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Home apnea hypopnea testing
#1
I see vendors offering home testing offering APAP prescriptions for  those identified with sleep apnea issues.. Are these legit and of adequate quality for those without resources or insurance for the normal sleep center testing under guidance of pulmonologists?
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#2
They are adequate to get a prescription and get started with therapy.
They are legit and comply with US law.

The full up polysonography, in theory, is better as it measures more items of interest in a sleep study.
Where this expensive process breaks down is: Few people are comfortable in the sleep lab which skews the data.

For the under or uninsured, it's a viable way to go.
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#3
They are legitimate in most cases, and in some cases a medical professional is paid to review questionnaires (basically Epworth Sleepiness Scoring) to identify if the person is at risk for sleep apnea. An actual sleep test may not be required where sufficient evidences exists for potential sleep apnea, and an auto CPAP machine may be recommended/ prescribed. In other cases a home test unit is sent out, and the results evaluated by a professional, and a Dx and Rx can be issued. Depending on the conditions of the test, that prescription may be used anywhere, or only at the site where the prescription was issued.

Whether these questionaires and homes tests are adequate is open to debate. Insurance is leaning towards using home sleep apnea tests which cost a few hundred dollars, vs full polysomographic diagnostic test in clinics, followed by self-titration with auto CPAP. Considering the potential savings, I think this works very good for most people, and a few with complications will need more follow-up. If what we encounter on the forums is any indication, I think the sleep specialists and clinics are huge money machines that rarely get better results than DIY and education.
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#4
High marks to Sleeprider for best answer.

I had not considered the questionnaire as a "sleep test."
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#5
JM, your answer was very good, and we were responding at the same time. There are no "requirements" for writing a prescription, only that one must present a prescription from a doctor, dentist or other prescribing professional, in order for a DME to dispense a machine. If insurance is involved, they may stipulate additional proof of medical need before reimbursing the cost. As long as a professional can form an opinion that his patient may benefit from CPAP, a prescription can be legitimately written.

I think we often confuse the simple requirement for a prescription, with some of the more expensive and complicated requirements imposed by insurance or government medical programs. Just think how much less expensive this would be if insurance was not in the picture.
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