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New Dr - Sleep Study
#1
Question 
Hi Everyone!

First, I would like to thank everyone for the hours of learning and entertainment I've gotten from reading the forums over the last few weeks.

In 2010, I had a split sleep study and was diagnosed with complex sleep apnea. I was given a Respironics BIPAP autoSV Advanced (1042907) and a Resmed Mirage Quattro FFM. I used it for about 3 weeks and abandoned it after a couple scary incidents with the machine. I should have pursued it with the doctor or DME, but I just didn't have time nor feel comfortable doing so.

I recently scheduled a consultation with a neurologist who works with the sleep center where I had the study done, not my original doctor though. The appointment is next week and I am unsure as to what my options might be and what I should ask for other than I wish to continue therapy now. I am bringing the machine w/card and the DME paperwork with settings on it.

Question: Should I ask for another sleep study or is the original split study enough to satisfy the insurance company? I have to pay 10%, so I'm leaning towards seeing if the original study would stand. I would also like new machine.

Does anyone have experience stopping treatment and going back?

Thanks in advance for any advice or experiences that might help me figure this out.
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#2
Hi ewok,
WELCOME! to the forum.!
Hang in there for suggestions and answers to your question and better luck to you the second time around.
trish6hundred
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#3
It's going to depend on the doctor and your insurance.
I took a run at CPAP in 2004. I didn't stick with it.
Then, in 2009, I got serious and went to the same doctor.
I had to have a split night study; and was issued an S8 VPAP.
I have been compliant since 2009; and upgraded my machine to an S9 in 2014.

I may find myself in a similar situation. I last saw my sleep doc in March.
I had a 6 mo appointment scheduled for September.
Meantime, my sleep doc pulled up his shingle and went to another state.
So, I have an appointment for November with a new doc in the same practice group.
If he wants me back in the sleep lab; sparks are going to fly.
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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#4
Hi ewok,
It depends on your doctor and insurance. It's been 5 years, and they may want another sleep study done. Five years is a long time to go with untreated apnea, and it may be worse that before.

You don't say what your issues were with your original machine, but the pressure probably was not set correctly.
OpalRose
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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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#5
Thanks trish!

Hi justMongo, yeah, I guess it will all depend on the doctor and insurance. I guess I was mainly looking to see if I should try and put up a fuss pointing out that the new doc has access to the old study. Good luck with the new doc and avoiding another sleep study. I'm wary of going again as I know it would be split. Check in time is always 8pm at the sleep center here and I NEVER go to sleep before 1am normally, so I'm a wreck the next day.

Hi OpalRose, you're right, doctor and insurance will really drive the decision and I might not actually get a say. You do bring up a good point, maybe I need a new sleep study anyway. As for my issue with the other machine, you may be right. Twice during the 3 weeks I used it, I woke up feeling like I needed to take a deep breath but the air wasn't forthcoming. The machine was on and blowing air, I just couldn't get enough air and felt like I couldn't breath. I had a FFM, so I ripped the mask off so I could breath and couldn't shake the feeling, scared the daylights out of me.
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#6
(10-05-2015, 09:28 PM)ewok Wrote: Hi Everyone!

First, I would like to thank everyone for the hours of learning and entertainment I've gotten from reading the forums over the last few weeks.

In 2010, I had a split sleep study and was diagnosed with complex sleep apnea. I was given a Respironics BIPAP autoSV Advanced (1042907) and a Resmed Mirage Quattro FFM. I used it for about 3 weeks and abandoned it after a couple scary incidents with the machine. I should have pursued it with the doctor or DME, but I just didn't have time nor feel comfortable doing so.

I recently scheduled a consultation with a neurologist who works with the sleep center where I had the study done, not my original doctor though. The appointment is next week and I am unsure as to what my options might be and what I should ask for other than I wish to continue therapy now. I am bringing the machine w/card and the DME paperwork with settings on it.

Question: Should I ask for another sleep study or is the original split study enough to satisfy the insurance company? I have to pay 10%, so I'm leaning towards seeing if the original study would stand. I would also like new machine.

Does anyone have experience stopping treatment and going back?

Thanks in advance for any advice or experiences that might help me figure this out.

Hi Ewok,

I'm going in for my 4th sleepstudy/titration tonight. New Doc says the original sleep study has a diagnosis (severe obstructive apnea) that is inconsistent with my symptoms and the many charts and graphs I printed out from Sleepyhead software. I have Central Apnea so the Doc says I need a new diagnosis and titration to satisfy insurance requirements. She can't prescribe an ASV machine without a consistent diagnosis. An ASV machine also needs a titration according to the Doc. Thus my 4th sleep study. I hope this helps with your situation.

Rich
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#7
Hi richb, thanks for the input.
4th?!? Oh-jeez My 2nd night was titration and luckily the tech caught that the cpap was sending my CSAs skyrocketing and switched me to ASV that night, which got good results... well in the sleep center at least. Hope your 4th is the charm and gets you what you need Smile
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#8
ASVs are much more complex machines. There are more setting to get correct.
Unlike plain vanilla OSA, where an AutoPAP can be used; and it will seek to the best pressures.
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
Hi again... answer is in... new sleep study it is.

The doc originally wanted to get my Respironics legacy ASV serviced and put me back on it based on my 5 year old study. The original DME went out of business, so it was a non-starter.

Now I'm waiting on pre-approval from insurance to schedule the sleep study. Thanks to Linn's thread and archangel's doctors who send patients to sleep studies without a sleep aid need to be flogged reply, I got the doc to prescribe me 2 ambien.

Here's to the waiting game....
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#10
I was fortunate that my sleep doctor routinely prescribes Ambien (2 of them) and has you take one before going to bed at the sleep clinic. It also comes with a warning not to take them at home. I had good sleep this way during the first part of the split test. Best wishes for success this time!
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