Getting the runaround for oximeter study: Any advice?

I'm trying to help someone sort out his sleep apnea treatment. It seems to be working somewhat but not fully, since he's still tired and falls asleep too quickly and is not refreshed in the morning. Better than before, though. He does not have a data capable machine.

We are working first on him getting a better mask, but also I thought it important for him to have an oximeter study once he gets a mask that doesn't have leak problems. He has type I diabetes, has had double bypass surgery and a few years later had a stent. During his first sleep study he had desats down to 72%. During the intial sleep study he had his major desats when he was in REM AND sleeping supine together. The titration study appears flawed, since he had REM sleep and supine sleep, but from the record it is not possible to tell if he had both at the same time. I think they goofed and the leads came off or something, since the study stopped recording his position at a certain point, but that isn't noted in the doctor's report.

I thought it would be easy for him to get an overnight oximeter study, based on the ease with which some people here have had them done. Yesterday he called his DME and they said that they don't do them. So, he called a major university sleep clinic to see if they did them and they said they never did them or recommended them. It feels like the old runaround!

Even with a data capable machine, if he is able to get one, it seems to me that he should have periodic oximeter studies. This is because he is at increased risk for stroke and heart attack given his current medical status.

He has a GP who would be willing to write a script (I think), but I need to know more about how to get this done. Any experiences any of you have had or any ideas would be appreciated!

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

His GP's office staff should know where to call in the script for an overnight oximetry so just have him ask his GP if he/she will script an overnight oximetry. I be willing to venture a guess that his current DME was just stonewalling him about not having an overnight oximeter and would by some miracle come up w/one if there were a script for it from a doctor.

Rose,

I doubt if many (if any) DMEs would do an overnight pulse oximetry without a prescription from the doctor......that's where it has to start.

Den

I suspect any DME that rents O2 concentrators would have the ability to do an overnight pulse ox study. O2 rental is big bucks for the DMEs (or at least used to be before new Medicare regulations).

Yes, a doc script is needed and any GP can order it. The nurse at the GP's office should be able to do the calling to find someone who can do it for them.

Thank you for the information everyone.

[quote="jules"]I suspect any DME that rents O2 concentrators would have the ability to do an overnight pulse ox study. O2 rental is big bucks for the DMEs (or at least used to be before new Medicare regulations).

Yes, a doc script is needed and any GP can order it. The nurse at the GP's office should be able to do the calling to find someone who can do it for them.

RosemaryB wrote:Thank you for the information everyone.

jules wrote:I suspect any DME that rents O2 concentrators would have the ability to do an overnight pulse ox study. O2 rental is big bucks for the DMEs (or at least used to be before new Medicare regulations).

Yes, a doc script is needed and any GP can order it. The nurse at the GP's office should be able to do the calling to find someone who can do it for them.

Is there more than one type of equipment that does this kind of study? Is the oxygen concentrator the thing that they clip on your finger during the sleep study? I thought that the equipment was called an oximeter.

The pulse oximeter is the thing that clips to your finger (uses infrared light to check your blood oxygen content). There are different brands, but basically they work the same.
The "concentrator" is a machine that pulls oxygen out of the air (concentrates it) and adds it to a person's nightly breathing supply via a tube attached to the hose or mask. I believe jules meant that since most DMEs handle the oxygen, that they would also have the recording pulse oximeters available.

Den

Some sleep labs also have recordable pulse oximeters that you could use with a physician order. Our lab has one as a courtesy to our patients. Call your local lab they may have one.


Good Luck...Joe

Wulfman wrote:I believe jules meant that since most DMEs handle the oxygen, that they would also have the recording pulse oximeters available.

yep -

for an O2 patient they need to know if the patient is really getting enough O2 and should routinely do a 24 hour study - of course what they should do and really do are miles apart

Who ordered the CPAP for your friend? He should follow up with that physician, explain that he is still not getting the results that he had hoped for with the CPAP. The CPAP pressure may not be adequate, your friend may need oxygen added to the CPAP. There may be other problems that need to be identified. If that physician is not available, perhaps your friend can find another sleep specialist. GPs are not experienced in interpreting sleep studies and overnight oximetries.

In this area, all of the DMEs and hospital respiratory therapy departments have pulse oximeters for in home testing. The sleep labs do not. An order is required, some charge, some don't.

Thanks Wulfman, that's much clearer. Also, Joethespy and Jules, that's good info.

New here, my friend never got to see the sleep doc though he asked. (Nor did I, with a different doctor and a different clinic). It was his GP who originally ordered the study. The info about hospital RT depts might come in handy.

I was surprised that the DME stonewalled him on the oximeter availability.

That just blows me away that neither of you got to see the sleep doctor. How did the doc do a physical exam, look at the upper airway, anatomy of head and neck? Our physicians see every patient the morning after the test in the lab or within a day or two of the test in their office They spend about an hour going over the results, showing printouts of representative info from the data, fit with a mask, instruct in basic use of CPAP, etc. If the physician's are getting behind, I jump in and take over the mask fittings and instructions. Patients are allowed to sample masks if needed for 4-6weeks.

[quote="new here"]That just blows me away that neither of you got to see the sleep doctor. How did the doc do a physical exam, look at the upper airway, anatomy of head and neck? Our physicians see every patient the morning after the test in the lab or within a day or two of the test in their office They spend about an hour going over the results, showing printouts of representative info from the data, fit with a mask, instruct in basic use of CPAP, etc. If the physician's are getting behind, I jump in and take over the mask fittings and instructions. Patients are allowed to sample masks if needed for 4-6weeks.