New patient. Have been having horrible nights.

[Walla Walla]

Walla...API American Petroleum Institute?

Stupid Gremlins!

[zzzZorro]

Josephdfco: I do not see where you responded to SR's question about heart health.  This bugaboo can be a monumental stumbling block to getting the help you need IF you fit into that category.  If one has 'Left Ventricle Ejection Fraction' (LVEF) below 45% (<45%) the medical profession in their wisdom has mandated you will NOT be ineligible for a 'Auto Servo Ventilator' (ASV) machine.  It is a shock to be told that your problem would be remedied with a ASV, BUT YOU CAN'T HAVE ONE.

I sincerely hope you are not among the LVEF people.  I am a BIG fan of suggesting ANYONE who has the vaguest suspicion they may be progressing toward a heart problem or developing 'Congestive Heart Failure' (CHF) get themselves checked promptly by a cardiologist.  It is said that sleep apnea can cause heart-attack (M/I) or stroke and even if one survives a M/I and gets stints or a bypass they may have been able to be >45% if the procedure would have been preformed PRIOR to the event.  I am not a professional in any of this but just speaking form a been-there-done-that position to give a heads-up to those who haven't.

You mentioned VA, Thank You for Your Service. God-speed on your journey.

[Josephdfco]

Thank you very much, zzzZorro, and thank you all for the warm welcome and the help.  Here is last night's data after switching to CPAP mode, by the way:  (oops! It won't let me post a link)   Also, as far as I know, I do not have any cardiac problems as of yet, but I can certainly ask them to check.

---

Here is the second half of the graphs:

[Josephdfco]

I'm also very, very worried about my wife.  She is 48 years old, in menopause, but has been a terrible sleeper for many years (very shallow, easy to wake up, and often has a difficult time getting back to sleep). She's been under tremendous stress, is depressed and anxious, and has been crying a lot lately. I think that her lack of good sleep (she never feels rested) is exacerbating her stress and depression, maybe it's even a big causal factor.  She doesn't snore, as far as I can tell, but I can't help but wonder if she might have sleep apnea nonetheless.  I'd love to have her get a sleep study. It will be costly, because we still haven't met her deductible, but that's not a deal-breaker. I'd pay anything to get relief for her.  We even spent $6000 on a Tempur-Pedic mattress, the best we could find, but it only helped a little.  Who can she go to to get a referral? Right now, she doesn't have access to a primary care doctor because of some sort of insurance battle.

[Walla Walla]

Try a dentist or a walk in clinic. Both can give a referral.

[pholynyk]

Also Supplier #29 on our list offers a home sleep study for $250 that you can use to get a prescription from any dentist or doctor. It's under Alternatives & Services in the left side column. You don't always need a full in-lab sleep study (in the USA).

[Josephdfco]

Thank you!  My only concern is that I had the home study done last year, and believe it or not it failed to pick up on my condition. How much do the full-lab tests cost, ifit turns out that the home test misses it?

[Walla Walla]

It depends where you go. It cost my insurance about $2000 if I remember right.

[Boodmaster]

I’m in the EXACT same boat as OP. 2 months in, AHI of 30, ALL central. On the ResMed Aircurve 10 VAuto. It’s doing nothing. I’m just pausing my breaths up to 40 seconds and it’s destroying my life. Gonna call Monday to beg ASV. I don’t have a backup timer, so obviously nothing helps. 10 / 4 pressure. Practically 0 apnea’s of all kinds, except central. 31, 165lbs, 6’0”.

[Sleeprider]

Joseph, let's solve your problem, and find a good solution that doesn't break the bank. Your apnea events are half on CPAP compared to the bilevel. We can probably reduce events further by reducing CPAP pressure, so give 7.6 cm pressure a try next.

You need ASV. Ask your doctor to write the prescription. If he will, then you can purchase a "lightly used" Resmed S9 VPAP Adapt or newer model Aircurve 10 ASV from Supplier #2 (SecondwindCPAP). If you have met your deductible, then just use your DME supplier to get the machine. For insurance, you will probably have to do a titration study to show ASV is effective, but if you are self-financing, then you can probably avoid that step. ASV will work, but the other condition, as mentioned before is a LVEF>45%.

With regard to your wife, some sleep studies are better than others. Most can detect severe obstructive and central sleep apnea. It really comes down to interpreting the test. At a minimum, the home test unit must have a flow canula, chest strap to measure effort, and an oximeter monitor to measure blood oxygen and pulse rate. Supplier #30 also offers home sleep testing services. Clinical polysomnography is pretty expensive, and the best bet is to call around and ask for quotes. Even if your deductible is not met, your insurance company has negotiated discounts with in-network providers, so get that list and have the sleep clinic bill through the insurance so you get the discounted approved reimbursement rates. Even if you pay all of it, the price will be below the invoiced price to uninsured patients. In most cases a patient can self-refer to a sleep clinic. Call, talk, ask. If she has no primary or any coverage, why are you paying for insurance? Call them and get it straightened out or drop them.