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Undiagnosed, Sure I Have It, Self Employed, Need to Keep Costs in Check
#11
(04-22-2013, 03:50 PM)danstelter Wrote: I've heard of home testing and searched at Google for that, but it seems somewhat scammy when I search on it.

Call or go online to visit your insurance company. Look for a list of medical equipment providers. Call them and ask about in-home sleep studies.

Take it from there.

Supplier #2 has good used machines and a reputation for good service and reliability.
Sleepster
Apnea Board Moderator
www.ApneaBoard.com


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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#12
Lots of good advice given.Cool

Best if you have a sleep study....... However

Some people may be willing to slide the risk vs reward scale to one side and "do it your self" without a sleep study.

Many years ago I fell rock climbing and had no insurance, and very little money; and I sewed up my arm with 8 stitches. Thinking-about

So considering the source of what might be considered bad advice, and Unsure

If you really want to get a machine, mask and all the trimmings without a prescription ............ you can.

Craigs list is a good place, In the greater Boston area, I regularly see 4 to 10 CPAP machines available for about half the cost of new.

I found one on line supplier that will sell you equipment, masks, hoses and everything you need without prescription, "as parts" pm me if you choose to go the non-recommended path.

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#13
(04-22-2013, 04:26 PM)DocWils Wrote: 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.

I think there's very little risk of doing yourself significant direct harm doing your own CPAP vs. working with a doctor.

However, there's a signicicant chance you won't get the treatment right. You could think you're doing better, but still be suffering from the life threatening effects of apnea. Treating apnea is not necessarily simple, even with an auto CPAP machine. The auto CPAP machines are intended to be used with the pressure set to a range of pressure with the correct range determined by your doctor.

You may also fail to adapt to CPAP without professional help to solve your problems.

It's also possible that your problems are not apnea, and you'll go untreated for your real condition because you're self treating for the wrong illness.

It's also possible to make your apnea worse. Some people develop central apnea under CPAP pressure and that can be worse with CPAP.

If you do go on your own, be sure to get a fully data capable CPAP machine. There are some links in my signature line to tell you what machine is fully data capable. Actually, insist on one of these even if you go with the full sleep lab and doctor route.

I think there are some online suppliers who will send you an overnight apnea test, and do a prescription for you if needed.

An in-lab PSG sleep test does tell you a lot more than any in-home test. As long as you manage to sleep in the lab, that is.
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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#14
Sorry to argue with you Archangel, but can seriously compromise your health if the CPAP is not correctly set. Incorrect settings can put too much pressure into the mask, or too little - overnight problems could be few, but long term it may be as bad as not having the mask at all, or worse - for instance, you may increase CSA events considerably and then suffer from that for many years, or instigate other problems that can long term do as much harm as not using therapy at all. Only when the device is correctly adjusted does it do even an iota of good. Otherwise it is a useless as t**s on a bull, and could be even more harmful than doing nothing at all.

Further, you may need a very specific sort of device depending on the type of apnoea you have, or you may not actually have apnoea and your symptoms, although similar, are from something else. All this needs to be determined, and you can't do it yourself. You need the experience, knowledge and training of sleep specialists to determine what is and what isn't. Medicine isn't a racket, and when something is restricted, there is a reason for it. I know of no country at the moment where CPAP is an over the counter treatment, and the equivalent of the FDA in each country has very good reasons for restricting it.
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#15
In aviation we have a saying:
"A Superior pilot uses his superior knowledge and superior wisdom so he does not have to use his superior skill."

ie: Learn everything you can about what's going on.
If you are here then you have already made a good start!

Peace, Love & Carrots.


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

Cool
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#16
These are all great suggestions - I'll start taking some actions and let you know what I end up finding out! Sounds like talking to the GP and doing a home test will work and will keep the out-of-pocket costs minimal.
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#17
I went the traditional sleep study route which was affordable thanks to my health insurance. An alternative you might wish to explore is to go to the Supplier List and click on the link to Supplier #10. Then click on Home Sleep Test. I haven't personally tried this service, but a friend of mine did and felt he got good feedback and results, was accurately prescribed, saved significant sums of money and is now benefitting from effective CPAP therapy.

I am NOT personally endorsing this product, I'm just presenting you with an alternative that may fit your needs as you expressed them in your OP.
We're all family here...you can call me B36 if you'd like!Cool
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#18
It is possible to self-titrate the proper CPAP pressure for a newbie. Note I said "possible". But, that's really not my main concern for you.

The question is not titration, but rather proper diagnosis. A proper overnight sleep study can and many times does identify other health issues in addition to or apart from sleep apnea. There's a number of conditions that could be mimic the symptoms of Obstructive Sleep Apnea (OSA), but in fact have nothing to do with OSA. If you simply assume that you have OSA, and you're wrong, you could be using a treatment (CPAP) that could do you no good whatsoever at best, or make the situation worse.

That said, I tend to side with Archangle once you know for sure you have OSA. While it's not for everyone, once a patient becomes educated, there is little risk that they will be doing themselves great damage by self-titration, as long as they follow precautions, use a data-capable CPAP and make any pressure adjustments in small, incremental changes over a long period of time, as we promote on this page.

That said, DocWils is also correct in that it's much safer to use the advice of a medical professional who is trained in sleep medicine. But I realize that many folks nowadays (like myself) cannot afford health insurance or to pay for a sleep study out-of-pocket at all (being self-employed), so for me the choice has been made by my wallet.

But, all of medical knowledge is just that: knowledge. It can be learned. And, I firmly believe that while the average OSA patient cannot hope to attain to the level of sleep medicine knowledge as that of a professionally-trained physician, they can (over time and given the right resources) obtain a great degree of knowledge in this area that will at least provide them with an adequate understanding of titration methods so that they can avoid many of the associated pitfalls and risks if and when they decide to take an active role in their own therapy, including adjusting their own CPAP pressures.

Smile




SuperSleeper
Apnea Board Administrator
www.ApneaBoard.com


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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#19
My story:

If I may suggest please read my thread at:

http://www.apneaboard.com/forums/Thread-...ASV-to-get

I am coming to see that my bypass surgery is very likely caused by sleep apnea.

READ that again.

My chest will NEVER be as it was before the surgery, and my life maybe shorten because of all of this.

And my last 5 years of illness maybe caused by sleep apnea, and if I had not been able to work at home and at my own hours I would not be typing this. (I have had two decades of chronic fatigue..)

You’re lucky, 30 years ago this problem was more or less unknown, 20 years it was not very well known, and 10 years ago it looked like a fad problem (remember restless legs??)

Heck to me it still kind of looks kind of like a scam..There is so many health problems being tied to this problem, weight gain, not being able to lose weight, tired run down feelings, chronic fatigue, heart attacks, stroke and others.

And what some companies are doing the independent truckers over this problem is a nightmare: making them pay for sleep studies and machines out of their own pockets..(of course a big rig being driven by a sleepy driver is not good either.)

BUT after research I have come to believe most of the reports as true.

Found this:


"Roughly every other minute through the night you are stopping breathing...oxygen levels drop...heart gets stressed out...heart works harder trying to oxygenate the blood so that some important organs in your body don't starve...heart produces a little stress hormone called ANP http://en.wikipedia.org/wiki/Atrial_natriuretic_peptide ( and I think another stress hormone that I don't remember the name) which in turns goes to the kidneys and the kidneys kick into over drive...adrenaline gets dumped in the blood stream...pulse races...blood pressure increases.
So you are putting undo stress pretty much on your entire circulatory system every other minute throughout the night..and that's the best case scenario assuming you spread those events out equally throughout the night when in reality they don't come spaced out nice and evenly...they like to come in nasty clusters like every 30 seconds for 5 or 10 minutes so that multiplies the stress because the body doesn't get to recover before it gets slammed again.
Not to mention that each time this happens it is disturbing sleep cycles at the same time.

I happen to be have a situation where my OSA is worse in REM stage sleep (which is fairly common) with 53 per hour..
Now in Non REM sleep...a measly 12 per hour BUT those 12 had some massive long durations because my oxygen levels went down to 73%. So even if my REM stage sleep wasn't so ugly...12 per hour in Non REM sleep that were a minute long...that does some damage."


So I am getting used to my surgery after effects, and to my ASV PAP machine as well.

NOW to your problems of costs.

I found Dentist’s offering free interviews, and free home study tests. (watch out for the $3500.00 +appliance they want to sell you) (They only work for very mild cases of Obstructive apneas.)

Either I was so bad or he had to get a sleep Doctor to prescript as he then sent me to a sleep Doctor.

IF your really going to do this RIGHT Get a GOOD pulmonologist. (You REALLY SHOULD)

First call a Doctor’s office and ask if they have self-pay prices. I have been able to cut costs by 50%

Also you can ask for the Medicare prices as well , I got a couple of my Doctors to charge me at this lower rate.

It may help that I will be on Medicare this June 1st.

I also called almost all the sleep centers and ask those pricing questions and found two that would do a FULL study (This includes probes on your head to really see what is going on..) For $600.00.

I have major problems with Central Apneas, CAUSED BY CPAP TREATMENT: It is called complex central apneas and I have big problems with Hypopnea.

Due to my complex problems I will end up spending about $130,000.00 for my heart surgery.

My Apnea sleep studies cost $1200.00 ( 2 were needed)

My top of the line system:

Machine: Respironics DS950HS
Mask Type: Full face mask
Mask Make & Model: Respironics FitLife FFM
Humidifier: Respironics
CPAP Pressure: 7/15
CPAP Software: SleepyHead EncoreBasic

Cost $1900.00 (From a certain second hand dealer)

I fear that IF I had spent the $1200.00 and then the $1900.00 I would not be facing the $130,000.00 for my heart surgery and a change in my life.

A word to the wise.

Rich

PS some of this I have said other threads ...
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#20
(04-23-2013, 04:21 AM)DocWils Wrote: Sorry to argue with you Archangel, but can seriously compromise your health if the CPAP is not correctly set. Incorrect settings can put too much pressure into the mask, or too little - overnight problems could be few, but long term it may be as bad as not having the mask at all, or worse - for instance, you may increase CSA events considerably and then suffer from that for many years, or instigate other problems that can long term do as much harm as not using therapy at all. Only when the device is correctly adjusted does it do even an iota of good. Otherwise it is a useless as t**s on a bull, and could be even more harmful than doing nothing at all.

Further, you may need a very specific sort of device depending on the type of apnoea you have, or you may not actually have apnoea and your symptoms, although similar, are from something else. All this needs to be determined, and you can't do it yourself. You need the experience, knowledge and training of sleep specialists to determine what is and what isn't. Medicine isn't a racket, and when something is restricted, there is a reason for it. I know of no country at the moment where CPAP is an over the counter treatment, and the equivalent of the FDA in each country has very good reasons for restricting it.

I will disagree with you strongly here. Yes, increasing central apnea is a risk. Those who go it alone definitely need a fully data capable machine. Even if the machine is an older one that doesn't distinguish central from obstructive, it will still detect it and show it in your AHI.

There are some other problems that occur infrequently like bullous lung disease. There are some less serious problems like gas.

Other than that, I believe the main risk is not getting effective therapy. Even then, as long as you check the data and get a good AHI, you're probably getting a large benefit.

There is especially the problem of misdiagnosing a different problem as apnea and not getting treatment for the real problem. Blaming everything on apnea is even a problem for those who do have apnea and ARE being treated for it by a doctor.

Yes, it is better to be diagnosed and treated by a medical professional. If you do it on your own, you do need to learn what you're doing. Even an good Auto CPAP machine is not simply a "turn it on and forget about it" device. It's not something your average ignorant American consumer will get right.

I DON'T recommend that people try to diagnose and treat on their own.

I just don't believe that direct harm is really that likely.
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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