Trouble meeting compliance.

I was called in a few days ago and was told that I was not meeting compliance and that I was around 40%. Thing is I use the machine when I do sleep and every time I sleep. I have bipolar disorder and very bad insomnia. So on the days that I do sleep it is 6-20 hours at a time. The days I don't sleep at all may be 1-3 days a week. This has been an ongoing issue since I was a teenager. Recently for instance I was awake 4 days in a row with zero sleep, I was up for that length of time with a slight manic episode ongoing and never got tired at all. My family physician tried to switch me from ambien to lunesta because after a couple years of use the ambien doesn't work. The same insurance that approved the cpap also denied me to switch sleep medication. If it was explained to me clearly at the beginning how compliance doesn't care if I sleep 12 hours one day and 2 hours the next. I still am not compliant. I would have told them in the beginning it was impossible for me to do this and would have refused treatment completely because I know that I have not had a consistent sleep pattern for decades. It seems it would be counterproductive to have to sit around the house while awake and wear the mask 4 hours while doing such things as using the computer or watching tv. (suggestion from physician) when I cannot sleep. It seems such a chore to unplug it and move it around the house with me to wear while awake and am already having an issue where I am nodding off without the machine because I forget that I left it somewhere else in the house and sleep without it. I am frustrated with it because I thought I was doing really well because I had no trouble adjusting to the machine or mask and it made me feel better and more rested when I do sleep.

ckani wrote: ...It seems it would be counterproductive to have to sit around the house while awake and wear the mask 4 hours while doing such things as using the computer or watching tv. (suggestion from physician) when I cannot sleep...

Is it counter productive if it helps you meet a goal? I'm not sure what accomodations insurances might make for persons whose sleep is as irregular as yours - one would think a note from the doctor would suffice. But at any rate, those hours don't have to be in one block of time. I'd suggest picking a place where you sit most often and get those compliance hours in increments if that works better for you. Maybe not convenient, but since your machine is helping you when you sleep, the goal is to see that help continue. Best wishes with all this.

On the days you cannot sleep, use the machine while you are awake watching TV. It will show that the machine was used...it doesn't know if you were awake or asleep. The Insurance Company will be happy.

It appears you are "marching to the tune of a different drummer..."

Here is an idea.

Use a sleep diary to record every time you sleep and how long you sleep. Next have your diary entered into your medical record by your doctor. Now your doctor can go to bat for you and find a work around for the compliance issue.

If that doesn't work, disable all the auto shut off features on your machine. Turn it on every day and set a timer for 4 hours. Then shut if off.

What medication are you taking for the bipolar disorder? Both my ex wife and ex MIL were bipolar and both of their meds were able to knock the edge off the mania so they were able to sleep. going 4 day w/o sleep is very damaging to your health and well being, and it will get worse as time goes on. You need to get the mania treated adequately. If it is treated properly then your pdoc should be able to contact your insurance co and get you some leeway on the compliance issue.

Thanks for your ideas. The sleep journal thing my therapist used recently for about 3 months tracking my sleep and her reaction was, "My God how do you live like that?" So she should have a record if it does any good. I'm just considering how much a bother it will be to move the machine all over the house and still get the benefit of actual use . I'm not moaning, making excuses, being obstinate because I am refusing to use the machine. It is because the concern is while I do stay awake for long periods of time I also crash from those hard and I will doze off sitting down lately and won't have the machine available when that happens so I will miss using the machine sometimes for 18-20 hours which will also make me non compliant. I mean if it was battery powered it would be awesome. I would use in on these 2 hour long physician visits. The sleep clinic I go to recommended I see a psychiatrist in their report which was not possible before because not many here accept any kind of insurance.

I just switched family Dr.'s in the last couple of days and he has referred me to a psychiatrist in his network but, I don't know how long that will take. I think medication issues need to be looked at and the doctors I had been going to wouldn't touch my medication because a lot of them are psychiatric meds (12). For the time being I'll see what I can do the next couple weeks and if it isn't working out I will just have to return the machine and hopefully come back to it someday if my sleep schedule ever balances out.

I am on Depacote and the only reason I am is because this insurance wouldn't pay for Saphris any longer so it is one of the meds that the family dr messed with out of necessity.

Unless you are a commercial driver or a pilot, compliance requirements are only for 90 days. Get used to dragging the machine around with you and having the inconvenience. It won't last long.

Guest wrote:I'm just considering how much a bother it will be to move the machine all over the house and still get the benefit of actual use .

Is it not possible to set the cpap up at a place you frequent so you won't have to move it?

SewTired wrote: compliance requirements are only for 90 days.

I thought compliance for most insurance was 70% for 30 consecutive days not 90 days.

Guest wrote:

Guest wrote:I'm just considering how much a bother it will be to move the machine all over the house and still get the benefit of actual use .

Is it not possible to set the cpap up at a place you frequent so you won't have to move it?

SewTired wrote: compliance requirements are only for 90 days.

I thought compliance for most insurance was 70% for 30 consecutive days not 90 days.

Yes, it is 70%, but whether it is 30 days or 90 days varies depending on insurance. I don't make assumptions on coverage because there is so much variability. With Original Medicare, the first 30 days are all you need unless you FAIL to make 70% for 30 consecutive days. In that case, you get another 30 days within that 90 day period.

It would be helpful for the OP to find out EXACTLY how much time and from when to when so he can boost his numbers only until he doesn't have to any longer. The DME should be able to help with that.

Remember, unless you are on Medicare, the required compliance percentage and periods may vary with different insurance.
YOU HAVE TO ASK your insurance. What is true for one of us may NOT apply to you.

HoseCrusher wrote:
If that doesn't work, disable all the auto shut off features on your machine. Turn it on every day and set a timer for 4 hours. Then shut if off.

The machine will not count the hours as therapy hours since it can tell that nobody is breathing into the mask.

I believe there are 3 options:

Use the machine while awake on non-sleeping days to achieve compliance (once achieved, you should be find for several years).

Buy your own machine, so you don't need compliance.

Lose the machine (not a good choice).

I like this idea.

zoocrewphoto wrote: Buy your own machine, so you don't need compliance.

check Craigslist under Health & Beauty for cpaps in your area.

SewTired wrote:whether it is 30 days or 90 days varies depending on insurance. I don't make assumptions on coverage because there is so much variability.

Who made assumptions here?

SewTired wrote:Unless you are a commercial driver or a pilot, compliance requirements are only for 90 days.

chunkyfrog wrote:the required compliance percentage and periods may vary with different insurance.
YOU HAVE TO ASK your insurance.

Always the best idea even the DME can make mistakes.