Diagnosed with OSA

[Osiris357]

Would anyone be able to tell me why I was diagnosed with OSA when I only had 4 obstructives? Almost all the rest were hypopneas, 190 of them. With 25 centrals and 1 mixed. 210 in total in 6 hours with an AHI of 35.2.

I can’t post my scan of my sleep study from my phone. I’m wondering why I wasn’t diagnosed with UARS instead since most were hypopneas? Apneas were scored with a 90% drop in flow and hypopneas were scored if there was a drop of 30%. RERA’s were not scored.

Thanks 

Eric

[OpalRose]

They won’t use UARS as a diagnosis as insurance doesn’t recognize it. Doctors know this, so if they turn UARS into insurance as a diagnosis, your machine may not be covered.

It seems that OSA is a generic term they use for everything. This way your covered. Unfortunately, this attitude by insurance companies doesn’t always get you the correct machine.

[Osiris357]

They won’t use UARS as a diagnosis as insurance doesn’t recognize it.  Doctors know this, so if they turn  UARS into insurance as a diagnosis, your machine may not be covered.

It seems that OSA is a generic term they use for everything.  This way your covered.  Unfortunately, this attitude by insurance companies doesn’t always get you the correct machine.

That makes sense. Thank you OpalRose

[Sleeprider]

We see this very commonly among members here. The logical diagnosis for you would have been mixed or complex apnea, particularly as a large majority of apnea were central and hypopnea are often indeterminate. Most diagnoses we see here are for OSA, and since the only therapy that will be approved regardless of apnea type is CPAP, it makes no difference. About the only way you can skip CPAP and move directly to bilevel is with a pulmonary disease (COPD), Neurological thoracic disease or hypoventilation syndrome, and most of those get diagnosed as OSA too. It's no secret that sleep doctors do not diagnose, they transcribe technician findings for insurance approvals and send the patient off to fend for himself. This is not medicine or science, it's a scam that seeks to determine if a problem measured in AHI meets the criteria for treatment. Welcome to our world where everyone has the same problem, treated the same way, and some succeed or not.

[Osiris357]

We see this very commonly among members here. The logical diagnosis for you would have been mixed or complex apnea, particularly as a large majority of apnea were central and hypopnea are often indeterminate.  Most diagnoses we see here are for OSA, and since the only therapy that will be approved regardless of apnea type is CPAP, it makes no difference. About the only way you can skip CPAP and move directly to bilevel is with a pulmonary disease (COPD), Neurological thoracic disease or hypoventilation syndrome, and most of those get diagnosed as OSA too.  It's no secret that sleep doctors do not diagnose, they transcribe technician findings for insurance approvals and send the patient off to fend for himself.  This is not medicine or science, it's a scam that seeks to determine if a problem measured in AHI meets the criteria for treatment.  Welcome to our world where everyone has the same problem, treated the same way, and some succeed or not.

Thanks Sleeprider, I came across a really good article about someone’s journey with cpap that gets into a lot of interesting things am I allowed to post the link? If I’m allowed I’ll post it in its own thread so it’s easy to find. It’s gets into how sleep apnea is basically ignored my high science and is not understood at all and all of us are basically test subjects feeding the industry info about it. But very slowly because compliance rates are horrible. Among other aspects of sleep apnea.

Back to my original topic, I recently talked to my actual doc who I initially had who sent me for the study and diagnosed me, not the NP I see now. I didn’t ask him the above question at the time but he did say that he wasn’t sure if those 25 centrals were “real” or not after the study because I didn’t have an EEG during it. And that it appears that if any were real and not from awakening or changing position they were very few in number and my recent spike was just treatment induced and I seem to have acclimated to therapy and pressure support (EPR3) over the past month. For example last night I would’ve had an AHI if 0 if it weren’t for 3 centrals from awakening and position changes. So it looks like I don’t have central apnea in it true form. Thank god.

 I also discovered thanks to my girlfriend paying attention to my head position while I was sleeping that I’m chin tucking when my flow limitations spike but without the characteristic cluster of obstructives as a dead give away. As soon as I turned on my side they went down to nothing. I ordered the dr. Dakota a week ago but there is a delay in shipping for an undetermined amount of time (Walmart is claiming this not FedEx or UPS). So I’ve discovered why I was getting high FL’s with a full face mask. I tend to sleep on my back with those on. 

Sorry about the long winded story. It’s just great to have a place to say all this and not have someone say “I have no idea what you’re talking about”

[Sleeprider]

From what I have seen you have not continued to have problems with CA in your therapy. Your account of flow limitations that coincide with chin tucking is consistent with the positional issues we have discussed in a lot of threads. Severity varies, and flow limitation is mild obstruction. I see much of the same in my own results, but it is not severe enough to motivate me to treat it.

As far as linking web pages, it is commercial links that are banned. If the page is not selling a product or have a click-through to a store or place to buy something it is not prohibited. If you're uncertain, quoting the title of the article and even telling us the domain name without the .com is allowed. You have certainly see even products identified on Amazon or on Ebay. There is no problem with any of these unless the name of the store ends in .com or something similar. Read the commercial links policy and I think it's pretty clear. http://www.apneaboard.com/forums/Thread-...#pid104423

[SorryIamNormal]

We see this very commonly among members here.   It's no secret that sleep doctors do not diagnose, they transcribe technician findings for insurance approvals and send the patient off to fend for himself.  This is not medicine or science, it's a scam that seeks to determine if a problem measured in AHI meets the criteria for treatment. 

You just gave me great satisfaction by that comment.  Thank you for telling it like it is.  So the real answer is that it's all about business and we will change the criteria until you fit our model.  And if you don't like it you can get no treatment.

[Dormeo]

Unfortunately there is some evidence that Dr. Dakota is no longer in business. I hope that's wrong; I think it's an excellent collar. Let us know if you finally get one, would you?

[Osiris357]

From what I have seen you have not continued to have problems with CA in your therapy.  Your account of flow limitations that coincide with chin tucking is consistent with the positional issues we have discussed in a lot of threads. Severity varies, and flow limitation is mild obstruction. I see much of the same in my own results, but it is not severe enough to motivate me to treat it.

As far as linking web pages, it is commercial links that are banned. If the page is not selling a product or have a click-through to a store or place to buy something it is not prohibited.  If you're uncertain, quoting the title of the article and even telling us the domain name without the .com is allowed.  You have certainly see even products identified on Amazon or on Ebay. There is no problem with any of these unless the name of the store ends in .com or something similar.  Read the commercial links policy and I think it's pretty clear. http://www.apneaboard.com/forums/Thread-...#pid104423

Yes my centrals have backed off. Just recently for a week straight (I didn’t post any screenshots) I was getting more than 10 up to 30 a night and I would wake up with very bad anxiety, except for 2 days. Only on those days with a lot of centrals (for me at) I woke up like that. It was very concerning because my hands would be shaking at work. Everything else was ruled out and since on those 2 days where I had none or just a few like last night I woke up fine and full of energy till 4 or 5. But that appears to be in the past and just a blip I hope. If it wasn’t for the anxiety when they appear like that it would be a nonissue.

As for the article as far as I know it’s not a website selling anything. It might have ads but that’s everywhere

[Osiris357]

Unfortunately there is some evidence that Dr. Dakota is no longer in business.  I hope that's wrong; I think it's an excellent collar.  Let us know if you finally get one, would you?

I will Dormeo. You may be right because amazon says they have no idea if they will be back in stock. That usually means discontinued or out of business