At Home Sleep Apnea Test

Sir NoddinOff wrote:A few months ago I had a long conversation, via the telephone, with the main sleep tech at 1800CPAP. The home testing process does include a prescription if you exhibit apnea symptoms, however he was very upfront about the fact that Medicare, Medicaid and many insurance companies generally will not accept their prescriptions. My feeling was that if a self-treating patient wanted to buy new equipment from 1800CPAP, that they would be happy to sell you a new machine if you are willing to put up the cash for it. That being said I've bought masks and minor stuff from them in the past and they do have good prices and fast free shipping with no tax - no complaints there. However that being said, our website host also has very good discount pricing also. Something to consider.

Thank you, Sir, but since my COBRA coverage ended today, insurance is not an issue. Not sure if that's the good news, or the bad news, but I'm hoping to successfully complete this at home test, and can't find info on how tightly the chest strap should be attached. Thoughts? Best guesses, appreciated!

G'night Gracie wrote:Thank you, Sir, but since my COBRA coverage ended today, insurance is not an issue. Not sure if that's the good news, or the bad news, but I'm hoping to successfully complete this at home test, and can't find info on how tightly the chest strap should be attached. Thoughts? Best guesses, appreciated!

When I had a home test done several years ago I remember the chest strap being snug but not tight, certainly not uncomfortable! The straps rested on my skin but didn't press into it. I also remember being told to shave my chest hair around that location, but probably not a big deal for women I also remember that once the blood O2 finger clip came off my finger in the middle of the night, so I put some tape around the edges to prevent it happening a second time. Sounds like 1800CPAP might be a good fit for you, let us know how things turn out. EDIT: Now that I remember correctly, the shaving was for the sensors that were taped to my chest, not for the strap!

Sir NoddinOff wrote:

G'night Gracie wrote:Thank you, Sir, but since my COBRA coverage ended today, insurance is not an issue. Not sure if that's the good news, or the bad news, but I'm hoping to successfully complete this at home test, and can't find info on how tightly the chest strap should be attached. Thoughts? Best guesses, appreciated!

When I had a home test done several years ago I remember the chest strap being snug but not tight, certainly not uncomfortable! The straps rested on my skin but didn't press into it. I also remember being told to shave my chest hair around that location, but probably not a big deal for women I also remember that once the blood O2 finger clip came off my finger in the middle of the night, so I put some tape around the edges to prevent it happening a second time. Sounds like 1800CPAP might be a good fit for you, let us know how things turn out.

OMG! I will totally not be shaving my chest, but SO appreciate the funny visual and the laugh! Thank you for your reply!

Here's an interesting question that just occurred to me ... will our website host, https://www.cpap.com honor 1800CPAP prescriptions??? Carolyn, care to join the discussion?

Mine was just snug. Less tight then my bra but it didn't move around and was comfortable to sleep with. I had my stuff fitted on me by the hospital lab so I knew how it would assemble.

I would go with "fairly snug", checking the fit after you lie down.

Sir NoddinOff wrote:Here's an interesting question that just occurred to me ... will our website host, https://www.cpap.com honor 1800CPAP prescriptions??? Carolyn, care to join the discussion?

I would think that any supplier would honor the prescription. 1800CPAP would be committing crimes if the prescriptions are not written by licensed professionals.

But that does not mean that Medicare or an insurance company will accept such a study as a basis for paying for your equipment. They can set their own criteria for that.

Home tests aren't for everyone. The AASM approves the use of home tests only if you meet the following criteria.

You are between 18 and 65 years of age. Home sleep tests are not recommended for children or older adults.
You have a high risk of moderate-to-severe sleep apnea. Your risk for sleep apnea can only be determined by a complete sleep evaluation. Key risk factors include loud and frequent snoring, daytime sleepiness, obesity, and witnessed pauses in breathing during sleep.
You have no other major medical problems. Other medical problems can affect the results of a home sleep test, including lung disease, neuromuscular disease, and congestive heart failure.
You have no other sleep disorders. Other sleep disorders also can affect the results of a home sleep test. During your evaluation the sleep specialist will determine if you show signs of having another sleep disorder. Examples include central sleep apnea, periodic limb movements, insomnia, parasomnias, circadian rhythm sleep disorders, and narcolepsy.

You also may be eligible for a home sleep test if health or safety concerns prevent you from being able to leave home for a night. A home sleep test also may be used to evaluate your response to some sleep apnea treatments, including oral appliances, surgery, and weight loss.

You will need to go to a sleep center for an overnight study if you do not meet the criteria listed above.

http://www.aasmnet.org/jcsm/acceptedpapers/pmproof.pdf

PolysomnoGuy wrote:The AASM approves the use of home tests only if you meet the following criteria.

However, this point is relevant only if you happen to be going to an AASM-accredited sleep entity.

Because if your INSURER doesn't approve it, then HST here we come.

And if your HCP does not know the "Key Words" when securing pre-certification for the PSG, then HST here we come.

And unless you get a "complete sleep evaluation" (which would only occur if one went to a "sleep specialist" (and one might argue about the quality of the "sleep specialist" if all they're doing is operating an OSA factory)) then HST here we come.

Further, the type is device is critical here. If they're using a Type IV device you better hope that you have a 20 inch neck and your wife says "Omigod! He stops breathing for 2 minutes at a time!"

ApneaLinkPlus (the device the OP is using) as a Type III device, still has limited-data capability (I don't know why they even call this a "Home Sleep Test" anyway. It doesn't measure sleep).

Hey GNC! Why not get an "archived" copy of the actual study when you're done? Then we can see how good they (and this is an all-inclusive "they"- equipment, personnel, etc.) are.

Call them up and ask them BEFORE you send it back.

Also, how many nights are you doing?

Why do they charge you 2000 for the unit if you don't return it? The thing only costs 350.

Hey, I see what business they're in...

mollete wrote:Hey GNC! Why not get an "archived" copy of the actual study when you're done? Then we can see how good they (and this is an all-inclusive "they"- equipment, personnel, etc.) are.

Call them up and ask them BEFORE you send it back.
I like the idea of getting a copy. I'll call and ask.

Also, how many nights are you doing?
One night.

Why do they charge you 2000 for the unit if you don't return it? The thing only costs 350.
They said they'd had trouble getting the units returned and/or returned in a timely fashion. The $2k will certainly motivate me to send the device back promptly!

Thanks to everyone who commented. The equipment came assembled, so all I had to do was attach it to myself. I went with "snug" on the chest belt, the finger sensor was obvious, and hope I got the nasal cannula in the right position. Will keep y'all posted on how things go from here.

Thanks for sharing your experience. Please keep us posted with your outcomes and overall experience.
I have recently read some articles were they compared HST with auto cpaps vs. in lab titrations and set cpaps by a physician and in most studies the results have been very similar for both groups. Here is a link to one of the articles: http://www.journalsleep.org/Articles/291110.pdf

If done correctly I think you should be fine.

Regarding 1800cpap. I have never dealt with them or even heard of them but if someone is claiming I am going to receive a Rx and then never send it or send a "fake" one I would be calling, emailing and threatening to report them to the FDA, BBB etc.. Until I got my prescription.

Please keep us posted and Good luck!

teachcsg wrote:If done correctly I think you should be fine.

Could you explain what you mean by this in a little greater detail?

Thanks!

In my opinion no reputable DME would provide you a CPAP machine without a prescription from a board certified Doctor, Dentist, or a few other specialists. This is Medicare requirement and all health insurers in the U.S. follow. Several "At Home Sleep Test" entities do it with the cooperation of Doctors as mentioned above.


About Medicare requirements:

"The role of the physician with respect to home medical equipment:

•Every item billed to Medicare requires a physician's order or a special form called a Certificate of Medical Necessity (CMN), and sometimes additional documentation will be required such as copies of office visit notes from prior visits with your physician or copies of test results relevant to the prescription of your medical equipment.
•Nurse Practitioners, Physician Assistants, Interns, Residents and Clinical Nurse Specialists can also order medical equipment and sign CMNs when they are treating you.
•All physicians have the right to refuse to complete documentation for equipment they did not order, so make sure you consult with your physician about your need for medical equipment or supplies before requesting an item from a provider."


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