Ok. I feel like a complete idiot - and this has probably already been discussed - but some things I have been reading on the forum have made me wonder if my sleep study experience has been typical or not.
So my question is - what were your sleep studies like?
I had 2 nights. The first was without a mask. Lots of sensors. It started at 9 pm and ended at 5 am.
I got a call from the sleep clinic said I had an average of 14 occurrences of OSA an hour and 88 during the entire night. (I didn't sleep the entire time. I know I was awake until about 10:30 and for about an hour and a half later.)
The second was about a week later and I was connected to a CPAP the entire night - again with all the bells and whistles. Beginning at 9 pm and ending at 5 am. Again I didn't sleep the entire night. It took at least 2 hours to get hooked up and get the equipment working correctly and to get to sleep. Then I had a horrible hot flash and I woke up tearing off the mask and chin strap and it took awhile to hook back up and get back to sleep.
The "nurse" (I suppose she was a nurse) called me about 3 days later and told me that my "prescription" would be 14 and that the home health (DME) I had selected would be contacting me about getting me my machine.
I was never shown my sleep study results. I didn't get a copy of my prescription (or even get to see it). The DME was very quick to respond - the same day!!! They came to my house and brought a machine, hose, humidifier and mask. My machine was set to 16. I was not given any options on any of it (I am thinking I should have been. I expected to, but...)
My Doctor did tell me at my first followup that if I could get through 6 months my insurance would cover any mask I wanted.
DOES THIS SOUND TYPICAL?
Wondering what everyone else's sleep studies were like-
13 posts
• Page 1 of 1
You can ask your doctor for a copy of your sleep study and for a copy of your prescription. Make sure you ask for both the summary report, AND the complete sleep study with all the graphs and charts.
Most DME's will try to force a machine on you and either tell you that you have no choice, or just pretend that there is no choice in machine. They have a financial incentive to give you the cheapest machine they can. If your insurance is renting the machine for the first six months and it is not what you want then argue with them until you get what you want before you are faced with buying it.
You should also have had a choice of masks. There is no "standard mask", and on size or style definitely does not fit all. If you cannot tolerate the mask they gave you, you will never last 6 months on cpap. My DME had a very liberal trial mask policy and I got to use 3 different masks before I settled on one. I can also get a new mask every 3 months. That being said I have also bought two masks out of pocket because I could not wait for the next new mask cycle.
Good luck with this new turn in your life. CPAP can be difficult and aggravating but if you persevere it will be worth it. This is a great forum for info and support of all kinds. You found the right place.
Most DME's will try to force a machine on you and either tell you that you have no choice, or just pretend that there is no choice in machine. They have a financial incentive to give you the cheapest machine they can. If your insurance is renting the machine for the first six months and it is not what you want then argue with them until you get what you want before you are faced with buying it.
You should also have had a choice of masks. There is no "standard mask", and on size or style definitely does not fit all. If you cannot tolerate the mask they gave you, you will never last 6 months on cpap. My DME had a very liberal trial mask policy and I got to use 3 different masks before I settled on one. I can also get a new mask every 3 months. That being said I have also bought two masks out of pocket because I could not wait for the next new mask cycle.
Good luck with this new turn in your life. CPAP can be difficult and aggravating but if you persevere it will be worth it. This is a great forum for info and support of all kinds. You found the right place.
I'm totally new at this too, but I'm learning all I can from reading this forum.
My first sleep study was two weeks ago. I was told that if I had a lot of apnea events, they'd put me on a CPAP that night. I slept with lots of wires from around 10:00 pm to about 5:45 am (woke up several times of course). They told me that my AHI was about 15 and my oxygen saturation got as low as 81%.
The next week I had a sleep study with a CPAP that the technician could adjust from her station. I started with a Swift nasal pillow at my request because I have a beard and moustache and expected that to work best. After a few hours they could tell I was having problems with mouth leaks at higher pressures, so they switched me to a below the chin full face mask. I slept much better and swallowed much less air, but there was a constant and I thought significant leak below my chin. (It was enough that I felt a constant blowing on my mouth, cold when I inhaled, warm when I exhaled.) They didn't tell me my AHI, but my minimum oxygen saturation was better at 89%. The tech suggested a pressure of 11, but mentioned that when she tried to go higher I would wake up.
The morning after the test, a DME called "on behalf of the Dr." to set me up with equipment, but I put them off because I wanted to talk to the Dr. first. It was about 3 days later before the Dr. reviewed the results. I was contacted by his office and told to get a CPAP and come see him in 3 months. I tried to ask questions about the equipment, but I already know more than the lady who called me from his office. The bottom line is that he'll write a perscription for and auto if I want one, but insurance won't pay any extra.
I'm strongly considering getting an auto so that I can fiddle with the pressure to find what works best. Aside from writing the perscription, I'm not expecing much help from the Dr.
The Dr.'s office didn't tell me anything about the sleep study or offer to send me the results, but I'll call tomorrow to ask them to mail it to me.
The DME carries only M-Series machines. They have a basic one, one with C-Flex, and an Auto. They didn't mention the PRO and acted like they had never heard of it.
My first sleep study was two weeks ago. I was told that if I had a lot of apnea events, they'd put me on a CPAP that night. I slept with lots of wires from around 10:00 pm to about 5:45 am (woke up several times of course). They told me that my AHI was about 15 and my oxygen saturation got as low as 81%.
The next week I had a sleep study with a CPAP that the technician could adjust from her station. I started with a Swift nasal pillow at my request because I have a beard and moustache and expected that to work best. After a few hours they could tell I was having problems with mouth leaks at higher pressures, so they switched me to a below the chin full face mask. I slept much better and swallowed much less air, but there was a constant and I thought significant leak below my chin. (It was enough that I felt a constant blowing on my mouth, cold when I inhaled, warm when I exhaled.) They didn't tell me my AHI, but my minimum oxygen saturation was better at 89%. The tech suggested a pressure of 11, but mentioned that when she tried to go higher I would wake up.
The morning after the test, a DME called "on behalf of the Dr." to set me up with equipment, but I put them off because I wanted to talk to the Dr. first. It was about 3 days later before the Dr. reviewed the results. I was contacted by his office and told to get a CPAP and come see him in 3 months. I tried to ask questions about the equipment, but I already know more than the lady who called me from his office. The bottom line is that he'll write a perscription for and auto if I want one, but insurance won't pay any extra.
I'm strongly considering getting an auto so that I can fiddle with the pressure to find what works best. Aside from writing the perscription, I'm not expecing much help from the Dr.
The Dr.'s office didn't tell me anything about the sleep study or offer to send me the results, but I'll call tomorrow to ask them to mail it to me.
The DME carries only M-Series machines. They have a basic one, one with C-Flex, and an Auto. They didn't mention the PRO and acted like they had never heard of it.
How would I find out whether my insurance is renting the machine, or if it is paid for. The DME dodged my money q's when I asked. He said that I shouldn't have to pay anything if I've met my deduct. (which I had). Other than that they seemed helpful. He gave me his phone numbers and said to call day or night. I'm still so foggy that I can't even figure out what q's to ask.
You need to ask your insurance provider. Don't trust your DME for a straight answer.....or did you already figure that out?jjposey wrote:How would I find out whether my insurance is renting the machine, or if it is paid for. The DME dodged my money q's when I asked. He said that I shouldn't have to pay anything if I've met my deduct. (which I had). Other than that they seemed helpful. He gave me his phone numbers and said to call day or night. I'm still so foggy that I can't even figure out what q's to ask.
Den
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05
JJ, your experience sounds pretty typical, altho many don't have the DME calling or knocking on their door that quickly.
Your insurance doesn't give a rip if you get a bare-bones compliance data only CPAP or a fully data capable AutoPAP. They are going to reimburse the local DME supplier the same amount for either. Insurances reimburse by medical codes (HCPCS Codes). There are only two codes for xPAP machines: CPAP or Bi-level PAPs. The Auto is not a bi-level PAP machine so it is coded under the CPAP code. [E0601]
The DME may try to charge you the difference between the E0601 allowed reimbursement and their inflated charges for an AutoPAP, but, you should NOT have to do so. You "might" need a Letter of Medical Necessity" from your sleep doctor to convince your DME to supply the Auto.
If you press hard enough, they may be willing and eager to compromise by providing you w/a fully data capable CPAP w/C-Flex or EPR and data card which are great machines for most PAPpers. Do NOT let them provide you w/ANYTHING LESS than a fully data capable CPAP w/data card!!!
How else is your sleep doctor going to be able to monitor your therapy and response to therapy or judge whether you may need some "tweaking" of your pressure needs? And THAT is exactly the way I would present the request for a fully data capable CPAP to your sleep doctor (nicely backs him into a corner) AND to your DME supplier.
The SOONER you insist on an exchange of equipment, the easier it will be to get what you want. First tho, check on your machine to see EXACTLY which machine you have and then check out its capabilities at cpap.com. You might have a good machine!
FIRST thing TOMORROW call your insurance company and found out just what your DME benefits for CPAP are. (NEVER trust what your DME tells you your insurance benefits are. Sins of omission and outright lies are too often forthcoming.) Will your xPAP be a capped rental (for how long), outright purchase? How often are you eligible for a new mask and headgear? (Many DMEs charge them as separate items). Ask them what local DMEs they are contracted with. (You may well have a choice of 2 or 3 or even more and can use THAT as a bargaining tool w/any DME you select).
Ask the DME supplier what their "mask trial period" is.
Ask for a copy of your equipment order and full sleep study and titration study results from your sleep lab/sleep doctor. They are part of your medical records and in the US you have a LEGAL RIGHT to copies of ALL your medical records.
Your insurance doesn't give a rip if you get a bare-bones compliance data only CPAP or a fully data capable AutoPAP. They are going to reimburse the local DME supplier the same amount for either. Insurances reimburse by medical codes (HCPCS Codes). There are only two codes for xPAP machines: CPAP or Bi-level PAPs. The Auto is not a bi-level PAP machine so it is coded under the CPAP code. [E0601]
The DME may try to charge you the difference between the E0601 allowed reimbursement and their inflated charges for an AutoPAP, but, you should NOT have to do so. You "might" need a Letter of Medical Necessity" from your sleep doctor to convince your DME to supply the Auto.
If you press hard enough, they may be willing and eager to compromise by providing you w/a fully data capable CPAP w/C-Flex or EPR and data card which are great machines for most PAPpers. Do NOT let them provide you w/ANYTHING LESS than a fully data capable CPAP w/data card!!!
How else is your sleep doctor going to be able to monitor your therapy and response to therapy or judge whether you may need some "tweaking" of your pressure needs? And THAT is exactly the way I would present the request for a fully data capable CPAP to your sleep doctor (nicely backs him into a corner) AND to your DME supplier.
The SOONER you insist on an exchange of equipment, the easier it will be to get what you want. First tho, check on your machine to see EXACTLY which machine you have and then check out its capabilities at cpap.com. You might have a good machine!
FIRST thing TOMORROW call your insurance company and found out just what your DME benefits for CPAP are. (NEVER trust what your DME tells you your insurance benefits are. Sins of omission and outright lies are too often forthcoming.) Will your xPAP be a capped rental (for how long), outright purchase? How often are you eligible for a new mask and headgear? (Many DMEs charge them as separate items). Ask them what local DMEs they are contracted with. (You may well have a choice of 2 or 3 or even more and can use THAT as a bargaining tool w/any DME you select).
Ask the DME supplier what their "mask trial period" is.
Ask for a copy of your equipment order and full sleep study and titration study results from your sleep lab/sleep doctor. They are part of your medical records and in the US you have a LEGAL RIGHT to copies of ALL your medical records.
_________________
| Mask: Quattro™ FX Full Face CPAP Mask with Headgear |
| Additional Comments: PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2 Software - Contec CMS-50D+ Oximeter - Respironics EverFlo Q Concentrator |
Women are Angels. And when someone breaks our wings, we simply continue to fly.....on a broomstick. We are flexible like that.
My computer says I need to upgrade my brain to be compatible with its new software.
My computer says I need to upgrade my brain to be compatible with its new software.
Yes typical sleep study for someone who hasn't read about sleep studies/sleep apnea ahead of time. I didn't 'study' before either.
Be there at 8pm i'm instructed.. okie dokie.. Sign in, watch a video, fill out the forms, get all wired up... Now go to sleep.. HA! I normally don't sleep until 5am... ok double up the ambien, watch tv for a couple hours... Turn off Tv.. yell at the video camera to the sleep tech that I'm going to sleep now.. Voice from nowhere comes in.. okay goodluck!
3 hours later... wide awake... tech comes in as he sees me trying to unhook the cables cuz a girls gotta pee. I'm like unhook me dude.. and unlock the doors i'm going outside for fresh air and a smoke or 2. Get back in bed.. laying there, laying there.. Tech comes back in.. problems he asks? Yeah man i got a horrible headache... So he wanders off brings me some motrin.. cool man.. laying there some more... guess he's like screw this.. cuz in comes the mask.. UT OH.. I'M FAILING THIS TEST .. Hooks me up... next thing i know its 5 am and he's waking me up. Gets electrodes off, Some Dr. walks in says I have severe sleep apnea at 40 episodes per hour and that home health will be contacting me within 3 days.. that afternoon they call to schedule an appt the next day.. I go pick up equipment.. end of story... learn the rest from here.
Be there at 8pm i'm instructed.. okie dokie.. Sign in, watch a video, fill out the forms, get all wired up... Now go to sleep.. HA! I normally don't sleep until 5am... ok double up the ambien, watch tv for a couple hours... Turn off Tv.. yell at the video camera to the sleep tech that I'm going to sleep now.. Voice from nowhere comes in.. okay goodluck!
3 hours later... wide awake... tech comes in as he sees me trying to unhook the cables cuz a girls gotta pee. I'm like unhook me dude.. and unlock the doors i'm going outside for fresh air and a smoke or 2. Get back in bed.. laying there, laying there.. Tech comes back in.. problems he asks? Yeah man i got a horrible headache... So he wanders off brings me some motrin.. cool man.. laying there some more... guess he's like screw this.. cuz in comes the mask.. UT OH.. I'M FAILING THIS TEST .. Hooks me up... next thing i know its 5 am and he's waking me up. Gets electrodes off, Some Dr. walks in says I have severe sleep apnea at 40 episodes per hour and that home health will be contacting me within 3 days.. that afternoon they call to schedule an appt the next day.. I go pick up equipment.. end of story... learn the rest from here.
Ramping is for the weak.
JJ posey
Why was your machine set at 16 when your prescription is 14?
I would want to see my prescription before accepting any machine. Like taking a drug from a pharmacy without being sure what the doctor actually prescribed.
You are under no obligation to buy from a certain DME. You get to choose. If you choose to use your insurance benefits you may have a limited number of choices.
If you go on your own (online DME with your prescription) you can get any brand and model you want.
You have been given one of the cheapest, machines that does not record useful data. This is the case many times as the DME gets paid the same for an M series plus and an M series Pro......
If you want to change machines and you haven't had it very long, now is the time.
Yes your experience is unfortunately typical, from the lack of choice of machines, to the 5am wakeup call. I certainly wake up normally at 5am. That is the middle of my night, yet the sleep center felt the need to wake me and make me get up.
Not giving you copies of your sleep study or your prescription is also typical.
BUT now you have found this forum you can take charge of your treatment.
Why was your machine set at 16 when your prescription is 14?
I would want to see my prescription before accepting any machine. Like taking a drug from a pharmacy without being sure what the doctor actually prescribed.
You are under no obligation to buy from a certain DME. You get to choose. If you choose to use your insurance benefits you may have a limited number of choices.
If you go on your own (online DME with your prescription) you can get any brand and model you want.
You have been given one of the cheapest, machines that does not record useful data. This is the case many times as the DME gets paid the same for an M series plus and an M series Pro......
If you want to change machines and you haven't had it very long, now is the time.
Yes your experience is unfortunately typical, from the lack of choice of machines, to the 5am wakeup call. I certainly wake up normally at 5am. That is the middle of my night, yet the sleep center felt the need to wake me and make me get up.
Not giving you copies of your sleep study or your prescription is also typical.
BUT now you have found this forum you can take charge of your treatment.
I just went through this same thing about three months ago, so I'll share my experience.
I was initially scheduled for a split study, done in a private hospital room, (hospital bed but still very comfortable, they claim they used this bed type to force people to sleep on their backs). Lots of wires. I laid there for about 4 hours or so before I finally fell asleep, and by the time they saw the apnea, it was too late to start titration.
second study was done in the clinic which was an hour closer to my house and cheaper because I didn't have to pay the hospital too. Wish they'd told me about this place the first time. It was clean and nice, though not in the best part of town. Again I had trouble falling asleep, probably only got 3 hours of sleep or so, and got a titration of 10cm.
Came home, waited for docs approval. He followed the sleep labs recommendations and prescribed me a machine at 10cm and the breeze mask. Went to a DME (just picked the ad that looked the best in the phonebook, big mistake) and they gave me the S8 Compact and like you I wasn't given any choice on machine, they didn't even act like there was a choice. They did give me a choice of mask though and I selected the Swift.
Then I get home and use the cpap for about a month w/o seeing any improvements. When I decide I want to get the card read to see if the therapy is working, I find out that isn't a feature of my card. at the suggestion of some of the folks on the board I followed several avenues. First I contacted my current DME and asked for a better machine. They gave me the runaround stating that I would need a Scrip if I wanted the APAP or the Elite and that I would have to pay the difference out of pocket and quoted me $900 for the price difference, which is more than the whole machine costs on CPAP.com. So I talked to my insurance company, they said they were renting the machine so if I switched to a new machine or DME that I would have to pay out of pocket for the month they had already paid in rent, but wouldn't really lose much else. Then I sent my Doc a letter requesting a scrip for the S8 Autoset vantage, which he faxed me back the same day. I took it to a new DME and they got me set up with the new machine, and were very helpful and friendly.
I took the old machine back to the other guy, he was very nice, but was unwilling to budge on giving me a different machine. I had emailed him back and told him I had got the scrip and the insurance approval to switch, and then he said he didn't have that machine in stock and wouldn't be able to get it. I told him I would return it and buy online or go elsewhere, and he seemed fine with that so it's what I did.
Bottom Line is, I'd use a three pronged approach if you are wanting a better machine. First contact the DME and see what they are willing to do. Then based on what they tell you, you can go from there. If they tell you you would need insurance approval, talk to your insurance company. If they ask for your doctors approval, talk to your Doc. If they are still unwilling to help after you've jumped their hoops, look for a DME that cares more about you than their bottom line.
One other thing is that the people on this board were completely awesome in helping me with this. If you have any questions, all you need to do is ask.
And with that novella, I'm off to work on my thesis
I was initially scheduled for a split study, done in a private hospital room, (hospital bed but still very comfortable, they claim they used this bed type to force people to sleep on their backs). Lots of wires. I laid there for about 4 hours or so before I finally fell asleep, and by the time they saw the apnea, it was too late to start titration.
second study was done in the clinic which was an hour closer to my house and cheaper because I didn't have to pay the hospital too. Wish they'd told me about this place the first time. It was clean and nice, though not in the best part of town. Again I had trouble falling asleep, probably only got 3 hours of sleep or so, and got a titration of 10cm.
Came home, waited for docs approval. He followed the sleep labs recommendations and prescribed me a machine at 10cm and the breeze mask. Went to a DME (just picked the ad that looked the best in the phonebook, big mistake) and they gave me the S8 Compact and like you I wasn't given any choice on machine, they didn't even act like there was a choice. They did give me a choice of mask though and I selected the Swift.
Then I get home and use the cpap for about a month w/o seeing any improvements. When I decide I want to get the card read to see if the therapy is working, I find out that isn't a feature of my card. at the suggestion of some of the folks on the board I followed several avenues. First I contacted my current DME and asked for a better machine. They gave me the runaround stating that I would need a Scrip if I wanted the APAP or the Elite and that I would have to pay the difference out of pocket and quoted me $900 for the price difference, which is more than the whole machine costs on CPAP.com. So I talked to my insurance company, they said they were renting the machine so if I switched to a new machine or DME that I would have to pay out of pocket for the month they had already paid in rent, but wouldn't really lose much else. Then I sent my Doc a letter requesting a scrip for the S8 Autoset vantage, which he faxed me back the same day. I took it to a new DME and they got me set up with the new machine, and were very helpful and friendly.
I took the old machine back to the other guy, he was very nice, but was unwilling to budge on giving me a different machine. I had emailed him back and told him I had got the scrip and the insurance approval to switch, and then he said he didn't have that machine in stock and wouldn't be able to get it. I told him I would return it and buy online or go elsewhere, and he seemed fine with that so it's what I did.
Bottom Line is, I'd use a three pronged approach if you are wanting a better machine. First contact the DME and see what they are willing to do. Then based on what they tell you, you can go from there. If they tell you you would need insurance approval, talk to your insurance company. If they ask for your doctors approval, talk to your Doc. If they are still unwilling to help after you've jumped their hoops, look for a DME that cares more about you than their bottom line.
One other thing is that the people on this board were completely awesome in helping me with this. If you have any questions, all you need to do is ask.
And with that novella, I'm off to work on my thesis
Hey, when you are not sure of what you are doing, better safe than sorry. Baby steps are the way to go.
This forum is great to check any answers you get from your DME just 'cause on accountta you can't always trust the local DMEs, many of whom put profit above assistance. Its also great when not only is your DME a jerk outfit but if your sleep lab and/or sleep doctor also aren't much help. Not all of us are fortunate enough to have a caring, interested and knowledgeable sleep doctor.
And last, but not least, no matter how educated, unless one sleeps w/xPAP and has encountered the trials and tribulations and "tricks" that work, there really is no match for the experience to be found in this forum.
Its just a matter of keeping in mind what makes sense to you, what you are comfortable trying and, finally, what really works for you. What works for one person doesn't necessarily work for the next person. For the most part, CPAP therapy is pretty much a trial and error experience until you find that "sweet spot" that gives you comfortable, healthy, restful sleep.
This forum is great to check any answers you get from your DME just 'cause on accountta you can't always trust the local DMEs, many of whom put profit above assistance. Its also great when not only is your DME a jerk outfit but if your sleep lab and/or sleep doctor also aren't much help. Not all of us are fortunate enough to have a caring, interested and knowledgeable sleep doctor.
And last, but not least, no matter how educated, unless one sleeps w/xPAP and has encountered the trials and tribulations and "tricks" that work, there really is no match for the experience to be found in this forum.
Its just a matter of keeping in mind what makes sense to you, what you are comfortable trying and, finally, what really works for you. What works for one person doesn't necessarily work for the next person. For the most part, CPAP therapy is pretty much a trial and error experience until you find that "sweet spot" that gives you comfortable, healthy, restful sleep.
_________________
| Mask: Quattro™ FX Full Face CPAP Mask with Headgear |
| Additional Comments: PR SystemOne BPAP Auto w/Bi-Flex & Humidifier - EncorePro 2.2 Software - Contec CMS-50D+ Oximeter - Respironics EverFlo Q Concentrator |
Women are Angels. And when someone breaks our wings, we simply continue to fly.....on a broomstick. We are flexible like that.
My computer says I need to upgrade my brain to be compatible with its new software.
My computer says I need to upgrade my brain to be compatible with its new software.
13 posts
• Page 1 of 1