Dreamstalker hits it on the head.
All the fancy wires and O2 monitoring and most of the bells simply rule out other conditions which is important to a degree.
If the ONLY question is whether a person has OSA or not, then an APAP will answer this in a very high percent of cases and determine the pressure range..
I'll venture to say that 90 pct of the regulars here could interview a person and come up with a probability that the patient has OSA.
OSA diagnosis is not rocket surgery.
The question them becomes what degree of certainty is needed and how much risk the patient is willing to take.
If a patient has all the symptoms and no money in hir pocket, I vote for APAP self titration.
You be the judge.
Cost Effective Treatment
I didn't check their math but here is the cost info from Stanford Sleep Disorder Clinic for their sleep studies.
Continuous monitoring of EEG (electroencephalogram), EMG (electromyogram) leg muscles, EOC (electro-oculogram), ECG (electrocardiogram), Thoracic Respiratory Effort, Oximetry, Microphone to pick up snores......$3,760.
PES (esophageal pressure sensor)......$898.
Physician Interpretation......$860.
Total for diagnostic PSG $5,518.00
And as a grand finale the Titration PSG
All of the above plus positive airway pressure at $575 for a total of $6093..
Grand Total $11,611, (Minus 1796 if you are lucky enough to not have the PES or you refuse it-I would have declined it).
Lest you think this is excessive remember you do get a bed, as many pillows and blankets as you desire, and someone to watch over you-who will come and disconnect the gadgetry should you need to go to the bathroom in the middle of the night. I also got 5 mg of Ambien for each study. I don't think there was an extra charge. Forget warm milk at bedtime or AM coffee and donuts.
People who need it the most-those without insurance-get no break on this. Insurers refuse to pay it-so make an agreement as to how much they will pay and patients have a variable copay or if insurance is good (and expensive) no co-pay.Ya pay at the front of the line or the end.
The $ must go for the names on the business cards at the front desk and the electronics--it does not go for beds, mattresses, or pillows.
The doctors are excellent-it is the place to go for complex sleep disorders-though others may have better beds. There are many other disciplines/specialties at Stanford for consultations and treatment if needed-at extra cost of course.
Did I need all this stuff for my run of the mill sleep apnea??? No. Am I glad I had insurance that paid for most of it? Yes. And it is nice to know if it had been a more complex sleep disorder I would have been in the right place. Will I go back? As long as I have insurance or some way to pay-you bet!
Continuous monitoring of EEG (electroencephalogram), EMG (electromyogram) leg muscles, EOC (electro-oculogram), ECG (electrocardiogram), Thoracic Respiratory Effort, Oximetry, Microphone to pick up snores......$3,760.
PES (esophageal pressure sensor)......$898.
Physician Interpretation......$860.
Total for diagnostic PSG $5,518.00
And as a grand finale the Titration PSG
All of the above plus positive airway pressure at $575 for a total of $6093..
Grand Total $11,611, (Minus 1796 if you are lucky enough to not have the PES or you refuse it-I would have declined it).
Lest you think this is excessive remember you do get a bed, as many pillows and blankets as you desire, and someone to watch over you-who will come and disconnect the gadgetry should you need to go to the bathroom in the middle of the night. I also got 5 mg of Ambien for each study. I don't think there was an extra charge. Forget warm milk at bedtime or AM coffee and donuts.
People who need it the most-those without insurance-get no break on this. Insurers refuse to pay it-so make an agreement as to how much they will pay and patients have a variable copay or if insurance is good (and expensive) no co-pay.Ya pay at the front of the line or the end.
The $ must go for the names on the business cards at the front desk and the electronics--it does not go for beds, mattresses, or pillows.
The doctors are excellent-it is the place to go for complex sleep disorders-though others may have better beds. There are many other disciplines/specialties at Stanford for consultations and treatment if needed-at extra cost of course.
Did I need all this stuff for my run of the mill sleep apnea??? No. Am I glad I had insurance that paid for most of it? Yes. And it is nice to know if it had been a more complex sleep disorder I would have been in the right place. Will I go back? As long as I have insurance or some way to pay-you bet!
Faced with the choice between changing one's mind and proving that there is no need to do so, almost everyone gets busy on the proof.....Galbraith's Law
I am in Dutchess County (just up the road from you in Rockland) and my sleep place (associated with St. Francis hospital), billed the following this past winter....
Standard polysonmnography $3011
Paid by insurance by insurance 1911 + 385.6 (don't know why $split in two)
Paid by me 714 (I have a 618 deductable)
this doesn't include the $220 that the doctor that read the study charged.
Titration polysomnoraphy billed and pd by insurance 2142 + 880
Paid by me $220
Also another $220 to the sleep doc to read the study
This is with a 20% copay and having to satisfy a $618 deductable
$5000 sounds a bit steep but you are nearer to the city and may be in a different reimbursement pool, so if they can get more they will. I know westchester is in the city rate pool and dutchess was (and maybe still is in an upstate pool). People here complain all the time about that.
I came out of the sleep study with my mask (actually 2 masks a nasal and full face). I tried both during the titration phase and they let me keep them. Saved me some money there.
Of course what the contracted prices are for each insurance company may differ even at the same hospitial. But this gives you an idea what was charged just north of you this calendar year.
I thought I remembered a difference between charged and paid (allowed by insurance) so I pulled out the bills to write this and was surprised that the two numbers matched. Guess my memory wasn't that good.
On top of that I have a Remstar Auto (I paid $280 copay via insurance) but can get for $709 cash on this host's website. And if you need a mask, have to buy that too.
If I had it to do again, knowing what I do now, I would work on my doc to just prescribe an auto and let me use that and skip the sleep study. It was expensive, very unplesant, and my husband already knew that I snored and gasped. Wasn't a stretch to figure apnea. I just needed the kick in the pants to get there and do something about it.
I agree that the formal study rules out other issues. All depends what you are comfortable with and what your doc will agree with and what your pocketbook will handle. The low end is buy an auto used online without dealing with the medical community at all, the top end is do the full sleep study route, and there are certainly levels in between which others have mentioned.
If you are paying yourself and want the study, I think the split night is the way to go. I didn't have that option, since my insurance co would not pay for a split night, instead insisted on two seperate ones complete with $220 each time to the sleep doc for reading the results.
So the only way to know what your insurance co will pay for is to call them. Everyone's is different.
Standard polysonmnography $3011
Paid by insurance by insurance 1911 + 385.6 (don't know why $split in two)
Paid by me 714 (I have a 618 deductable)
this doesn't include the $220 that the doctor that read the study charged.
Titration polysomnoraphy billed and pd by insurance 2142 + 880
Paid by me $220
Also another $220 to the sleep doc to read the study
This is with a 20% copay and having to satisfy a $618 deductable
$5000 sounds a bit steep but you are nearer to the city and may be in a different reimbursement pool, so if they can get more they will. I know westchester is in the city rate pool and dutchess was (and maybe still is in an upstate pool). People here complain all the time about that.
I came out of the sleep study with my mask (actually 2 masks a nasal and full face). I tried both during the titration phase and they let me keep them. Saved me some money there.
Of course what the contracted prices are for each insurance company may differ even at the same hospitial. But this gives you an idea what was charged just north of you this calendar year.
I thought I remembered a difference between charged and paid (allowed by insurance) so I pulled out the bills to write this and was surprised that the two numbers matched. Guess my memory wasn't that good.
On top of that I have a Remstar Auto (I paid $280 copay via insurance) but can get for $709 cash on this host's website. And if you need a mask, have to buy that too.
If I had it to do again, knowing what I do now, I would work on my doc to just prescribe an auto and let me use that and skip the sleep study. It was expensive, very unplesant, and my husband already knew that I snored and gasped. Wasn't a stretch to figure apnea. I just needed the kick in the pants to get there and do something about it.
I agree that the formal study rules out other issues. All depends what you are comfortable with and what your doc will agree with and what your pocketbook will handle. The low end is buy an auto used online without dealing with the medical community at all, the top end is do the full sleep study route, and there are certainly levels in between which others have mentioned.
If you are paying yourself and want the study, I think the split night is the way to go. I didn't have that option, since my insurance co would not pay for a split night, instead insisted on two seperate ones complete with $220 each time to the sleep doc for reading the results.
So the only way to know what your insurance co will pay for is to call them. Everyone's is different.