Sleep Medicine Dr. Says I Don't "Look" Like I'd Have Apnea

My split-night study was - $1,244.23

% PLAN PAYS - 80%
TOTAL AMOUNT PAID - $995.38
PATIENT PAYS - $248.85


Den

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Each of my diagnostic studies was surprisingly only $750. I think the list price was about $1,200. Not sure why some insurance companies have such high allowable amounts. It was a nice new facility too, and on a Friday, 2 of the 3 times the tech didn't have a second patient, just me. And yes I was special enough to need 3 lol. They only have two rooms though, so the wait can be long. Six weeks once. Best wishes.

jaycee2 wrote:I found a sleep medicine doctor/pulmonologist to see me last week! But he said that I don't look the type to have sleep apnea. I'm not obese and my throat was open and clear when he examined me. But he ordered a sleep study anyway based on my symptoms. However it will not be a split study because he seems certain that I don't have apnea. He wants me to take melatonin and zolpidem/Ambien for the study to make sure that I sleep. Otherwise the insomnia might interfere. He said that if need be I would return to the sleep lab for titration or do an auto-titration at home. And the sleep lab is backed up due to "summer vacations" so I won't have the study for 3-4 weeks. After that it will take 10 days for him to get the results.

Is there a "type" or look or typical sleep apnea patient? It would be wonderful if he were right, no apnea.

Hi Jaycee- it sounds like your doctor is related to the the doc I had in June... mine told me that he himself "...snored and had every apnea symptom I told him I had, and he didn't have sleep apnea so therefore I didn't have it..." Yes - exact words; you have to laugh, or you'll end up insane

As for the "typical" apnea patient- all I have to say is that Ted Bundy didn't look like a serial killer either... who would have guessed by his good looks, wit, and charm that he was truly a psychopath? The "apnea look" is completely bogus; if you do your research, you will learn that babies can be born with apnea, and the previous 'theories' the medical profession has about apnea patients, no longer hold much validity.

I would suggest you contact your local DME and ask if they do in-home apnea tests. If your insurance won't cover it, I did find a place on the internet that does not require a doctor's prescription to get one done. The cost is $250. PM me for that info, if interested.

I took an in-home apnea test 2 weeks ago, and got results last Friday. I have moderate OSA; the study I did gave a recommended titration rate of 7 - I did not need another test. Since there are only 4 months left in this insurance benefit year (for most), I would suggest weighing your options between out-of-pocket costs on a sleep lab test vs. going with an in-home test. If your insurance benefit year ends in December (like mine does), then any monies you've paid toward your deductibles and out of pocket costs are 'null and void' after 12/31/14. If you don't get your CPAP machine & supplies (provided you do have apnea) before the end of your benefit year, then you may have increased costs due to having to start over again with new yearly deductibles.

Thanks for all the advice and opinions. I've decided to go ahead and have the sleep study at the lab the way my dr. wants. My insurance will cover it. This dr. was able to see me ten days after I called. My original referral was to another dr. and the appointment was for three months out. And she uses a different sleep lab as well. I've read enough on this board to know that you have to manage your own treatment and that most drs. and DMEs really are too busy or uninvolved to be much help.