AHI displayed on machine vs. a sleep study

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njride
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AHI displayed on machine vs. a sleep study

Post by njride » Wed Oct 27, 2021 5:20 am

What is the relation between the AHI displayed on my Dreamstation machine and the AHI score that I would be getting in a sleep lab? I have mild apnea now (it used to be moderate) but still definitely benefit from cpap. The doctor ordered a home study device for me but "it didn't show apnea" according to him, so Medicare wouldn't pay for a new machine. He said I could choose to do a sleep lab study, but I'm wondering if it's worth the hassle - - especially staying off a cpap machine again for at least 5 nights prior to the test - - for another probably low AHI score. The 7-day AHI displayed on my Dreamstation is 1.7, and the 30-day number is only 1.0. Does that mean that I should just stay home and pay for my own future cpap needs?
Thanks for your help.

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Julie
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Re: AHI displayed on machine vs. a sleep study

Post by Julie » Wed Oct 27, 2021 6:25 am

The score on a test, whether in-lab or at home is the number of apneas you experience on that night, and likely similar to what you'd have shown on any overnight test. The score you see after wearing cpap overnight is the 'treated' one, the one that's hopefully much better (under 3-5 events) than whatever the testing score was. That's the point of C or Apap - to bring your apneas down to almost none, so your sleep isn't interrupted all night and you actually feel rested.

When you get a second test (for 'titration') it's to see how many apneas are prevented by cpap at a given pressure level on the machine to let the doctor set that pressure on the machine you end up with at home. That's your prescription setting, though as often as not it does eventually get changed a bit, often to a higher setting, once results of your sleep-with-cpap are known (as they would be if you used software such as Oscar to look more closely at overnight results), but that's just a possibility - raising the original pressure setting - not a given.

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Pugsy
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Re: AHI displayed on machine vs. a sleep study

Post by Pugsy » Wed Oct 27, 2021 6:41 am

Request a copy of that home sleep study results. See exactly what it said.

AHI displayed on the machine is the AHI AFTER cpap treated therapy and the Home study AHI is the UNTREATED AHI.
Medicare requires a certain number of UNTREATED apnea events to be found on the sleep study before they will pay for cpap equipment. The number required varies a bit depending on whether someone has other potential comorbidity factors.

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njride
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Re: AHI displayed on machine vs. a sleep study

Post by njride » Wed Oct 27, 2021 8:42 am

Julie wrote:
Wed Oct 27, 2021 6:25 am
... When you get a second test (for 'titration') it's to see how many apneas are prevented by cpap at a given pressure level on the machine to let the doctor set that pressure on the machine you end up with at home. That's your prescription setting...
To clarify: The doctor was not referring to a second test for titration. He was only suggesting I could "take a chance" that a lab test might produce a higher AHI score than the WatchPat did. So I'm asking what are the chances of that actually happening. Thanks.

njride
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Re: AHI displayed on machine vs. a sleep study

Post by njride » Wed Oct 27, 2021 8:47 am

Pugsy wrote:
Wed Oct 27, 2021 6:41 am
Request a copy of that home sleep study results. See exactly what it said.
I'll try to get a copy, but I'm curious how that might affect my decision. BTW thanks for the explanation about the difference between the two scores.

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Pugsy
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Re: AHI displayed on machine vs. a sleep study

Post by Pugsy » Wed Oct 27, 2021 9:05 am

njride wrote:
Wed Oct 27, 2021 8:47 am
Pugsy wrote:
Wed Oct 27, 2021 6:41 am
Request a copy of that home sleep study results. See exactly what it said.
I'll try to get a copy, but I'm curious how that might affect my decision. BTW thanks for the explanation about the difference between the two scores.
Well....it depends on what the score actually was and how borderline it might have been along with any comorbidity factors you may or may not have as to whether there is much chance at all of your meeting the criteria for Medicare to pay for the machine or not.

It's a long shot as to the chances of an in lab sleep study differing markedly from the home study....but there is a chance.
Example....what if the home study showed AHI of 4.7 and you have other issues that earn you the diagnostic line of 5.0...there is a chance an in lab sleep study might give results 5 to 6 to 7 AHI.
BUT if the home study showed AHI of 2.0...that's a lot of ground to make up to get Medicare to pay for the equipment.

So it might help you with your decision as to how to proceed....resign yourself to DIYing things yourself or further pursuit of trying to get Medicare on board. Maybe give you an idea how close you are with the WatchPat results in getting Medicare on board.
I don't have all the exact criteria needed to get Medicare on board handy but you can find it at the Medicare website but if you have the sleep study report in your hands you can compare the results with what is needed for Medicare to pay ....and then decide how you wish to proceed.

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ChicagoGranny
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Re: AHI displayed on machine vs. a sleep study

Post by ChicagoGranny » Wed Oct 27, 2021 11:00 am

njride wrote:
Wed Oct 27, 2021 5:20 am
so Medicare wouldn't pay for a new machine
Hasn't your machine been recalled? See thread near top of index page. Can't you get a new machine via the recall?

njride
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Re: AHI displayed on machine vs. a sleep study

Post by njride » Wed Oct 27, 2021 3:23 pm

ChicagoGranny wrote:
Wed Oct 27, 2021 11:00 am
njride wrote:
Wed Oct 27, 2021 5:20 am
so Medicare wouldn't pay for a new machine
Hasn't your machine been recalled? See thread near top of index page. Can't you get a new machine via the recall?
Yes, if I want to wait a year or so for the Philips backlog.

njride
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Re: AHI displayed on machine vs. a sleep study

Post by njride » Wed Oct 27, 2021 4:54 pm

Pugsy wrote:
Wed Oct 27, 2021 9:05 am
Well....it depends on what the score actually was and how borderline it might have been along with any comorbidity factors you may or may not have as to whether there is much chance at all of your meeting the criteria for Medicare to pay for the machine or not.

It's a long shot as to the chances of an in lab sleep study differing markedly from the home study....but there is a chance.
Example....what if the home study showed AHI of 4.7 and you have other issues that earn you the diagnostic line of 5.0...there is a chance an in lab sleep study might give results 5 to 6 to 7 AHI.
BUT if the home study showed AHI of 2.0...that's a lot of ground to make up to get Medicare to pay for the equipment.

So it might help you with your decision as to how to proceed....resign yourself to DIYing things yourself or further pursuit of trying to get Medicare on board. Maybe give you an idea how close you are with the WatchPat results in getting Medicare on board.
I don't have all the exact criteria needed to get Medicare on board handy but you can find it at the Medicare website but if you have the sleep study report in your hands you can compare the results with what is needed for Medicare to pay ....and then decide how you wish to proceed.
Thanks for your suggestion. Attached is the home sleep study report. It does indeed supply more information than my doctor offered, though the magic number seems to be only 1.5, so not much of a chance, right?
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home sleep study edited p.2.jpg (315.29 KiB) Viewed 548 times
home sleep study edited p.3.jpg
home sleep study edited p.3.jpg (204.08 KiB) Viewed 548 times

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palerider
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Re: AHI displayed on machine vs. a sleep study

Post by palerider » Wed Oct 27, 2021 7:54 pm

njride wrote:
Wed Oct 27, 2021 4:54 pm
It does indeed supply more information than my doctor offered, though the magic number seems to be only 1.5, so not much of a chance, right?
But, during REM, it's over 9. and you had some significant O2 desats.

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Re: AHI displayed on machine vs. a sleep study

Post by njride » Wed Oct 27, 2021 8:16 pm

palerider wrote:
Wed Oct 27, 2021 7:54 pm
But, during REM, it's over 9. and you had some significant O2 desats.
But does Medicare pay attention to any data other than AHI? Or are you suggesting that a lab study might show higher total AHI on the basis of what you're pointing out?
Thank you.

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palerider
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Re: AHI displayed on machine vs. a sleep study

Post by palerider » Wed Oct 27, 2021 9:03 pm

njride wrote:
Wed Oct 27, 2021 8:16 pm
palerider wrote:
Wed Oct 27, 2021 7:54 pm
But, during REM, it's over 9. and you had some significant O2 desats.
But does Medicare pay attention to any data other than AHI? Or are you suggesting that a lab study might show higher total AHI on the basis of what you're pointing out?
Thank you.
I'm not suggesting anything about what Medicare would or wouldn't do... your AHI might be worse in a lab setting, since it's an unusual environment for you.

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