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Getting 2nd sleep study tonight so I can get new mask prescribed
I'm finally going to get a 2nd sleep study, tonight at the REM Sleep clinic, so that I can get a prescription for a new mask from Dr. Liberatore. I got my first sleep study more than 2 years ago, at a different clinic, and got a mask that was too big, bulky and uncomfortable for me so I've rarely used my C-PAP machine. Haven't gotten a good night's sleep for over 17 years. I haven't been here for a while to read the posts on this forum so not sure what I should expect or if there's anything I need to do or say when I go for this second overnight sleep study. I wonder if I could get a new C-PAP machine, one of the newer portable models (or will I need to have my current machine which was mostly paid by Medicare for 5 years), and which full face mask I should get. I guess I should search the posts for recommendations after I return from the clinic. When I had the first sleep study I had no idea what to expect, what questions I should ask, and my options for C-PAP machine and masks, I just thought I had to accept the one I got. I'm also worried that Medicare might not cover all the costs (before I also had Medicaid but not anymore), for the sleep study and the new mask, though I've been told by the clinic that they accept payment from Medicare. Not really sure why I'm posting this since I don't know what I should ask. Just feel like I'm going into this unprepared again, though not as ignorant as I was first time.
Views: 887
Replies to This Discussion
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Permalink Reply by Mary Z on
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This is another thing to take up with the sleep Doc. Often we don't feel as though we are sleeping, but really are. There is really not any use speculating until you get the results of your study. As I said, the doc will take your symptoms into account as well as your sleep study results. When is your appointment? Did you say 10 days after the study? Hang in there. Your questions are good, write them down for the doc.
Sonia S. said:Oh, and if I didn't get much sleep during the sleep study, how effective can the results be?
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Permalink Reply by Sonia S. on
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Well it's been 3 weeks and I still haven't heard back from the sleep clinic. I will call them today to ask when I can find out the results of my sleep study.
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I called the REM Clinic and was told that the results were sent to Dr. Liberatore on November 21st, so don't know why no one has bothered to call me from her office yet. Just called her clinic and spoke to the receptionist who looked at my records and couldn't find the sleep clinic eval. or results. She said she would call the sleep clinic to ask them to send the results again and took my number so the doctor can call me later. Wouldn't be surprised if a week pass and I get no call and will have to be the one to call again.
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Permalink Reply by Todd Loren Sinclair on
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So, I've had sleep apnea and been using cpap for about 10 years.
Basically you have a sleep study to determine the type of apena you have and severity and pressure required to correct it. When I did my last study to get a new cpap ... (which you can have replaced and paid for every 5 years under most insurance and medicare) they require 1st taking readings for a few hours without a mask and then several hours with a mask ... the without a mask part was required for a new machine ...
Once they determine your type and severity and pressure setting they send a report to your primary physician who writes a prescription for your machine with the pressure setting from the report. There are several types of cpap ... bipap vpap apap ... if you need a cpap try to get you physician to write the rx for an auto cpap ... gives you more options and it has a setting for straight cpap available also. You definitely need a heated humidifier with your cpap ... don't settle for an unheated passover humidifier ..., and mask and headgear. I use the resmed mirage quattro full face mask.
You can normally choose you medical equipment provider often referred to as you MDE. Some carry only one brand cpap and several brands of masks.
The MDE will will be where you go to get new masks, headgear, hoses, replacement cushions ... you don't need a new rx to get these items ...and they are covered by insurance and medicare, medicaid.
You can get a new full face cushion once a month, nasal cushions or pillows two per month, new nasal or full face mask every 3 months, new headgear once every 6 months, chinstrap once every 6 months, tubing once every 3 months and water chamber for humidifier once every 6 months. I urge you to order these items as often as you can ... cushions especially as they break easily and having a backup is a lifesaver. You can get a new machine and humidifier every 5 years ... with a new study.
The insurers or medicaid, medicare usually rent the machines for 1st 10 months them then buy them (They may wave this if you already have a history of sleep apnea and cpap use ... the other items are sold and yours immediately.
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Hi Todd,
Thanks for all the info. I got a CPAP machine and full mask (which was paid by Medicare) 2 years ago after I got my 1st sleep study, but because I got such a large and uncomfortable mask, that I had no idea I could request to change, I've rarely used the CPAP during the 2 years I've had it. I lost a lot of weight, over 130 lbs., and my sleep didn't seem improved so I went to see an ENT specialist, Dr. Liberatore, to see if there was another reason beside the OSA that was causing my breathing/sleeping problem and thought I needed a new sleep study in order to get a prescription for a new mask, and the doctor didn't say I didn't need a new sleep study and had one scheduled for me at the sleep clinic where she also works (after I'd waited a couple of months). At the 2nd sleep study I had 3 weeks ago, the tech didn't think I still have OSA so didn't do the 2nd part of the sleep study with a mask on me. The 5 or so hours I was there trying to sleep (from after midnight to before 6am), and feeling like I wasn't getting any sleep, the study was done without CPAP, which I wasn't happy about. So now I probably won't be able to get a new mask so can't use my CPAP machine. I feel like I didn't get a good sleep study and I'm afraid that I won't get a solution for my sleeping problem.
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Yeah I read most of the thread ... I'm surprised they didn't use the mask as well during the study ... sounds like a pretty shoddy sleep lab and I'd be looking for another GP too if I were in your situation ... Congratulations on the weight loss ... that would really affect the sleep apnea greatly ... at the very least by lowering the pressure requirements several points. masks are pretty expensive but you can sometimes find relativity inexpensive bargains at cpapauction There are some cpap user groups in larger metro areas where members might share their experience or let you try their mask .. most cpap users have more than one. Sleep problems are dangerous ... not just to your health and heart but many people with sleep issues fall asleep at the wheel and are injured or perish in auto accidents ... and the population in general doesn't take sleep difficultys seriously ..
Sonia S. said:Hi Todd,
Thanks for all the info. I got a CPAP machine and full mask (which was paid by Medicare) 2 years ago after I got my 1st sleep study, but because I got such a large and uncomfortable mask, that I had no idea I could request to change, I've rarely used the CPAP during the 2 years I've had it. I lost a lot of weight, over 130 lbs., and my sleep didn't seem improved so I went to see an ENT specialist, Dr. Liberatore, to see if there was another reason beside the OSA that was causing my breathing/sleeping problem and thought I needed a new sleep study in order to get a prescription for a new mask, and the doctor didn't say I didn't need a new sleep study and had one scheduled for me at the sleep clinic where she also works (after I'd waited a couple of months). At the 2nd sleep study I had 3 weeks ago, the tech didn't think I still have OSA so didn't do the 2nd part of the sleep study with a mask on me. The 5 or so hours I was there trying to sleep (from after midnight to before 6am), and feeling like I wasn't getting any sleep, the study was done without CPAP, which I wasn't happy about. So now I probably won't be able to get a new mask so can't use my CPAP machine. I feel like I didn't get a good sleep study and I'm afraid that I won't get a solution for my sleeping problem.
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Got a call back from Dr. Liberatore a few minutes ago and she said that the results weren't too bad and show I have mild sleep apnea now. She asked me if I had gotten a Ct(?) scan before the study and I replied that I had not been told I needed to get one. I think she said I had about 9 apneas in an hour and my blood oxygen was 93% but she doesn't think I got enough sleep during the study, and I said I felt like I didn't sleep, but before I could tell her why she told me about my treatment options - using CPAP therapy or an oral appliance. I asked if I could use both and she said that people usually use one of the other. I told her that I tended to open and breathe through my mouth while I slept, so she said I wouldn't be a good candidate for the oral appliance then. I told her that I had wanted a new mask but now couldn't get one since CPAP wasn't done during my sleep study. She said because I couldn't sleep enough the tech probably couldn't do the part of the study that uses the CPAP. She didn't know about my experience at the sleep clinic during my study so I told her about it, which explain why I wasn't able to sleep, and she was really surprised. She asked me if I would be comfortable going there again for a second night study if she had the tech supervisor in charge. I said that maybe if I was in another room I might not be awaken by the noise of toilet flushing. So she's going to schedule a second night sleep study for me since the 1st one was such a wash, and I really hope it will be covered by Medicare, though I don't think they shouldn't even be charging for that 2nd night study because of the terrible 1st one. So now I have to go through another uncomfortable sleep study.
Would like to hear about any member that uses a mouth appliance to sleep. Do you think it works? Would it work for people that open their mouth while they sleep? I thought it helped to keep your mouth closed. Can it be used in conjunction with CPAP? Could it be better than using CPAP for those with mild sleep apnea?
Thanks
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Permalink Reply by Janknitz on
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Personally, I don't see how you could trust ANYTHING from that sleep study. These sleep techs were a bunch of crooks. It is absolutely WRONG that they left patients unattended in the lab and they should both be fired. It makes me question everything they did, and I would not trust that sleep lab for any reason. You should file a written complaint. There are other sleep labs and you should go to one that is more carefully supervised and treats the patients a lot better.
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Wait. First off, because I am so impressed, I HAVE to say CONGRATULATIONS and a 130-140 lbs weight loss!!!
Second, many states REQUIRE a new prescription each year for the purchase of a mask or other accessories. IF you are doing well w/your CPAP most sleep doctors will just write the script for you assuming it is the same sleep doctor who ordered your original equipment.
IF you are NOT doing well w/your mask and equipment, and ESPECIALLY after such a great weight loss, it is totally reasonable that a new sleep study be recommended and ordered. It becomes even more reasonable when this is a totally new sleep doctor who hasn't seen you before.
Its not clear whether a split-night study was ordered, or if you expected a split-night study or if you just expected a CPAP titration study rather than a sleep evaluation study. Most insurances, including Medicare, will not approve and pay for a split-night study (first part of night w/o CPAP, second part of night w/CPAP) unless certain specific criteria are met during the sleep evaluation portion of the study (the part w/o CPAP and mask). When I had my in-lab sleep studies done Medicare required a MINIMUM of 2 hours sleep out of 6 hours bedtime. Meaning for a split-night study you would have had to have a minimum of 4 hours of sleep.
The fact that Dr Liberatore asked you if you would be comfortable going for another sleep study at this lab if she ensured that the sleep tech supervisor would be in charge says volumes.
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Mm, now I don't know if I should have that second night study at the same sleep clinic, but if I don't what are my options? I just have Medicare which is going to be billed for the 1st night sleep study at this clinic no matter how messed up it was. Afraid Medicare might deny paying for a 2nd night study at the sleep clinic. Don't know what to do.
Sonia
Janknitz said:Personally, I don't see how you could trust ANYTHING from that sleep study. These sleep techs were a bunch of crooks. It is absolutely WRONG that they left patients unattended in the lab and they should both be fired. It makes me question everything they did, and I would not trust that sleep lab for any reason. You should file a written complaint. There are other sleep labs and you should go to one that is more carefully supervised and treats the patients a lot better.
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Thanks Judy.
I didn't feel it was bad for the doctor to have me do another sleep study so I could get a new prescription for a new mask for my CPAP machine, especially after having lost so much weight, but I do feel that the staff, at her clinic and at the sleep clinic are not very good. First at her clinic it took many weeks for me to get a call, after I had called, from a staff member just to schedule the appointment for the sleep study. Then the behavior of the staff at the sleep clinic was not good, bad enough to warrant suspension. Then after the sleep study 3 weeks go by with no call from either a staff from the doctor's clinic or the sleep clinic, so I don't hear anything until I call the both clinics to find out what's going on.
I don't know what to do, if I should take the chance and have the 2nd night at the same sleep clinic, and hope that it goes well and that Medicare will pay the bill for 2 nights at that sleep clinic. The 1st one was supposed to be a split study, without the CPAP during the first 2 hours, then with the CPAP the rest of the night, but since I couldn't really sleep and due to the results the tech saw she said the CPAP wasn't going to be used, though the reason she gave me was that it appear I might no longer have sleep apnea. When I mentioned that I didn't think I was getting sleep she said that I was getting enough sleep for the study. Anyway, I don't know what I can do now, if I should try getting the study done at another sleep clinic, don't know if Medicare would cover a sleep study at another clinic, or just take my chances and have it done at the same clinic.You said "the fact that Dr. Liberatore asked you if you would be comfortable going for another sleep study at this lab if she ensured that the sleep tech supervisor would be in charge says volumes." Does that mean you recommend I stay with the same doctor and clinic, and have the 2nd night study there again?
Sonia
Judy said:Wait. First off, because I am so impressed, I HAVE to say CONGRATULATIONS and a 130-140 lbs weight loss!!!
Second, many states REQUIRE a new prescription each year for the purchase of a mask or other accessories. IF you are doing well w/your CPAP most sleep doctors will just write the script for you assuming it is the same sleep doctor who ordered your original equipment.
IF you are NOT doing well w/your mask and equipment, and ESPECIALLY after such a great weight loss, it is totally reasonable that a new sleep study be recommended and ordered. It becomes even more reasonable when this is a totally new sleep doctor who hasn't seen you before.
Its not clear whether a split-night study was ordered, or if you expected a split-night study or if you just expected a CPAP titration study rather than a sleep evaluation study. Most insurances, including Medicare, will not approve and pay for a split-night study (first part of night w/o CPAP, second part of night w/CPAP) unless certain specific criteria are met during the sleep evaluation portion of the study (the part w/o CPAP and mask). When I had my in-lab sleep studies done Medicare required a MINIMUM of 2 hours sleep out of 6 hours bedtime. Meaning for a split-night study you would have had to have a minimum of 4 hours of sleep.
The fact that Dr Liberatore asked you if you would be comfortable going for another sleep study at this lab if she ensured that the sleep tech supervisor would be in charge says volumes.
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It sounds to me that Dr Liberatore was both embarrassed and seething that you were left unattended and will be climbing on the backs of the owner of the sleep lab AND the techs.
I would be inclined to send a WRITTEN request to the sleep lab requesting a copy of the full scored data summary report w/condensed graphs AND the tech's notes as well as a copy of the doctor's dictated results report. The full scored data summary report w/condensed graphs AND the tech's notes should be especially interesting!!!! These are part of your medical records and as such you have a LEGAL RIGHT to them under HIPAA.
I would also send a diplomatically WRITTEN description of your sleep study experience to the sleep lab director. I would state that I felt there should be NO CHARGE for such a shoddy experience given the disgraceful and unprofessional conduct of the sleep techs. Keep it brief and to the point. I would also ask if this sleep lab was accredited.
Sleep labs, like local DME providers, submit a billed amount to Medicare. There is an allowed amount that the labs have agreed to accept in order to qualify for Medicare reimbursement. Medicare pays 80% of that allowed amount. You are responsible for the remaining 20% of the allowed amount. In order to qualify for Medicare reimbursement the sleep lab can NOT charge you any more than the 20% of the allowed amount.
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