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new apnea diagnosis
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terapnstn Offline

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Post: #1
new apnea diagnosis
Hi all,
Thanks for being here, and for providing support for us newbies that don't know anything yet.
My husband has been diagnosed with atrial fibrillation, and sleep apnea. He has a prescription for a cpap, and an appointment to get fitted for one on Monday. But apparently he is supposed to have ANOTHER sleep study with the cpap on, and we got a statement from the insurance that they will cover "2 months' rental at 80%"
I get the feeling that the 20% we pay will cover the cost of a cpap, and isn't it something he will be on indefinitely?

Should we buy our own? What kind? Do we REALLY need another sleep study? Can't he just buy a regular cpap machine?

Thanks in advance for your help and advice.
09-27-2013 10:58 PM
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JJJ Offline

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Posts: 751
Joined: Apr 2012

Machine: ResMed S9 Autoset
Mask Type: Nasal mask
Mask Make & Model: Most recent: Wisp, Pilairo, Mirage Vista
Humidifier: ResMed S9 Autoset
CPAP Pressure: 17-20
CPAP Software: SleepyHead

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Sex: Male
Location: USA 97217

Post: #2
RE: new apnea diagnosis
(09-27-2013 10:58 PM)terapnstn Wrote:  My husband has been diagnosed with atrial fibrillation, and sleep apnea. He has a prescription for a cpap, and an appointment to get fitted for one on Monday. But apparently he is supposed to have ANOTHER sleep study with the cpap on, and we got a statement from the insurance that they will cover "2 months' rental at 80%" I get the feeling that the 20% we pay will cover the cost of a cpap, and isn't it something he will be on indefinitely? Should we buy our own? What kind? Do we REALLY need another sleep study? Can't he just buy a regular cpap machine?

Apnea Board members are from all over the world and you didn't say where you are located. But assuming you are in the US you need a prescription to buy a CPAP machine or a mask. You are entitled to a copy of the prescription, so if your doc hasn't given you a copy of it yet, just call up and ask for it. Once you have the prescription in hand you can order a CPAP machine on your own, and the total cost can be less than the copays that you may have. Personally I prefer Supplier #2 (see the Supplier list at the top of every page on Apnea Board). They sell gently used and open box machines for a fraction of what they would ordinarily cost.

Before you race off and buy a machine be sure you do a lot of reading here to figure out which machines are the best and which ones to stay away from.

Having said that, there are advantages to getting a machine (and especially the mask) from a local supplier. They will spend time explaining how to use the machine and will help you get the mask adjusted. Most of them also allow returns on the mask for a couple of weeks or so - there are dozens and dozens of masks on the market to choose from. This is very helpful because the mask is the hardest part.
09-28-2013 12:47 AM
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Tez62 Offline

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Posts: 837
Joined: Feb 2013

Machine: Resmed S9 Autoset
Mask Type: Full face mask
Mask Make & Model: Resmed Mirage Quattro
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CPAP Pressure: 5-15
CPAP Software: SleepyHead

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Sex: Male
Location: Melbourne, Australia

Post: #3
RE: new apnea diagnosis
terapnstn, welcome, the other reason why he needs a second sleep study is to work out what pressures he will require, you can't just guesss that and everyone is different. If he gets an Auto machine they will give him a high and a low pressure which is normally more comfortable. If he gets a straight CPAP the pressure is fixed. Most of us use either a Resmed Autoset or it's Phillips equilivent. They are also data capable so he can look at his own data and take his therapy into his own hands if he wants. We can help you on here download the free software and he can watch Youtube video's or ask questions.
Following on from JJJ it does depend on which country you live in as to the procedures, it sounds like the US so what JJJ said is good advice., good luck,keep us updated and ask any questions.
09-28-2013 02:34 AM
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trish6hundred Offline

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Posts: 6,450
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: #4
RE: new apnea diagnosis
Hi terapnstn,
WELCOME! to the forum.!
Your husband probably needs a second sleep study to determine what pressure he needs.
Hang in there for more responses to your post and best of luck to you both.

trish6hundred
09-28-2013 11:29 AM
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PaulaO2 Offline
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Posts: 8,067
Joined: Feb 2012

Machine: S9 Autoset
Mask Type: Full face mask
Mask Make & Model: F&P Simplus
Humidifier: H5i
CPAP Pressure: 14-20
CPAP Software: SleepyHead

Other Comments: Ehlers-Danlos Syndrome, Hypermobility Type; chronic sarcasm

Sex: Undisclosed
Location: western NC, USA

Post: #5
RE: new apnea diagnosis
The second study, as others have said, is important.

Some people have "adverse" reactions to the CPAP pressure as they increase it. The reaction is to have more Central events as the pressure is increased even though the Obstructive events cease. This does not mean the person has Mixed Apnea. It is just something that happens to some people. They would be able to determine this as they do the study.

Some people cannot breathe out against the pressure, especially someone with low lung function due to lung issues or heart issues. The face he is having heart issues is important. You want him to have the optimum pressure determined.

Once he has the second test and once you know the pressure, then you can find out your out of pocket expense. What happens after the "rental" period ends? Usually the rental period is to make sure they don't fork over money for a machine and then he not use it. It is all about compliance. If the patient is compliant, some insurance companies then go into a kind of "rent to own" deal with the supplier. You continue to pay the 20% until the machine is yours. If your out of pocket money is more than buying one outright from Supplier #2, then get it on your own.

BUT this means you are also on your own for supplies for the machine, such as hoses, filters, and replacement humidifier tubs. And make sure the insurance will still cover the cost of the mask if you buy your own machine.

PaulaO2
Apnea Board Moderator
www.ApneaBoard.com


Breathe deeply and count to zen.

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.
09-28-2013 10:44 PM
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