[Cloud Nine]

Hello all,
I have been using a CPAP machine for one year in October, struggling and not enjoying the tubes and equipment. I believe I am supposed to be checked by a physician at least once a year as required by either the insurance company or by Medicare.
I received extremely poor education on its use…. About 20 to 30 minutes tops.
What I am requesting is advice on a new medical practice who will help me and reeducate in Cpap use.
Currently, I am with Ocala Lung and they keep scheduling me and then canceling appointments. This has happened twice this month.
Any suggestions for a new medical practice?
Thank you

[BrianL99]

Originally Posted by Cloud Nine

Hello all,
I have been using a CPAP machine for one year in October, struggling and not enjoying the tubes and equipment. I believe I am supposed to be checked by a physician at least once a year as required by either the insurance company or by Medicare.
I received extremely poor education on its use…. About 20 to 30 minutes tops.
What I am requesting is advice on a new medical practice who will help me and reeducate in Cpap use.
Currently, I am with Ocala Lung and they keep scheduling me and then canceling appointments. This has happened twice this month.
Any suggestions for a new medical practice?
Thank you

Turn it on, put your mask on, go to sleep. Nothing complicated.

I believe the requirement for "durable medical equipment" as it applies to CPAP, as your provided gives you the machine and monitors the first 90 days, in which you have to use it, something like 70% of the time. I may be different with Medicare, as I've never been monitored.

The company what provided your CPAP should have all the information you need. I've never heard of any requirement for "on going care" or monitoring. If you have Sleep Apnea, you got it ... it's not going away.

There are a zillion Internet Forums for CPAP users & folks with Sleep Apnea. Tons of good information.

Here are a couple, but there are plenty more.



CPAP and Sleep Apnea Message Board | CPAPtalk.com

Apnea Board - Sleep Apnea discussion forums, CPAP Manuals and advice

[Keefelane66]

Here s your refresher course.

The process is straightforward and follows a series of steps.
Find a Good Space to Put the CPAP Machine. ...
Check the Filter. ...
Attach the Hose to the CPAP Machine. ...
Attach the Hose to the Mask. ...
Set Up the Humidifier (When Applicable) ...
Plug in the CPAP. ...
Put On and Adjust the Mask. ...
Turn On the Device.

It's not rocket science.

[Babubhat]

Phillips and Resmed have instructional videos on YouTube. One month should be sufficient to find if setup works for you. Try changing your type of mask if uncomfortable. A nasal mask is least restrictive but each person is different

Philips Respironics - YouTube

https://www.youtube.com/results?sear...d+cpap+machine

https://www.youtube.com/results?sear...+cpap+machine+

I have no experience with this but it’s close by

Welcome To Our Practice | Village Sleep Lab | The Villages, FL

[GpaVader]

I have been a CPAP user for almost 10 years. I did follow up with my pulmonologist about 6 months after I got on my machine, but after that it was an every other year appointment so I could get my prescription refills for supplies. I got my primary to take things over.

Use is pretty much as described above but two things to keep in mind:
1) surpirised no one said to keep the gear clean, I clean mine weekly but also use a So Clean to clean the mask and hose nightly. I don't run it through my machine because it is not rated for that. But I clean the resivour hose and mask weekly in mild detergent as was recommended by physician and the durable medical device provider.
2) you do have a few settings you may want/need to tinker with depending on the time of year and your sleeping habits. The main one I watch is the humidity levels. This is important, especially during the summer, so you don't end up with a bunch of water in your hose. Ask me how I know... the settings are usually something you work with your doctor if you are not sleeping well with it.

If you are struggling with the device sometimes its not the device but the type of mask you are using. This relates back to how you sleep. I sometimes sleep with my mouth open so I opted for a full face mask as opposed to just over the nose. I've tried both and find I get better results with the full face. I do have times where I wake up closterphobic and I have to take it off but that only happens on rare occasions. Good luck with the CPAP, it's made a world of difference for me but it does take some getting used to.

[asianthree]

Are you speaking of the pressure, that are being delivered, or just general use. Todays cpap can be monitored, pressure changed without a personal visit.

[Cloud Nine]

Thank you everyone for all your valuable information. I’m not having issues using it or understanding how to use it. My continuous issues are feeling comfortable with it and finding a medical practice/ doctor that is easier to deal with …… I will refer to some of the websites suggested.

[Babubhat]

I have had a cpap for over 15 years and Never had a follow up appointment. Hope you find a comfortable solution. They now make an implant with no hose or mask

Inspire(R) Device for Sleep Apnea

[CoachKandSportsguy]

Originally Posted by Babubhat

I have had a cpap for over 15 years and Never had a follow up appointment. Hope you find a comfortable solution. They now make an implant with no hose or mask

Inspire(R) Device for Sleep Apnea

From people who have had the implant, they are reporting very good results in the hospital circles. Not sure who qualifies for them, but if you are not comfortable with the machine, the implant might make sense

[asianthree]

Originally Posted by CoachKandSportsguy

From people who have had the implant, they are reporting very good results in the hospital circles. Not sure who qualifies for them, but if you are not comfortable with the machine, the implant might make sense

When the implant questions came up spouse had a long discussion with 2 colleagues that are pulmonologist, our granddaughter who does sleep studies, and 2 residents who does procedure and a nurse at sleep clinic.

Qualified as a candidate, did extensive research on negative issues, on why there could be failures. So 6 extensive conversations, each with the same in-depth information. Possible implications of implant issues, and some positive real time results, such as no more equipment, hoses masks.

Negative was some have issue with the device because it is located from the back of the throat. Gag reflexes are a problem. The constant buzz they sometimes can wake you. Some patients still end up back on Cpap with the implant, to alleviate some issues.

The fail rate was higher than I expected, plus…

If you have had mastectomy, scar tissues may not allow proper placement of implant.
Spouse was offered the implant and procedure at no cost, and turned it down. With history of gag issues, a mastectomy and the sleep clinic pass fail rate and possible return to Cpap need, it was a hard NO.

[Haggar]

Originally Posted by Cloud Nine

Thank you everyone for all your valuable information. I’m not having issues using it or understanding how to use it. My continuous issues are feeling comfortable with it and finding a medical practice/ doctor that is easier to deal with …… I will refer to some of the websites suggested.

There's all sort of different equipment - full mask or not a full mask.

I've got one the tube is the top of my head rather than in front of my nose. Much more comfortable. There are those with humidifiers and other with heated humidifiers.

I worked with my ENT to find one that is comfortable. I find I sleep more through the night with it on but it makes more noise if it is not a tight fit on my nose. And then my wife wakes me up to tell me to adjust it.

[Caymus]

Originally Posted by GpaVader

I have been a CPAP user for almost 10 years. I did follow up with my pulmonologist about 6 months after I got on my machine, but after that it was an every other year appointment so I could get my prescription refills for supplies. I got my primary to take things over.

Use is pretty much as described above but two things to keep in mind:
1) surpirised no one said to keep the gear clean, I clean mine weekly but also use a So Clean to clean the mask and hose nightly. I don't run it through my machine because it is not rated for that. But I clean the resivour hose and mask weekly in mild detergent as was recommended by physician and the durable medical device provider.
2) you do have a few settings you may want/need to tinker with depending on the time of year and your sleeping habits. The main one I watch is the humidity levels. This is important, especially during the summer, so you don't end up with a bunch of water in your hose. Ask me how I know... the settings are usually something you work with your doctor if you are not sleeping well with it.

If you are struggling with the device sometimes its not the device but the type of mask you are using. This relates back to how you sleep. I sometimes sleep with my mouth open so I opted for a full face mask as opposed to just over the nose. I've tried both and find I get better results with the full face. I do have times where I wake up closterphobic and I have to take it off but that only happens on rare occasions. Good luck with the CPAP, it's made a world of difference for me but it does take some getting used to.

Do you know what the Medicare charges for the machine and supplies would be? My current ResMed was obtained while I was on private health insurance. I found that out of pocket replacement parts from Amazon were more convenient and less expensive than from the original provider. I notice that I can buy a new CPAP machine online (including a "prescription") for less than I paid originally in insurance deductibles. I would also not need to prove that I met the reimbursement usage levels.

[villagetinker]

Originally Posted by Cloud Nine

Thank you everyone for all your valuable information. I’m not having issues using it or understanding how to use it. My continuous issues are feeling comfortable with it and finding a medical practice/ doctor that is easier to deal with …… I will refer to some of the websites suggested.

My wife uses one of these, and she has had to go through several different masks until she found ones that work. She uses MyDMEDOC in Spanish Springs and they have been very helpful in getting the correct mask. I understand they were just merged with another company, so no idea if this will still work for you. However, if you are using another supplier, you should be able to have them work with you to get a mask that works well.

[Garywt]

No idea where you should go but my wife uses one. She went through 4-5 different attachments until she found one she was comfortable. The company just kept sending her stuff for free. Masks did not work and various nose things didn’t work. Currently she has a hose that comes from above her head and down to her nose and it works great for her. I hope you can get it all straighten out so you can sleep well.

[BrianL99]

Originally Posted by Caymus

Do you know what the Medicare charges for the machine and supplies would be? My current ResMed was obtained while I was on private health insurance. I found that out of pocket replacement parts from Amazon were more convenient and less expensive than from the original provider. I notice that I can buy a new CPAP machine online (including a "prescription") for less than I paid originally in insurance deductibles. I would also not need to prove that I met the reimbursement usage levels.

I did the same thing for 10-12 years. Once I decided to let Medicare pay for everything, I had to go through the process. You'll have check with your Insurer to ascertain the deductible for durable medical equipment. I think I paid around $200, but that's a guess.

You'll need a new sleep study and a new prescription. I understand you can do the sleep study at home.

You can select your own provider, usually for the sleep study and for the equipment. Contact your PCP and he can simply send the order to whoever you specify for the sleep study and have who ever performs the sleep study, send the resultant prescription to the equipment provider you want to use. You can also choose what CPAP machine you want and your provider will get it for you.

Next think you know, you'll have a brand new CPAP and be bombarded with free supplies. Medicare authorizes a ridiculous amount of supplies & parts replacements.

The whole secret in my opinion, is getting the right "mask". Your equipment provider is REQUIRED by Medicare, to send a person out to you, to "train" you on CPAP use and help with mask selection. You'll normally get 30 days to test drive a mask and if you don't like it, you can get another one.

I don't use heat or the humidifier, they're a PITA and unnecessary in my opinion. if you don't use water, you won't have to deal with all the cleaning BS. I clean mine, *maybe* once ever month or two and don't have any issues.

I have severe Apnea, with 100's of events/night. With CPAP, no humidifier, nor moisturizing, I average less than 1 event/hour. The goal is to be under 5.