New here ! have a few questions

[dc7730]

Hello all, not sure where to start. I was diagnosed at sleep study as having mild or borderline ( don't remember what was said exactly) sleep apnea about 15 years ago. I never pursued any treatment. However I am sure I need help today. I am not sure where to start, so here is my first post with some information and questions.
Me: 53, 6'0" 250# ( trying to lower that #) loud snorer, restless especially early a.m.
1. I have NO insurance 2. I will pay out of pocket for everything 3. want to the best products.

QUESTIONS:
1. Do I have to do a sleep study at a hospital or other place?
2. Do I need a prescription to buy a unit?
3. Can I pursue this remedy without Dr. care?
4. Are the machines adjustable by patient

I look forward to sleeping soon....... sorry if these are silly questions, I just found your site and finally come to the realization I need HELP

[cflame1]

for question 2... unless you're willing to buy on craigslist or from a seller here... you'll need a script. That script can even be written by your GP/internist/dentist

for question 4... yes

[Pugsy]

Welcome to the forum.

1...It would be better to have a sleep study done because there are other issues that might be caught by a tech
There are also home studies available for much less...how accurate depends on the home study and what they check for but for plain jane vanilla OSA..would work.
But it can be done on your own with a full data machine. Takes some education and patience on your part and if you have only plain jane vanilla OSA. Several forum members here have had good success with self diagnosis and self treating.
So no...you don't HAVE to have an in lab sleep study but there are some advantages to having one that is monitored by a tech.

2...Yes, online purchases of a cpap/apap/bipap machine will require a RX from someone who can write a RX...doesn't have to be a sleep doctor. It can be from anyone who can legally write a RX if they will do it.
There are other avenues for obtaining the equipment though...private sales are done all the time.
Oh...the masks also require a RX but there are ways of obtaining masks without RX...Most often we can just buy the replacement parts, since replacement parts don't require a RX, and build your own mask.

3..Again yes, you can as long as you have plane jane vanilla OSA and no other complicating factors as mentioned in response to question number 1. May not be ideal but it can be done.

4..Yes, the machines are easily adjusted by the patient...that part is super easy.
Understanding why to make adjustments is part of the education process that I mentioned in response to question number 1.
We don't go changing things willy nilly without good reason and understanding those reasons and what to expect.

I would suggest looking at the 2 main players in the xpap market...Respironics and ResMed. They both have full efficacy data machines that gather the most comprehensive data to enable you to have the best understanding of what is going on and the software for either is free and easily available and also easy to use.

The 2 main machines I would suggest..
The Phillips Respironics PR System One 60 Series Auto CPAP machine
and the ResMed S9 AutoSet machine.
Both machines have 2 modes of operation...cpap mode which is a fixed single pressure and also apap mode which allows for the pressure to auto adjust as needed. APAP mode will help you find the needed pressure more easily but it can be done with cpap mode..just takes a bit longer.
Know your machine models....make sure what you are looking at will do what you expect it to...like in the ResMed line avoid anything with Escape in the model number. Still gives good therapy but the data is either severely limited or non existent depending on the model.
In the Respironics line..avoid any machine with model number below 450 as they don't gather any useful information beyond hours of use.

If money permits I would get the newest model but a slightly older PR S1 machine model 450 (that's the cpap model) or 550 (that's the APAP model) would still get you the data you need to monitor your therapy.
The Resmed line is a bit easier to keep the models straight...you have the S9 Elite (cpap model) or the S9 AutoSet (APAP model)
All APAP models also have cpap mode available...so it's like getting 2 machines in one and the price difference isn't all that much.

The new PR S1 60 Series machines (will have X6X ..60...as the last 2 digits of the model number)...like 460 or 560...the main difference between the 50 series and 60 series machines is the optional heated hose which allows for more customization of the humidity and temperature of the air going to the face. The ResMed machines have a similar feature called ClimateLine hose.
Personally I think it is worth having...better to have something and not need it than need it and not have it....and again the cost difference isn't huge. Both can be added later as an option though.
Only thing is we can't make a 50 series PR System One machine into a 60 series machine...the blower and humidifiers are not compatible.

When paying out of pocket the PR System One machines are going to be less expensive than the ResMed S9 machines but you aren't sacrificing anything if you choose the PR S1. I have used both brands in the bilevel pressure machine line and it's a toss up as to which one is "best"....both have minor pros and cons but none are deal breakers or makers.

Do you have a friendly doctor who would write a RX for you so you could get the xpap machine and humidifier (which also requires RX) online or do you need to go the private purchase route?
Send me a private message if you are going to want to go the private purchase route...I have a couple of leads you might be interested in.

Take a look in my signature line for software information...I have a thread that explains a lot of what we see on the software reports and how to get it and use it. Will give you an idea what we monitor.

Do get a machine that flags centrals (clear airway apneas) just in case....the older technology machines don't flag centrals and the presence of a large number of centrals would be a complicating factor that needs to be addressed....a few centrals are no big deal but in large numbers we get to have a totally different discussion but I won't go there unless needed. It will just confuse you at this point most likely.

[Oddprofessor]

I'm assuming that you're in the US? You of course are under no obligation to explain anything to me, but I wonder why, if you have no insurance, you don't look on the exchange for your state, or the Federal site (yeah, good luck with THAT, I know!) and get some insurance? If you're American in the US, you'll be required to do so in any case, and why pay out of pocket? My in-facility sleep study cost $3197, and the consultations before and after were separate charges. I'm paying 20% of my machine and that's going to run me roughly $200, so the machine and mask apparently are about $1k. I did have the option of a home study, where they would send equipment home with me, with careful instructions on hooking myself up, but I don't know what that would have run. Depending on the insurance plan you choose, your annual premiums won't be multiples of this amount (or may be roughly equal) and then you're covered for this and whole lot more.

I'm no expert, and others on this forum can probably give you better advice, but I wouldn't try to navigate this without a doctor's guidance. First just to understand what is happening with me, and second the best way to approach my particular case.

If you can get insurance and pay for things that way, I would suggest strongly that you do that. If you've lived this long, you can probably go another 6 weeks before the insurance would kick in on Jan. 1.

[Pugsy]

If you can get insurance and pay for things that way, I would suggest strongly that you do that. If you've lived this long, you can probably go another 6 weeks before the insurance would kick in on Jan. 1.

I am going to respectfully disagree with you here.
Would you tell someone who is diabetic to wait till next year to have their blood sugar tested if they were having symptoms of blood sugar issues?

Yes...Ideally an in lab sleep study would be the best option but even those don't always work out for any number of reasons.

A home study that is fairly accurate can be done for about $300.
Kaiser has been doing them for years and sending patients, who have OSA per the home study, home with APAP machines to get the titration. Only the complicated cases get in lab sleep studies.

[Oddprofessor]

Well, I will freely acknowledge that I have a lot to learn about apnea, that's for sure. But I was concerned about the OP's apparent willingness to dive into this treatment without professional guidance. I absolutely understand how lack of insurance can drive one to look for a less expensive way to get the treatment that is needed, but if you don't really know that you have apnea, it may be premature to buy a machine and start treating oneself.

I get it, but I worry about it, and since insurance will soon be much more easily available than it is now, I wondered if it wouldn't be better to wait. Or, do the home study now, and ask for the full magilla after Jan. 1?

Vicki

[Pugsy]

It remains to be seen just what the status of any insurance coverage is going to be after the first of the year..which plan will someone be able to afford...only the Bronze with a high deductible and higher copay? Just because someone has insurance doesn't mean they can always afford their copays and deductibles...and getting Medicaid...that opens up a whole new can of worms in regards to equipment provided and replacement of supplies.

I wouldn't wait...when someone is finely ready to address a problem that they have been putting off for a long time...I wouldn't give them a chance to put it off again and maybe be even longer wait this next time.

I understand that you aren't comfortable with going the non traditional way but it really isn't that big of a deal unless there is some weird complicating factor that pops up and then a person can always go to the doctor later if need be.
So for you it sounds scarey but it really isn't and besides....in lab sleep studies aren't always perfect either.

I get it, but I worry about it, and since insurance will soon be much more easily available than it is now, I wondered if it wouldn't be better to wait. Or, do the home study now, and ask for the full magilla after Jan. 1?

[dc7730]

Thanks for the great advice....looking forward to learning more so I can make educated decisions.

[Bobshouse]

Well, I will freely acknowledge that I have a lot to learn about apnea, that's for sure. But I was concerned about the OP's apparent willingness to dive into this treatment without professional guidance. I absolutely understand how lack of insurance can drive one to look for a less expensive way to get the treatment that is needed, but if you don't really know that you have apnea, it may be premature to buy a machine and start treating oneself.

I get it, but I worry about it, and since insurance will soon be much more easily available than it is now, I wondered if it wouldn't be better to wait. Or, do the home study now, and ask for the full magilla after Jan. 1?

Vicki

Mr. President, is that you again?!