Newbie question over home study and no insurance

[Kali]

My person physician told me I have sleep apnea and that I should get a test done, but he can tell simply by looking at me. I have postponed the test for quite a while and now have decided to take the plunge and fix this issue no matter what the cost.

Here is my dilema, I dont have insurance (for my height and weight it is difficult to obtain) and do not mind paying for the test/ machine out of pocket. Here are my issues:

I have difficulty sleeping in other beds and I am used to sleeping in my bed only. I have heard the horror stories of these sleep studies and would prefer to take the test at home. Are these home study tests effective, how much do they generally cost and how can I find someone local here in Socal to help with the test?

Also, is a test neccesary to properly use the CPAP machine?

Thanks

[Bearded_One]

A test is necessary to verify that it is sleep apnea, and type and severity of your sleep apnea. A titration is necessary to know what pressure is necessary to treat your apnea. A prescription is necessary in order to obtain a CPAP machine.

[Guest]

Sleep studies can be done at home. Most of the people who post on this message board have had their studies done at a clinic. Hopefully, someone with a home study experience will give you the information that you need.

If you are unable to have one done at home, don't fret too much about going to a sleep lab. Lots of people sleep poorly, but the RT told me that he was able to get the needed information with just a few hours of patient sleep.

Keep posting and let us know how your experience is progressing. There are a lot of people around this place who can and will give you invaluable information. Also, spend some time searching for answers to questions that you may have. My CPAP therapy has been really enriched by my membership on this board. And it's good to have you join us.

[GumbyCT]

I know the sleep labs bill the Insurance $5-6k for a sleep study = ouch. I have no idea what they charge for a home study but from what I have read here, it is very limited in what it can check & only determines that you need to go in for a sleep study, ha.

fwiw- A sleep study (PSG) is the best known way to determine if you have a sleep disorder and how to correct it. Keep in mind PSG determines other sleep related problems besides OSA.

So what to do?

If your doc has already determined that YOU have OSA - have him write you a script for an Auto-Aflex w/smartcard & HH - tell him to use a pressure of 10-14 cm & fill him in on what you intend to do. If he will do that for you, he is a keeper. Then you will need the software & card reader. YOU will need to spend alot of time reading & learning how YOU can tell from the software if/when you are having apneas AND how to determine YOUR pressure.

If you can get that far - I am certain you will find many people here to help you.

Good Luck,
GumbyCT
ps. You can order all of the above right here at cpap.com but MUST have a script.

[p2pjunkie]

Doctors and tests are really nice to have...
Prescriptions are also nice, but there are ways around that also...

I bought a used machine and tried it.. I started with a machine I found on Craig's list, and an mp3 player/voice recorder as my data recorder. I adjusted the pressure until I stopped snoring. I quickly noticed improvement. I was hooked.

At this point I have spent a ridiculous amount of time and money, but my apnea is well treated. I bought a better machine, a large collection of masks, a card reader for data. I have spent hours and hours reading this site for ideas on how to deal with, or improve on everything.

My friend that did the tests and the doctors, but never found this site. The machine is in a closest somewhere, and he sleeps in the basement on the sofa. His wife won't let him sleep in the same room and his new favorite soda is AMP energy drink.

[Slinky]

You either want to improve your health - or you don't. You either want to improve your sleep - or you don't. Simple as that.

... I have postponed the test for quite a while and now have decided to take the plunge and fix this issue no matter what the cost. ...

Good for you. NOW you're talking some sense!

... I dont have insurance (for my height and weight it is difficult to obtain) and do not mind paying for the test/ machine out of pocket. Here are my issues:

I have difficulty sleeping in other beds and I am used to sleeping in my bed only. ...

That's a cop out. Either you want to help yourself or you don't.

... I have heard the horror stories of these sleep studies and would prefer to take the test at home. ...

Come on now, horror stories? Lets be real. Some of us got real crappy sleep or virtually no sleep at all, but "horror"?? As long as you realize that the home sleep studies are NOT as thorough, are NOT able to detect any other sleep disorders you may have, hoping for an at-home sleep study is not unreasonable. Just realize that they are NOT an adequate substitute for an in-lab study.

... Are these home study tests effective, how much do they generally cost and how can I find someone local here in Socal to help with the test? ...

They CAN determine IF you do have OSA. I've read an estimated cost of $500. I would think your best bet would be to contact your local hospitals, ask if they have a sleep lab and ask to speak to their sleep doctor, explain your situation and ask if they have the equipment to do an at-home sleep study. IF not, call the various local DME suppliers and ask them if they are aware of who does them. An overnight OXIMETRY is NOT sufficient!

... Also, is a test neccesary to properly use the CPAP machine?

Yes, and no. Anyone can learn to turn a CPAP on. Its knowing what pressure(s) you need that is the "kicker". A rented autoPAP for two weeks or so can give a good indication of your pressure needs IF it is a fully data capable autoPAP and IF the rental place will do the download and printout of the results. You're much less likely to find your pressure needs w/in two weeks if you have only the data on the LCD display to work with. And even then that depends on how well you manage to educate yourself and understand.

Sleep study costs vary from area to area. In my area of mid-Michigan at my sleep lab (hospital sleep labs are generally more expensive than independent sleep labs, mine was an independent sleep lab) the sleep evaluation is somewhat less expensive than the titration. My sleep and titration studies combined were billed to Medicare at $3,300.00 of which Medicare allowed $1,700.54. Medicare then pays 80% of that allowed amount, $1,360.44 and my copay was $340.10 . Some hard nosed medical facilities and professionals insist on the non-insured paying the full price. Others will reduce the price for self-payers, some to at or below the Medicare allowed amount.

I would suggest you start w/your family doctor and discuss your situation and fears and excuses and ask that he help you come up w/a solution you are willing to undergo.

Good luck and God bless.

[Julie]

Important point - IF you get a script from your MD, and presuming you'd buy from Cpap.com (the best, cheapest, smartest place to go), you need to tell him to write the script for Cpap, because while they can provide you with an Apap machine with only a script for Cpap, the opposite cannot be done (whether or not it makes sense to us... it's a legal issue for Cpap, who need to do things properly to stay in business. You should also ask Cpap.com for the Respironics machine with A-flex and, if you can afford it (you'll need it to titrate your pressure) get the 'bundle' one that comes with the smart card and Encore program for your computer - if you have a PC. If you have a Mac, you'll need to have an Intel capable one with Bootcamp to set it up to read the program.

[alnhwrd]

Kali,

Slinky is right, sleep studies are not all bad. Mine was a very positive experiance. The sleep techs who did mine were very professional and patient. A good sleep lab will do everything it can to make you as comfortable as possible. A sleep study also checks for restless leg syndrome, and other sleep disorders besides sleep apnea, and will let you know if you you have a propensity for central apnea or other problems. They are spendy, mine was 3500, with insurance I paid 500.

[Guest]

HI Kali,

I am not sure what a physician NEEDS to know before writing you a Rx for CPAP.
It sounds as if your Dr. says he already is certain you have it.
If you have all the symptoms, I don't see where it would be a stretch to buy an AUTO CPAP (on-line is WAY cheaper), and titrate yourself. (if the Dr. would agree to write you a Rx, and knows that there is such a thing as an auto CPAP, that adjusts to what pressure you need.)

This is just my personal opinion and experience! I am not a Dr.!

I had a sleep study done in a hospital sleep lab 5 years ago and it was inconclusive, as I couldn't sleep long enough.

I later had an in home study, that proved that I had sleep apnea.

I can see how an in home study could miss some other sleep issues, as there definitely were not as many wires...i.e. brain wave.

But bottom line...I was able to get an Auto CPAP and am getting the treatment I need.

As far as costs...I am not sure, if you don't have insurance. Also, I have never rec'd a bill for my study and it's been a year. I am not sure what happened there! Twice there were Explanation of Benefits from my insurance co. that I rec'd, and I believe they were for $500 a night X three nights. Both times they were denied by my ins. but I can't remember the explanation. And i can't remember if there were additional costs for reading the reports.

I would have a serious talk with your Doc and see what he can do for you.

It sounds like you are ready and willing to feel better, don't give up....which ever way you have to go......Keep coming back and asking questions!

Best of luck to you!