Very likely sleep apnea; can't afford sleep study. What to do?

[Axmann]

So, the nearby sleep center gave me an estimate on a HOME(!) sleep study: $500, after insurance pays. I simply can't afford it and have read home sleep studies have poor diagnostic value. Add to this that I don't feel relaxed in my own home.

A little bit of history:

24 year old male, overweight (5'11, 250 lbs), diagnosed deviated septum and lifelong nasal breathing problems (had adenoids removed before), snoring observed by partner, confirmed severe dust mite allergies, and an impressive psychiatric history including lifelong, severe treatment-resistant depression, lifelong insomnia, and ADD-PI (Primarily Inattentivd).

Recently, my sleep has become much worse with sudden wakenings after 3-4 hours of sleep, despite different cocktails of multiple sleep medications (with doctor's approval).

It is probably highly likely that I have some form of sleep apnea, but right now I just can't afford the sleep study (let alone a CPAP machine).

I have read about SnoreRx, but unsure if using it would help significantly. Thoughts? Is there any way I could get an affordable sleep study?

I'm really in need of help here.

[OpalRose]

Axmann,
Check out Supplier #30 from Supplier List at top of page.
http://www.apneaboard.com/forums/Thread-...plier-List

They offer in home sleep studies for a little less.
I believe they accept insurance, may be worth checking into.

The other option is to buy an Auto Cpap, and titrate yourself. You will still have to spend a few hundred for a machine, and you will need a perscription.
Supplier #2 offers lightly used and also new open box machines at reasonable prices.

Don't know anything about SnoreRx.

[cate1898]

Welcome to the forum Axmann! You'll get lots of great advice here. Hope you find a viable solution at a cost you can afford. Keep us posted!

[justMongo]

If you truly have sleep apnea, then oral appliances are of questionable value.
Be advised that sleep meds may make apnea worse.

[Sleeprider]

Axman, I would have a discussion with your family physician. With knowledge of your medical history, risk factors and financial position, most are willing to write the prescriptions you will need to obtain machine, mask and supplies. Without a sleep study, those costs may not be insured, but you can get everything cheaper than the out of pocket of most high deductible and copay insurance. It's possible, your doctor's diagnosis based on his interview of you and your symptoms may also be insurable. It's worth a try, and might be insured with your usual copay and deductible.

As mentioned above, Supplier #30 does offer a prescription and home sleep study service. All-in it is $400, but the prescription (based on a questionnaire) is $99. It's completely legitimate and similar to what I suggested you do with your family doctor.

A brand new Philips Respironics System One 60 Series Auto CPAP with humidifier can be purchased for about $400 as they are being discontinued for the new Dreamstation series. Check Amazon, Supplier #2 and other places for this kind of deal. This is a fully data capable machine that will adjust pressure to your needs. We can help you get it setup and optimized. Self-titration with an auto CPAP is a fairly common approach these days. If you need to go even cheaper, there are often machines available on Craigslist, but be very careful with used machines not to get an outdated model or one that doesn't have features that will let you optimize the treatment (data and auto). Good luck, and go get it!

[trish6hundred]

Hi Axmann,
WELCOME! to the forum!, and much success to you.

[worn_out_in_lebanon]

I don't know your financial situation...
But if you have sleep apnea, it's very likely you will spend more in the long run, and have worse health, than if you can find some way to get it treated, if at all possible. The interview approach sounds reasonable. A used machine is an option, I got an open box / used unit from #2 myself. It had not actually been used from what I could tell - all the accessories were sealed, and the hours were zero.

[y_not]

Hi Axmann, like you I am very new to all this. I was only recently diagnosed (UK so NHS pays the bill and supplies the equipment) but before diagnosis I spent some time (3 weeks or so) using an oximeter with USB connection. Wore it every night and downloaded the data every day - showed oxygen levels as low as 76% (worst) and the fluctuations during the night. It's not a perfect fit but does give an indication and the SPO2 unit only costs around $25 from Amazon.

It won't solve any problems but is a cheaper way of finding out if there is an issue.

Hope it helps

[cant_sleep_in_nj]

i was fairly certain i had sleep apnea so i bought a used unit and played with pressures for a few weeks till i got it just about right. i then ended up getting a sleep study and they confirmed it and also told me the pressure which i had figured out on my own.

[kbeckman]

I had a sleep study, but it nearly killed me!

Something happened while they were adjusting the pressure, which caused my throat to close. I woke up and could not breathe. It took nearly a minute before I could get air in my lungs. After that, I refused to use the mask, but continued to allow them to monitor my sleep. I had severe sleep apnea. I was told I would have to do another study, which I refused.

I picked up a used Resmed S9 on Craigslist for $200. The S9 in the APAP mode will figure out the pressure for you. With the help of the Sleepyhead software I was able to fine tune the settings.

Basically all you need to start with is the lower pressure. The S9 will determine the right upper limit depending on your needs. Here are my current S9 settings:

Mode Autoset (Puts unit in APAP Mode)
Max Pressure 14.0 (This is max pressure)
Min Pressure 7.0 (This is min pressure)
Max Ramp Off (Turn ramp off)
Start Pressure 4.0 (Not used)
EPR Full Time (EPR lower the pressure when you exhale)
EPR Level 3 (This is the maximum setting, and nice)
Mask Pillows (I use Swift FX pillows)
Tube Slimline (I use a Slimline hose)

I originally started at 5.0 min, and 12.0 max, and could tell that a higher min was needed as the S9 increase pressure right away. Going from 5.0 to 7.0 eliminated all apnea events when first starting the therapy. Looking at the data, I could also see that 12.0 was too low, as I was reaching this pressure level, and could tell that it needed to be higher. I now use 14.0. Looking at Sleepyhead data again, I can tell it never needs more than 14.0, as it just barely gets up into that range every once in a while.

The Ramp setting is where the initial pressure is lower to start. You may need this to get used to the APAP, but it is just a crutch, that you will do better by just never starting. If you have to have such a high pressure that you have trouble breathing into you starting pressure, you could try using the ramp to assist in falling asleep faster, but this is more of a fine tune adjustment to do later. The Start Pressure right after the Ramp setting is the starting pressure of the Ramp. Since I have it turned off, it is not used.

EPR is something nice about the S9. It lowers the pressure when you are exhaling, so it is not as hard to exhale into a higher pressure. 3 is the highest setting, where it will lower the pressure by 3 units when exhaling. I like it, but EPR is not necessary for therapy.

The Mask and tube are just the setting of what you are using for equipment.

I have now been using the APAP for just over 3 years. About 6 months after my study fiasco, my doctor convinced my to come in and see him. I brought in my SD card from the S9, which he analyzed.

He didn't change a thing.

My long term AHI is now under 1, and typically in the 0.5 range. The biggest problem with CPAP type equipment is that there is a 75% patient rejection rate, which is the biggest hurdle.

Don't even bother trying a CPAP the first time, go right into an APAP like the S9.