting? CFlex is optional and strictly for patient comfort. You should be able to change it to whatever feels best to you or even turn if off.

Determine for sure which model you have and request the provider manual here for that machine
http://www.apneaboard.com/adjust-cpap-p ... tup-manual

For quick instructions on how to get to the clinical setup menu (like to see CFlex or change it if you can't get to it now)
http://www.apneaboard.com/pr-system-one ... structions

I will let the Canadian members explain your payment system. I am not in Canada and don't have a clue.

Welcome to the forum.

[CentralScrutinizer]

Cflex is supposed to provide exhale relief, however I've never really found it all that helpful. AutoPAP is what has helped me more then anything else.

With AutoPAP, the machine has a range of pressures that it will operate at, it operates at the low end of the pressure range unless or until it detects a apnea event, or other signs such as snoring that would indicate you are likely to have a event. It increases pressure when it feels that more pressure is needed... The long and the short of it is, when your first getting to sleep, it will be at a lower pressure, and this will help you get to sleep. Also it will remain low unless you really need more pressure, this will help you avoid getting air inside you, if your prone to that sort of thing...

My first machine did not have AutoPAP, however after going back to the sleep Dr a few times and complaining that I had a hard time getting to sleep, I was given a prescription specifically for AutoPAP, since then I've had very few problems.

[Sloop]

Well I think C-Flex is great. Some people like Chevys, some like Fords.

JO'M, sounds to me like you have C-Flex turned off. You might experiment first with a setting of 2. If you still need pressure relief, go to 3.

[JO'M]

Thanks for your replies Pugsy and CentralScrutinizer

I'll confirm which machine I have this evening. My current pressure is 12. It is set with a ramp feature which is programmed to start at 6 and ramp up to 12 within 10 minutes. I mentioned to the RT when I talked to her after my 2nd night that it felt like I was drowning in air and I had a hard time getting to sleep.

[JO'M]

oops and Sloop too.

I will check and see if the C-flex is turned off. Thanks.

[nanwilson]

bump.....
Just a bump to refresh your thread, so that those in Ontario can answer your questions.
And of course a big WELCOME to the land of hoseheads or hosers (whichever name you prefer)

[JohnO]

Welcome. If the machine, is, in fact a Pro, it has full data capability, so you can track your progress. I believe the model number for that machine is the 460 (New 60 Series). If it is a "Plus," then it doesn't have the data tracking. I find the Philips Respironics naming scheme difficult to decipher. It would be easier if the numbers were more evident.


I have an Auto-CPAP version of the Pro machine. If it is properly configured, the exhalation breathing should not be a problem. There -are- lots of options though.

I have the same mask, and have had good luck with it. I have a size "small" which is perfect for me. If you find yours to be too loose or leaking around your eyes, you might benefit by getting a smaller mask.

John

[Hawthorne]

I am in London Ontario Canada. The ADP will pay 75% fo the cost. I don't know if there is an "approved" price. It is a long time since I bought a machine in Ontario. I buy online now. I did enquire in 2008, when I had my last sleep study, and was told that ADP pays 75%. I have an Extended Health Plan that would have covered the other 25%. Not all Extended Health Plans cover anything cpap. I was told, by the Provider I spoke to at the time, that a Pro (it was an earlier model Pro than the one you have) would be totally covered by the ADP and my Extended Health Plan. I did not buy it because I wanted an Auto. My Sleep Specialist would not prescribe an Auto and, without a prescription for an auto, Ontario vendors cannot sell you one.

The Provider can only give (sell) you what the prescription says in Ontario is my understanding. When the Sleep Specialist reviews your data he/she MAY decide an auto would be good for you and prescribe it. ADP will pay 75% of an auto, if it is prescribed.

I don't know if the exhalation relief (C-Flex) was activated on the machine you have or at what setting. It sounds like it is not set on yours is not set at a good setting for you if you are having trouble exhaling.

Your Provider may have a different make of machine that you could try (Resmed, Devilbiss or Fisher and Paykel) but maybe not. You will not get an auto unless your doctor prescribes it but you can still get a fully data capable machine. The Pro you have is fully data capable.

It sounds like the modem is monitoring helpful data. If you are getting an AHI of 4.1, your Sleep Specialist may be quite happy with that and not prescribe an auto.

It is good to use a Provider and get the ADP help on your first machine in Ontario but be sure you get a copy of your prescription. This will be useful in the future if you should decide to buy a backup machine (a good idea) online later. Cpap.com will sell you an Auto with a prescription for a straight cpap and it doesn't matter how old the prescription is.

Do NOT use the cpap.com prices to try to figure out what a machine might cost in Ontario. It could be almost 3 times as much in Ontario.

I don't know if I have been much help but ask and I might be able to answer other qestions about buying cpap in Ontario.

[tschultz]

There should be a newer version of this document but the one from 2010 should be helpful for those in Ontario. It does show what they allow "cover" for the various company's equipment.
http://www.health.gov.on.ca/en/pro/prog ... manual.pdf

This guide shows only what the ADP allows for pricing, higher prices can be charged when "extra" items are included but they only cover 75% based on their pricing allowances.

There is additional and very specific criteria that must be met to "qualify" for APAP under the ADP program, so CPAP is what most people wind up with.

[rosacer]

Hi JO'M

Read this viewtopic/t81041/viewtopic.php?f=1&t=77 ... 11#p707311 There you will have the answers, I already ask what you want to know about the Ontario program to help buy a CPAP. Yes it is super complicated mean impossible to have the approvals for an APAP at least you have a very special situation.

Rosie

[Panchali]

In May I purchased one in Ontario Canada (The Niagara Region to be specific). ADP covered $780 of the price. (Total price was $1544). Pretty basic unit for that price.

[JO'M]

I double checked. It is a Pro Model 451 that I have. I checked the C-flex setting and set it at 2 and it was much easier to exhale. I didn't feel that I was drowning in air last night. I slept mostly ok last night, I wake up a lot though.

Thanks for all the information on the ADP program, from what the RT said it seems like they automatically submit to ADP to pay a portion of the cost. Then my extended health benefits will pick part of the remaining costs and they will also pay for monitoring and supplies. I'm fortunate that I don't have to depend upon what the program/insurance will cover. I didn't want to get a machine that was old technology and be stuck with it because I didn't know any better. I have to admit I was drawn to pink S-9, it would coordinate with my bedroom

Hawthorne - the thought of having someone local who will monitor my progress at the beginning is very comforting to me.

John - I have the petite size mask - I get a good seal with no leaking. A too big mask was the main reason my 2nd sleep study was torture. The hospital didn't have masks small enough to fit my face. And the tech kept waking me up to switch masks.

It looks like most people have a couple of different types of masks. If the True Blue works for me, is it worth getting a 2nd True Blue Mask? or just the replacement parts, in case something happens?

(I tend to be a bit of an overplanner, just a warning... btw)

Thanks for your input and help.

[JO'M]

@ Nanwilson - who knew there was another meaning for Bob and Doug MacKenzies slang name

[Pugsy]

You should be able to use SleepyHead with your machine. Look in my signature line for links. Be sure to read the User Guide especially the part about navigating to the drive where the SD card sits. Most common mistake is that people go too far.

Give yourself a few nights with the True Blue to make sure you are satisfied with it before worrying about buying a spare. Then yes...if you are happy with it...get an extra complete mask setup at your convenience (shop around for best price). That way you have an extra of everything...then from then on you can buy just a cushion replacement.
The headgear part of it will last a long time and only the cushion will need replacement on any regular basis.
It's always good to have a spare of everything just in case. In my case it is "just in case the dog gets a hold of something and it becomes a chew toy".