At home sleep test and treatment

[restwell]

Hi, 

I'm an entrepreneur passionate about the OSA space and making the process of diagnosis and treatment easier. 

Has anybody been diagnosed with sleep apnea and treated using only a home sleep test and telemedicine? If so, I'd love to speak to you about the experience (please private message me).

If you haven't, would you ever? Or did you feel your in-person experience (at either a sleep clinic, your PCP, or your DME) was instrumental?

Thanks!

[Sleeprider]

We encourage members to keep discussions on the forum when possible. No offense, but as a new member we know nothing about you or what information you might seek via the PM channel which is one reason the number of PMs are seriously limited for new members.

That said, home sleep testing is becoming common to save costs and some of the DME suppliers like Supplier #30 offer home sleep testing, evaluation by a physician and prescription services.

[Walla Walla]

[restwell]

Fair enough! Was just trying to avoid spam to other members. However, my question would still stand in the public forum: if anybody has gone through a full remote process (HST, physician evaluation, and prescription) I'd love to hear about the experience. Namely:

1. Why did you choose fully remote instead of going into your doctor?
2. How did you find the platform that you chose to use?
3. Did you feel well-supported throughout the process?
4. Was there anything that could be improved?

[Ron AKA]

However, my question would still stand in the public forum: if anybody has gone through a full remote process (HST, physician evaluation, and prescription) I'd love to hear about the experience. Namely:

1. Why did you choose fully remote instead of going into your doctor?
2. How did you find the platform that you chose to use?
3. Did you feel well-supported throughout the process?
4. Was there anything that could be improved?

I am from Canada and the process you describe has some similarities to what we have in our province. It starts with a simple questionnaire screening from a doctor which then is used if positive to schedule an appointment with a so called sleep clinic to pick up a take home sleep study equipment. In my case it was the Philliips Alice NightOne. You sleep one night with it at home and return the equipment for data analysis. It is not at all a comfortable process even though it is in your own bed. However, I believe it does work, and give you a reasonable diagnosis of your sleep apnea status. This data is reviewed by a technician and a doctor that you never meet. That report is sent to your doctor and he/she checks off one of three boxes; no treatment, treatment with dental appliance or CPAP, or CPAP treatment. It is dated and signed by your doctor and this becomes your prescription. There is no appointment with your doctor, but the doctor may schedule one in some cases, but not mine. The sleep clinic reviews your diagnosis and treatment recommended with you in an interview. They offer a free trial machine for two weeks. At the end of the two weeks if you are agreeable to CPAP treatment you can buy the machine from them at an exorbitant price of about $2400. If you have insurance, they will forward an estimate to them, and if they agree you get the machine. The other alternative is that you can buy your own machine at about $800-$900 from an on line CPAP supply company in Ontario. That province regulates the pricing of CPAP supplies. They will require a copy of your prescription which you can get from the sleep clinic or your doctor. 

Was I well supported and could anything be improved? Well I got a basic auto CPAP similar to the one I trialed on and I am now not sure it is the best choice for my condition. It turns out I have a higher portion of central apnea events, and I was not warned by the doctor or the sleep clinic that a standard auto CPAP may not be the best choice. I probably will achieve an average treatment level of <5.0 AHI, but it is not certain at this point. The next step up to a BiPAP machine may have been more appropriate and not all that much more in cost. There was no advice as to what the best machine might be given my higher proportion of central events. I did ask what the ratio was, but I was not that aware of the implications at that point. So my advice is that this is a method that may work best for those who are very well informed about sleep apnea, the various forms of it, and how it is best treated. And those who are very well informed on the cost of CPAP equipment and what hoops they have to jump through to buy it. 

Hope that helps some,

[Walla Walla]

Telemedicine? Sure I watch the Dr Oz show.

[Ron AKA]

Just as a follow up on my post about my home sleep test experience, here is a link to a somewhat local news article about issues with home sleep testing. I think it kind of repeats some of the things I said about my experience. My test was done after the new regulations were in force, but they are not really being enforced until 2020 or so. I will add I was not at all impressed by the knowledge of the so called sleep tech that gave me the equipment and explained the report. She told me that a CPAP would cure my diabetes. Yeah! Tell me another one...

Alberta Unregulated Sleep Clinics Face New Standards

[CB91710]

Telemedicine? Sure I watch the Dr Oz show.

LOL!

Seriously....

I went to my GP and got a referral to the sleep center.
I was dreading the thought of sleeping in a strange bed wired up.
They gave me a simple device with two torso bands, a pulse oximeter, and a cannula.

I ended up having to run the device for 3 nights because the first night I did not have a high enough AHI to justify treatment.

I was issued a loaner Airsense, and the sleep center monitored the data for 2 weeks, then I was issued my permanent machine.