Referrals for Bay Area sleep center?

[robrdavis]

I've been diagnosed with OSA, but have found out that my health plan (Kaiser) does not cover DME, and if I choose not to go through their DME provider (Apria) that they refuse to do any further testing. Apparently I'm on my own to deal with all the awful problems that they told me that OSA can lead to. So much for preventative medicine, I guess...

Anyhow, I'm looking for referrals to sleep centers in the California Bay Area. Please let me know of your good and bad experiences, who to see and more importantly, who to avoid.

Thanks in advance!
Rob

[Guest]

here's one in Walnut Creek:

http://www.ccsc.yourmd.com/ypol/user/us ... =0.1478196

[Maryb]

The Stanford Sleep Center is supposed to be excellent. It is headed by Dr. William Dement who has lots of experience in sleep disorders. He has even written an excellent book, "The Promise of Sleep" which is well worth reading.
That said, my doctor in SF sent me to a place called "SleepQuest" in Redwood City which was pretty good. I believe Dr. Dement is tied into SleepQuest somehow (either the founder or CSO).

Maryb

[krousseau]

Dr. William Dement and Dr. Christian Guilleminault must be the "Fathers" of sleep research and they founded the Stanford Sleep Disorders Clinic. Dement is not listed on the website’s staff roster. Guilleminault is still at the clinic but is not listed as the director on his business card or on the clinic’s website (no one is). It appears that he signs all the prescriptions for xPAPs and everyone follows him around. It is a certified sleep center. There is also a certified sleep center at UCSF and I think it is located at Mt Zion (Hospital) Campus. Stanford is tightly booked for months in advance but they also have a lot of cancellations and if you are able to be "on call" things can move quite quickly. They also seem to give higher priority to people who have severe OSA. Where do you live? If in the East Bay-Walnut Creek has a sleep center and Stanford has one in the Fremont area.
Does Apria give Kaiser patients a special rate? If Kaiser won't pay it seems strange that they require you to use a specific DME. It may be illegal for them to refuse care if you don't use Apria. Contact the California Insurance Commissioner's Office. You are going to pay a lot out of pocket if you are planning to get care out of Kaiser-and if you change insurance you'll have a preexisting condition.

[robrdavis]

Thanks for the answers!

I do live in the East Bay. Antioch, actually. I've seen that there's a couple of centers in Walnut Creek, and was hoping to get feedback from those who have had their sleep studies there, as well as from those who have used centers in other parts of the Bay Area.

Kaiser is not refusing care for me, Apria is. I am under the impression that Apria will be doing the titration (sp?) test, or that their center of choice will. It's my understanding that Apria is refusing to do the sleep study since I so not plan to purchase the equipment through them. I will look further into the cost of going through them, just to have a base-line to compare to.

My doctor has no problem with me going outside of Kaiser. He said all I need to do is pick a place and let him know what they need of him to get my testing done and the equipment prescribed and he'll do it.

In the mean time, the suggestions and advice is most welcome! Thanks again!
~rob

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CPAPopedia Keywords Contained In This Post (Click For Definition): Titration

[krousseau]

My only suggestion has nothing to do with the quality of the lab-it is that I hate to park in SF and the parking at Mt Zion is horrible. Don't know about any of the labs except Stanford. It is good. It didn't seem exceptional (but I have nothing to compare it to). I imagine it would be a great place to go for complex sleep disorders as they have been doing research so long and have sleep physicians with experience in pumonary, ENT, neurology.

If you don't mind-tell me how Apria is going to do your titration. Do you go a lab run by them or do you do a self titration at home on an auto CPAP. If it is done on an autoPAP and you have to buy your own machine anyway -it may be more cost effective to get the machine,software and card reader online-run it with the smart card for 5 nights-print out the results and send them to your doc. Bet people on this forum would help get good info-for the doc to look at and set your parameters .There is documentation in the medical literature that home titration is effective will look for that thread after I post this.

[dllfo]

One thing I did not like about some of the sleep centers around Sacramento was this "take it or leave it" attitude concerning the testing. They wanted me there at 6 pm, get wired up and then you are out of there at 6am. I told them I normally get to sleep around 11pm, why come in at 6 or even 7pm. No reason given, just be here.

I found California Sleep Solutions, in Roseville, CA. They said I could come in at 11pm if I wanted, they would hire a tech for that time frame. I hate to just sit around with wires hanging off my body, so I opted for the 10:30pm show time.

If you have any meds, or medical problems that might cause a problem, ask them ahead of time. If you have a medical condition that would be aggravated by low air flow, talk to them.

Sorry to hear about Kaiser...it is real frusrating. As I told my doctor, "Are you here to relieve stress or create it?" THAT got his attention. I found I had to be very proactive. Good luck.

[Guest]

you are barking up the wrong tree with Apria, they are a lousy national DME and have NOTHING to do with Sleep studies or testing.

they ONLY provide cpap equipment after you have had your study completed by the sleep lab.

Contra Costa Sleep Center in Walnut Creek (over by the hospital) suggested takes Kaiser insurance, I know several that have gone through it with Kaiser. Stanford is probably the better place to go but you'll have like a year's wait to get into that place.

[krousseau]

I waited 6 weeks for my first appt at Stanford-and had my titration & CPAP within 3 weeks. It depends on how much flexibility you have. They have a lot of cancellations -so if you can take a cancellation at the last minute it helps. You go in at 7 PM and are out by anywhere from 5 Am to 8 AM depending on how well you sleep and if you need to get to work.

[surfingwoman]

When I go to Stanford Sleep Center, I'm usually seen by an intern, and then seen by Guillemenot. If you can get into Stanford, and see Dr G, you should do it. He knows more than anyone else (except Dement) in the WORLD about Apnea. He spent 3 hours examining me, and I've never encountered a more knowledgeable doctor, ever. (Note, the exam was no fun, I felt like a bug under a microscope, but I'll put up with that).

For overnight sleep studies, Stanford Sleep Center is not the most comfortable place in the world. The building is old, and both times I stayed there the bathrooms off the room were a little less than clean. Plus, you need to check in a 7 pm, and you need to have eaten by then, since they have no food service.

[krousseau]

I've never seen an intern at the Stanford clinic. It isn't part of basic medical training. I have seen residents in sleep medicine and specialists who are doing sleep fellowships at Stanford. That means many of these docs have completed residencies in neurology, family practice, pulmonary, neurology, whatever-then they decided to do training in sleep medicine. One I saw was in pediatric pumonary medicine. Yes after the doc in training sees you-Guilleminault, Black, Robinson, or Brooks come in to see you. They also have groups and private sessions for insomnia. And the more interesting/complex your case is-the more doctors you meet. Fortunately I am not very interesting-the only reasons I've met some of them is that I've asked questions the 1st doc couldn't answer, I'm monitoring my therapy, and my son-in-law was a sleep researcher and I listed him as the referral source. I also picked it because I did part of my training at Stanford-worked there-and still have many connections. I'm sure that For my OSA just about any sleep lab could have handled it. If I had anything complex you can bet I'd look for a place like Stanford.

Right on about the facility-they must have put all their money into technology. It wasn't into mattresses. Take your own pillow. Cleanliness was not a problem. Lack of food service-at least a continental breakfast is inconvenient. But you can trundle yourself down the road a quarter mile and eat in the hospital cafeteria-that may not seem attractive but Stanford has a "5 star food service"-at student prices. Parking is abundant at the sleep center. During the day there is a parking fee-the machines take credit cards or cash and do not give change-so take ones and quarters. No parking fee at night. There are plenty of towels but take shampoo and a very fine comb to get the electrode glue/colloidian out of your hair in the morning.

[scalkins]

[quote="Anonymous"]you are barking up the wrong tree with Apria, they are a lousy national DME and have NOTHING to do with Sleep studies or testing.

they ONLY provide cpap equipment after you have had your study completed by the sleep lab.

[robrdavis]

Thank you all for all of the information! Especially about the info about CC Sleep Center taking Kaiser's insurance. I'll talk to my doctor and see what I would have to do to get in there.

Also thanks for the beginnins of a "things to bring" list. I'm sure that whoever tests me will give me a list, but they most likely won't have the little tricks listed like a fine tooth comb for the adhesive left in your hair...

All the info is very much appreciated by a soon-to-be-noob.

[GoodKnight]

robrdavis,

krousseau is right on about the Stanford Sleep Center. I would see them if you possibly can. They know all there is to know about the problem. They are the third sleep doctors I have seen in the area and they are absolutly the best.

Another good place is the Sequoia Hospital Sleep Disorders Center, Medical Director: Dr. Bernhard Votteri. He also knows what he is doing. They are in Redwood City, phone number: 650-367-5137

How is this for a rarity: both of them prescribed APAP for me with no urging from me. Based on what I read on this forum few docs prescribe APAP without some urging from the patient.

I have a friend who was treated for sleep apnea by Kaiser in Southern California.
As far as I could tell, they did an at home sleep study with a APAP machine for 4 nights, analyzed the data, prescribed a machine and sent it home with him, no fuss, no muss, no dealing with Apria at all. It was very easy and he was very satisfied. It sounded like a pretty reasonable thing to me.

[gfriend]

If Apria is a terrible DME, who do you recommend as a better one?
Thanks.