Have to wait 3 months for a sleep study - what to do?

[tobysmith]

Hello

I did a home sleep test with the full nasal cannula/chest strap/pulse oximeter.

I had an AHI of 15 on the with quite a few Apneas up to a minute.

I'm in the UK and being told I'll have to wait months for a hospital sleep test on the NHS. I don't have the money for a private one.

I don't want to wait 3 months - what can I do? Buy a machine privately and test that way?

Thanks

[LSAT]

Hello

I did a home sleep test with the full nasal cannula/chest strap/pulse oximeter.

I had an AHI of 15 on the with quite a few Apneas up to a minute.

I'm in the UK and being told I'll have to wait months for a hospital sleep test on the NHS. I don't have the money for a private one.

I don't want to wait 3 months - what can I do? Buy a machine privately and test that way?

Thanks

u

YES....you could treat yourself if you purchased an auto machine and used sleepyhead software to adjust your therapy.

[Pugsy]

I don't want to wait 3 months - what can I do? Buy a machine privately and test that way?

Buying privately and using available software to self treat is pretty much your only option if you don't want to wait and go through your NHS system in the UK.

You might check out secondwindcpap.com. They have both gently used low hour machines and brand new open box zero hour machines...and I think they even have some masks. They will ship to the UK. You might compare their prices with what you can find where you live.

You need to know which models offer data with easily available software...I would suggest targeting the ResMed and Respironics models.
If unsure about data or software capabilities of what you are looking at come back here and tell us what you are looking at and we can verify if it is a model that will do what you are going to do or not.

It can be done...just takes a bit of education on your part...and of course the money.

[tobysmith]

Great, thank you both.

Did some searching and found some useful threads on here.

I'm looking at getting the System One REMstar 60 Auto CPAP System. Any reason to purchase a Dreamstation APAP instead of this one?

BEen doing some searching and can't see how best to choose machines? Why are some more expensive etc.

Also on the mask front - is there a clever way to test out various masks? As you can't return them, I don't want to have to buy 3 or 4, but would like to test them somehow.

Thanks!

[yaconsult]

Sleep labs keep a waiting list because it's not unusual for people to cancel their appointment at the last minute. You can ask to be put on the waiting list to be called if there is a cancellation. Most sleep labs have them, so they may also be available in the UK. When someone cancels, they start going down the waiting list and calling people until someone on the list says they will come to the sleep lap. Their goal is to fill every bed every night.

The downside is that you have to be ready to head to the sleep lab on very short notice - like within an hour or so. I did this and it got me into the sleep lab months earlier than it would have been otherwise.

Here in the US, our sponsor cpap.com offers free return insurance on some of the most popular masks and return insurance can be purchased for the masks that don't have it. This is an excellent way to be able to try different masks, but that doesn't help you in the UK. The most popular mask around here seems to be the AirFit P10.

[Pugsy]

If money is tight...Save some money and get the PR System One 60 series Auto machine. The new DreamStation has some minor feature differences but none are critical. The PR S1 60 series Auto cpap will do all you are going to need it to do.
ResMed equivalent is going to cost a little more...is it really worth the extra cost...that's sort of question we can't answer. If you happen to need pressures in the teens I personally think that the ResMed exhale relief is a little better and we won't know what pressure you need until you use the machine.
I have used both brands...I tend to lean towards preferring the ResMed..partly for the exhale relief and partly because I think it is a little less noisy (but the PR S1 isn't loud noisy).
Plus you don't have to do or get anything special to use the heated hose with the ResMed and you have to have a special power brick and humidifier lid to use a heated hose.

If money is really tight...get the PR S1 auto...if you can find a ResMed AutoSet (S9 would work) for a price that doesn't take food off the table....I would definitely suggest considering the ResMed AutoSet.

If you can get it with the heated hose ahead of time it puts you one step ahead of things if you run into trouble with the humidity..
Do get the humidifier..while not everyone needs a lot of added moisture most people will need at least some added moisture.

Masks are probably the hardest part of this entire process. I suggest starting with simplest if at all possible.
So...how's your nose...do you have much nasal congestion that forces you to have to breathe through your mouth very much? If the answer is "most of the time I breathe easily through my nose and rarely need to mouth breathe" then I suggest you start with a nasal pillow mask. They are the lightest weight and simplest in terms of getting and keeping a good seal because there's minimal surface area touching the skin and needing to seal.

Look at the mask (there's a link below my post here) that I use. It's lightweight and pretty much silent in terms of vent noise. ResMedAirFit P10 nasal pillow mask.
The Respironics Dreamwear nasal cushion mask might also be something to look at.

If you have a history of significant nasal congestion issues and you probably can't get them cleared up enough to breathe easily through your nose only and you just have to mouth breathe...get a full face mask and I suggest looking at the Respironics Amara View.

So figure out what type of mask you are going to need and then we look at the options in those types of masks.
Your choices are
Nasal pillow masks
Nasal cushion mask (covers the nose) or in the case of the Dreamwear uses a little cradle cushion under the nostrils
Full face mask....covers nose and mouth ...needed if you just have to mouth breathe because if you mouth breathe very much therapy pressure will go out your mouth instead of down your airway.

It's a crap shoot...what I might like you might hate but I have tried a lot of masks just to be trying them and I think the ones I mentioned here are a good place to start when it comes to masks for newbies.
I can explain pros and cons more once we know what type of mask you think you want to initially try.

[D.H.]

I don't know of you can do this in the U.K., but it's a pretty common practice in the U.S.

Call the sleep lab and ask to be on the "stand-by" list (which might have a different name in the U.K.). This means that if (for any reason) somebody cancels, they start calling people on this list.

Be ready to go on very short notice.

I hope this helps.

[mibbim]

I waited for the sleep study for 1 month, and then the insurance denied it as they requested the doctor who orders it to submit additional info. I have an AHI 40. I am trying the wedge pillow (I sleep on my back due to neck problem) and cervical collar, the wedge seems making the snore worse. I am skinny, so basically, my mouth opens when I sleep on my back due to the TMJ problem. I thought the wedge pillow will help sleep apnea? I am hastate to get a cpap without the testing. My original study said I have both central and obstructive apnea. But the sleep medicine doctor I got to see said differently, he said I only have the obstructive apnea, that's why the second sleep study has been ordered. My first machine is bpap, but I returned it since I can't sleep. I was thinking may be getting a oximeter to help while I am waiting. I download the app - snoreclock, it only shows and record snore during my sleep, but won't tell me if I stop breathing or not, or the oxygen level is how much. Any other suggestions besides getting a cpap while I am waiting?

[D.H.]

I waited for the sleep study for 1 month, and then the insurance denied it as they requested the doctor who orders it to submit additional info. I have an AHI 40. I am trying the wedge pillow (I sleep on my back due to neck problem) and cervical collar, the wedge seems making the snore worse. I am skinny, so basically, my mouth opens when I sleep on my back due to the TMJ problem. I thought the wedge pillow will help sleep apnea? I am hastate to get a cpap without the testing. My original study said I have both central and obstructive apnea. But the sleep medicine doctor I got to see said differently, he said I only have the obstructive apnea, that's why the second sleep study has been ordered. My first machine is bpap, but I returned it since I can't sleep. I was thinking may be getting a oximeter to help while I am waiting. I download the app - snoreclock, it only shows and record snore during my sleep, but won't tell me if I stop breathing or not, or the oxygen level is how much. Any other suggestions besides getting a cpap while I am waiting?

Note that if you have a Bi-PAP, you can set the inhalation and exhalation pressure the same, forcing it to function like a simple CPAP.

[tobysmith]

Thanks for the help all.

If money is tight...Save some money and get the PR System One 60 series Auto machine. The new DreamStation has some minor feature differences but none are critical. The PR S1 60 series Auto cpap will do all you are going to need it to do.
ResMed equivalent is going to cost a little more...is it really worth the extra cost...that's sort of question we can't answer. If you happen to need pressures in the teens I personally think that the ResMed exhale relief is a little better and we won't know what pressure you need until you use the machine.
I have used both brands...I tend to lean towards preferring the ResMed..partly for the exhale relief and partly because I think it is a little less noisy (but the PR S1 isn't loud noisy).
Plus you don't have to do or get anything special to use the heated hose with the ResMed and you have to have a special power brick and humidifier lid to use a heated hose.

OK, I saw your post elsewhere about secondwindcpap.com which looks good - they ship internationally for $85. The s9 and s10 are at a good price. These seem to have built-in humidifiers which aren't meant to be good for travel since the water can leak?? I travel a lot.

Buying from the UK the PR System one 60 is still quite expensive with the humidifier and heated hose accessory - over $1000 equivalent.

The s9/s10 from secondwindpap would be cheaper even with shipping (although not sure about duties - they should be duty free)

"and you have to have a special power brick and humidifier lid to use a heated hose"

-- which one is this for?

So...how's your nose...do you have much nasal congestion that forces you to have to breathe through your mouth very much? If the answer is "most of the time I breathe easily through my nose and rarely need to mouth breathe" then I suggest you start with a nasal pillow mask. They are the lightest weight and simplest in terms of getting and keeping a good seal because there's minimal surface area touching the skin and needing to seal.

I do have quite bad nasal congestion. I need to see an ENT as I suspect some issue with small nasal cavities or enlarged turbinates, deviated septum.

[mibbim]

I don't have the machine anymore since I had to return it within 30 days without charging me. And my sleep medicine doctor appo was months away. But I had to wait for another month for my sleep study appo. It supposed to be tomorrow, but insurance co denied it due to the doctor didn't submit some info, so I have to cancel it, and waiting again who knows when.

[Pugsy]

"and you have to have a special power brick and humidifier lid to use a heated hose"


-- which one is this for?

Sorry...that is for the PR S1 60 series machine. This particular model comes 2 ways...
1...with a 90 watt power brick and a humidifier lid with the needed electrical connection for the heated hose.
2...with a 60 watt power brick and the humidifier doesn't have a lid capable of power
but one can change out the lid and power brick to make it capable and it's easy to do..I did it to a 60 series machine that came without heated hose capabilities initially. There's an upgrade kit available but it costs around $75 US to make the upgrade.

The ResMed units you mentioned are all heated hose capable without the need to purchase a new power brick or lid for humidifier.

These seem to have built-in humidifiers which aren't meant to be good for travel since the water can leak?? I travel a lot.

You will want to remove the water from the water chamber prior to travel...that's with any machine using a humidifier.
Just dump the water pack it up in its bag and refill once you get to your destination and ready for bed. Not a big deal.
Actual use during travel (airplane maybe) is a whole different discussion to have due to power issues...no matter which machine is used.

You probably should target a full face mask initially with your history of nasal congestion issues though I do know people who initially used full face for the very reasons you mention and they ended up trying a nasal pillow mask and find that the humidity and pressure actually helps clear up nasal congestion and breathing and made the switch to nasal pillows.
But to start with and due to the expense of all the mask experiments I would suggest you start with full face mask at least for now. Maybe wait until NHS coverage kicks in down the road and you can get a nasal pillow mask to try and not have to pay for it.

[Pugsy]

I don't have the machine anymore since I had to return it within 30 days without charging me. And my sleep medicine doctor appo was months away. But I had to wait for another month for my sleep study appo. It supposed to be tomorrow, but insurance co denied it due to the doctor didn't submit some info, so I have to cancel it, and waiting again who knows when.

Where are you located?
In the US or UK (like the OP in this thread) or elsewhere?
Insurance requirements and procedures here in the US aren't the same as in the UK or elsewhere in the world.

[chunkyfrog]

If you get an Airsense 10, but choose to not humidify when traveling, you will likely need the end cover.

[tobysmith]

Luckily I import and export products to the UK so i know a bit about import duties:

It seems that CPAP machines should be subject to zero import duty rate:

Import tariffs are always a slightly grey (gray!) area since there is a qualitative choice.

To me it seems that they would best fit within category 9019200000: "Ozone therapy, oxygen therapy, aerosol therapy, artificial respiration or other therapeutic respiration apparatus"
https://www.gov.uk/trade-tariff/commodi ... &year=2016

Ie they would be artificial respiration or perhaps "other therapeutic respiration apparatus".

Which is zero 0 % VAT / import duty from a 3rd party non-EU country (ie America).

So even with the terrible exchange rate at the moment, importing CPAP into the UK from USA seems significantly cheaper.

If the pound was still at 1.5/1.6 dollars, it would be incredibly cheap.

Interesting

edit: masks and hoses should also be, since they would fall within "apparatus" as well

2nd edit: https://www.dutycalculator.com/hs-code- ... 0000/3835/ this backs up my thought on CPAP in this 0% category

Good news for Brits