Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?

wdotdiddlysquat · Post by **wdotdiddlysquat** » Wed May 31, 2023 9:28 am

I've been using my Resmed Airsense 10 since 2015 with minimal problems. I currently use the Resmed n30i nasal pillows mask.
I've never really felt less daytime sleepiness but we've done titration studies and they had finally decided that I must have another issue causing the fatigue. They leaned towards Chronic Fatigue Syndrome, but I declined a stimulant because I was worried about it triggering my anxiety. Due to other issues, I began taking Vyvanse a couple years later and found it to be a massive improvement in my daytime sleepiness. It's still not great, but I can do more mundane things with out having to worry about if I might fall asleep.

I was thinking it's probably getting to be time to look into a new machine since it's getting old. A week or so ago, I got a notice on my machine that "motor life has been exceeded" so I figured that was the push to make the call about getting one ordered.

The DME I use said they wanted me to have a telehealth visit with their dr to renew my rx (I was previously with Lincare when I started therapy and switched to this local place about a year ago. I no longer see the PCP who initially prescribed my cpap).

I mailed in my SD card, they downloaded the data from it and then I just had my online visit with their doctor. She said the data looks good, my compliance is 100% and my events are .5/hr. However, she wants me to repeat the sleep study because of my symptoms never improving. She recommends an in lab study over the home test despite already being diagnosed with OSA and having success with treatment.

I don't want to have another sleep study. I just want a machine that I know will continue working. I realize the "motor life exceeded" notice may be a ploy from the company to get people to buy a new machine rather than being a real warning, but I also don't want to gamble and find myself with out my machine. I feel comfortable with my pressures. When we did the titration study, I was unable to tolerate higher pressures and they caused a chronic sore throat that I did not have any improvement from until we lowered the pressure again. The idea of having to do another study is causing me distress and is making me want to just forget the whole thing altogether and just use what I have. I know that logically, that's not a smart response, but I'm wondering if it's really necessary to do a study.

Is it better to circumvent the dr and purchase my own machine online or to try to push them to provide me with a machine with no study? I did not tell her I wasn't willing to do one, so I'm not sure if she would decline to write the RX if I told her that. Or should I just suck it up and do the test even with the therapy seeming to be working the way it's supposed to?

ChicagoGranny · Post by **ChicagoGranny** » Wed May 31, 2023 10:51 am

Do you have a copy of your prescription? Typically, they don't expire.

If you use OSCAR, you can get help here looking into your CPAP effectiveness.

Miss Emerita · Post by **Miss Emerita** » Wed May 31, 2023 11:04 am

Actually, you might want to look at the opportunity to have an in-lab sleep test as a plus, given your continued problems with daytime sleepiness. This could help your doctor identify any non-apnea problems you may be having with your sleep, e.g., periodic limb movements. If you go that route, I'd recommend not using your CPAP machine for about a week in advance of the test to avoid distorting the results.

wdotdiddlysquat · Post by **wdotdiddlysquat** » Wed May 31, 2023 11:47 am

ChicagoGranny wrote: ↑
Wed May 31, 2023 10:51 am
Do you have a copy of your prescription? Typically, they don't expire.

If you use OSCAR, you can get help here looking into your CPAP effectiveness.

No, I never received any of the reports. I'm not sure if I would go back to that doctor or to one of the DME providers I've used to get a copy of it. But, I'd assume the current DME provider wouldn't be requiring me to see their doctor and do a new sleep study if they had my RX and it was unexpired...?

wdotdiddlysquat · Post by **wdotdiddlysquat** » Wed May 31, 2023 11:50 am

Miss Emerita wrote: ↑
Wed May 31, 2023 11:04 am
Actually, you might want to look at the opportunity to have an in-lab sleep test as a plus, given your continued problems with daytime sleepiness. This could help your doctor identify any non-apnea problems you may be having with your sleep, e.g., periodic limb movements. If you go that route, I'd recommend not using your CPAP machine for about a week in advance of the test to avoid distorting the results.

I have considered that. I'm curious though, wouldn't they already know that from my first study?

ChicagoGranny · Post by **ChicagoGranny** » Wed May 31, 2023 12:42 pm

wdotdiddlysquat wrote: ↑
Wed May 31, 2023 11:47 am
But, I'd assume the current DME provider wouldn't be requiring me to see their doctor and do a new sleep study if they had my RX and it was unexpired...?

Never assume any DME is honest or competent. It's not their damn business to tell you to get a repeat sleep study.

What's this bit about "their doctor"? DMEs don't have doctors.

chunkyfrog · Post by **chunkyfrog** » Wed May 31, 2023 3:44 pm

ChicagoGranny wrote: ↑
Wed May 31, 2023 12:42 pm

wdotdiddlysquat wrote: ↑
Wed May 31, 2023 11:47 am
But, I'd assume the current DME provider wouldn't be requiring me to see their doctor and do a new sleep study if they had my RX and it was unexpired...?
Never assume any DME is honest or competent. It's not their damn business to tell you to get a repeat sleep study.

What's this bit about "their doctor"? DMEs don't have doctors.

Unless there is a financial connection.
(Google: "cahoots")

Miss Emerita · Post by **Miss Emerita** » Wed May 31, 2023 3:58 pm

wdotdiddlysquat wrote: ↑
Wed May 31, 2023 11:50 am

Miss Emerita wrote: ↑
Wed May 31, 2023 11:04 am
Actually, you might want to look at the opportunity to have an in-lab sleep test as a plus, given your continued problems with daytime sleepiness. This could help your doctor identify any non-apnea problems you may be having with your sleep, e.g., periodic limb movements. If you go that route, I'd recommend not using your CPAP machine for about a week in advance of the test to avoid distorting the results.
I have considered that. I'm curious though, wouldn't they already know that from my first study?

It depends entirely on the nature of the study. Do you have a copy of it? And does your current doctor have a copy of it?

wdotdiddlysquat · Post by **wdotdiddlysquat** » Wed May 31, 2023 5:12 pm

ChicagoGranny wrote: ↑
Wed May 31, 2023 12:42 pm

wdotdiddlysquat wrote: ↑
Wed May 31, 2023 11:47 am
But, I'd assume the current DME provider wouldn't be requiring me to see their doctor and do a new sleep study if they had my RX and it was unexpired...?
Never assume any DME is honest or competent. It's not their damn business to tell you to get a repeat sleep study.

What's this bit about "their doctor"? DMEs don't have doctors.

They offer sleep studies in house. It’s a local place called Sleep Disorders Institute. The people I call to order supplies through set me up with a video call with a doctor that works with them.

wdotdiddlysquat · Post by **wdotdiddlysquat** » Wed May 31, 2023 5:16 pm

Miss Emerita wrote: ↑
Wed May 31, 2023 3:58 pm

wdotdiddlysquat wrote: ↑
Wed May 31, 2023 11:50 am

Miss Emerita wrote: ↑
Wed May 31, 2023 11:04 am
Actually, you might want to look at the opportunity to have an in-lab sleep test as a plus, given your continued problems with daytime sleepiness. This could help your doctor identify any non-apnea problems you may be having with your sleep, e.g., periodic limb movements. If you go that route, I'd recommend not using your CPAP machine for about a week in advance of the test to avoid distorting the results.
No, it was given to my PCP who ordered the study initially. I have currently been seeing a PCP who is affiliated with the same network of hospitals, so I’m sure she would have access to the records, however she is on maternity leave with no return date scheduled as of now.
I never received a copy of any of the reports. I know the place I get my supplies from got the info they needed from Lincare when I switched providers. The doctor I saw today mentioned it not having many of the details she would like to be able to examine.
I can understand her reasoning for wanting to do one, I just feel like she wants to look for other things and I really just want my cpap in good, working condition.

I have considered that. I'm curious though, wouldn't they already know that from my first study?
It depends entirely on the nature of the study. Do you have a copy of it? And does your current doctor have a copy of it?

wdotdiddlysquat · Post by **wdotdiddlysquat** » Wed May 31, 2023 5:18 pm

chunkyfrog wrote: ↑
Wed May 31, 2023 3:44 pm

ChicagoGranny wrote: ↑
Wed May 31, 2023 12:42 pm

wdotdiddlysquat wrote: ↑
Wed May 31, 2023 11:47 am
But, I'd assume the current DME provider wouldn't be requiring me to see their doctor and do a new sleep study if they had my RX and it was unexpired...?
Never assume any DME is honest or competent. It's not their damn business to tell you to get a repeat sleep study.

What's this bit about "their doctor"? DMEs don't have doctors.
Unless there is a financial connection.
(Google: "cahoots")

Oh I’m sure they are benefiting each other. FWIW, I feel like this is a company providing more comprehensive sleep care rather than being something like Lincare who is primarily a DME provider. I think they’re more like a sleep study clinic who provides supplies? I’m not positive but that’s always been the vibe I’ve gotten!

chunkyfrog · Post by **chunkyfrog** » Wed May 31, 2023 7:00 pm

Are you aware that Medicare will not do business with many "one-stop shops",
as the likelihood of collusion for profit is high?
My first DME was also a sleep lab. They are not on the Medicare providers list.
Of course, I had fired them years before, because I had figured that out already.

ozij · Post by **ozij** » Wed May 31, 2023 9:22 pm

wdotdiddlysquat wrote: ↑
Wed May 31, 2023 9:28 am
She said the data looks good, my compliance is 100% and my events are .5/hr. However, she wants me to repeat the sleep study because of my symptoms never improving. She recommends an in lab study over the home test despite already being diagnosed with OSA and having success with treatment.

I don't want to have another sleep study.

I just want a machine that I know will continue working. I realize the "motor life exceeded" notice may be a ploy from the company to get people to buy a new machine rather than being a real warning, but I also don't want to gamble and find myself with out my machine.

I feel comfortable with my pressures. When we did the titration study, I was unable to tolerate higher pressures and they caused a chronic sore throat that I did not have any improvement from until we lowered the pressure again.

The idea of having to do another study is causing me distress and

is making me want to just forget the whole thing altogether and just use what I have. I know that logically, that's not a smart response, but I'm wondering if it's really necessary to do a study.

I've never really felt less daytime sleepiness
Is it better to circumvent the dr and purchase my own machine online or to try to push them to provide me with a machine with no study? I did not tell her I wasn't willing to do one, so I'm not sure if she would decline to write the RX if I told her that. Or should I just suck it up and do the test even with the therapy seeming to be working the way it's supposed to?

All emphasis in the above is mine.
And I'm confused. I don't know why you think the therapy is working -- unless you consider AHI the only mark of successful therapy. And, if you don't have your Rx or sleep study, you clearly couldn't hand them to the doctor she could understand where you're coming from medically.

I have currently been seeing a PCP who is affiliated with the same network of hospitals, so I’m sure she would have access to the records, however she is on maternity leave with no return date scheduled as of now.

And the PCP has no substitute that will take of her patients while she's on maternity leave?

I think your sleeo doctor is making sense. I also think that if you want to buy a new CPAP machine like you would buy a new car, you simply have to get your old Rx and upload it to a place that sells CPAP equipment.

Miss Emerita · Post by **Miss Emerita** » Thu Jun 01, 2023 10:36 am

If you live in the U.S., you have a legal right to see your earlier sleep study. Ask your current doctor for a copy, or if your former PCP is part of a practice, ask the staff there.

But really, I'd go ahead and have the study. You might learn something new that would help you feel better.

Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?

Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?

Re: Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?

Re: Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?

Re: Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?

Re: Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?

Re: Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?

Re: Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?

Re: Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?

Re: Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?

Re: Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?

Re: Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?

Re: Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?

Re: Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?

Re: Time for a new machine- dr wants to repeat sleep study to approve Rx--should I buy one on my own?