Just diagnosed moderate

[swimgeek]

Hello,

After 3.5 months from referral to sleep doctor, got results of home sleep study yesterday, 91 events per night, moderate sleep apnea.

It seemed like an unnecessarily long time to get results, but now onto more testing or a auto machine.

Doctor tried a few times to get insurance to pay for in lab study, and finally accepted they would only pay for home study.

Now, he's wanting a in lab test for cpap titration, since he said that's better than the auto-cpap the insurance wants to have.

Although, it seems kind of scammy, I heard him talking to the guy next to me before my turn, and the guy said the auto machine has changed his life, but he's tired when he only sleeps 4-5 hours, and the doctor said submit a in lab sleep study since he's still experiencing fatigue.

In any case, happy to find this forum, hope to do some research and learn from you all, and excited to see where things go.

33m, 240lb, have been pretty tired since gaining weight but inconsistent, some nights great (weight management has always been a struggle), not much time to research as much as I usually would so probably will ask dumb questions and not be as educated as I normally would like (exciting life times haha)

[Pugsy]

Now, he's wanting a in lab test for cpap titration, since he said that's better than the auto-cpap the insurance wants to have.

Hmmm....guess which makes the doctor more money....reading the results of the in lab titration study and/or even making more money if he is affiliated with the sleep lab itself
or just doing the auto/apap machine to figure out the pressure needs????

BTW....I had an in lab titration sleep study and they didn't come up with my optimal pressures....I had to adjust them later once I saw the results from my apap machine. They don't always get it right....we don't sleep the same each night for one thing and it's not always so easy to sleep in the lab setting for another thing.

Welcome to the forum. More and more insurance companies are opting for only paying for home studies and dispensing apap machines for titration...it saves them money that way. Save in lab stuff for the complicated cases where problems come up and those are rare.

[swimgeek]

Hmmm....guess which makes the doctor more money....
Welcome to the forum.

thanks for the thoughts, may call back today and request the auto machine and they withdraw the request to insurance for in-lab. also found another sleep doctor near my house (current is near work), so may try to switch if things continue to drag on after I get started with treatment.

any thoughts on what i should ask the doctor for in terms of data/results from the home sleep test? I copied some of the data onto local computer and tried to use SleepyHead but it wasn't wanting to read the data. I have Matlab at work and saw there are some resources for reading and manipulating the data with that, but available time is quite low to do that level of investigation haha

edit: don't know much about results now except he said 91 events per night. also I did 4 nights of hooked into the sensors so not sure how each one compared.

[LSAT]

You are entitled to a copy of your Sleep Study Results

[palerider]

Although, it seems kind of scammy,

Bingo, scammy. You get better data over a period of time with an auto than you do in a few hours in a foreign setting.

But, that doesn't make the doctor as much money. Or, maybe he's just stuck in the past.

[swimgeek]

Got a copy of my study results and seeing primary care tomorrow to discuss results and options. Haven’t heard back from the sleep doctor yet.

[Okie bipap]

Ask your PCP to write you a prescription for a Resmed Auto for her, climateline hose and a mask of choice to be filled as written.

[Janknitz]

In lab titrations are the standard, but IMHO it makes more sense to do it at home on an auto machine as long as you are reasonably intelligent and persistent because it's not very easy at first.

Kaiser does ONLY in home titrations for run of the mill OSA and there's good data on how well it works--sleeping in your own bed and sleeping conditions. The only thing you really miss out on is getting a good mask selection and fitting.

Some people take to CPAP like a duck to water, but others struggle with the plastic thing on their face. We can help if you run into problems.

[swimgeek]

Thanks for the comments. Already have a new lab requested authorization for titration, I’ll have to ask if they could titrate the resmed 10 autoset? It’s only a few minutes from home so having someone help set it all up would be good I think. If insurance denies then I’ll have PCP write prescription for auto.

Given my breathing is varied night by night (anecdotally based on wife observation), seems like auto would be warranted as most here suggest

[swimgeek]

Insurance approved the sleep study, going in a couple of weeks.

Still asking about how I get a machine etc. since I don’t know if the sleep study place does it or some other way.

[Okie bipap]

Check with your insurance to see which DMEs are in their network. Most insurance companies limit you to a few choices, quite often one or two. Once the titration study is done, your doctor will send a prescription to the DME who will provide you with the machine. Your prescription may or may not specify a brand name. Once you finish the titration study, ask for a copy of the study results as well as your sleep study results and machine prescription. If you have a copy of every thing, it lessens the possibility of the DME lieing to you.

[swimgeek]

Once you finish the titration study, ask for a copy of the study results as well as your sleep study results and machine

Thanks for the suggestion.

They had a cancellation so I went in for titration last night. I was kind of restless going to sleep, just with my mind running. I slept for half the night on my side, as I usually do, then slept the second half on my back. I could tell that the tech bumped up the pressure for the second half.

I am pretty sure I woke up fairly often, and feel pretty tired today. Not sure if it was the new surroundings, sensors hooked up, or the cpap machine being new.

I used the dreamwear under nose nasal mask, after trying on about 4-5 with the tech. It felt comfy all night, didn’t notice any issues. Had some soreness under nose when taking it off, but went away quickly.

I should get the study results this week and discuss with my doc. Then to figure out how much machine would be going through insurance vs. buying used.

[swimgeek]

Provider finally called and said I was authorized for the machine, and copay is $150. My provider said they have had issues with the insurance company I have not paying and that I may need to pay more out of pocket, which seems weird. Trying to talk with insurance to understand that. Getting close...

[Okie bipap]

Many DMEs have a tendency to lie, especially the large, national chains. Take everything the DME tells you with a grain of salt.

[swimgeek]

Well I am on day 3 or 4 with the machine. First few nights I woke up with dry mouth often, but last night wasn't too bad. One of my nostrils is plugged completely, so that may be related.

I have attached a graph from last night, looks like very little pressure needed, and near zero events.

Any thoughts from the crowd?

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