Why do you need a sleep doctor?

[itsjustme8]

If you have obstructive sleep apnea and an auto CPAP with an SD card/ability to read performance, why is a sleep doctor needed?

Do experienced folks even deal with a doctor? Pardon this, but it seems like a big racket. An at home study was $600 and inconclusive. An overnight study a week from tonight is $1500 and a machine could run me $1000.

Im looking to go back on CPAP again (I was diagnosed 6 years ago) but am on a very high deductible insurance policy.

[LSAT]

Once you have a sleep study and are diagnosed, you get a CPAP and a prescribed pressure. After that, if you have an auto machine, you can monitor your own therapy...many of us do it. After 6 years, your health and diagnosis may have changed. Why did you quit?? What happened to your 6 year old CPAP?

[itsjustme8]

Good questions. I gave my machine to a brother in law who was really suffering and had no insurance or job.

I was borderline apnea (low AHI). Now, I've been unemployed for awhile. My home study was inconclusive so now another overnight study.

[Julie]

Only when they eventually prove to be, not otherwise necessarily. And they don't diagnose other related issues that only in-lab studies can.

And if you don't have a doctor, who will prescribe machines for you? It's one thing to say that theoretically your dentist or some other med professional can, but I don't know any doctors (or dentists) who prescribe at a patient's request without doing their own exams and tests... and what dentist is equipped to do a sleep study?

But once you have a machine and Sleepyhead you can monitor your own progress, so may not need further testing at all otherwise.

[Julie]

Well, if you don't mind being treated by quacks, that's your problem. I expect more from my doctors.

[loggerhead12]

Pardon this, but it seems like a big racket. . . . An overnight study a week from tonight is $1500 . . .

It's a massive racket. I already met my deductible so it was 100% covered, but the sleep lab at a major local hospital billed my insurer $9,400 for my 1 night split sleep study. Insurance discounted it by almost half but they still paid $4,800 for what was basically a hotel room with a tech and some equipment. The DME billed $6,700 (which insurance knocked down to $2,500) for a Vauto machine, a Simplus mask, and a 20-minute session, and would happily sell me a new mask every month if I signed up for the auto-supply. That's the Amway/Quixtar model.

There's big money in sleep apnea.

[kteague]

If you are going through insurance for testing and equipment or using traditional provider sources, a doctor is needed to provide required prescription and documentation. If one is without insurance or with high deductible and plan to self pay through non traditional sources (Craigslist, etc) one can do it without a doctor. While there are advantages to lab studies and a doctor's oversight, particularly in complicated cases, basic OSA can be managed without that oversight. A user who is not equipped to monitor their own treatment either due to technology reasons, overload with too many medical issues, or just plain don't want to be bothered might prefer to just let a doctor handle it. Nothing wrong with that. Had a friend who was fighting metastatic breast cancer, damage from a thyroid surgery gone wrong, and kidney failure with dialysis. She simply didn't have the heart to add anything else. There's no shame in going through traditional channels. Nor in managing it oneself. Whatever works.

[chunkyfrog]

My apnea/treatment is relatively simple.,
but I need doctors to fill out paperwork so Medicare and my supplement
cannot weasel out of paying for what I need and have paid PREMIUMS for.

[#1Guest]

If you have obstructive sleep apnea and an auto CPAP with an SD card/ability to read performance, why is a sleep doctor needed?

Do experienced folks even deal with a doctor? Pardon this, but it seems like a big racket. An at home study was $600 and inconclusive. An overnight study a week from tonight is $1500 and a machine could run me $1000.

Im looking to go back on CPAP again (I was diagnosed 6 years ago) but am on a very high deductible insurance policy.

Yes it can be a racket as explained. Follow kteague's lead. Drs are esp required when using insurance but can be done if you are willing to spend the time needed to read and learn here.

The foggy brain makes it more difficult. Of course if you had paid attention 6yrs ago you would be ahead of it curve today.

[chunkyfrog]

My apnea/treatment is relatively simple.,
but I need doctors to fill out paperwork so Medicare and my supplement
cannot weasel out of paying for what I need and have paid PREMIUMS for.

====

but cant the family doctor do all that
do you need a higher priced specialist to do paperwork

My regular doc refused to, but when I look at the Medicare statements,
they both get lowballed good and hard.
So I don't really mind.
Using up appointment time for 20 cents on the dollar--it works OK.

[SewTired]

If you want insurance to pay, then yes, you need a sleep doctor (most of the time) to start. If you are paying it all, then you can (a) have your primary write a script for the machine and buy from an online retailer or (b) buy a machine that works with Sleepyhead off Craigslist. Supplies can be had from Ebay and sometimes Craigslist.

My primary knew nothing about apnea and mine turned out not to be simple. However, I no longer go since I don't see the doctor, so have my primary write my scripts.

For do-it-yourselfing, I think you are best off with an auto-machine and O2 monitor that works with Sleepyhead. People here can help you maximize your therapy. Save your study for another year when you use up the deductible for something else.

[kell420]

My doctor said he would not even bother with the sleep study he said one look into someone's throat he can tell you if you have sleep apnea because he has to get insurance to pay they won't pay unless you get a sleep study. My insurance has a $1500 deductible which I met and my cpap was about $1500 at least their cost. One thing I never knew was how low my O2 was (68-72%) I stopped breathing 60 times an hour about every minute, and he said how dangerous it would be for me to sleep while at higher altitude like one time when I was at my inlaws place which is about 7000 Feet I woke up my heart racing because I must have had a very low O2. I can't sleep on a airplane either he told me that is how many have heart attacks on airplanes they are pressurized to around 8k feet.

[SleepyBobR]

Gotta say, it's a very good question. Best answer I can think of is that you need a sleep doctor to get a sleep study and a prescription for a machine. Other than that they don't do much and don't even seem to know very much. I think the reason is because most sleep doctors don't attend sleep studies as part of their job so they never actually see their patients exhibiting symptoms. The sleep techs running the lab get all the hands-on experience and have a much better feel for the condition and its response to the various therapies. The doctor just receives a report and does what it recommends hoping that anything useful was actually learned during the study. The people who get the best results from their therapy are those who educate themselves and take responsibility for their treatment.

[kell420]

Gotta say, it's a very good question. Best answer I can think of is that you need a sleep doctor to get a sleep study and a prescription for a machine. Other than that they don't do much and don't even seem to know very much. I think the reason is because most sleep doctors don't attend sleep studies as part of their job so they never actually see their patients exhibiting symptoms. The sleep techs running the lab get all the hands-on experience and have a much better feel for the condition and its response to the various therapies. The doctor just receives a report and does what it recommends hoping that anything useful was actually learned during the study. The people who get the best results from their therapy are those who educate themselves and take responsibility for their treatment.

The doctor I saw was a specialist in sleep disorders and he showed me o2 levels and all the readings from the test how I stopped breathing how my o2 levels dropped. Then he had a few CPAP machines brought in I could try a few masks he showed me how it works. Later I came back and saw a respiratory therapist who fitted the mask. I don't know where you went sounds like a GP sent you for a sleep study and just red a few lines on a report. I would make sure you see a specialist I got a referral from my regular GP didn't' see him again until the next year but he had nothing to do with the testing or cpap. THe doctor who was the specialist said he only does the study because insurance makes him do it.

[SleepyBobR]

You are fortunate to have a doctor with such expertise and knowledge. I have had two specialists, both specializing in sleep medicine, and neither of them seemed to know very much. You can tell when a doctor is faking it when he won't look at SleepyHead or ResScan reports and can't answer basic questions about machine settings, instead referring you to your DME as if such things are beneath him. Providing real help and advice requires knowledge which can only be acquired through real engagement with patients and hands-on experience which many so-called specialists simply don't have.

JMO.