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Prescription - how to get
#1
Question 
Prescription - how to get
Hi there, 

I'm asking for an advice. For the past 3 years I've had sleep issues and 4 separate doctors stated it sounds like sleep apnea. 
I've done 3 tests so far
1. Lab test - couldn't fall asleep with all the wires and stayed awake for the entire night 
2. Lab test - this time they gave me a sleeping medication but their IR camera was broken and needed to keep lights on to have a video recording. Didn't fall asleep despite the sleeping pill. 
3. Watchpat at home test that didn't detect anything. 

I'm out of pocket roughly $2,500 already between these failed tests. 
Following the 3rd test (Watchpat) I bought the O2ring PulseOxi. I noticed that at some nights my SpO2 will drop as low as 82% from 96% average and I'll experience 60+ events with drops below 4% than average. Other nights I'm doing OK with SpO2 at 92% or higher. 

So here is my question. 
Doc wants another sleep lab after seeing PulseOxi results. $1200 after insurance but I barely sleep at night as it is and am afraid I won't fall asleep at the sleep lab again, or it'll be one of the "good nights".

What is the most straightforward and successful way to test or towards obtaining a prescription for a Cpap machine? Is the test required or a discussion of my symptoms plus PulseOxi reports should be sufficient? 

I basically just want to try the machine, buy with cash if needed, as it seems I tried everything else already and I feel horrible at just barely 40yo.

Thank you for your help.
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#2
RE: Prescription - how to get
The supplier list at the top of the site (shopping cart) #2 on the list sells lightly used machines. I bought a aircurve VAUTO top of the line for 800. You can get the air sense (both are Resmed machines). I purchased mine without a prescription.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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#3
RE: Prescription - how to get
Cubus,
Are you going through your insurance or buying out of pocket?

If insurance, then you need to check if they require an overnight test. Your doctor should be able to help with that.

If buying on your own, as many of us do, then depending where you buy, your doc could write a script. But as stacy said, Supplier #2 sells low hour used machines and also open box new. You could call them for information.

The only problem is that we don't have the results for any of your sleep tests to help guide you. You could end up spending money on the wrong type of machine.

If you want to start looking on your own, then search for a ResMed AirSense 10 AutoSet.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization


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
RE: Prescription - how to get
(08-05-2020, 05:50 PM)OpalRose Wrote: Cubus,
Are you going through your insurance or buying out of pocket?

If insurance, then you need to check if they require an overnight test.  Your doctor should be able to help with that.

If buying on your own, as many of us do, then depending where you buy, your doc could write a script.  But as stacy said, sells low hour used machines and also open box new.  You could call them for information.  

The only problem is that we don't have the results for any of your sleep tests to help guide you.  You could end up spending money on the wrong type of machine.  

If you want to start looking on your own, then search for a ResMed AirSense 10 AutoSet.

Thank you OpalRose and Staceyburke.

I do have health insurance but with family deductible and low coverage it costs me over $1,000 per sleep study out of my own pocket. I basically told the doctor I already bought a few machines with what I paid so far, and he said I need a sleep lab result confirming apnea and "we have a payment plan" if I need it. 

So, I'm happy to save some $$$ and buy out of pocket, cash, today just to try it at worst and solve issue or move on. 

I've attached 3 files with sleep reports. I'd truly appreciate if you'd take a look and try to make a sense out of it. 
1. 2020 Sleep Study is a copy of the WatchPat sleep report - sorry for the quality, doc's office offered only this poor quality report. 
2, 3. Titled "Bad night" Are two different sleep reports using my PulseOximeter.

I've checked PulseOxi with another device (wore two of them one night) and it seems to be accurate. 

Thank you again!


Attached Files
.pdf   2020 sleep study result_1-min.pdf (Size: 771.57 KB / Downloads: 23)
.pdf   Bad night_82low_20200723213747_OXIRecord.pdf (Size: 299.84 KB / Downloads: 19)
.pdf   Bad night_83_low_20200724215157_OXIRecord.pdf (Size: 329.71 KB / Downloads: 12)
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#5
RE: Prescription - how to get
The WatchPat report doesn't show much to go on, but the oximeter reports do show the dips in your oxygen levels during the night.  This is probably why your doc wants another Sleep test.  He wouldn't be able to justify to insurance a need for Cpap or supplemental oxygen if needed.

But it's understandable the cost of these studies is ridiculous, and if you can't sleep, they won't be able to tell you much.

Ask you doctor if he would let you trial a Cpap machine and go from there.  If not, then your only recourse is to look for a good used machine on your own.  There are many places to look, like Offer Up, Marketplace, Craig's List and of course Supplier #2 which has been mentioned.

We could certainly help you get set up, but look for a decent machine, like the AirSense 10 AutoSet.
OpalRose
Apnea Board Administrator
www.ApneaBoard.com

OSCAR Chart Organization


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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#6
RE: Prescription - how to get
Cubus, it is easy to obtain a highly discounted auto CPAP machine and self titrate. I encourage you to get a Resmed Airsense 10 Autoset because it has the best pressure delivery and full data. I don't know what kind of doctor you are using, but those tests are not worth the paper they are printed on. Let me know what part of the country you are in, and I'll help you find what you need.

Last piece of advise. Don't use a sleep specialist when your primary care doctor will do. You are willing to pay out of pocket and only need a prescription. A test costs more than a new machine at $700. Your symptoms should be sufficient for your personal doctor to write a script to buy online.
Sleeprider
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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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#7
RE: Prescription - how to get
Thank you all. 

This is all very helpful. So the way I understand it is that I can buy the Resmed Airsense 10 from Supplier #2, i.e. Open Box for $550 without prescription at all. That would save me roughly $600 as comparing to a sleep lab test.

Newb question. Can those machines be harmful? Meaning, if I don't have sleep apnea, can I cause myself any medical harm by using these?
I just can't understand why insurance would ever authorize an almost $10k lab test if a simpler solution would be "give this guy a $800 machine and see if his problems go away". 


I just watched the AirSense 10 marketing video and it apparently even identifies events, is that correct? In other words it could diagnose me with a Sleep Apnea?


I'm cautious to make sure I'm not missing anything. 

Is the Airsense 10 Autoset "plug and play"? Would it really automatically adjust to my needs?
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#8
RE: Prescription - how to get
(08-05-2020, 07:16 PM)Sleeprider Wrote: Cubus, it is easy to obtain a highly discounted auto CPAP machine and self titrate. I encourage you to get a Resmed Airsense 10 Autoset because it has the best pressure delivery and full data.  I don't know what kind of doctor you are using, but those tests are not worth the paper they are printed on.  Let me know what part of the country you are in, and I'll help you find what you need.  
Sleeprider,
Thank you. I live in NW Connecticut, very close to Danbury, CT.
I'd appreciate any help I can get.  Also AirSense 10 Autoset is definitely within my budget (anything less than the cost of sleep study at $1,200 is within my budget really). 
Are any other required accessories?
What kind and how would I select a mask?
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#9
RE: Prescription - how to get
I'm not coming up with anything a PAP can do negatively if you don't have apnea. The AutoSet will give therapy with default wide open settings. But if you want good effective therapy, you'll want the OSCAR free data program for seeing your sleep data off of the SD card in the PAP machine. Gurus like Sleeprider will see that posted data and give suggestions on setting the machine. This small action will give you very good results quickly, and this is my suggestion to do as stated. The setup this way is normally quick, painless, and free. Just get the doc to script ResMed AutoSet default pressure 4-20, mask of patient's preference, Dispense As Written.

PS Mask? Do you mouth breathe? Yes, then you might need a full face mask or other items like a chin strap or tape to keep the lips sealed. No, then you can choose pillow style or nasal. I would say consider the ResMed P10 if you don't think mouth breathing is an issue.
Dave

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INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEBSITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#10
RE: Prescription - how to get
No nothing is plug and play. But this group will give you what to put in and you will post here using OSCAR (free download and advise) and you will make changes to the machine and put your nights report from OSCAR AND SO ON. take a look at YouTube search for airsense clinicians settings. It will show you how to make changes to the airsense.
Apnea (80-100%) 10 seconds, Hypopnea (50-80%) 10 seconds, Flow Limits (0-50%) not timed  Cervical Collar - Dealing w DME - Chart Organizing
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