Test Results In - Considered Severe

Ok here we go - Just got home from the Doc and got my Sleep Study results - Severe Obstructive Sleep Apenea Syndrome

Results are as follows

Baseline Summary:
Total Sleep Time - 120 minutes
Sleep Efficiency Index - 70%
Sleep Latency - 30 minutes
REM Latency - 286 Minutes
Apnea-Hypopnea Index - 105 per hour
Lowest Oxygen Saturation - 79%


Some Notes:
Latency to State REM sleep was delayed at 286 minutes - sleep staging was notable fore th absence of sleep stages 3,4 and REM during the baseline period. - Don't understand what stage 3,4 are

Patient demonstrated an overall Apnea+Hyponea indes of 105 events per hours - This included 153 obstrucitve hypopneas, 6 obsructive apneas, 1 central apnea and 51 mixed apneas. Oxygen saturations were typically in the 92-94% range with cyclic desaturations to 84% - loowest saturation was 79%

Optimal CPAP pressure was 15-17 cmH2o reducing the Apnea+Hypopnea index to 8 events per hour, including REM and supine sleep.


Recommendation is Nasa CPAP at 16cmH2O - alternative pressure: 14-15 cmH20

Comments / suggestions / discussion is welcome and encouraged. Doc is faxing perscription to local DME (same group who does the study), but I am looking into buying directly from cpap.com. still talking with insurance about how to proceed.

Want to get REMstar Auto C-Flex CPAP, Encore Pro Software & Smart Card Reader, and still looking at mask. was tested with a Comfort Gel mask according to the study.

Guess I am a formal member of the community now


Don

Hi Don,
Welcome.
Stages 3 and 4 are the Slow Wave Sleep (SWS) stage, the stages where sleep is deep, and where the real rest and recuperation occur. Many of us don't get there because our obstructions have us bouncing awake before we ever reach stage 3 and 4.

REM -Rapid Eye Movement sleep is when we dream. Apneas are frequently more frequent in that stage.

Good luck,
O.

Thanks, appreciate the support. Just talked with the recommended DME, and they know nothing. all he could/would tell me that they they have a remstar m machine, they don't recommend that you use the encore software because it scares people, and other then that they only carry two machines, both remstars. Not a whole lot of help they are.

Talked with "billmyinsurace.com", and they are "out of network" for my insurance so they prefered not to work with me


Starting to really enjoy this adventure

Don,

I love that recommendation from the DME don't use the software becuase is scares people. That was the same thing my Dr said about using a pulse oximeter. However, even though he didn't recommen using it, he did write me a prescription for one. Some say you need it others say you don't, it depends on where you buy it.

Anyway, although the software can be a little intimidating and takes some learning to understand, the data can be invaluable.

Are there any other DMEs "in network" for your insurance? If not what is their policy regarding repayment on out of network out of pocket purchases? Also, check your co-pay/deductible, it can be more than the cost of paying out of pocket through cpap.com, depending on your coverage. Its amazing how much DMEs bill insurance for vs. cpap.com's cash prices.

Good luck!

communilink wrote:Thanks, appreciate the support. Just talked with the recommended DME, and they know nothing. all he could/would tell me that they they have a remstar m machine, they don't recommend that you use the encore software because it scares people, and other then that they only carry two machines, both remstars. Not a whole lot of help they are.

Talked with "billmyinsurace.com", and they are "out of network" for my insurance so they prefered not to work with me


Starting to really enjoy this adventure

Have you checked with your insurance provider to see if they will reimburse you for out-of-pocket purchases (YOU should be considered in-network to them). If they will, you should be able to purchase what you want from CPAP.COM and then submit an invoice from yourself to them for the equipment.....then they would reimburse you at the in-network rate.

Den

Do what Den (wulfman) said. You will be happy you did - since it's obvious that your DME doesn't know what the heck he is talking about.

I have sent you a PM (private message). Click on the upper right on "You have messages" box.

PS: Good machine choice. it's what I use and have no problems.

I think you definitely want an Auto machine - it allows you to use a lower pressure the majority of the night, but bumps up when needed to stop apneas.

It does appear that I won't be able to get the "auto" though, I will have to start with the Remstar Pro M series, as the doctor does not believe there is a justification for the auto since I did so well with a single pressure during the study. I was also able to talk with a different employee at the DME and he was very helpful, provided alot of information regarding what machines they had available, and even told me that if I wanted a specific machine, to have the doctor prescribe that machine and they would order it in with no problem. I do have to rent for 90 days, and then convert to purchase. Insurance won't approve straight to purchase. Thanks for all the help!!

What they pay if I go out of network is pretty low

Don

communilink wrote:What they pay if I go out of network is pretty low

Don,

I think you missed my point......YOU should be considered "IN-NETWORK" to your insurance provider.

Did your insurance provider tell you that you had to rent for 90 days or did the DME? I'll bet you could challenge them on that. Does your insurance pay 100%?

With a prescription for a CPAP, you can get an APAP from CPAP.COM.
At least with the Pro M machine, you can monitor your therapy.

Den

I spoke directly with my Insurance company, they require that you rent for 90 days then they will purchase outright. This is to verify you use the machine.

They also said that they would only pay 70% of the "out of network" agreed on price (not the actual price of the machine) if I bought it myself or went to a non approved DME. I think I will deal with the rental for 90 days to get more information so that I can try and move to an Auto. From talking with the Doc and the DME, I guess that my case is severe, but because my study was a "split night" and did not do specific titration studies for variable pressure, I can't get an auto at this time.


As far as monitoring, if I buy the encore software from cpap.com, will that work with the new "M" machines?

Just so you know. I have the same situation with insurance. I spoke directly with them numerous times and they will not buy without a 90 day rental. Also, they will pay out of network on Cpap.com, but I have a separate out of network deductable that makes this a joke. The machine is less than the out of network deductable. They will not cover anything with me as a provider (lucky Wulfman that his will). Great that some people seem to have made this work but I understand your delima.

Only other item I want to comment on is the pressure range statement due to split night sleep study.

I had a 2 full night studies and I got the same line from the sleep doctor about not being able to give a range since it was a study for a CPAP titration (MINE WAS NOT A SPLIT NIGHT LIKE YOURS AND I GOT THE SAME LINE). Personally I thing it is a load of "$&%$%^U"

If you are happy with your rental CPAP go for it. BUT if you have trouble due to the really high pressure you will be set at, get back in there to see the doc and complain. APAP in your case might be very helpful, due to not having that really high pressure all night. Might reduce mask leaks etc. A lot of insurance will pay for APAP if the patient tries CPAP and has issues that the APAP will help with.

So try their machine (CPAP) but think hard about how you feel about it before you put too many months on the rental.

One and maybe the only advantage to renting is that it can be switched to an auto.
Why would they switch you to an auto. At the pressures you will be using aerophagia or air swallowing is common, can cause bloating, pain, cramping, flatulence. APAP can help that. Someone may have other reasons to switch.