Why all the hate?

[SemperVaporo]

I slogged through a lot of the bureaucrat language of the CMS dot gov document referenced above and I have no idea what they are talking about! My sleep study was done at the Neurologist's office complex by people that worked for him. I went in at abut 9 PM, they put electrodes all over me; temples, behind my ears, neck below the jaws, on my back at the shoulder blades, about 8 places on my chest and stomach, my knees and ankles, elbows and wrists. A set of pitot tubes were positioned via headgear in front of my nose and mouth, and a strap was put around my chest. I don't remember an oxygen measuring device like the hospital slips on your finger these days, but I think they had not been invented yet. All the wires went to a large box with about 100 multi-color pin connectors on it and a thick cable from it went through a small window high in the wall to a room that, from my vantage point laying on the narrow bed, seemed to be illuminated by CRT screens (and I think one was a TV that they watched while I slept!)
They had me blink each eye, grit my teeth, twitch my arm and leg joints, all one at a time, I suppose to determine which wire went where on the junction box. I tossed and turned about an hour and then suddenly they were in the room waking me up, telling me it was time to go home... it was 2 AM! BLEAH! They pealed off all the electrode pads using acetone to loosen them and I blearily drove myself home. The next morning I took a shower before going to work (late as usual) and discovered a numb lump on my back just above the right shoulder blade. REALL SCARED ME! I could barely touch it with my hands, but after positioning 3 mirrors to be able to see what it was, I could see that was an electrode patch they neglected to remove. I did manage to get it off with a set of long (really long) nose pliers.
About 2 weeks later I was called to the Dr. office and he had a long stretch of fanfold paper with preprinted graph lines on it and lots of squiggly lines (like a lie detector you see on TV crime dramas) and lots of written notes all over it. He asked me how long I could hold my breath and I said, "I don't know, I've never tried to measure it." He responded, "Well you held it for 53 seconds the other night. And several times for shorter periods. You have Obstructive Sleep Apnea." He said my insurance would not pay for anything until I tried a drug therapy. I took pills (dunno what they were) for about 1 week and was so thirsty I was going to the drinking fountain every few minutes, but had so much saliva that I could hardly swallow it all. So I was taken off of it.
Then I was sent to an Ear, Nose and Throat Doctor and he said I was a candidate for removing a portion of my soft pallet and uvula, as well as him removing a lot of flesh in my nasal cavities. BUT, before the insurance would cover that, I would need to use a CPAP. The Neurologist then prescribed the CPAP. I found instant relief of my migraines with the CPAP and decided against have a Roto-Rooter run up my nose! That was 23 years ago. I doubt if any medical records exist anymore, since the Neurologist was killed in an auto accident a couple of years later and the Ear, Nose and Throat Doctor has long since retired.
I figure I should request another sleep study to get a good prescription for CPAP to satisfy Medicare, but I am scared that I might PASS the test and not get it.

[Okie bipap]

In 1996, I had a sleep study that was just like the ones I had in 2014 and 2015. The test was conducted in a sleep lab where I was wired up similar to tests today. The only difference, I did not get a copy of my test results in 1996. In stead of getting a cpap machine, I opted for surgery. I had a very badly deviated septum which prevented me from breathing through my nose a large part of the time. I had the deviated septum repaired, turbinate reduction, and UPPP surgery all done at the same time. I did not do a follow up study, but I started sleeping through the night, I didn't snore any more, and my wife said I no longer stopped breathing when I slept. Shortly before I retired in 2013, I began to show signs of sleep apnea, and was finally tested in 2014. I started treatment in May, 2015 and have been using my machine ever since.

[ChicagoGranny]

but I am scared that I might PASS the test and not get it.

Your case may be different, but I would be scared it would take me a week to recover, if ever, from a night without CPAP.

I would ask them as soon as they had enough time to meet the criteria for a positive test to hook me up to a CPAP for the rest of the night (split study).

[SemperVaporo]

but I am scared that I might PASS the test and not get it.

Your case may be different, but I would be scared it would take me a week to recover, if ever, from a night without CPAP.

I would ask them as soon as they had enough time to meet the criteria for a positive test to hook me up to a CPAP for the rest of the night (split study).

AMEN!

It has been so long since I have slept (in bed) without the CPAP, I have no idea what it might be like, but I agree, I don't want to even try to sleep (in bed) without the CPAP.

I specify 'In bed' because I often fall asleep in front of the TV when there is some program I really want to watch! (Dag nab-it!) I figure that is because I relax then and am comfortable, but I know I don't rest well that way and I am pretty sure that is not just because I am sitting up.

[chunkyfrog]

Another argument SUPPORTING TV in the bedroom!
Either that or a spare cpap in the TV room.
Another thought: if you are falling asleep before bed, think about why--
Then CUT THAT OUT!

[zoocrewphoto]

Also, light sleeping is often a SIGN of sleep apnea. One way the brain tries to prevent damage from sleep apnea is to keep the events from getting too long and causing low oxygen. So, instead, it remains vigilant and causes the person to stay in light sleep and rouse a little each time to prevent the events from getting bad. My oxygen went below 90% for 13% of the diagnostic phase. The lowest was 84%. But I had a high number of short events. And I never reach deep sleep or REM without cpap. My sleep was too light. It's a defense mechanism to avoid deep sleep.

That was an eye opener for me. I always wrote off my light sleeping as "just the way I am" and didn't think it meant anything. Looking back, I realize now that it was my brain keeping me awake just enough to keep breathing.

When I was a child, I was a deep sleeper. I could sleep through storms. Also, people could "wake" me up, have me do something, and I would have no memory of it in the morning. Back in the 80s, we got our first computer (with a tape casette player for software). My mom needed to print a resume for the next day, but couldn't get it to print. I think I was 12 or 13. She woke me up and had me print it. I have no memory of it, but she says I did it, and I believe her.

I also wonder if I became a severe night owl because of sleep apnea. I know I became a night owl when I was college. I have no idea when I started snoring. (My mom doesn't snore, so I could have had sleep apnea before I started snoring). Anyway, I know that years before I was diagnosed, I was aware that when I had asthma problems, I would put off sleep because I knew I would have trouble breathing at night. I would try to prop myself up, but I would eventually slip down and struggle. So, even then, I would avoid sleep when I knew it would not be good. So, maybe back then, I was having trouble in my sleep and avoiding it without truly realizing it. And then it just became the new circadian rhythm after many years.

[CPAPLuv]

Why do the people who want to spoof eye examinations get so much hate on here?

I found this site trying to spoof eye examinations so as not to show eye glasses are needed because of a DOT exam. And before you people climb up my ass I have no trouble seeing. I Never feel like I have trouble seeing while driving and I feel good after a few drops of Visine though I will admit to about 15 minutes of blurriness at first. I miss the toilet every night when I urinate. Why the hell should the DOT decide that my vision is not adequate and I need to A. Spend money that I do not have on eye glasses that will lead to B. Wearing glasses that will actually prevent me from looking stylish.(I am very sensitive about my appearance and get excited immediately if someone touches me. I have trouble picking up chicks with glasses (on my eyes) and that is a definite no go.

[JayDee]

Why do the people who want to spoof eye examinations get so much hate on here?

I found this site trying to spoof eye examinations so as not to show eye glasses are needed because of a DOT exam. And before you people climb up my ass I have no trouble seeing. I Never feel like I have trouble seeing while driving and I feel good after a few drops of Visine though I will admit to about 15 minutes of blurriness at first. I miss the toilet every night when I urinate. Why the hell should the DOT decide that my vision is not adequate and I need to A. Spend money that I do not have on eye glasses that will lead to B. Wearing glasses that will actually prevent me from looking stylish.(I am very sensitive about my appearance and get excited immediately if someone touches me. I have trouble picking up chicks with glasses (on my eyes) and that is a definite no go.

"...Like I told my last wife, I says, "Honey, I never drive faster than I can see. Besides that, it's all in the reflexes..." ~ Jack Burton, Pork Chop Express

[JayDee]

"...I made them return my check, and give me a copy of the prescription and I now buy what I need via the internet and pay out of pocket..."

Had I found this forum before I made my first sleep-doc appointment (If I knew then, what I know now), I would have never made the appointment. I think it was about $1400 (+/-) for three Dr. appointments plus the equipment. For that amount, I could have probably bought a slightly used machine and mask, plus a slightly used backup (or travel) machine and mask, and quite likely still had money left over.

If an APAP machine fits your needs, I don't see any reason a doctor's involvement is *required*. APAP therapy is easy. The hardest part of APAP therapy is finding a mask that suits you. A Dr. should be optional (go pay a doc if you can't figure it out for yourself and/or you want the Rx so insurance will pay) and self-guided therapy should be allowed with no prescription required for a machine or mask. Just my personal, uneducated, non-medical opinion.

-JD

[chunkyfrog]

Sometimes insurance goes out of their way to waste your time, make you miserable, etc.
Because they DON'T WANT TO PAY.
Sometime you gotta be very stubborn, see a lawyer, etc. to get what YOU paid the premiums for.

[kaiasgram]

Not all sleep studies done way back then would satisfy Medicare criteria.

Do we have any examples among members whose study did not meet the criteria?

The criteria are liberal and have become more liberal over time - https://www.cms.gov/medicare-coverage-d ... AAACAAEAAA&

CG, not sure if this is what you’re asking, but hubby had a sleep study prior to Medicare age where he did qualify under his insurance at the time for CPAP machine coverage, but in that study he did not meet Medicare criteria so once he reached Medicare age and needed a new machine he had to do a new sleep study.

[ChicagoGranny]

CG, not sure if this is what you’re asking, but hubby had a sleep study prior to Medicare age where he did qualify under his insurance at the time for CPAP machine coverage, but in that study he did not meet Medicare criteria so once he reached Medicare age and needed a new machine he had to do a new sleep study.

K, If I understand correctly, his condition was not severe enough to meet Medicare guidelines for requiring treatment. I was talking about medical facilities whose testing did not meet the current guidelines. It seems most facilities performing in-lab studies in the past met the current guidelines.