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Wanting a reality check!
#1
Wanting a reality check!
I'm looking for the point of view of folks who have been through sleep testing.

Took a sleep test at the advice of my dentist because of potential grinding/clenching.

Just got results from the sleep study and both nights of full sleep I had AHI of 4, so normal. The 3rd night was only for 4 hours (forgot to change the batteries in the sleep kit) and that one was 6.8 AHI. Oddly enough on the night of 6.8 AHI I had amazing sleep and woke up feeling refreshed and was bummed that I didn't think that night would be included in my test results.

Based on a result of 6.8 on that partial night sleep, and also an average of 25 hypopnea events per night and oxygen level going to 82-84% range for a few minutes each night, my dentist is recommending a dental appliance, CPAP, or surgery. I'm feeling really skeptical since 2 of the 3 nights AHI was in the normal range, and the other night was on the very low end of mild.

On top of that, my insurance is now refusing to pay for the $1200 sleep test saying it wasn't medically necessary. (I had been told by the sleep study folks that my insurance had approved it, or I never would have taken this test!)

Given my results and also the insurance bait and switch, I'm feeling skeptical about this whole process. I don't want to ignore this if it really is a problem that needs to be treated. But I don't want to spend more money on treating something that is so mild it may not even need treatment. My results don't seem that serious to me, but maybe I'm in denial. I guess I'm wanting a reality check from folks who have been through the testing and understand it better than I do!
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#2
RE: Wanting a reality check!
G'day MasMoudi. Welcome to Apnea Board.

On the basis of what you've told us it doesn't sound like you have a serious apnea problem - certainly nothing that would warrant surgery!

Although AHI is the benchmark for apnea there are other considerations such as RERA (Respiratory effort- related arousal ), flow limitations and others more less on a spectrum from no obstruction through to full apnea. These may not be picked up by a home sleep test but should be observed in a full in-facility polysomnography. So while the AHI is low there can sometimes be an underlying issue.

There is a simple questionnaire which will give you your "Epworth Sleepiness Score" which is a subjective measure of how badly your sleep problems (if any) affect your performance through the day. This should be the first step. You can take the test here and let us know how you got on: https://www.apneaboard.com/sleep-apnea-i...iness-test

If your problem is limited to teeth grinding, there are simple dental appliances to protect your teeth, which I'm sure your dentist can provide.
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#3
RE: Wanting a reality check!
Sleep apnea is just one of the underlying causes of bruxism so I'm a bit surprised that your dentist went down that route. Other causes are stress, anxiety and lifestyle. Maybe he should have referred you back to your GP.
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#4
RE: Wanting a reality check!
Welcome to the Apnea Board. Another thing to consider is the sleep test was for 3 nights. Obviously we don't know what's happening during the other 4 nights. We also don't know which is more typical for you, the 2 nights with a few events or the 1 night that tested with higher events.

As for the insurance issue, it's possible they have an appeal process. Assume for a moment it's determined you medically need the overnight sleep study and/or a script for CPAP. Your home test seems to have been needed for medical diagnostics to treat symptoms. I'd suggest investigating and fighting insurance non payment especially after it's initial approval. Maybe insurance customer service helps tell you the why behind that. Example: I did an approved by insurance procedure then they refused payment. I called my insurance and customer service stated the doctor's office filed incorrectly, stating initial visit when it wasn't. CS even called doc's office and told them to refile and say x y z and it was processed and paid. Bottom line is I'd suggest fighting to get it covered. Best to you on it.
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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#5
RE: Wanting a reality check!
Hmmmm...any results on sleep disruptions? It's possible to have something like UARS (Upper Airway Resistive Syndrome) and have a low AHI (mine was only ~6) but have far more sleep disruptions. I used to clench a lot more (before CPAP) as it was part of my body's ways of trying to keep my airway open.

If your overall symptoms are suggestive of sleep apnea / sleep disruptions, it may be worth following up on. There may be other ways to investigate further before squaring up to your insurance company at the get go (perhaps a repeat of the overnight study...many durable medical equipment (DME) shops do a basic sleep study for free up here). Might give you a little more ammo to use with the insurance company for either a full sleep study or a machine in the future.
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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