RE: Home Sleep Study
It's a tough call, because we do not know the motivation.
I had both studies as well, but I figure the home study was good for an initial diagnosis. I only had the full study after 50 days of APAP at 5-20, which was a bit of a wild ride and only lowered my AHI from ~56 to ~8.5. The full study included titration, which informed the doc as to how to set the range a little better, and then AHI went under 3.
But here is the important part, which is I got SleepyHead, learned what was going on through research (much of it from the fine gurus on this forum), parsed my own data, took control of the therapy myself, tweaked the settings based on that, and brought that down to a 1.7. So I recommend this to you.
Was the motivation to get a payday from a home study and a sleep study both? I have no way of ever knowing. But I would like to think that they had my best interests at heart, and that it was critical to the therapy. I think that often the home study, which is a mere fraction of the cost of a full study, plus has a much better compliance factor (folks are intimidated by the full study, and rightfully so, so many blow it off), can be a good way to go because if it shows you do not have apnea or have mild apnea, they can then treat that without the cost of a full study. But often the home study reveals that they need to dig deeper. They could do that by just doing the full study, but that is a roll of the dice; costly if it turns out not to have been necessary (you won't know without doing it or without the prior home study), and then there is that compliance factor.
So I am on board with having both, as it is the best assurance of the best diagnosis for those of us who have severe OSA or something even more complex and dangerous. And my insurance co seems to think this roll of the dice is a good strategy as well, as they paid for both. If they hadn't, I might not agree quite as much, but I would also not want to save a couple of hundee by not taking the full test and not finding out exactly what the therapy should be, and therefore not getting the exact therapy I need.
Without the full test, the fact that an ASV or a BiPAP or supplemental 02 might be required might not even register with them. These are things you do not want the doc to miss. I used the experience as an opportunity to pick their brains on the subject, with intelligent questions based on my research and the help and advice of folks on this forum, some who have posted here right in this very thread. I never would have discovered the P10 without the recommendation of the sleep tech in charge of my full study, who has 26 years of experience doing this. Every little bit of what they do and know can be valuable info you would otherwise miss.
So this is another reason why I recommend parsing your data and taking control of the therapy; if you know your data well and the machine is telling you there are no instances that signify maybe that you need a full test, then if they are asking for one, you have a very hard question for them to answer as to why, and if they are simply gouging those that are uninformed to pay their sleep clinic bills, trying to slip one past them, this may be a deterrent to them gouging someone who knows what is going on.
Information is power. We know to not let the used car guy sell you the undercoating, and you can use knowing what is going on to prevent that sort of thing from being a waste of your time and money taking a sleep study that you possibly don't need.
But start from the assumption that you do; it's better to be gouged and get the right therapy than to not be gouged and not get the right therapy.
One last thing; the full lab sleep test is a document that holds up in court. What I mean by that is that if it shows you have a certain condition that should be treated, the last thing an insurance co or doctor wants is to be cast in the role of being an entity standing in the way of that. So it compels them to sign off on the therapy. A home study maybe is not as airtight. It might be easier to make a "he said; she said" issue out of something that is not as definitive as a full test. Potential litigation is a powerful motivator, and may be one of the reasons why they seem to want the full test, which is why docs routinely overtest everyone for everything. In their minds, they are erring on the side of caution, an argument that has a certain amount of merit. I would rather be overtested than undertested.
(This post was last modified: 02-23-2015 09:35 PM by TyroneShoes.)