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Not going to pay for sleep study .. bought cpap
#11
RE: Not going to pay for sleep study .. bought cpap
(07-10-2015, 03:03 PM)Mosquitobait Wrote:
(07-10-2015, 11:41 AM)tedburnsIII Wrote: I agree with OpalRose.

In light of OP's situation, i.e., he already has CPAP, I think that before purchasing APAP or other, sleep study (overnight home or preferably lab) might be better for him. Let's face it, OP and we are 'blind' about his condition. For all we know he may need a different machine than APAP or CPAP. Perhaps he will need BPAP, or ASV type of machine.

This whole discussion is placing the cart before the horse.

On another matter, OP, does your machine (discontinued) really use Rescan? Are you sure? I saw otherwise in doing a Search.

OP, please post some recent data.

While I agree with you Ted, the financial reality for many is that they can afford the apap or they can afford the sleep study, but not both the same year. If the OP CAN afford it, I agree that he should do the home sleep study first. If he can't, getting therapy as quickly as possible is better than nothing at all for months. Very few people need BPAP or ASV in the absence of already existing respiratory or heart problems. Even Medicare starts just about everybody on a CPAP first anyway - probably no different where the OP lives.

To clarify, and perhaps others would disagree, seems to me that you are less likely to run into problems running an apap at 6-20 than you could running a straight pressure until your wife reports you are no longer snoring.

He already has a CPAP machine. He has failed, and continues to fail, to provide data for us to review. He needs to get his data, and perhaps do pulse oximetry at the setting that works best according to his data. Start with 10cm, take it from there.

I can not see why he'd want to spend again for another machine, APAP or not, when CPAP works famously for many with OSA.

He may have enough with just the CPAP and an overnight pulse oximeter until he can do the home study. My PO cost less than $70 shipped. To me, that seems the better way to economize and get results.

He has appeared once only in this thread. Makes one wonder just how serious he is about getting better.

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#12
RE: Not going to pay for sleep study .. bought cpap
Regardless, the point this raises is a good one. If you suspect SA, maybe a $700 xPAP machine is a better gamble than a $3700 sleep study that tells you to buy a $700 xPAP machine. If insurance will not foot the bill, this seems tempting.

Sure, we have all of the caveats that have been mentioned, and true, a sleep study will give more data than any xPAP ever will, but it does it in a single snapshot and an APAP can provide (more-limited) data over any number of sleep sessions, and a large data sample has value beyond a tiny data sample.

If you buy an APAP that can provide data to SleepyHead or the equivalent, educated choices can be made regarding what pressure range should be set, by making small adjustments over time based on understanding and interpreting that data. There is a great deal of value in that approach. Certainly, the best approach is to begin with a sleep study and get a sleep doc to advise and prescribe, but $5000 later, you have a good chance at nearly-similar if not virtually the same therapeutic result by doing it this way instead.

If you know what you are doing, and understand what you are missing by not going the conventional route (there is risk involved here), it is a valid choice.
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#13
RE: Not going to pay for sleep study .. bought cpap
I am a newbie and may regret my course of action later, but for now I am following a similar course. Yes, price is an issue. My insurance will not pay for a sleep study or the equipment.

I picked up an Airsense 10 Autoset and have used it for two nights. I am very pleased with the quality of the machine, the low noise levelBefore getting the APAP, I saw an ENT Doctor and told him that I wanted to go ahead and try an APAP. He agreed that the cost of the machine was much lower than the cost of the study and wrote me a prescription. He told me that if I had had a higher BMI, he would have insisted on a sleep study. However, with a BMI at 27.7, he felt comfortable.

So, with the APAP, I can get tons of data and experiment with the settings. My wife is the best diagnostician for the number of apnea events prior to the machine. Last night, she said that I am much easier to sleep next to already just because I am quieter.

So, I am very hopeful and will see how it goes.

By the way, I was able to buy the APAP machine second hand without the prescription. However, I got the prescription so that I get a mask from a local medical supply store. The people at the store gave me a lot of help choosing, fitting, and adjusting the mask and the machine. Without the prescription, I would not have had that help, so even without the sleep study, the prescription has been very helpful to get the assistance from the medical supply company whose help has been invaluable.
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#14
RE: Not going to pay for sleep study .. bought cpap
I must agree, the APAP is a good gamble.
chances of needing a BIPAP or ASV are much longer shots.

Get the APAP that is SleepyHead compatible and start using it and collecting data.
That will get you started by showing you what is happening.
A Pulse Oxymeter will provide good verification on the SleepyHead info.

Keep the older machine as a backup in case the main malfunctions or needs repairs.

If you are still showing issues later on down the road then you can consider additional action.

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

Cool
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#15
RE: Not going to pay for sleep study .. bought cpap
I was quite shocked to find that my recent sleep study was billed to insurance at $5,800.00
This seems pretty darn excessive to be monitored for one nights sleep.
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#16
Money 
RE: Not going to pay for sleep study .. bought cpap
(08-06-2015, 02:26 PM)Marc615 Wrote: I was quite shocked to find that my recent sleep study was billed to insurance at $5,800.00
This seems pretty darn excessive to be monitored for one nights sleep.

wow! holy dollars, batman!

compare that to just under $500 my Insurance paid for my home study... no wonder insurance companies are going that direction!
هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه  هههههه
Tongue Suck Technique for prevention of mouth breathing:
  • Place your tongue behind your front teeth on the roof of your mouth
  • let your tongue fill the space between the upper molars
  • gently suck to form a light vacuum

Practising during the day can help you to keep it at night

هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه هههههه  هههههه
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#17
RE: Not going to pay for sleep study .. bought cpap
(08-06-2015, 08:52 AM)SleepSailor Wrote: I picked up an Airsense 10 Autoset and have used it for two nights....
I am very hopeful and will see how it goes.

Hi SleepSailor. A warm welcome to Apnea Board, and thanks for sharing your experience.

Your profile presently says your pressure is 4-15.

4 quickly becomes uncomfortably low. I suggest raising the Min Pressure to 5 or 6 or whatever feels most comfortable. If you use the Ramp, I suggest a Start Pressure of 5 or 6 or whatever feels most comfortable.

Also, I suggest lowering the Max Pressure setting. Setting the Max Pressure all the way up to 20 is not uncommon even by doctors but I think a Max Pressure higher than about 10 would be slightly risky, since you haven't had a sleep study. A small percentage of patients have serious problems at high pressures, so I suggest setting the Max Pressure to perhaps 10 and not raising it until you see from the data that you're having obstructive apneas which are not being prevented by a Max Pressure of 10 (or whatever) and you are not having more central apneas than obstructive apneas.

Congratulations on a good start in your journey toward better health.

Take good care,
--- Vaughn
The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies.  Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment.
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#18
RE: Not going to pay for sleep study .. bought cpap
(08-06-2015, 02:26 PM)Marc615 Wrote: I was quite shocked to find that my recent sleep study was billed to insurance at $5,800.00
This seems pretty darn excessive to be monitored for one nights sleep.

Yep, it's a ripoff. However, the insurance probably paid a lot less than that. Probably more like $1000.
Get the free OSCAR CPAP 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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#19
RE: Not going to pay for sleep study .. bought cpap
(07-09-2015, 04:57 AM)mikeinthecountry344 Wrote: Hey ive been using cpap machine on and off past year or so..

most of the time not using it but trying to change that.

I have my good night set to about 10.0.

I think i've got a pretty good/ severe case of sleep apnea.

People say i snore like crazy anways..and snort when i stop breathing and start breathing again.

Anyways i can determine a good setting?
If i could get a good deal on an Auto adusting cpap then i would not need sleep study right?
Maybe i should have sleep study can do at home for about 300 eh?
I could handle that.

Thanks mike
I get it because I am still paying for my lab sleep study, they are expensive and not always necessary. The at home test while not as good as a lab study will tell you a lot and I would be inclined to at least have one done before going on CPAP. Talk to your doctor about it. He or she can give you the pro's and con's of both so you can make the best decision for your self. Take care and good luck to ya.

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#20
RE: Not going to pay for sleep study .. bought cpap
(08-07-2015, 01:08 AM)vsheline Wrote: Hi SleepSailor. A warm welcome to Apnea Board, and thanks for sharing your experience.
...
Also, I suggest lowering the Max Pressure setting. Setting the Max Pressure all the way up to 20 is not uncommon even by doctors but I think a Max Pressure higher than about 10 would be slightly risky, since you haven't had a sleep study. A small percentage of patients have serious problems at high pressures, so I suggest setting the Max Pressure to perhaps 10 and not raising it until you see from the data that you're having obstructive apneas which are not being prevented by a Max Pressure of 10 (or whatever) and you are not having more central apneas than obstructive apneas.

Vaughn, Thank you for the comments. Having used the machine for 4 nights, I can already state that I did not feel like I was about to fall asleep during the work day--so I know it is helping.Smile

In reading the SleepyHead graphs, how would I identify an OSA event that is "not prevented by a Max Pressure of 10 (or whatever)"?

e.g., last night I had an AHI of 2.78. However, I see 10 CAs, 11 OSAs and 10 Hypopneas. In zooming down on the OSAs and the CAs, I notice periods of non-existent flow rate that last about 10-13 seconds long. To me, these are events that were not prevented. The By Pressure chart shows that .8 minutes were spent at a pressure of 9 and .2 minutes were spent at a pressure of 10.

So, are you suggesting that the APAP machine is able to "Prevent" the OSAs altogether? I guess I am not understanding the basic theory behind blowing air into one's face all night and exactly how that works. Does the machine increase pressure in real time to break up a specific OSA or CA? Or, does the constant pressure reduce the events?

I think there is a probably a post somewhere that explains this in detail which I will start looking for.

Also, I see that you are using an S9 with a separate humidifier. My S10 has a "humidifier" integrated into the machine (a pan of water over which the air blows). The climate in Utah is VERY dry and I have woken up with a very dry mouth at times. I wonder whether people with integrated humidifiers will sometimes get an external humidifier and why and how helpful that is.

Thank you for commenting and for the welcome to the forum! My life is already changing. The last four nights have been hard work, but they have paid off during the day I am hoping to get to the point where sleeping is not work Shy
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