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Home AND Lab Sleep Studies?
#1
Hey all,

New here and I have a question. My wife, who is studying to be a PA, has been pushing me for some time to get a sleep study, after dealing with my horrendous snoring and witnesses me stop breathing during the night. I finally went to the doctor who prescribed an in lab study. My insurance (Aetna) denied the in lab study in favor of an at home study. I ended up using a Watermark Ares for my home sleep study. I just learned that the results came back as "significantly abnormal" (all my doctor told me -- I'm not sure what questions to even ask). In turn, the sleep lab is now recommending I get an in lab study also -- they are submitting a claim to my insurance again, hoping they will approve it this time. Is it normal to required both forms of sleep study? How likely is it my insurance will actually approve it this time?

Thanks for any help!
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#2
Hi heavydutydev,
WELCOME! to the forum.!
Hang in there for more responses to your post.
trish6hundred
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#3
Ask for a copy of the report and explain "significantly abnormal"
We should not be guessing, the doctor ought to explain the result in details so you know whats going on

Home study has limitation ... Lab study can reveal and diagnose other sleep disorders than just plain OSA

Best of luck
Happy wife ... Happy life


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#4
I agree with zonk. You need to get a copy of your test report.

I only had lab sleep studies. Sleep-well
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#5
(04-01-2013, 04:43 PM)cbramsey Wrote: I agree with zonk. You need to get a copy of your test report.

I only had lab sleep studies. Sleep-well

I was able to get my full results from my doc through their patient portal. After reading the results, I guess I understand why the sleep specialist wants an in-lab test. The results seem somewhat inconclusive and the specialist believes the at-home test may have underestimated the problem, based on my symptoms. The results are as follows:
AHI: 3
RDI: 10
Time <90% SpO2: 2%
Mean SpO2: 93%
Time Snoring >30 dB: 25.5% (10.9% very loud)
Sleep Latency: 6 minutes
Sleep Efficiency: 85.9%

The other thing the sleep specialist pointed out that has me slightly concerned is pulse rate variability, with >115 episodes per hour or heart rate increase/decrease >= 6 BPM (mean: 64, max: 91, min: 47). He recommended my doctor follow-up with a cardiac evaluation. At 25, my heart was not something I had hoped to worry about.
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#6
Me too.
#1. Get that lab report. If they get all squicked about giving you that holy document then walk out on them.
They are a bunch of crooks and you need to find another Dr.

#2. Looks like the insurance company is the problem here. They don't want to pay up.

#3. From the sound of it, methinks you are likely to be having apnea problems but I'm not your Dr. so you might get the sleep study
anyway if you and your PCP kick up enough fuss.

If that doesn't work then you can go to plan 'B'
Start buying a few things you need to be able to demonstrate that you *DO* have sleep issues.
Hopefully you wont need to go to plan 'B'

Cheers & Good Luck!
"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#7
(04-02-2013, 10:17 AM)Shastzi Wrote: Me too.
#1. Get that lab report. If they get all squicked about giving you that holy document then walk out on them.
They are a bunch of crooks and you need to find another Dr.

#2. Looks like the insurance company is the problem here. They don't want to pay up.

#3. From the sound of it, methinks you are likely to be having apnea problems but I'm not your Dr. so you might get the sleep study
anyway if you and your PCP kick up enough fuss.

If that doesn't work then you can go to plan 'B'
Start buying a few things you need to be able to demonstrate that you *DO* have sleep issues.
Hopefully you wont need to go to plan 'B'

Cheers & Good Luck!

Results posted above Smile We must have posted at about the same time.
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#8
Oops. Got it heavyduty!

Big Grin
"With ordinary talent and extraordinary perseverance, all things are attainable." - Thomas Foxwell Buxton

Cool
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#9
Do the lab test. And get a cardiac follow up just to safe. Age is no factor when heart problems arise, believe me. If apnoea can strike at a young age, so can heart problems, so heck it all out - if nothing else comes form it, you have a base line to refer to should later problems crop up.
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#10
Just thought I would follow up on this. I had my lab sleep study last night -- amazingly (perhaps unfortunately?) I feel like I slept better at the lab than I do at home. My insurance requires split-night studies, and they set me up with a mask at the start of the night, but they never came in to actually put me on the CPAP. I'm not sure if this means that I don't have sleep apnea, didn't meet their threshold, something like that? The lab techs of course wouldn't really tell me anything, but after forgetting my pillow and going back in with a different tech (not the one that observed me), this other tech told me that they were looking at my results and that my breathing patterns appeared similar to my home study. Given that my home study seemed rather inconclusive/leaning toward not having sleep apnea, I'm not sure if this is a good result. It appears my insurance will not cover the CPAP unless AHI is above 15, or AHI of 5-15 with significant daytime impairments.

I guess now is the waiting game -- I am supposed to hear back within 10 business days.
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