Severe Apnea - Advice Needed

[Crimson Nape]

Dreams of Green,
I know that any person with a DEA number can write a script for a CPAP and masks. This includes dentists. I don't know about the test.

[DariaVader]

altho a rx can be written without the test, if you are trying to get insurance to cover, they won't without a test -- ymmv -- but that is my understanding. You can get home tests and most insurance will cover that, and it is faster - this is really location dependent, tho. Once tested, given the severity you have described, they will not linger on getting him what he needs. My son had a home test; his doc made sure he got a cpap the very day she read his report (his AHI was > 100 and his desats in the low 70s)

[Dreams of Green]

I'm still working on this. Does anyone have any recommendations clinics that do online consultations, then send a sleet test kit out? My family member is traveling the next 3 weeks and I'm still trying to figure out a way to make this happen sooner rather than later.

Thanks

[chill]

Supplier #10 as noted earlier in this thread.

[Dreams of Green]

So as expected, this has been a typical healthcare industry nightmare. We got him to see a sleep specialist, who instantly agreed he is a textbook case of severe apnea.....and scheduled him for an in office test 2 months from now as their earliest opening. Insurance did approve, so that's good. Asked the doctors office for an in home test so he doesn't have to wait 2 months and got the totally BS response that would also take a month and a half. We considered continuing to call around and seeing who could test him fast, but I know the game, they'll all want to see him before committing to a schedule, won't be able to use the insurance approval he's already got, and by the time we get him into see someone else, then schedule, we might as well have waited the 2 months.

So at this point were going to stick with the appointment so he can get the official diagnosis, but I'm ordering a CPAP machine for him using my prescription. So here are my questions:

1. I have some extra nasal masks he could start with. We don't really know if he mouth breathes. Do we start with a nasal, use sleepyhead to monitor the results, and if AHI are brought under control we know he doesn't mouth breathe? Getting him the proper mask type is my biggest concern.

2. Is there ANY danger I am missing of letting him start treatment before diagnosis? I mean, we know right now he has severe apnea with severe oxygen deprivation, so the greatest risk to me seems to be to let him go 2 more months like this! It's having a major impact on his life - constant exhaustion, memory issues etc. I'm thinking get him the autoset and set a good range and it'll do it's job of setting the upper limit.

Thanks

[icyura10]

There's nothing wrong with finding a sleep specialist that has their own sleep lab for study and titration purposes.

I generally prefer to find a dr that doesn't have a sleep lab associated with him because they might be inclined to do things that aren't in your financial best interest.

I went to an internist, not a GP, not a Cardiologist, not a Sleep or pulmonary specialist. My internist wrote me up as being a candidate for having a Cardiac issue as well as potential for Pulmonary Edema.

The sleep lab had a wait of 14 weeks, but with my Dr suggesting my issues, I was in the study within a couple of weeks.

Unfortunately, they did a full sleep study and not a split sleep study.

In the Split, once they see you have sleep apnea (usually within an hour or two) they turn right around and titraiate you the same night.

The obvious benefit of this is it completely short circuits the process by up to a few months and the $$$ to you and the insurance co is less. Besides, within a couple of days usually you have an Rx for a ?PAP and associated equipment.

So try to get a split test if you can, and if you can get someone that's not associated with a sleep lab its even better.

The other thing to concern yourself about with a "one stop shop" as you seem to have, is they may or may not have a wide array of masks and devices that would benefit your partner the best. Trying to chance from a sleep lab to another DME can be a royal pain in the tail feathers.

Hope that helps

Oh.. BTW.. welcome and sorry to hear of the affliction, but happy there's a treatment for it.. not likely a cure.. but a treatment..

BTW, you didn't say where you live, but here's a site that may help you find a facility:

http://www.sleepapnea.org

http://www.sleeptember.org/

[Dreams of Green]

Thanks, the study is a split study. At this point I think we are good and going to stick with that. I just want to help him get a cpap and mask now. We don't care about the extra cost at this point, his health is too important and his condition is severe enough that it's absurd for him to wait another 2 months. He needs to start feeling better now.

[Dreams of Green]

So as expected, this has been a typical healthcare industry nightmare. We got him to see a sleep specialist, who instantly agreed he is a textbook case of severe apnea.....and scheduled him for an in office test 2 months from now as their earliest opening. Insurance did approve, so that's good. Asked the doctors office for an in home test so he doesn't have to wait 2 months and got the totally BS response that would also take a month and a half. We considered continuing to call around and seeing who could test him fast, but I know the game, they'll all want to see him before committing to a schedule, won't be able to use the insurance approval he's already got, and by the time we get him into see someone else, then schedule, we might as well have waited the 2 months.

So at this point were going to stick with the appointment so he can get the official diagnosis, but I'm ordering a CPAP machine for him using my prescription. So here are my questions:

1. I have some extra nasal masks he could start with. We don't really know if he mouth breathes. Do we start with a nasal, use sleepyhead to monitor the results, and if AHI are brought under control we know he doesn't mouth breathe? Getting him the proper mask type is my biggest concern.

2. Is there ANY danger I am missing of letting him start treatment before diagnosis? I mean, we know right now he has severe apnea with severe oxygen deprivation, so the greatest risk to me seems to be to let him go 2 more months like this! It's having a major impact on his life - constant exhaustion, memory issues etc. I'm thinking get him the autoset and set a good range and it'll do it's job of setting the upper limit.

Thanks

^^^ Anyone? ^^^

Thanks!

[chill]

Perhaps you should consult with a medical professional. I am not a doctor. I can imagine that specific, severe heart, lung, ear, eye, and stomach issues could be impacted by CPAP. Does he have any other known health issues? ASV machines (which are not ordinary CPAP machines) are known to cause problems with certain heart conditions.

That said, none of those conditions are likely to get diagnosed during an overnight sleep test. Specialist medical advice is needed.

[justMongo]

Dreams of Green: Perhaps your greatest risk is financial. If you purchase an Autoset and the diagnosis is mixed or central apnea, the Autoset may be the wrong machine. Are there physical risks -- some. There are some conditions for which CPAP is contraindicated. So, it's an "at your risk" situation; although I do understand your desire to do something ASAP.

If he is seriously desaturating, he may require an oxygen concentrator to induce supplemental oxygen into the PAP flow.