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[News] Home testing for sleep apnea bankrupting U.S. sleep centers
#11
I have always found DMEs to be useless. But I have had (and kept) my great sleep Doc. Getting APPTs in less than a week is no issue, either for a study or to see the Doc. My issues are a bit more complex, I did need surgery (at least to my nose), and I have never tried a 'home test'.

For some, a home test with an APAP and someone with knowledge looking at the results may be enough. But for me (and some others), I do not believe that will cut it - which is what does concern me.
*I* am not a DOCTOR or any type of Health Care Professional. My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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#12
I think a lot of opinions are down to personal experience, and for me it could have been very costly.
As I'm a Brit living in Singapore, i don't have access to the local medical insurance, which is pretty poor anyway, and my private health insurance doesn't cover Apnea related disorders, I had to take matters into my own hands and learn to be my own mini insurance company for myself.

i saw an ENT consultant who gave me a home sleep test, and 1000 dollars and two days later I was diagnosed with moderate OSA with an AHI of 22.
i was given the address of two suppliers, I guess its the equivalent of DME in the US, and was allowed to borrow a brick for two weeks, and was told that I needed a pressure of 8 by one supplier, thats it total info I received
I felt the benefits but wasn't about to spend approximately $2,000 on a brick, with a mask that cost $220, which I had to buy to have the trial!

I found this forum and others, and went into deep research mode, and have now equipped myself an A10 Auto and a Transcend II Auto (for back up and travelling) a P10 mask and Nuance pillow mask, all for the same price that i'd have paid for a brick and a crap mask here, and I've just pulled the trigger on a Nonin 3150.

So now I'm pretty much good to go and become my own supplier.

The help and knowledge I've gained on this forum so far has made it all possible.

So once again huge thanks to all.

D
Failure is NOT an option.
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#13
Nobody cried for Kodak Photo Processing stores when digital photography took off.

They simply went out of business. Employees got jobs somewhere else like the emerging Cell Phone stores.

Such is life.

Can't stay in the horse and buggy days, gotta move on.
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#14
Here in the UK, I had three overnight sleep tests in hospital, but it was only after I had an at-home overnight test arranged privately that I was prescribed the cpap machine that I had needed for at least 15 years. My AHI in that test was 35.

This option has only been available in the UK for about half a dozen years. Had it been available sooner, I could have avoided many years of untreated severe OSA - & all the health, work & relationship problems that resulted from it

So, not surpringly, I'm in favour of home testing.





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#15
Whole industries get built around "things" then the "things" change, and the old industries become obsolete. This is the nature of things. At some point there was one guy left making riding crops for horses and buggies, I bet he made the best damn riding crops there were. then came the car, and as time went on there was less and less of a need for riding crops and people using horses for transportation. I bet there was also a bunch of people that were paid to shovel the horse poop, and with no horses, no more poop, time for a new job. Horse posts were replaced with parking spaces, and bike racks, and so goes life. New technology, new opportunity, out with the old in with the new. This is especially true when an industry or people in general realize they have been being taken advantage of for far too long.
If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
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#16
Speaking of crooks (surely not off topic in a sleep study thread), did you ever wonder what kind of shenanigans are going on when for example some medical service bills Medicare for $4000 and Medicare pays $400 and the patient pays $100 which means the service gets paid $500 for their $4000 service, yet it's considered paid in full and they obviously made a profit.

There is something about that that I don't understand. I've always figured the service provider was getting something more that wasn't readily apparent. Do you think they may be allowed to use the write-off against taxable income or is there some other means whereby they can recoup that difference. The tax write-off would let them recover quite a bit when you realize what marginal tax rate they likely pay. I think the whole scenario stinks and just wonder if anybody actually pays the full fees that they submit when Medicare isn't involved.
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#17
The home study I had said it could determine CA from OA ox sat, and several other things. I wouldnt have needed a lab after that but thats the way they do things here so I did.

The wired up brain wave sleep lab came up with exactly the same results as the home test did across the board.

The Doc at the lab got the min pressure way to low, and insisted on maintaining at least a 9 Cm spread from min to max pressure.

So when the machine I have said I needed to start at 8 instead of him setting 8 to 15 max which was my top pressure from the lab, he set 8 to 18!!!

Until then I barely every reached 15. Now I go 17 pretty regular and sometimes 18 because the range is way to wide.

Because of keeping peace with my DME since hes a pretty decent guy Ive not changed my own pressure during the compliance phase letting him do it. My compliance is up this Sat. Likely last time he or the Doc sees me about SA for the next year. Ill get the range set myself where it needs to be.
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#18
Surferdude and a bunch of us really have the sleep centers number so to speak.

Somewhere right now there is a smart guy who owns 10-20 sleep centers talking to his people about making the next newest OSA home testing units that will do almost everything they do at the lab so they can charge the insurance companies $200 a pop and deliver it nationally, and put all the other sleep centers out of business while they rake in all the dough. And that ladies and gentleman is capitalism at its finest.

I honestly see no reason why a home sleep study apparatus can't be built to do everything they do in the sleep center. Wasn't all that long ago that a cardiac monitor took up so much room that they could only do it in a hospital, and then came someone with halter monitors they could send you home with. Wasn't long ago that a portable oxygen concentrator would be unheard of, and now here it is.

So let's develop the new in home sleep study setup together and then sell it to these criminals and we'll all be rich and apnea board will be funded forever and ever Big Grin
If everyone thinks alike, then someone isn't thinking.
Everyone knows something, together we could know everything.
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#19
You could take a reasonably bright high school graduate, train him with a 2 week class to read the results of a home sleep study, dispense a good data capable CPAP, monitor the data through the wireless modem and SD card, work with some computer programs, take calls from the patients and answer questions and make changes.

Train him when to refer a patient to a real sleep doctor or therapist.

Have the doctor do real in-lab PSG sleep tests when needed.

While an actual doctor exam is a good idea, you could do most of this over the phone or internet.

You'd probably get better therapy than most of the current apnea patients are getting though our current high dollar medical system.

The medical mafia will fight really hard to keep something like this from happening, though.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#20
To Surferdude2:

You may want to read this (written by an MD on the inside):
truecostofhealthcare.org
Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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