Sleep study costs and expectations

[Sluggish]

Been on Cpap over a year and still never sleep.
Told my MD and he suggested sending me to a proper supervised sleep study.

Without insurance that will cover it... anyone know what kind of costs I might be looking at??
For folks who have done this,..how was the experience? Did you learn anything? Did it help? Are these places as bad as all the reviews I'm reading? Is there even such a thing as a 'sleep doctor'??

My patience has worn thin for all these "professionals" and their guesses. They're really no different than amateur guesses, just more expensive. Sleep apnea (or whatever I have) sucks.

[LSAT]

If you are monitoring your sleep data with sleepyhead ,you should be able to zero in on any problems without a sleep study. Your autoset is capable of adjusting to your needs. If you are using SH, how about showing some data, if you are not...you should be. Sleep studies can vary from $2000 on up.

[Sluggish]

Thanks that's what I thought. And from what I gather results are mixed.

Yes I'm using sleepyhead. I used to look at my charts daily now it's about every couple of months. I've posted charts in the past and don't mind doing it again. But in my head rings the old add-age that I've heard so many times on the forums ... 'It's more about how you feel than charts anyway'. Mostly my charts vary from the occasional good night to pretty bad on other nights and I have no idea why. On the rare chance I get a 'good' night I don't really feel any better. The main issue seems to be leaks. Tried many many masks and cannot use anything without a diffused exhaust so that seriously narrows my options. I settled on the P10 as being 'good enough' not my ideal but better than all the rest I tried.

other random info::
Mouth taped shut
P10 with hose hanger management
Never sleep more than 6hrs.
Rarely ever dream or feel well rested in the morning

Past 2 days charts included. As you can see, one bad and one good (kinda).

[palerider]

I'd raise your min pressure by one or two cm

[Julie]

And maybe consider what you can do (e.g. full face mask) re your leaks.

[kjvh2004]

I can't give the advice so many others here can, about what kind of adjustments to make.

What I can do is answer the question about the cost of a sleep study, as I just got the EOB (explanation of benefits) from my insurance (BCN - Blue Care Network).

Last December when I originally contacted BCN about going to a sleep doctor, I was told I didn't need a referral from my physician...

I was first given an at-home sleep study which indicated Severe Sleep Apnea (AHI of 57). The insurance was billed $392.40 from the sleep clinic, and $132 from the doctor for analyzing the results. All I had to pay out of pocket for this was the $132 for the doctor bill. They also requested that I do an in-lab titration as soon as possible, so they could get my pressure needs determined.

Fast forward a couple weeks, I go in for an overnight titration study. I get a rather generic feeling, but yet effective prescription for 10-20 APAP...thankfully my sleep doctor only works with the Resmed Airsense 10 Autoset.

My insurance statement had the following information for the cost:
POLYSOMNOGRAPHY W/CPAP $3722.10
Sleep Doctor Analysis $1503.00

Amount to be paid by me: $0.00

With the following message:
The service isn't payable because we have no record of a referral from the patient's PCP of record authorizing this care. Since we communicate directly with the providers who bill us, we automatically inform the provider of this decision. You aren't responsible for paying this charge. If you are billed for this service, please call BCN's Customer Service.

It seems I 'lucked out' somehow...I may have been told I didn't need a referral, initially...but I'm not complaining.

Hope this helps.

kjvh2004

[ChicagoGranny]

Hope this helps.

The OP stated "without insurance".

[Sluggish]

Thank you all for the help and replies.
As I suspected, the cost is far beyond what the average person can afford.

[katestyles]

Thank you all for the help and replies.
As I suspected, the cost is far beyond what the average person can afford.

....and the results may not reward the outlay.

Did you up your pressure as suggested?

[Miss Emerita]

I’m curious how you did with a pressure change, if you made one. I see that the majority of your events are CAs, which may not respond to pressure changes.

Have you ever zoomed in on a CA to see whether it appears to be preceded by “awake-looking” breathing? You could post a zoomed-in shot; just make sure the event is over toward the right so that there’s a view of what went before it.

About the leaks—I wonder whether you’ve tried a different size of nasal pillow or a different size of headgear. If not, maybe experiment? Ditto for the tension on the straps. And any chance air is sneaking out of your mouth?

Finally, it’d be great if you could sleep longer. Do you wake up and find you just can’t get back to sleep? Any way you could try going to bed earlier?

[Pugsy]

The problem with an in lab sleep study when people are simply having trouble sleeping (either falling asleep or staying asleep) is that they can't always tells us why we aren't sleeping so great.
They can tell us if we have an arousal from a breathing event of some sort but if our poor sleep isn't from breathing issues the sleep study can't always tell us "why"... and the why is very important if we are expected to try to fix it.

Not all our problems sleeping are related to breathing issues.
A person could spend lots of money on an in lab sleep study only to find out that "yep, they don't sleep so great"...but offer no reason as to why they aren't sleeping so great.
They can spot arousals on the sleep study but not always why the arousal happened or what is causing a person to not be able to fall asleep or stay asleep.
There are breathing related arousals....cpap can usually help with those.
There are spontaneous arousals....and all that means is that for some unknown reason we woke up but it can't tell us why we woke up.
And the list for potential culprits for spontaneous arousals is a mile long.....cpap can't help unless the arousal is related to breathing issues...no matter how much we tweak the settings or want it to help or expect it to help.

[djams]

I'd raise your min pressure by one or two cm

And I'd recommend the Bleep Dreamport.

I also mouth tape. With a full beard. Short. Never could get the leaks under control until I got the Bleep. Knowing with certainty that the mask isn't leaking allowed me to focus on the mouth tape. Went through 3 types of tape, and a bunch of application methods. I've got it down now, and boy do I sleep great.

Yours may not be mouth leak. Even more reason to give the Bleep a try

[katestyles]

I'd raise your min pressure by one or two cm

And I'd recommend the Bleep Dreamport.

I also mouth tape. With a full beard. Short. Never could get the leaks under control until I got the Bleep. Knowing with certainty that the mask isn't leaking allowed me to focus on the mouth tape. Went through 3 types of tape, and a bunch of application methods. I've got it down now, and boy do I sleep great.

Yours may not be mouth leak. Even more reason to give the Bleep a try

Wanna share your mouth taping technique? I thought I had it down.......

[Sluggish]

I’m curious how you did with a pressure change, if you made one. I see that the majority of your events are CAs, which may not respond to pressure changes.

Have you ever zoomed in on a CA to see whether it appears to be preceded by “awake-looking” breathing? You could post a zoomed-in shot; just make sure the event is over toward the right so that there’s a view of what went before it.

About the leaks—I wonder whether you’ve tried a different size of nasal pillow or a different size of headgear. If not, maybe experiment? Ditto for the tension on the straps. And any chance air is sneaking out of your mouth?

Finally, it’d be great if you could sleep longer. Do you wake up and find you just can’t get back to sleep? Any way you could try going to bed earlier?

I’ll up the minimum pressure tonight. It will probably take a few days (at least) before I am able to discern any deference. I was under the impression the machine would auto-adjust because it’s an APAP.

If I’m being honest about the charts.. I don’t really know how to read them other than recognizing leaks. I’m not even sure the difference between CA and the OSA.

Leaks...
Medium nasal is my size for sure. There is no way to adjust headband tension on the P10 (the little clips are useless I’ve posted at length about this previously). Sometimes I drool or blow a small escape route through the adhesive on the tape and obviously this will cause a leak but usually won’t wake me up. The other type of leak I notice is from the edge of the nasal cushion and always wakes me fully up because of the tickle/itch it causes. This leak usually occurs while sleeping on my side and the pillow pushes the nasal cushion out of my nose unless I rest my head at the extreme edge of the pillow so that my nose hangs off the edge a bit.

Going to bed earlier... Midnight is the earliest I ever anticipate going to bed. Keep in mind I am usually napping by noon daily because I am so tired. Maybe if I power through the day without a nap I will be tired enough to sleep longer but I don’t get home from work till 10:00pm and if I don’t nap before work I can barely function. I can recall plenty of times I’ve not napped thinking “oh boy am I gonna sleep tonight”.. nope, 5-6hrs no matter how tired I am.

Funny thing is, I swear my charts look better 6 months ago. I remember having a few 8hr nights and even had a 0.0 reading ONCE. I have no idea what has changed. Overall there have only been a handful of good nights out of hundreds.

[palerider]

I was under the impression the machine would auto-adjust because it’s an APAP.

They do auto adjust, *after* you have a breathing event: https://www.youtube.com/watch?v=-gie2dhqP2c Then... after they get pressure high enough to stop the events... thy start dropping the pressure back to whatever the minimum is, because they foolishly trust whoever set up the machine...

So, what that means is that, if your min pressure is too low, you'll have a recurring cycle of events>pressure raise > pressure drop> events> pressure raise, ... on and on all night long.

So, you need to get the pressure high enough to prevent most events in the first place, and rely on the auto abilities to handle exceptions, like rolling onto your back, or REM cycles... etc.