I have a split sleep study this Sunday and I think there will be problems

[crab-legs]

I have had two sleep studies in the past, on 8/2017 (split) and 6/2018 (non-split). These confirmed my OSA and the need for PAP therapy. I paid for the CPAP machine on my own.

The problem is now I want Medicare to pay for supplies and a new machine. Medicare requires that I have a split sleep study done within the past year in order to pay for the new machine and supplies. This was confirmed by two different DME suppliers.

Problem 1: I cannot sleep without PAP therapy. I have tried about 10 times in the past. So, during the non-PAP portion of the study, am I just supposed to lie there in bed awake for hours twiddling my thumbs??? I have appointments the next day, and need my sleep.

Problem 2: I just switched to nasal pillows, which I used successfully in my second sleep study on 6/2018. I just finally got around to buying them and used them the past two nights for 2.5 hours each, and could not fall asleep with them. So I switched back to my regular FFM each night, and then I slept just fine. The problem is my mouth is filling with air a lot when I use the nasal pillows, and I have to open it to expel that air, like 10 times in the 2.5 hours. I think my pressure might be too high for pillows, so I need to use the pillows in the upcoming study so they can titrate the pressure. But I can't fall asleep with them on, as of right now. So I will just lie in bed awake all night during the sleep study?? And all the FFM's leak for me at the bridge of the nose, so if I use mine, I will have to stick a wad of folded-up toilet paper under the mask seal there in order to stop the leak, but the RT at my last sleep study would not allow that. So either way, I am damned??

[Pugsy]

The problem is now I want Medicare to pay for supplies and a new machine. Medicare requires that I have a split sleep study done within the past year in order to pay for the new machine and supplies. This was confirmed by two different DME suppliers.

You might want to confirm that with Medicare instead of the DME suppliers because Medicare will most likely accept the results of the past sleep studies as long as they met Medicare criteria which is fairly simple and easy to meet.

Medicare has special provisions for people who are just now getting on Medicare and have been on cpap for a period of time prior to Medicare age.

[crab-legs]

The problem is now I want Medicare to pay for supplies and a new machine. Medicare requires that I have a split sleep study done within the past year in order to pay for the new machine and supplies. This was confirmed by two different DME suppliers.

You might want to confirm that with Medicare instead of the DME suppliers because Medicare will most likely accept the results of the past sleep studies as long as they met Medicare criteria which is fairly simple and easy to meet.

Medicare has special provisions for people who are just now getting on Medicare and have been on cpap for a period of time prior to Medicare age.

I am going to call them right now!! Thank you.

[crab-legs]

Well, well well...I have good news! I went to Medicare Live Chat. Here is what they said:

"[3:38:48 pm]: [my name]
Hi, I want Medicare to pay for my CPAP machine I am getting. I have had two sleep studies in the past, August, 2017 and June, 2018, which confirmed my obstructive sleep apnea and need for CPAP. But two different DME suppliers told me I need a new Medicare sleep study, which was done in the past year to get Medicare to pay for a machine and supplies.

Is this true, or will Medicare accept the past two sleep studies?

[...]

[3:47:36 pm]: Ashley
Based off the information shown it doesn't state that the sleep study has to be recent. you are able to use the sleep study that you have already had. You may want to try a different supplier."

Thank you Pugsy! Now I just have to convince the DME supplier to believe me.

[RogerSC]

Hope that you get to use your past sleep studies. If not, though, in my first sleep study, I barely got 3 hours of sleep after lying awake for 5 hours at the sleep lab. Just enough sleep data to show that I needed a CPAP. The next sleep study that I had, about 5 or 6 years later, my sleep doctor recommended using Ambien. He wrote me an Rx, I used it, and got a lot more sleep, and he got the data that he needed. So consider using Ambien, if you need a new sleep study, or for your next sleep study.

[chunkyfrog]

Just use a different supplier.
This BS is common with sketchy outfits you will be better off avoiding.

[chunkyfrog]

There is a chance Medicare will not pay for an unnecessary study,
and you might be stuck.
You might want to cancel it.

[crab-legs]

There is a chance Medicare will not pay for an unnecessary study,
and you might be stuck.
You might want to cancel it.

Good point! You know what...I am going to try Medicare Live Chat tomorrow with a different agent, and see if he or she says the same thing. If so, then I will cancel my study tomorrow. Although I would feel bad because the medical assistant there went out of her way to get me this appointment, as they normally schedule only 4 weeks out, with 2 weeks notice required, which means you have to pick a time between 2-4 weeks away. And, unlike my past two sleep study centers, this one has showers in each room, full-size beds, and open early, at 7 PM (the others didn't open until 8 or 9 PM). Heck, the first one didn't even have air conditioning.

[crab-legs]

Hope that you get to use your past sleep studies. If not, though, in my first sleep study, I barely got 3 hours of sleep after lying awake for 5 hours at the sleep lab. Just enough sleep data to show that I needed a CPAP. The next sleep study that I had, about 5 or 6 years later, my sleep doctor recommended using Ambien. He wrote me an Rx, I used it, and got a lot more sleep, and he got the data that he needed. So consider using Ambien, if you need a new sleep study, or for your next sleep study.

Thanks RogerSC! You know, they did actually offer me an Ambien during my first study (without a prescription), and I declined. I just hate using artificial means if I can avoid it. Plus, there have been horror stories from using Ambien, like sleep walking at night a doing something dramatic, like driving a car, and then not remembering it. Scary.

[Okie bipap]

I used Ambien on both of my last two sleep studies without any problems. If you take the Ambien just before they put you in the bed, it will have around 8 hours to wear off. You will be monitored the entire night so there is not danger of you getting up and walking out while under the influence of the Ambien. I knew I had trouble sleeping during previous sleep studies and my sleep specialist suggested I use the Ambien.

[palerider]

Plus, there have been horror stories from using Ambien, like sleep walking at night a doing something dramatic, like driving a car, and then not remembering it. Scary.

A very small minority of people have an adverse reaction with zompidem tartrate, but it's a very very small number. Weird things though, like going into the kitchen and making a cigarette butt sandwich, of having sleep sex, sleep walking, etc.

None of which would happen when you're in a supervised medical facility.

I had a roommate years ago that would use ambien as a recreational drug. He was on the aspergers spectrum, but when he'd take an ambien, it was like that part of his brain would go to sleep, and he'd behave like a person completely unaffected by aspergers. it was weird as could be... he'd be a totally different personality, till he went to sleep and woke up again, as his regular self.

[crab-legs]

I used Ambien on both of my last two sleep studies without any problems. If you take the Ambien just before they put you in the bed, it will have around 8 hours to wear off. You will be monitored the entire night so there is not danger of you getting up and walking out while under the influence of the Ambien. I knew I had trouble sleeping during previous sleep studies and my sleep specialist suggested I use the Ambien.

I used Ambien on both of my last two sleep studies without any problems. If you take the Ambien just before they put you in the bed, it will have around 8 hours to wear off. You will be monitored the entire night so there is not danger of you getting up and walking out while under the influence of the Ambien. I knew I had trouble sleeping during previous sleep studies and my sleep specialist suggested I use the Ambien.

Ok, thank you to both of you. I guess I am just a scaredy-cat when it comer to trying new medications. We'll see!

[palerider]

I've used ambient quite a few times... all it does to me is make me sleepy (usually) once in a while it seems to do nothing, it does say "take on an empty stomach' and sometimes I've had a bedtime snack. (often, a mug of cereal).

[deerhound]

I recently went through this and I finally changed sleep center and DME my new machine arrived in 2 weeks without a new sleep study.
viewtopic.php?f=1&t=177440&p=1328134#p1328134