Mail order home apnea testing?

I'm an Occupational Health RN who on occasion has said to an employee: "hey, have you ever considered that you might have sleep apnea/hypopnea?"

Occasionally people listen and occasionally they return and said: "You were right." Then I see that some would rather die than do without their device, and others who use it off and on, and some who stick it under their beds and never use it.

Well, I have a friend, who for several years now I've said: "You have sleep apnea." It's amazing how people can be see the problem, admit to it and then simply do nothing about it. In this case, after the "uh...I don't think so," I suggested that the person use a recorder to record sleep noise, the result was damning: "gosh, I sound like a Mack truck terminal." And...hmmm....add to evidence: "Uh...your dad has a CPAP...." This person estimates about one hour or less of sleep a night. Ouch.

So now, after about three years this person is considering actually doing something. But, like so many, there's no insurance, and no job, though the "no job" part, in my view, may be a symptom of the disease, not just a factor of an ailing economy.

As an RN, frankly I'm totally disgusted with our entire medical system--it's obscene. I won't go deeply into the subject but the simple fact is that a hospital based sleep study ain't gonna happen here.

So....are these "ship to your house" sleep analyzers like the ones from 1800cpap dit com worth anything. And more importantly if a person gets back results that indicate apnea, will this be a viable route to finding a device that works?

So let's say that this rented device for $300 says: "patient has apnea." How does a person then go from "ok the device says I have sleep apnea" to a good nights sleep?

From my point of view, I'm not sure why such a "testing machine" is even necessary. Dad has apnea, patient in question has all the signs and symptoms, so using Occams Razor also known as the Kiss principle (keep it simple silly) so why won't (or maybe some will) a general practitioner simply write a script: "CPAP device." But then, who and how does one define which device is needed, is best, and what settings are used?

On occasion I can diagnose nursing deficits that point to apnea, I haven't much of a clue as to the path that one takes.

So...any suggestions as to how a person who might be able to scrape together a paltry total of thousand dollars can get to a good nights sleep?

Several forum members have self diagnosed and self treated. While not ideal...by gosh it is better than going untreated.

Keeping costs down...for best evaluation...get a cpap machine that has auto titrating capabilities (or APAP) they are 2 machines in one...can be used in straight cpap mode also.

Make sure to get the latest technology machine and one will full data and easy to get software so you can monitor the reports to see what is going on with pressure, leaks and events.

A RX is needed to order from online sources. Can he get a RX from a friendly doctor? If so...to keep costs down and order online...consider slightly used. If he can swing new..get a Respironics PR System One Auto CPAP with AFlex....Machine and humidifier can be bought from our forum host cpap.com for about $600 and that includes hose, travel case and SD card. The ResMed S9 Autoset is also a great machine but it costs nearly twice as much as the Respironics machine (and not twice as better).
Used machines online...secondwindcpap.com. used and open box new deals. Some quite good.

No RX...we get to go to the blackmarket. Craigslist. Deals are there, just have to really know your machines.

I would zero in on either PR S1 Auto CPAP or ResMed S9 Autoset...if it were me. New or used. The software is easy to use (check my signature) and the machines with latest technology offer more comprehensive data to monitor.

I would think an at-home sleep test (approximately $500)
Then a friendly doctor to write an APAP prescription
Then a good new or lightly used APAP from cpap.com, secondwindcapap.com or - ugh - craigslist

Unfortunately, a patient can have apnea and not show any apneas on CPAP due to there being a minimum of 4 cm pressure. Also, a CPAP machine may show apneas when none exist because there are no O2 or EKG sensors.

That doesn't mean it's "wrong." A lot of people would get good treatment. If you mailed the SD card to someone competent to read, a lot of people would fall into the "clear apnea sufferer" category, but some would be in the gray zone.

A person trying to diagnose apnea and do treatment on their own could blame apnea for their problems when the real cause is some other deadly medical condition and not get treated for that. He could also do CPAP wrong and not get any benefit of the treatment. Or give up and not get treated. Or develop central apnea because of CPAP.

If you can get a doctor to prescribe a CPAP, get a PRS1 Auto (NOT AutoIQ) or S9 AutoSet (Not S9 Escape Auto or S9 Auto.) They collect a lot better data than older S8 or earlier Respironics models. You also don't need special hardware to read the data.