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[Diagnosis] Need advice please about the necessity of getting a machine
#1
Thanks in advance
I was diagnosed with sleep apnea but I was only at 5.9
I am with a hmo and its difficult to talk to my doctor
Is having a read of 5.9 serious enough to warrant a machine?
I don't trust a for profit hmo to be honest Sad
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#2
Hi LarryPer123 - Welcome

Most insurance companies usually won't approve payment for a CPAP if your AHI is below 20. It is also considered treated if your AHI is below 5. I'll be interested to see what they tell you.
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#3
At 6 events per hour, you stop breathing over 40 times per night. It disrupts your sleep and can mean you need to go to the bathroom, and may experience daytime fatigue or need to nap. If you don't feel it is adversely affecting your life and lifestyle at this time, then you may want to decline treatment for now. If you are experiencing common side-affects of sleep apnea, it will help to start therapy; just be sure to get an auto CPAP machine that will provide you with data related to the effectiveness of treatment.

Keep in mind, a sleep study is just a snapshot of your sleep disorder. It may be worse on nights when you sleep deeper without the test equipment. Whether or not to use CPAP should be decided in part based on your commitment to using it and sense that it will be beneficial. Ask for the complete results of your sleep study so you can see the types of events, and the results of the blood oxygen saturation monitoring. It's good to have this for your records, and the details may make a difference in making your decision, and let you discuss it with your doctor.
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#4
Thanks [url=http://www.apneaboard.com/forums/User-Sleeprider][/url]

I am always tired and my sleep is refreshed Sad
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#5
I had 30 events an hour. If my current numbers were 5.9, I would want to adjust my pressure to get under 2. But I've already have gone through the adjustment to being a masked fighter pilot at night
whether I would start cpap would be the o2 results from the sleep test and the length of time of the apneas. 5 x 10s ones or 5 x 30s ones are a big difference.
If my o2 fell below 90% I definitely would get a cpap.
new user http://www.apneaboard.com/wiki/index.php...re_success
mask fit http://www.apneaboard.com/wiki/index.php...ask_Primer
From machine or sleepyhead, set the min CPAP 1cm below median pressure. Or 2cm below 90/95%. max at 20cm for now. Forum will help you fine tune settings
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#6
your insurance should cover it.  as far as i'm aware you need to have an ahi >5.  which you do.  curious...what is your RDI ?

"if your always tired"  then that is why you were tested for sleep apnea.  test showed you were positive, albeit mildly, but positive.  next step is to fix it...which means cpap.  you could possibly talk with your dentist about a mandibular displacement device if you didn't want to go the cpap route, but that is no guarantee to fix apnea.

The previous responses are good.
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#7
Also, keep in mind the way a HMO works. They are paid a set amount for your health care for a year. Every penny they do no spend on you is a penny that goes in their pocket. So if they say a CPAP is needed, the chances are it is really needed. Unless there are extenuating circumstances that you've not shared, I'll bet they decline coverage.
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#8
(06-01-2017, 02:26 PM)TASmart Wrote: Also, keep in mind the way a HMO works. They are paid a set amount for your health care for a year. Every penny they do no spend on you is a penny that goes in their pocket. So if they say a CPAP is needed, the chances are it is really needed. Unless there are extenuating circumstances that you've not shared, I'll bet they decline coverage.

Thats true but I have Medicare who pays them
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#9
If it is an HMO it still is on a capitation basis - Medicare supplement will pay the HMO X per year to take care of you. They are not reimbursed on a cost or incident basis. The less the HMO spends on you the more goes into their profit.
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#10
Hi LarryPer123,
WELCOME! to the forum.!
Hopefully, you are able to get a CPAP machine to treat your sleep apnea, good luck to you.
trish6hundred
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