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Undiagnosed, Sure I Have It, Self Employed, Need to Keep Costs in Check
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danstelter Offline

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Sex: Male
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Post: #1
Undiagnosed, Sure I Have It, Self Employed, Need to Keep Costs in Check
Okay, so my wife and I are 100% sure I have this, and I'm fully willing to take my health into my own hands. I've self-diagnosed other conditions and have turned out just fine. I snore horribly, feel half awake all day long, never feel refreshed, and always fall asleep earlier at night than I want to when watching TV with my wife. It's been exhausting and a downright nightmare the last 3-4 months. I don't know how I can work, spend time with my wife, and then give my children their time given how much I sleep and how tired I am all the time!

I have private health insurance, so cost is a major issue for me. Are there any at-home studies I can do that are more affordable (and also reliable) than a ridiculously expensive visit for a sleep study?

Once I get a CPAP machine from either the doctor or an at-home study, do I have to keep going in for follow-up visits? The one local physical place I called said I needed to go in every 3 weeks - 3 months for a visit - I'll handle it on my own and will be just fine thank you very much. Do you need a prescription to keep using a CPAP machine, or do you just need to keep monitoring and adjusting if necessary? Thanks in advance for all your help! Am located in Milwaukee, WI, US, by the way.

Dan
(This post was last modified: 04-22-2013 12:56 PM by danstelter.)
04-22-2013 12:52 PM
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trish6hundred Offline

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Posts: 6,449
Joined: May 2012

Machine: Resmed S9 AutoSet for Her
Mask Type: Full face mask
Mask Make & Model: Fisher & Paykel Simplus
Humidifier: H5i Heated Humidifier
CPAP Pressure: 10 - 7-20 Cm H2O
CPAP Software: Not using software

Other Comments: I started CPAP in 2008. Totally blind since birth.

Sex: Female
Location: Missouri, USA

Post: #2
RE: Undiagnosed, Sure I Have It, Self Employed, Need to Keep Costs in Check
Hi dan,
WELCOME! to the forum.!
You will need a prescription to get a machine and mask.
I don't know enough about home studies to help you but hang in there and I'm sure someone will have suggestions .
Best of luck to you.

trish6hundred
04-22-2013 02:26 PM
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imfletch Offline

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Posts: 22
Joined: Apr 2013

Machine: ResMed S9 AutoSet
Mask Type: Nasal pillows
Mask Make & Model: Swift LT
Humidifier: ResMed 5i
CPAP Pressure: 16
CPAP Software: ResScan SleepyHead

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Sex: Male
Location: Pensacola, FL

Post: #3
RE: Undiagnosed, Sure I Have It, Self Employed, Need to Keep Costs in Check
Dan,
Call it a racket, or just call it the way it is, you can't buy, rent or lease a cPAP machine (or even a mask for that matter) without a prescription.

Different doctors handle it differently as far as follow-ups. Mine, for example, had me come back six months later (just to make sure all was well.) After that, it is an annual visit.

Here is what you can expect to happen.
1.) Go to your regular family physician to get a referral
2.) The sleep clinic will call you a week or two later to set up your study.
3.) You will spend the night at the sleep center - connected to a few dozen wires and being observed by technicians.
4.) If your apnea is severe - they will awaken you mid-way through the night and begin titration (hooking you up to a cpap machine, putting you back to sleep while connected, and searching for the optimal pressure while you sleep). If you apnea is not severe...
5.) You will go home and await a call to return for a second night. This will be your titration night (does not apply if you case was severe).
6.) You will then go home and await a call to see the sleep doctor who, if you were indeed diagnosed with apnea, will then hand you the necessary prescription for a machine, hose, mask and all necessary equipment.

Once you have you prescription, you can buy with insurance or straight out of pocket. If you buy out of pocket, expect to pay $500 to $1,200 for the machine itself (and associated hose and humidification unit) and about $110 to $180 for the mask (depending on the style you choose.)

Know this: if you opt to go it alone and just buy your own stuff, the greatest challenge to proper cPAP therapy is getting the right mask. It can be maddening. The wrong type mask can be ineffectual at best, annoying and keep you awake or, at worst, create flesh-rotting pressure sores across the bridge of your nose.

Most new cPAP users go through three to six different masks before choosing "the one" that works for them. With masks costing $110 to $180 each, you can see that can get expensive. Some of the online companies offer a bit of "insurance." By paying an extra fee, they will allow you to return the mask within a specified time if it doesn't work.

Sleep clinics, on the other hand, typically allow you to keep returning one mask and trying another (if you don't keep it too long) until you find that "perfect" mask.

Personally, I went through five masks before finding the one that works for me.

On the plus side, however, once you reach effective treatment, your world will change:
Suddenly, I no longer fall asleep at traffic lights. I no longer fall asleep at the wheel on the interstate!!! I can sit through a movie without falling asleep. I no longer get up in the morning, quickly shower and shave so I can go sit on the couch and, hopefully, catch another hour of sleep. Quite the contrary, I now wake at 4:30 a.m. - fully awake. I find myself cleaning, etc. One Saturday morning, I was up at 5am, outside, washing the car. I can't remember when I had so much energy.

Yes, there IS a certain degree of "racket" to this because, with today's modern AutoPAP machines, the machine itself will zero in on the proper pressure for you, but the Catch22 is, you can't get the machine without the prescription and you can't get the prescription without the visit (UNLESS, you happen to have a family friend that is a doctor??!!)

I wish you well in your journey and... please... keep me informed.

Jim in Florida

ResMed S9 AutoSet with 5Hi humidification
ResMed Swift LT Nasal Pillow Mask
Pressure Setting: 16 cmH20
04-22-2013 03:07 PM
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Bompa Offline

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Machine: DreamStation Pro
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CPAP Software: SleepyHead Other Software

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Sex: Male
Location: Falkenburg,

Post: #4
RE: Undiagnosed, Sure I Have It, Self Employed, Need to Keep Costs in Check
I wouldn't try setting myself up with a CPAP system and pressures without the advice of a Professional, either an MD or Sleep Doctor.
It's not somrthing to just play with. It's a serious condition that need professional diagnosis and treatment.

Please seek professional help.
Coffee
04-22-2013 03:41 PM
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danstelter Offline

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Post: #5
RE: Undiagnosed, Sure I Have It, Self Employed, Need to Keep Costs in Check
Thanks for the info imfletch. It sounds like 500 - 1200 for a machine, so that's okay. Now, to make the tests affordable: I'd like to avoid sleep studies in a physical location if possible. I've heard of home testing and searched at Google for that, but it seems somewhat scammy when I search on it.

Bompa - I've sought professional helpful for many problems from the medical community before and came away very disappointed. In some instances, yes, doctors have the solutions. But, they also have a "god-complex" going on where they think they know it all and want to make decisions for you, even if they're not accurate. I'll try it myself first, and if I think I need the help of a medical professional, I'll go for it. I've resolved my own anxiety condition and helped my wife fix her ovarian cysts (with the help of a holistic doctor) - the doctors spent years and thousands of dollars and could provide no answer, and within 9 months, the holistic doctor had the answer - she hasn't had any problems since. Frankly, this whole focus on "the medical community has all the answers" is questionable at best and if you jump to their solutions/conclusions while not protecting your finances for your family, frankly, that is not thinking through all the logistics of the situation first.

Does anyone know of a reliable home test (they're much cheaper - a few hundred bucks) or cheaper way to get tested that is at the same time reliable?

Thanks in advance for your help!
04-22-2013 03:50 PM
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DocWils Offline

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Machine: Philips Remstar series 60
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CPAP Software: SleepyHead

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Sex: Male
Location: Switzerland

Post: #6
RE: Undiagnosed, Sure I Have It, Self Employed, Need to Keep Costs in Check
Firstly, there is no racket involved with these being prescription devices - you can seriously harm yourself if you just buy one and use it willy-nilly. Only with correct pressure settings is there even the slightest chance hat a CPAP will be beneficial to you - too high or too low and it could exacerbate your condition.

Second - most sleep clinics will offer you at home testing - if the basics are clear in the home test, a sleepover probably won't be necessary, so ask your doc. Your best bet would be hospital based sleep labs, since they are more than happy to not add yet another person to their overcrowded roster and will be happy to kit you out for a home test. A further sleep over for titration is necessary only if the case isn't clear as to what pressure levels are necessary or what treatment options are the best, or if the results of the home test are either inconclusive or troubling.
04-22-2013 04:26 PM
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Shastzi Offline

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Machine: ResMed S9 Autoset
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Mask Make & Model: FitLife Total face mask
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CPAP Pressure: 15cm-20cm H2O (auto)
CPAP Software: SleepyHead Other Software

Other Comments: CMS50-F wearable Oximeter; Software: SPO2 Assistant

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Post: #7
RE: Undiagnosed, Sure I Have It, Self Employed, Need to Keep Costs in Check
Hi dan,
Perhaps one thing you could try is find a sympathetic doctor (if you haven't already) and
get yourself a wrist worn pulse oxymeter that will log your blood oxygen saturation levels while you sleep. ($160)
each morning you can upload the data to your computer and make a graphic printout.
After a week of that you should have some pretty terrifying material to present your case to your primary care physician.
***
Any MD can prescribe a CPAP.
If you go this way check in here to get make & model of machines to avoid. !

Down side is that no insurance company will pay for it this way so all expenses will be out of pocket.

It may be a bit of a gamble this way if you have any complex or neurological disorders but a full recent physical can help there and working closely with your MD.

Cheers!

Welcome

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

Cool
04-22-2013 04:33 PM
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zonk Offline

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Joined: Feb 2012

Machine: A10 AutoSet
Mask Type: Nasal mask
Mask Make & Model: Activa LT
Humidifier: Integrated /ClimateLineAir
CPAP Pressure: 9/13
CPAP Software: ResScan

Other Comments: CPAP since Nov 2010

Sex: Male
Location: Australia

Post: #8
RE: Undiagnosed, Sure I Have It, Self Employed, Need to Keep Costs in Check
As you have insurance, you might want discuss options with your GP. Beside CPAP, insurance cover replacements schedule for mask, mask parts, hoses, filters, etc ... on regular basis. On-line purchases are not covered by insurance, you have to pay upfront and then makes a claim, the claim may or may not covered ... most cases ... not

Home sleep testing is good alternative to sleep lab testing, cheaper and convenient.
You may still need sleep lab study if your symptoms don,t improve on CPAP

Snore no more in Milwaukee offer home test using Itamar watch PAT 100 (FDA approved)
Supplier #10 offer home sleep study using ResMed ApneaLink Plus $349
ApneaLink Plus: http://www.resmed.com/au/products/apneal...c=patients
Registered Polysomnography Sleep Technicians manually scoring your test and a Board Certified Sleep Physician interpreting your test and giving recommendations and diagnosis if applicable.
Information on their site (suppier #10) http://www.apneaboard.com/forums/Thread-CPAP-Supplier-List

If CPAP is recommended for you, I advise on getting S9 AutoSet, not just my favorite machine but also its very easy to use and better display of data on LCD including leak data and AHI breakdown of events (not available on other machines)
Check Supplier #2 prices. New S9 AutoSet and accessories $879
04-22-2013 05:55 PM
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Shastzi Offline

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Posts: 1,174
Joined: Dec 2012

Machine: ResMed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: FitLife Total face mask
Humidifier: F&P HC150 with Hybernite heated hose.
CPAP Pressure: 15cm-20cm H2O (auto)
CPAP Software: SleepyHead Other Software

Other Comments: CMS50-F wearable Oximeter; Software: SPO2 Assistant

Sex: Undisclosed
Location: Florida, USA.

Post: #9
RE: Undiagnosed, Sure I Have It, Self Employed, Need to Keep Costs in Check
What DocWils & zonk said.
At the same time, there are certian clusters of vipers here and there that will try to empty your wallet while providing substandard service/equipment.
Be informed and be wary.

Sleep-well

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

Cool
04-22-2013 06:56 PM
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jgjones1972 Offline

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CPAP Software: ResScan SleepyHead

Other Comments: CMS50I PulseOx

Sex: Male
Location: Ohio - USA

Post: #10
RE: Undiagnosed, Sure I Have It, Self Employed, Need to Keep Costs in Check
There are quite a few variables to consider. Any MD or DO can write the Rx, but good ones won't without some kind of reliable test to confirm the diagnosis. Also, the insurance company probably won't pay unless certain criteria are met in the diagnosis. The best route is probably to talk to your GP. S/he should know what is available and what the insurance company will require.

I guess I just got lucky. My Doc (an Internal Medicine Specialist) took care of it all. He had the Home Sleep Study company send me the kit with directions. I did the home test and sent it back to them. My Doc called me a couple days later and told me to come back to see him for the news. I got the Dx that satisfied my insurance company and the Rx in hand for about $500 all together and I only had to pay about $50 out of pocket - the insurance company paid the rest (before equipment costs). No in-lab titration meant APAP was necessary; but, I'm glad I got an APAP anyway. All of that was quick, easy and relatively cheap. I didn't start getting screwed and cheated until I started dealing with the brick-and-mortar DME. If I had it to do over I would have went straight to dealing with on-line suppliers.

Anyway, I'm not sure how many family Docs or GPs will do it this way; but it's worth seeing if yours will.
04-22-2013 09:11 PM
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