Sincere question that may or may not be appropriate here...

pbcaddy · Post by **pbcaddy** » Tue Jan 08, 2008 4:03 pm

My dilemma is this: I have a rather intractable sleep problem (embarrassed to say how long I've lived with it) that until recently I thought couldn't possibly be apnea related (enormous trouble falling asleep, waking after 3-4 hours like clockwork feeling lousy... that is to say, all the hallmarks of an emotional disturbance such as anxiety or depression rather than a physical disruption). Which by the way has not responded to traditional psych intervention.

This forum and Dr. Krakow's blog however have made me question this assumption. I have decided that this is the year I give it my best shot to get off all medications and return to the once happy, productive person I used to be. One avenue I want to pursue is CPAP therapy. I can detect many symptons now that seem to make apnea a distinct possibility in my case. However I was dismayed to discover that cpap devices must be prescribed by an MD.

So the question I ask of you kind folks is this: Is it possible to buy or rent CPAP equipment without a Dr's prescription? My reasoning is this: Sleep clinics in my area cost $3,000 and up. I think I could put together a nice CPAP system for $500 at some of the auction sites. If I go to the Clinic and they tell me I have sleep apnea, I have spent $3000. If they tell me I don't, I have spent $3000 If I purchase a system on my own and learn from someone who uses it (yes, I know there are lots of adjustments and a learning curve involved...I'm ok with that) I'm only out $500 either way. My financial situation obviously is limited...no health insurance etc.

Any help appreciated, and appologies if this has been covered before or is a taboo subject.

JeffH · Post by **JeffH** » Tue Jan 08, 2008 4:12 pm

Ask your GP to give you a prescription. Tell him what you just told us.

Good luck.

JeffH

TXKajun · Post by **TXKajun** » Tue Jan 08, 2008 4:33 pm

Welcome to the forum, pbcaddy.

Hopefully, you're gonna stay in close touch with your doc while trying to get off all your meds!! There can be some darn scary side-effects if you try to go cold turkey on some of them, I bet.

Soooo, assuming you're going to be working with your doc on this, like JeffH recommended, have a nice heart-to-heart with your doc and explain just like you did here and ask for a prescription for an "Autoadjusting (or autotitrating) Continuous Positive Airway Pressure (APAP)" system which is fully data capable and then get the system and the software to monitor yourself. This will give you the ability to find out whether or not the system is responding to obstructive apneas, how many and what would be your optimum pressure/s if, indeed, you do have OSA.

Unfortunately, many (if not most) doctors are in the mindset "Well, if I suspect you've got OSA, then you've got to have a sleep test to find out for sure."

Hopefully, you've got a good relationship with your doc and he's open-minded about this.

Kajun

P.S.
If you read a bunch of the posts here, you're gonna find a few folks who have managed to snag a CPAP/APAP on their own and are doing just fine.

Perchancetodream · Post by **Perchancetodream** » Tue Jan 08, 2008 4:34 pm

There are ailments other than OSA that can cause the symptoms you describe. You might be better off investing the $500 in a good sleep doctor to help you find the source of the trouble. Your GP, or a sleep doctor may be able to set you up with an at home test for apnea.

You might also want to look into Dr. Krakow's book on sleep, "Sound Sleep Sound Mind". I haven't read it (on order from Amazon and should arrive today) but I think Jeff and a few other members have.

Good luck,
Susan

Wulfman · Post by **Wulfman** » Tue Jan 08, 2008 4:46 pm

Another thing that your doctor can prescribe is a pulse-oximetry test. The actual test is "free" (if you don't count the doctor's office visit). He'll order the overnight test that'll tell whether your blood oxygen levels are dropping. With the prescription (he'll probably contract with one of the local DME shops) they'll give you a meter with a cable attached that clips to the end of one of your fingers and it records what happens through the night. Then you take it back to the DME and they send the printout to your doctor.
If it looks like there is a sufficient drop in your oxygen levels, the doctor may be able to set you up with a trial on an APAP machine to see what happens during the night.

Ask him/her about it.

Good luck.

Den

Slinky · Post by **Slinky** » Tue Jan 08, 2008 4:54 pm

To the best of my knowledge, one would do just as well w/an overnight oximetry which a doctor can script and often is either free or $75 at most on room air and then a second overnight oximetry w/CPAP at the end of a one month rental of an autoPAP. That one month rental gives the patient time to adjust to the mask. But by the time you add the monthly rental for a humidifier and most likely purchase of a mask you may not have much choice on to the autoPAP rental, you are likely pushing close to $500.

deglorious · Post by **deglorious** » Tue Jan 08, 2008 4:58 pm

I think your question is most appropriate for this forum. Follow the advice of the previous posters and ask your family dr. for a prescription, then you can get the machine you want. Check cpapauction.com for a machine or use your local dme.

Good luck and keep us posted. I hope you have good sleep in the future.

Deglorious

allen476 · Post by **allen476** » Tue Jan 08, 2008 8:06 pm

Perchancetodream wrote:There are ailments other than OSA that can cause the symptoms you describe. You might be better off investing the $500 in a good sleep doctor to help you find the source of the trouble. Your GP, or a sleep doctor may be able to set you up with an at home test for apnea.

I agree. I don't know if this is standard practice with most DME's but Lincare here not only wanted the prescription but had me sign so that they could get a copy of the sleep study as well. They told me they had to have it on their files before they could fill the script.

Good luck,
Allen

preemiern · Post by **preemiern** » Tue Jan 08, 2008 10:11 pm

check your pm's!!

Guest · Post by **Guest** » Wed Jan 09, 2008 5:10 pm

Wow! I can only express heartfelt thanks to all who have responded to my post. What an amazing resource you guys are. It will take me a while to digest everything but I did want to acknowledge everyone's help and support.

I confess I hadn't even thought about working with my GP on this (he is not the person I go to for medication; if fact he's pretty anti that sort of thing...with good reason of course. Still, in my case 'desperate times' have called for desperate actions none of which I have shared with him,,,but think now would be a good time to own up.

Also, such great thoughts on the overnight oximetry, apap, other at home tests, Dr Krakow's book (ordered it yesterday from Amazon)....I know I'm leaving out other good suggestions since I can't see the forum. Thank you guys so very much. I'll respond in greater detail when time permits. ONe quick question; do I keep adding to this thread, or do I start a new one with updates that may be slightly off topic to the original theme? I'd really like to let everyone know if (when!) you're help has born fruit.

Thanks again,
Tom

mindy · Post by **mindy** » Wed Jan 09, 2008 6:16 pm

Hi Tom,

You can add to this thread or start a new one when you come back - whatever is easier. I want to wish you the best in this venture and know we'd all like to hear how things work out for you!

Mindy

RosemaryB · Post by **RosemaryB** » Wed Jan 09, 2008 7:30 pm

Hi Tom,

There's one other thing you may be able to try that is low cost or free. It's called Apnealink by Resmed. It is a device that you take home. Many DME's offer it for free, but you need to have a doctor write a prescription for you. You could use this along with the oximeter. The oximmeter measure oxygen, but the Apnealink shows apneas. If a DME in your area has these (we have at least one in our area that does) this would give your doctor more information.

Generally apnealink is used by doctors to determine whether or not to send a person for a sleep study. But it will also give additional information to the oximeter.

I wish you well and hope you will post back and let us know.

WNJ · Post by **WNJ** » Thu Jan 10, 2008 2:22 pm

One caveat: You could possibly have central sleep apnea, rather than obstructive sleep apnea. CPAP/APAP can make central sleep apnea worse, not better. Central sleep apnea requires a different machine for treatment.

I don’t believe there is a way to tell whether you have OSA or CSA (or a combination) other than an initial sleep study.

Best to work with your doctor to the extent you can.

Wayne

Slinky · Post by **Slinky** » Thu Jan 10, 2008 7:23 pm

ApneaLink by Resmed also performs overnight oximetry. One of our local hospital's sleep labs offer it overnight for free depending on your "score" on a written sleep test. Not sure if it is the Epworth or another written test. Just a few symptom questions is all the written test amounts to.

RosemaryB · Post by **RosemaryB** » Thu Jan 10, 2008 8:45 pm

[quote="Slinky"]ApneaLink by Resmed also performs overnight oximetry. One of our local hospital's sleep labs offer it overnight for free depending on your "score" on a written sleep test. Not sure if it is the Epworth or another written test. Just a few symptom questions is all the written test amounts to.

Mask

Additional Comments: Equipment isn't correct, S9 ASV w/H5i

Machine	Mask