Have to fail overnight cpap sleep study??

[Mimmie]

Hi guys. Lots of new folks here since I was here last. I have a question for anyone that's been through this situation. I have stage 4 copd and bronchial asthma and overnight oxygen. I have used my cpap faithfully since 2006, can't sleep without it. My drs said that a bipap would really help me out so we did the overnight study. Now, my insurance says that they won't pay for a bipap unless I FAIL an overnight cpap study. ???? How exactly does that happen? Any advice? Hope so. Confused.

[D.H.]

In this context "fail" means that CPAP is not controlling your Sleep Apnea. If you "pass," you do not need a BiPAP, as CPAP is controlling your Sleep Apnea.

If you need BiPap for a reason other than Sleep Apnea (COPD, asthma), the doctor treating that should be able to prescribe BiPAP.

[Okie bipap]

My first machine was a bi-level machine. The doctor simply stated "Patient did not tolerate CPAP" on the prescription and it went right through. Of course, every insurance has their own definition of what "fails CPAP" means.

[D.H.]

Most BiPAP or BiLevel machines (same thing, the first one is a trade name), can be used as plain-old CPAP machines. If you find that you don't need or can't tolerate a BiPAP - but already own the machine - that's the best strategy.

[Mimmie]

Thanks so much for the advice. The sleep center has turned the case over to my Pulmonologist and she will handle it from here. You guys were right. Cpap handles my apnea perfectly. The bipap will be for my COPD and they will have to pay for it. win win. (so to speak, i guess) Thanks.