Latest test didn't show apnea? But I know I need cpap.

Greetings. I was diagnosed with sleep apnea 8 years ago. My sleep test showed 17 apneas/hour, putting me in the moderate range. Because I've had a few job/insurance changes since then, and finances have been tight, I put off trying to get a new machine until now (when the machine said that the motor has exceeded its life). I've been VERY compliant, but I started the process to get a new one almost 2 months ago, still no dice. The doctors that I previously worked with have left the state, and I can't find them anywhere online. So now, I'm trying to go through my primary. The ins. company insisted on a new sleep study. Did an at home study which meant no pap therapy that night, hooked up to canula, a thing that went around my chest, and the thing that goes over my fingers to measure 02 and heart rate. I did NOT sleep well with the stupid lights shining in my face and no cpap therapy. I don't ordinarily sleep great (especially these days since my old pap machine is wearing out). But this was a horrible night. The test only showed 4 apneas though... and 10 hypopneas, and 160 snores for the whole night. I remember waking up A LOT. I got up twice to use the restroom, and one of those times I was awake for about an hour w/ insomnia. I did manage to get in a little rem sleep (had a dream, but now I don't recall what it was about). My big concern right now... How could I have been diagnosed w/ moderate sleep apnea 8 years ago, and now I don't reach the threshold? I haven't lost any weight (I am heavy). Granted, I didn't sleep well. I am concerned I won't get a new machine. When I was first diagnosed, my blood pressure was up and so was my blood sugar. I've been compliant w/ my treatment, on bp meds, and watching my sugars. But dang, if I don't get another machine, I'm worried this will all spiral out of control again. It's been a week and a half since the test, and although the results showed up on my mychart, no one has called me to follow up. Is it a matter of getting an "in lab" test? I don't think sleep apnea magically goes away. I DO know that when I first started my cpap therapy, it took awhile for the apneas to settle down into the "normal range" most nights. My concern is that it'll have to get bad again before I can get a new machine (feeling like the insurance companies ARE the proverbial "death panels.). Anyone ever been stuck in this conundrum?

HannahM13 wrote: ↑

Sat May 27, 2023 7:39 am

How could I have been diagnosed w/ moderate sleep apnea 8 years ago, and now I don't reach the threshold?

I'm going to go with hysteresis because you weren't off CPAP long enough and the HST probably didn't measure sleep so the results got watered down.

HannahM13 wrote: ↑

Sat May 27, 2023 7:39 am

The ins. company insisted on a new sleep study.

Tell us more about how this came about. What triggered the insurance company to ask for a new study? Did you submit a claim or preauthorization for a new machine? Or did something else trigger it?

Your recent HST was likely a false negative.

https://en.wikipedia.org/wiki/Hysteresis wrote:
Hysteresis is the dependence of the state of a system on its history.

When I had a repeat sleep study, I was told to stay off CPAP for 2 weeks.... But the doctor "let me off" after 10 days... this was 2017

If I remember correctly, Rubicon said relatively recently that a week should be enough.

ChicagoGranny wrote: ↑

Sat May 27, 2023 11:07 am

HannahM13 wrote: ↑

Sat May 27, 2023 7:39 am

The ins. company insisted on a new sleep study.

Tell us more about how this came about. What triggered the insurance company to ask for a new study? Did you submit a claim or preauthorization for a new machine? Or did something else trigger it?

Your recent HST was likely a false negative.

What triggered the insurance company to ask for a new study? Did you submit a claim or preauthorization for a new machine? Or did something else trigger it?

Yes, my NP req. the new cpap, but the insurance company wanted me to do a new sleep study. Did the HST, which didn't reach threshold. Part of the issue is that the doctors I worked with previously are gone. This was pre-pandemic. I don't know what happened to the ENT or the sleep specialist. Can't find either one of them online. I have no idea what happened to my med records. I DO remember that I had 17 apneas per hour when first diagnosed.

ozij wrote: ↑

Sat May 27, 2023 11:09 am

https://en.wikipedia.org/wiki/Hysteresis wrote:
Hysteresis is the dependence of the state of a system on its history.

When I had a repeat sleep study, I was told to stay off CPAP for 2 weeks.... But the doctor "let me off" after 10 days... this was 2017

If I remember correctly, Rubicon said relatively recently that a week should be enough.

Hysteresis is a new term for me. Thank you. This seems likely. I remember when I first started treatment, it took a few weeks for the apneas to calm down. It makes sense that it would be the same going in the other direction (for them to ramp up again). Makes sense. I will push for further testing.

And I bet a re-test would be on your own dime.
Nice. Insurance will use any damn excuse!
My initial AHI was only 13 and I have bought several machines on my own dime.
I would have bought from a forum member, had I lacked a prescription.

Have you considered requesting an overnight in Lab sleep study?

I have a friend that was borderline in terms of just shy of qualifying for CPAP (through insurance) by 1 point - and he is getting an overnight in lab study tonight, in hopes that that will show the numbers required by insurance . . . for him the re test in lab is covered by Insurance -

beautifuldreamer wrote: ↑

Sun May 28, 2023 4:52 pm

Have you considered requesting an overnight in Lab sleep study?

I have a friend that was borderline in terms of just shy of qualifying for CPAP (through insurance) by 1 point - and he is getting an overnight in lab study tonight, in hopes that that will show the numbers required by insurance . . . for him the re test in lab is covered by Insurance -

I believe an overnight in Lab sleep study would be next in line. Obviously not going to hear from anyone over the long weekend. Perhaps I'll hear back this week (will be calling, too).

Buy your machine privately.

Member LSAT sells often sells them for great prices. Manage your therapy privately. Thant's what many of us do.

HannahM13 wrote: ↑

Sun May 28, 2023 4:29 pm

the insurance company wanted me to do a new sleep study

Are they paying 100% of the test costs? Is this in-lab or HST?

Dog Slobber wrote: ↑

Mon May 29, 2023 6:35 am

Buy your machine privately.

Member LSAT sells often sells them for great prices. Manage your therapy privately. Thant's what many of us do.

I may need to go in this direction... my in lab test didn't show it either (even though I had a positive test 7-8 years ago... still trying to track down those results.

How do I connect with this person? I may need to do this.

ChicagoGranny wrote: ↑

Mon May 29, 2023 11:04 am

HannahM13 wrote: ↑

Sun May 28, 2023 4:29 pm

the insurance company wanted me to do a new sleep study

Are they paying 100% of the test costs? Is this in-lab or HST?

So far, the at home and in-lab both didn't show me in the clinical range for apneas/hypopneas. There was a lot of snoring in the at home test. Not sure about the results of the in lab test (lots of stuff I don't understand, but will be discussing w/ my NP next Wed). My concern is that now I'll be going without treatment. I'm going to see if I can buy one privately. I'm still trying to track down the old test results.

HannahM13 wrote: ↑

Fri Jun 23, 2023 5:11 am

Dog Slobber wrote: ↑

Mon May 29, 2023 6:35 am

Buy your machine privately.

Member LSAT sells often sells them for great prices. Manage your therapy privately. Thant's what many of us do.

How do I connect with this person? I may need to do this.

Send him a PM.

He's selling an AS 11 now, here's the topic.

viewtopic/t186861/FOR-SALEBrand-New-Air ... toset.html

HannahM13 wrote: ↑

Fri Jun 23, 2023 5:14 am

Not sure about the results of the in lab test (lots of stuff I don't understand, but will be discussing w/ my NP next Wed).

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