"please keep me updated about oximeters "
Sleep Apnea Forum Bringing Power to the Patient
New? Free Sign Up
Then check our Welcome Center to a Community Caring about Sleep Apnea diagnosis and Sleep Apnea treatment:
CPAP machines, Sleep Apnea surgery and dental appliances.
CPAP Supplies
Latest Activity
My At Home Sleep Study Experience
This is in response to Mike's request in another thread:
Mike said:
My sleep study was done through a private clinic. My family doctor recommended it because I had visited her to discuss the fact that I was too tired to get out of my own way, the noise from my snoring was waking me up, and my weight was spiraling out of control. I told her I need to get this addressed, and the most sensible place to start, is with my sleep. We had actually discussed my snoring about seven years ago when I had just started working shifts and was pregnant with my first child, and I saw an ENT way back then, but for many reasons, follow through never happened. I told her I wanted to be re-referred to the ENT (I was convinced the problem was simply that I needed my tonsils out).
Anyway, she said she expected I have sleep apnea ( I assured her I didn’t, lol), and wanted the ENT to have sleep study results when he saw me (I live in Canada, so it's going to take many months for the ENT appointment).
The clinic where I had my sleep study done is actually the DME as well, and I think the ENT to which my doctor referred me is a partner in the venture - so I guess there could be all kinds of issues of conflict of interest, but I haven't had any issues or concerns.
The clinic will arrange the sleep study without a referral, but they asked for one, and since I already had one, it wasn’t a problem. I visited the clinic and spent about 30-40 minutes with the sleep study coordinator who did my intake, asked me a bunch of questions, showed me the “WatchPAT 200" machine, and I watched a short video about how to use it while she programmed the device. We reviewed what to do with it to make sure I understood, and then I took it home.
It was an extremely easy process, you wear the device on your non-dominant wrist, like a large wristwatch, attach an O2 saturation and heartrate monitor to your fingers, and then there are two sensors that you feed up your sleeve to attach to your chest and at the base of your neck. One measures the decibels of your snoring, the other measures your sleep position. The next morning, I returned the device to the clinic. The sleep study coordinator was planning to send me the results in the mail, and also to my family doctor, but she only sent them to my doctor. It wasn’t an issue, because the next time I was there, I asked for it and was given the printout.
The entire cost for the sleep study was $75.00. I haven’t made the request for re-imbursement to my insurance yet, so I don’t know if that cost is covered. Not a big deal to me.
A few days later, my doctors office called me to come in, and my doc discussed the results with me, that I have moderate sleep apnea. We discussed whether I was open to CPAP therapy, and I told her “absolutely”. She wrote me a prescription for a CPAP machine, and I called the clinic back and made an appointment to get the machine. That only took a couple of days to arrange.
When I met with the therapist, she reviewed my sleep study results in great detail and also discussed my symptoms with me. She spent a lot of time getting to know my individual issues and is very nice to talk to.
The printout of my sleep study data is exactly as pictured and reviewed in the link Judy posted in the other thread:
http://www.centerforsoundsleep.com/blog/?page_id=150
I also asked for and received printouts of the smart card results every time, as well.
Here’s the process I went through:
- 30 day free trial with the CPAP machine
- Once weekly appointments to bring in my smart card and review the data
- The clinic prepared all the paperwork and submitted the pre-determination to my insurance company
Which I have now completed. My insurance covered at 100%, and the follow up is included in the cost of the machine. I go back in another 30 days, then at three months, then at six months. I assume there will be a cost for any further follow up, or I will have to get further approval from my insurance.
What I’m using:
Respironics REMstar Auto M Series with C-Flex
Humidifier
ResMed Swift LT for Her mask
I haven’t needed any alterations to the original set up that we worked out in the office except an adjustment to the C-Flex setting.
So far, my dog has chewed my nasal pillow thingey, and they replaced it, no questions asked. My therapist gave me three nasal pillow thingeys to try, in three different sizes, and she said to bring her back the two that don’t fit, and she will replace them with ones that are my size, so I will have a couple of spares in case the dog gets hungry.
I think I may have gotten a little off track here and there with personal details, but it’s difficult no to. My response to the sleep study result was that I was pretty excited to have a definitive diagnosis, with a clear cut avenue to address the problem. I’ve had a very good experience every step of the way, and remain enthusiatic about the process.
Mike said:
Moe-jo: you're one of the very few patients out there to have been diagnosed by an at-home sleep study. would you mind posting a separate thread on how you made the choice, whether it was your doctor's idea, how much your insurance covered, etc? i think it would be very interesting for folks on the forum to hear more about your experience.
Moe-jo said:I was diagnosed by an at-home sleep study. I wore a little machine called a WatchPAT 200. I haven't seen this mentioned elsewhere in this forum in my reading so far. I thought it was very cool.
My sleep study was done through a private clinic. My family doctor recommended it because I had visited her to discuss the fact that I was too tired to get out of my own way, the noise from my snoring was waking me up, and my weight was spiraling out of control. I told her I need to get this addressed, and the most sensible place to start, is with my sleep. We had actually discussed my snoring about seven years ago when I had just started working shifts and was pregnant with my first child, and I saw an ENT way back then, but for many reasons, follow through never happened. I told her I wanted to be re-referred to the ENT (I was convinced the problem was simply that I needed my tonsils out).
Anyway, she said she expected I have sleep apnea ( I assured her I didn’t, lol), and wanted the ENT to have sleep study results when he saw me (I live in Canada, so it's going to take many months for the ENT appointment).
The clinic where I had my sleep study done is actually the DME as well, and I think the ENT to which my doctor referred me is a partner in the venture - so I guess there could be all kinds of issues of conflict of interest, but I haven't had any issues or concerns.
The clinic will arrange the sleep study without a referral, but they asked for one, and since I already had one, it wasn’t a problem. I visited the clinic and spent about 30-40 minutes with the sleep study coordinator who did my intake, asked me a bunch of questions, showed me the “WatchPAT 200" machine, and I watched a short video about how to use it while she programmed the device. We reviewed what to do with it to make sure I understood, and then I took it home.
It was an extremely easy process, you wear the device on your non-dominant wrist, like a large wristwatch, attach an O2 saturation and heartrate monitor to your fingers, and then there are two sensors that you feed up your sleeve to attach to your chest and at the base of your neck. One measures the decibels of your snoring, the other measures your sleep position. The next morning, I returned the device to the clinic. The sleep study coordinator was planning to send me the results in the mail, and also to my family doctor, but she only sent them to my doctor. It wasn’t an issue, because the next time I was there, I asked for it and was given the printout.
The entire cost for the sleep study was $75.00. I haven’t made the request for re-imbursement to my insurance yet, so I don’t know if that cost is covered. Not a big deal to me.
A few days later, my doctors office called me to come in, and my doc discussed the results with me, that I have moderate sleep apnea. We discussed whether I was open to CPAP therapy, and I told her “absolutely”. She wrote me a prescription for a CPAP machine, and I called the clinic back and made an appointment to get the machine. That only took a couple of days to arrange.
When I met with the therapist, she reviewed my sleep study results in great detail and also discussed my symptoms with me. She spent a lot of time getting to know my individual issues and is very nice to talk to.
The printout of my sleep study data is exactly as pictured and reviewed in the link Judy posted in the other thread:
http://www.centerforsoundsleep.com/blog/?page_id=150
I also asked for and received printouts of the smart card results every time, as well.
Here’s the process I went through:
- 30 day free trial with the CPAP machine
- Once weekly appointments to bring in my smart card and review the data
- The clinic prepared all the paperwork and submitted the pre-determination to my insurance company
Which I have now completed. My insurance covered at 100%, and the follow up is included in the cost of the machine. I go back in another 30 days, then at three months, then at six months. I assume there will be a cost for any further follow up, or I will have to get further approval from my insurance.
What I’m using:
Respironics REMstar Auto M Series with C-Flex
Humidifier
ResMed Swift LT for Her mask
I haven’t needed any alterations to the original set up that we worked out in the office except an adjustment to the C-Flex setting.
So far, my dog has chewed my nasal pillow thingey, and they replaced it, no questions asked. My therapist gave me three nasal pillow thingeys to try, in three different sizes, and she said to bring her back the two that don’t fit, and she will replace them with ones that are my size, so I will have a couple of spares in case the dog gets hungry.
I think I may have gotten a little off track here and there with personal details, but it’s difficult no to. My response to the sleep study result was that I was pretty excited to have a definitive diagnosis, with a clear cut avenue to address the problem. I’ve had a very good experience every step of the way, and remain enthusiatic about the process.
Views: 464
Replies to This Discussion
-
Permalink Reply by Judy on
-
Thank you so much for sharing this!!! Fascinating! And that WatchPAT 200 sounds very promising for those who just absolutely can't do an in-lab study for whatever reason.
-
Permalink Reply by Mike on
-
Thank you for describing your experience. For most of us, this is closest we've gotten to the home test. I know there's a lot of buzz about insurance now covering home tests, but it still isn't prevalent, at least in my experience it's not. You're one of the only people I know who's done it.
I wonder whether the WatchPAT 200 is emerging as the home test of choice in the industry. The leads that you attach to your neck and chest seem a little complicated for the average person, and I've heard of home tests that are administered through a T-shirt that you wear -- seems even easier.
I'm happy your experience went so smoothly, and encourage anyone else out there who has had a home test, either with a WatchPAT 200 or other form of home test, to let us know what their experience was like.
-
-
You're welcome.
Mike, the leads weren't complicated at all, just peel and stick. One was a little round one that you stick in the hollow at the base of your throat, and the other was a small rectangular box that you stick in the centre of your chest. Easy peasey!
Here's a link to a video that shows how to wear the device...
http://www.thesnoreshop.ca/video/
The company also has a 1-800 number you can call 24 hours/day if you have questions or problems.
Pretty comprehensive.
-
Permalink Reply by Henning on
-
According to David E. Lawler, a dentist who also is a member of this forum, the WatchPAT 200 also detects UARS.
Most PSG studies cannot do that without extra gauges.
Here is a link to his website about UARS
http://www.centerforsoundsleep.com/Upper-Respiratory-Resistance-Syn...
Henning
-
-
I"m not going to argue the detection of UARS and hypopneas and apneas between at-home and in-lab sleep studies 'cause I don't know enough - but - what I do know is that there are some 80+ sleep disorders besides apneas and hypopneas and the in-lab sleep study is the most effective way to detect all known sleep disorders.
-
Permalink Reply by RockRpsgt on
-
I agree with Cindy. I do have some experience with the Stardust home test. Our lab uses them to PRESCREEN apnea among our inpatients at the hospital. We only use it for inpatients that are to sick to come to the lab. If the test is positive we give them an autoPAP set on a very short leash. When they can we bring them in for a proper assessment of their sleep usually followed up with a titration. This so far is the best use of these machines that I have seen so. As for detecting UARS, I doubt it. Well said Cindy.
i am however happy that it is working for you Moe-joe. I just don't see that this is a good way to evaluate sleep.
In my opinion the home test does not cover enough parameters, and will only make your journey to healthy sleep that much longer.
Cindy Brown said:Alright you guys knew I had to respond to this one.
I'm happy that you had a good experience with your home study and that you've had good results.
I don't have much experience with home studies but I think the gold standard for sleep is an in-lab sleep study and an in-lab titration (the application of CPAP).
The biggest reason I'm responding is the statement that the WatchPAT 200 can detect UARS that can't be detected in the lab unless there is the application of special gauges. I don't see how one can detect the narrowing of the airway or the increased work of breathing with a snore mic, position sensor, pulse ox and "pat probe". I'm not even sure what the pat probe does.
From my research you can detect the UARS with a pressure cannula in the nose. When a study is done in-lab we put on all the things the WatchPAT has (except for perhaps the pat probe) and way more. We put on belts that measure respiratory effort, flow sensors that detect flow from nose and mouth, and a pressure cannula that detects changes in pressure from the nose. In addition there is a tech listening to what's going on in the room. So to say that a PSG wouldn't pick up UARS is a bit bogus. We just don't call it that. I should think this syndrome would present itself as either hypopneas (a reduction in airflow) or snore arousals. Both of which are addressed in the sleep study.
I think in-home sleep studies can be a valuable tool but I don't think it's a replacement for attended in-lab sleep studies. Too much room for error.
Cindy
-
-
I don't know how the WatchPAT 200 detects UARS, I simply refer to an earlier article by David E. Lawler, and his Website.
A difference could be that the PSG equipment is set to only counting apneas and Hypopneas from 10 seconds and upwards.
As far as I know the only way to detect UARS by a PSG, is combining with a PES measurement. (Pressure in the Esophageal). This is done by a little balloon in the Esophageal. This is not a procedure used with a normal PSG.
Henning
-
-
Thank god it is not the psg that does the counting then. I think some of you are missing the point of a PSG. A PSG is not just a device for detecting flow limitation. Through a psg a good tech can paint a picture of your sleep architecture and present it with conclusive evidence that the doctor is right or wrong. We then get to take this information one step farther and determine whether or not the problem can be fixed. All on the same PC. At least 24 signals are recorded during a psg. Apnea and UARS are only the tip of the iceberg. A good tech can tell what kind of drugs your on by looking at your brain waves alone.
Henning said:I don't know how the WatchPAT 200 detects UARS, I simply refer to an earlier article by David E. Lawler, and his Website.
A difference could be that the PSG equipment is set to only counting apneas and Hypopneas from 10 seconds and upwards.
As far as I know the only way to detect UARS by a PSG, is combining with a PES measurement. (Pressure in the Esophageal). This is done by a little balloon in the Esophageal. This is not a procedure used with a normal PSG.
Henning
-
-
Rock, I agree with you in that.
But when we are talking respiratory problems like Apnea, Hypopnea AND UARS then (as I understand it) it is a question about detecting flow limitation, and here I always have read and heard that a PES measurement is the only way to detect UARS.
But maybe I'm wrong?
In this case, I would like to hear more about it because I am going to have a PSG with a PES measure next month.
Henning
-
-
Part of my assessment letter reads:
"These are called respiratory effort related arousals (RERA's) and are picked up by the WatchPat unit in the Respiratory Disturbance Index (RDI). RDI's greater than 10 events per hour in the presence of a normal AHI constitutes a condition known as Upper Airway Resistance Syndrome (UARS)."
Obviously - I didn't have a normal AHI, nor do I know how the device measured the RDI. My AHI was 20.9. My RDI was 23.7.
I am not adding this information in defense of my test or the process, or the clinic I attended. I am not entering into any debate on the subject, nor, am I offering any opinion, one way or the other. I'm just parroting this for information in case anyone is interested.
Rock, with respect to my sleep journey, I went from referral- to test- to diagnosis and treatment in fewer than four weeks. My AHI went immediately from 20.9 to a consistent number around 2, my large leak number is always 0. I know this is a lifelong process, but so far, I'm pretty happy with the pace. :-)
-
-
Most definiitely, I would be happy w/your results so far, too, Moe-Jo!!! Heck, lots of us have been on xPAP one heck of a lot longer and not getting quite so good results are you are getting so far.
It sounds, from your experience, like if the ONLY sleep disorder one has is a breathing disorder the WatchPAT 200 can do a pretty good job. But what about the other 80+ sleep disorders that can occur instead of or in conjunction with a sleep breathing disorder?? THEY can be an area of concern. WE are not trying to argue either, just trying to point out where WatchPAT 200's, and other at-home sleep testing equipment, are lacking.
-
-
Hi Moe-jo,
You don't have to defend your sleep test, or otherwise.
This tread has got itself into a more general discussion. I think that is fine.
Your test looks more like the way we handle it in Europe. We had a long time ago a very good discussion about this.
Here is a link to this discussion.
http://www.sleepguide.com/forum/topics/differences-in-health-care
The test you have received is for uncomplicated OSA. Most of Sleep Apnea patients have uncomplicated OSA.
So until now, I am sure you have got the best treatment very quickly.
Only if it proves complications it may be necessary with a larger study.
Henning
Moe-jo said:Part of my assessment letter reads:
"These are called respiratory effort related arousals (RERA's) and are picked up by the WatchPat unit in the Respiratory Disturbance Index (RDI). RDI's greater than 10 events per hour in the presence of a normal AHI constitutes a condition known as Upper Airway Resistance Syndrome (UARS)." Obviously - I didn't have a normal AHI, nor do I know how the device measured the RDI. My AHI was 20.9. My RDI was 23.7.
I am not adding this information in defense of my test or the process, or the clinic I attended. I am not entering into any debate on the subject, nor, am I offering any opinion, one way or the other. I'm just parroting this for information in case anyone is interested.
Rock, with respect to my sleep journey, I went from referral- to test- to diagnosis and treatment in fewer than four weeks. My AHI went immediately from 20.9 to a consistent number around 2, my large leak number is always 0. I know this is a lifelong process, but so far, I'm pretty happy with the pace. :-)
© 2024 Created by The SleepGuide Crew.
Powered by
