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Did in-home sleep study, seeking referral to remote sleep medicine doc (telemedicine)
#1
Did in-home sleep study, seeking referral to remote sleep medicine doc (telemedicine)
Hi Folks,

I had an in-home study - just wore a headband gadget for three nights. I did this through a dentist office - only cost $200. I just took the device home, followed the instructions, and brought it back. (Why a dentist? They sell dental appliances for sleep disorders.)

A doctor wrote a report with the results, I have mild apnea. Report suggests CPAP or a dental appliance.

The doctor is outsourced, impossible to reach. The whole system is convoluted.

I'm wondering if there's a web-based service where I can fwd my test results and get some guidance. I'd do it locally, but it's very expensive, with opaque pricing.

I needn't remind the members here what a clusterf*ck our health care system is.

Anyway, recommendations?

Thanks.
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#2
RE: Did in-home sleep study, seeking referral to remote sleep medicine doc (telemedicine)
Post your study here.  We understand that stuff pretty well.  We have been thru it ourselves.
Look at the success link in my signature.  Lots of stuff about what you are facing.

Oh and welcome to the Apnea Board Forum.

Fred
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#3
RE: Did in-home sleep study, seeking referral to remote sleep medicine doc (telemedicine)
If you have a digital version of the report, take screenshots and share here. Be sure to remove all personal data (name, address, email, etc). Just remember: we are not medical professionals. We're a bunch of folks who have been there, done that.

A dental device is iffy in terms of treatment. There's no way to prove the device is working other than a recording oximeter to see if the blood oxygen levels drop. Which isn't a bad thing, it's just different people's oxygen levels drop at different rates. So it's reliability is questionable. And it is your ONLY dataset.

The best thing is a CPAP machine. It keeps viewable, trackable, reliable data. An auto-PAP (or APAP) is recommended, actually. It adjusts to what you need. It could take time to find the treatment range if you are doing this on your own. Not too long, anywhere from a month to 6.

There's a lot of us who do this on our own. It is easier. Usually cheaper. Quicker. And less arguing.
PaulaO

Take a deep breath and count to zen.




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#4
RE: Did in-home sleep study, seeking referral to remote sleep medicine doc (telemedicine)
Hi Folks,

Here's my sleep study. Feedback much appreciated.

I have a Resmed 9. I tried using it once before, but I couldn't make it comfortable.

https://www.dropbox.com/s/xy4shypl8kln06...m.pdf?dl=0
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#5
RE: Did in-home sleep study, seeking referral to remote sleep medicine doc (telemedicine)
Thought I'd bump this.
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#6
RE: Did in-home sleep study, seeking referral to remote sleep medicine doc (telemedicine)
Sorry I missed the orig post

10/9   AHI 8 RDI 14
10/20 AHI 8 RDI 17
10/23 AHI 7 RDI 11 w oxygen desats

Overall AHI 8
           RDI 14
Both are considered Mild

The best treatment IMHO is the Auto-titrating PAP or AutoPAP with a suggested range of 5 - 20
IMHO the machine of choice is the ResMed Airsense 10 AutoSet.
This machine is fully data capable which is a very important consideration if you go this route.
Your dentist should be able to write a prescription for the above but she may be more inclined to offer a MAS Mandibular Advancement Splint or MAD Mandibular Advancement Device

One question I do have, alright two,
Why was the Sleep Study recommended?
How do you feel?

a 3rd one, what is your insurance situation?

Fred
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#7
RE: Did in-home sleep study, seeking referral to remote sleep medicine doc (telemedicine)
Thanks for persisting in asking for a response. Your AHI is "mild" but it is not at a level that anyone on this forum accepts for themselves. Events are high enough to be disruptive to sleep and to cause fatigue and impairment of your daily activities, especially those requiring concentration and alertness. The snoring and events would readily be treated by CPAP, and the logical choice here is a Resmed Airsense 10 Autoset. The Resmed does a great job of self-titration and you will quickly find your optimum pressure range. It allows up to 3-cm difference between inhale and exhale pressure, so it will treat hypopnea and flow limitation more effectively than a Philips machine. Your biggest challenge is to find a mask that is most comfortable for you. A nasal interface is the best to start with, and I would suggest nasal pillows like the Resmed Airfit P10 because it is quiet and the least intrusive interface. If it turns out you cannot tame mouth leaks, that is something to resolve after you try the smaller. more comfortable mask.

I assume you will be asked if you want to start CPAP treatment. You should accept and ask for the best possible equipment that will help you succeed.

Edit: Fred, we did it again.
Sleeprider
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www.ApneaBoard.com

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#8
RE: Did in-home sleep study, seeking referral to remote sleep medicine doc (telemedicine)
SR I saw that and just chuckled.  And with essentially identical advice.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#9
RE: Did in-home sleep study, seeking referral to remote sleep medicine doc (telemedicine)
Thanks, all. To answer some Qs:

Why was the Sleep Study recommended?

It wasn't - I pursued it myself due to longstanding poor sleep and daytime fatigue.

How do you feel?

See above - not great.

What is your insurance situation?

Super high deductible plan, ridiculously opaque pricing structure, i.e., "How much will this cost?" "We don't really know. Why don't you waste an afternoon calling around until you give up?"

I own a Resmed Autoset 9 and a Dreamwear Full Face mask. I tried them once before, but found them very uncomfortable. Would folks recommend a nose-only mask?

What about hiring a sleep tech to come to my home and help me set up my gear? I know folks here like the DIY approach, but I would benefit from having an expert help me on-site. Or is this something that can be done via Telemedicine?

Thanks,
Night Owl
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#10
RE: Did in-home sleep study, seeking referral to remote sleep medicine doc (telemedicine)
You can’t adequately and shouldn’t be trying to figure out your sleep apnea and treatment on your own. You need to see a physician practicing sleep medicine or go to a sleep medicine clinic. You can get great information on this site but you need to see a doctor, a sleep medicine specialist. Even though you don’t have great medical coverage seeing a sleep specialist could well be a life altering, life saving event.
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