Is this the right process?

[mrshickadance9]

Hey all

About a month ago, I was diagnosed with Sleep Apnea - AHI came in at 17 as diagnosed by an at home sleep study. After I was told this, my doctor said that I have to do a titration (sp?) study before I can get a CPAP machine. Correct me if I'm wrong, but with today's auto-adjusting CPAP machines, isn't this a little unnecessary? I ask, because I was told that after the titration study, it's going to take ANOTHER couple weeks to get the CPAP. I'm just so tired all of the time, and my work output is definitely suffering. It's so frustrating to know there is an answer to my constant tiredness and foggy mind, yet I have to keep waiting and waiting. Meanwhile, even when I get 10+ hours of sleep a night, I'm a zombie by noon.

I'm not questioning my doctor as much as wondering... did this take as long for you guys as it is for me? It's getting really frustrating...

[Diamondminek]

to some extent, you are right... but... having people who hopefully know what they are doing, can help get it on, can offer different masks, and can hopefully start you off on a fairly appropriate treatment level and comfort level is not a bad thing either, if they do a good job self managing will be easier afterwards too. doing it your self with an apap is what some people do - but there is the possibility than a cpap/ apap wont do the job, if you need higher pressures or have central apnoea.
i was 42 weeks from initial gp appontment to diagnoses and treatment starting, with 12-16 weeks between each stage of the process, on scotlands NHS... most systems work a lot faster, but delays are not unusual - be vocal about your desire to start treatment, and go on a cancellation list if you can.

[palerider]

but with today's auto-adjusting CPAP machines, isn't this a little unnecessary?

probably

I'm not questioning my doctor

why not?

[Cardsfan]

There are different types of cpap machines. If you just go out and by an auto, you may not be getting the proper machine for your needs. That's what the titration will help with.

[palerider]

There are different types of cpap machines. If you just go out and by an auto, you may not be getting the proper machine for your needs.

but the odds are, that he will get the right machine, which is why at least one, and possibly more, insurance companies have started just sending people home with an auto, and skipping titration until there is evidence they need more than a standard auto.

[zoocrewphoto]

There are different types of cpap machines. If you just go out and by an auto, you may not be getting the proper machine for your needs.

but the odds are, that he will get the right machine, which is why at least one, and possibly more, insurance companies have started just sending people home with an auto, and skipping titration until there is evidence they need more than a standard auto.

I'm on the fence about this once. I can see where a lot of people would do fine with an auto machine and using the data to hone in on the right settings.

At the same time, I can't help but wonder if I would have made it past the first week if I had done this. It took my 6 weeks to master the mask fitting, and that included special ordering smaller headgear that the first DME refused to order. They lied and said it didn't exist. When I proved them wrong, they said they couldn't order it.

I did a split night study, and my titration was the best 5+ hours of sleep in probably 20 years. The sleep tech fit me perfectly. I rolled over and slept for 5+ hours without waking up. because of that fitting,, I knew the mask I had requested would fit correctly. I just hadn't mastered it yet. And that beautiful taste of a good night of sleep left me excited and wanting to try a cpap as soon as possible. It changed my attitude from dread to excitement.

So, at least for some of us, the lab titration was an awesome thing and worth the price. And yes, mine was one of the more expensive sleep studies compared to what others have mentioned on this forum.

[Okie bipap]

I did a split study and a titration study, both. They could not find a satisfactory pressure during the split study, so I was scheduled for a titration study. As a result of the titration study, I was given an Air Curve 10 vauto with the pressure set for 20 - 25 cm H2O.

[yaconsult]

The extra step is most likely a requirement of your insurance company. They try the home test first because it's the cheapest one. The problem with going from home test directly to cpap machine is that some complications might not be detected, like central apnea, restless leg syndrome, etc. So there is a method to their madness.

Sometimes you can get things done more quickly by offering to be on their cancellation list to go for the titration on very short notice when someone cancels at the last minute or doesn't show up. It should not take long to get a machine after the titration is complete. Just make sure that you get a good auto cpap that is supported by the wonderful free sleepyhead software.

[chunkyfrog]

The titration study takes care of a lot of "what-ifs"; especially if you need a more advanced machine.

[jtravel]

It's all going to come down to your insurance companies Policy and the type of insurance you have.
it seems like Medicare covered patients and those who paid for the add on polices get very good coverage.
I'm not Medicare eligible yet and have a Cigna open access plan thru my employer.
They use Carecentrix for all Sleep apnea related claims and they have been a total nightmare to deal with.
They denied me a split night titration sleep study and only approved a home study. Now they want me to lease a Apap Machine fro 90 days and provide compliance data before they will approve a cpap machine purchase.
I couldn't wait as I was suffering the effect badly and was previously diagnosed and treated with Cpap many years prior.
Purchased my own equipment from a board member here and now have the relief I badly needed.
I'm still messing around with Carecentirx/Cigna 3 mounts latter to get the coverage I need.
I did their home sleep test and now waiting to be approved for the 90 day trial. I already have over 60 days of date on my PR system one 550 showing I'm using it and it works.
MY DR gave me a prescription to get an Apap of my choice 30 days ago but I'm still waiting for cigna to give the approval and tell me where I can order it from.
I have found my Cigna Insurance to be totally useless at this point in time.

[SewTired]

I'm not questioning my doctor as much as wondering... did this take as long for you guys as it is for me? It's getting really frustrating...

It was grueling and I broke down and bought a used auto machine that worked with Sleepyhead. Two weeks of that was fabulous. You DO have to stop using it two days before your sleep titration to get an accurate reading. Some of us with mild apnea can sometimes go a couple of days without the machine - it does catch up with you though. If it bridges you to your new machine, it is money well spent. Then, you will have a backup. Yes, it's true, that you COULD end up with a bipap or ASV - you could always sell the cpap again. Up to you. I could no longer drive, that's how bad it got over a very short period. As caregiver for a disabled person, this was unacceptable, but I could not get them to move any faster. However, if your DOCTOR can light a fire to get them to go faster.

[Okie bipap]

It's all going to come down to your insurance companies Policy and the type of insurance you have.
it seems like Medicare covered patients and those who paid for the add on polices get very good coverage.

It is true that Medicare does a good job of providing coverage for sleep apnea. However, your doctor must follow Medicare rules for documenting your diagnosis. I had to change sleep doctors and go through sleep and titration studies a second time before I finally got a machine. My original sleep doctor had put me on supplimental oxygen at night until I could get a machine.

[mrshickadance9]

Thanks for your insightful thoughts, everyone!

I had the titration study last night, and aside from the occasional sleep interruption for the technician to come in and fix a sensor, I have to say... WOW! I slept like a baby, and today, while I still feel a little sleepy, my focus and energy level has been better than it's been in YEARS. I've seriously been more productive today at work than I have in such a long time.

There was a point where the pressure got a little too strong and woke me up, but I have to say I think I took to the CPAP pretty well. I used a full face mask since I'm not sure if I sleep with my mouth open or not. Now I'm just bummed that i have to wait a couple weeks to get my own CPAP machine!

While it sucks that I have to use it, I'm so thankful that I hopefully have a solution. I'm never going to take good sleep for granted again, after all of this.

[Okie bipap]

When you get a machine, make sure it is fully data capable, and try for an auto adjusting machine. This will give you more treatment options. When I started treatment, my machine was set for a range of pressure, but I have found I do better with a fixed pressure.