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Sleep study
#21
(01-08-2016, 10:36 AM)Inky1 Wrote: Sleeprider, my deductible is $2000, I'm not sure what my co-pay amount is.

I'm supposed to go see a sleep doctor for a consultation on the Jan. 20th and then see about getting a HST. I'm skeptical of the HST because I suspect that I only have a mild case of OSA. But then of course who knows for sure, since my wife hit me in the ribs last night since I was snoring. Too-funny

You're essentially uninsured except for major medical. I'm sure you are in good hands, but I'll offer an alternative for comparison. Supplier #30 offers a home sleep study (Easy Sleep Apnea Test Package) with physician review, diagnosis and prescription for a fixed fee of $400, and they may be able to qualify it under your insurance deductible. It's worth comparing for cost. If it turns out you have sleep apnea and need to buy a machine, you own your prescription and can use it there or anywhere you choose.

Be sure any home test includes a bedside monitoring device that is attached to sensors for the chest, breath, and finger to collect sleep data like respiratory events (apneas and hypopneas), snoring intensity, blood oxygen saturation, pulse rate and respiratory effort. Don't get a test that is only pulse oximetry, since that won't qualify for insurance in most cases.

It's worth reading the American Sleep Apnea Association web page on the Medicare approval of home studies. It has good background and information, as well as discussing the objections of the American Academy of Sleep Medicine to home studies being covered by insurance.
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#22
How hard is it to self titrate using Auto CPAP? Is it more of a trial basis, hit or miss? Does the doctor give you a range to try out on during self titration?
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#23
Most auto CPAP titrations are done using a machine with "wide-open" settings from 4.0 to 20.0 cmH2O pressure. The machine automatically increases pressure as it detects flow limitations, snores and volume changes that may warn of impending airway collapse (obstructive apnea). Most people find the low starting pressure is claustrophobic, and need a higher starting pressure (6.0). You can do this yourself. After a week of this trial, the data can be looked at, and for most people the 90% pressure (pressure you are at or below 90% of the time) turns out to be the therapeutic CPAP pressure. You can leave the machine in Auto mode but it will work best if you increase the minimum pressure to within 3-cm of the 90% pressure or to the average pressure gathered during the titration trial.

It works very well for those with simple obstructive sleep apnea. A small percentage patients may have, or develop, complex apnea with the use of positive air pressure. It's pretty rare, but for them a different therapy approach is needed. Take it one step at a time. The online provider I told you about above, refunds your purchase if a survey they give you before the test is negative. If you find you have OSA, then the next step is a machine and mask. Again, new auto CPAP machines are currently out there for as little as $400, and masks around $100. This doesn't have to cost a fortune just because you don't have insurance. If you do have a Flex Spending account for medical, be sure the source you are buying from is allowed for reimbursement.
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#24
Thanks Sleeprider. Do you have the web address for Supplier #30? I would like to look at their website if possible.
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#25
(01-08-2016, 03:06 PM)Inky1 Wrote: Thanks Sleeprider. Do you have the web address for Supplier #30? I would like to look at their website if possible.

Use the Supplier List and the address is there: http://www.apneaboard.com/forums/Thread-...plier-List Or just search for "Easy Sleep Apnea Test Package"

Note this site does not allow links to DMEs or equipment suppliers in posts. You will get a stern reminder and the link deleted. So let's not go there.
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#26
I just did the search I recommended and found out that there is an option, that if you are under the routine care of your own physician, the test is $299.99. I had not seen that before. They call that one the "Home Sleep Test".

I'm going to disclaim, that I have not personally used these services or have any experience with them; however I think it's great that an affordable alternative exists to what we affectionately refer to as "the medical mafia". Most sleep testing is extraordinarily expensive, and by itself exceeds the cost of therapy. It is inefficient, expensive and takes months to get scheduled and results and finally a prescription. It's really stressful when all you want to know is, do I have apnea, and how do I treat it?
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#27
I have some more questions in regards to what is considered an apnea.

Is an apnea only when you stop breathing for 10 seconds? How about snoring for 10 seconds is that the same thing or different? It is confusing as to what is considered an apnea. Please give any advice on apneas at all.

I know that I snore at night and occasionally gasp for air but not as much as snoring. Thanks in advance for the help!
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#28
An apnea is defined as a cessation of breathing for 10 seconds or more. If you ever look at your sleepyhead chart you can see the breathing waveform and it is essentially a flat line at zero flow. There may be some oscillation in the pattern but it is a no flow scenario. Snores look completely different and are a partial obstruction of the upper airway and usually the soft palate or other tissues vibrate causing the snore. This also has a distinct appearance on the flow rate waveform, usually a slowing of the flow rate with a jagged line showing the snore. This is covered really well in the Beginners Guide to Sleepyhead http://www.apneaboard.com/wiki/index.php...sleepyhead

[Image: Isolated_apnea_zpscf3f0501.jpg]

[Image: Flow_limitation_images_zpsdb148d1f.jpg]
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#29
Thanks for the information I will look at that.

However, I don't have a CPAP machine yet to be able to track the progress. I guess I should've phrased my question in regards to how apneas are tracked during a HST or PSG test. If I snore but don't gasp how is that measured? If I don't gasp that much am I likely to have OSA? I can snore for 10 seconds but as far as I know I don't stop breathing for 10 seconds after the snoring. I can ask these questions more in depth when I go for a consult at my sleep doctor.
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#30
Inky, it's not much different in PSG. Respiratory effort is measured using a strap around the chest, and airflow (pressure) is measured with a canula connected to sensors. The airflow direction and pressure is charted just like you see above. An actual snore sensor charts sound. It looks like this to the tech:

[Image: ScreenShot052.png]
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