No Insurance, Sleep Study And CPAP question

[jsand5048]

Hello everyone! Long time lurker, first time poster!

I've read a LOT of the topics here, and a lot of articles online and I think I may have sleep apnea. After calling around I've gotten prices for sleep studies from $1000-3000 and I simply cannot afford that since I don't have insurance.

I've thought about just going and purchasing a used CPAP machine on one of the websites that I've found on these forums but I am not sure if that would be advisable or not.

Heres some info on myself:

I'm 6'3 270 Ibs.
I'm ALWAYS tired after a nights sleep.
I wake up maybe 3-4 times during the night.
I snore loud enough that my girlfriend can't fall asleep sometimes..

Any suggestions on what I should do?

Thanks ahead of time!

[Ford Guy]

I thought that under Obamacare everyone could get insurance or they paid a penalty.

[Pugsy]

So you want to self diagnose and self treat? It can be done but you need to really educate yourself.
Could you afford to do a home study?
I am not promoting this particular website but offer it just so you can learn about the various levels of home sleep studies.
http://axgsleepdiagnostics.com/

If you wish to continue with the DIY route....we can help.
If you have plain jane vanilla OSA with no complicating factors it's pretty straight forward. If you have complicating factors pop up then you have no choice but to go the doctor route. Odds are that you won't have any unusual problems though...most have plain jane vanilla OSA but I wanted to warn you.

I would suggest getting a full data apap capable machine...and I would limit the choices to either ResMed or Respironics
Respironics PR System One Auto CPAP model 550 or 560....or ResMed S9 AutoSet. There are other brands that will also work but either they don't flag centrals separately or the equipment to use software jacks the cost up .......so I would stick with these 2 brands to make searching easier.
DIY'ing it can also be accomplished with a fixed cpap machine but it is a bit more work...but can be done.

You will need a RX for a machine and mask though if you want to buy from an online supply source like cpap.com.
We can get around the RX requirement for masks by purchasing replacement parts and building a mask that way.
There are ways to get around the RX for machine requirement also...buy off the secondary market privately. Craigslist is and option but you really have to know your machine models when you do that.

[jsand5048]

I thought on secondwindcpap you didn't need an RX?

I'm only considering the DIY option since it'll be cheaper... I can MAYBE afford a $400 machine...

I actually looked on craigslist and saw a few cpap machines but I don't know if it's safe purchasing from CL since I'm scared about it not being sanitary.

As you said, I'm hoping its "plain jane vanilla OSA" without any complications...
Whats the benefit of a full data apap capable machine besides the data? What would I be doing with that, since I don't have insurance I wont have any doctor reviewing it...


edit: I went to the website that you suggested for the home sleep study and they're sold out of both services but, seemed steep $300, cant I buy a machine for that?

Basically, is it ok to treat the presumed issue without proper diagnosis? I mean, hypothetically if I got a sleep study wouldn't they just prescribe a cpap machine anyway? Seems like going directly to a cpap machine is logical...

Am I wrong? or am I missing something?

[palerider]

I thought on secondwindcpap you didn't need an RX?

I'm only considering the DIY option since it'll be cheaper... I can MAYBE afford a $400 machine...

I actually looked on craigslist and saw a few cpap machines but I don't know if it's safe purchasing from CL since I'm scared about it not being sanitary.

all my machines came off craigslist.

gotta be some pretty strong bugs to crawl up a 6 foot+ hose against strong airflow to get to the machine, and once they did, there's nothing in there for them to live on.

[Pugsy]

The data available from a full data machine is extremely important ...
The newer machines will flag centrals...and you want to know if centrals are a potential problem or not..it's one of those possible complicating factors I mentioned. About 10 to 15% of the people who have OSA and start cpap therapy will develop centrals (and more than just a few) and need a different machine. Odds are small but they are still there.
Plus you want to know if leaks are an issue...if leaks are really bad then we don't know if we can trust the data the machine is giving us.

There are other reasons for a full data machine but those 2 are the main ones IMHO and pretty much validate the need for full data.

Now we don't have to have APAP capabilities..so you could maybe save some money there but apap can make things go easier and sometimes it really comes in handy in terms of therapy treatment.
Example...My OSA is worse in REM sleep and often when in REM stage sleep my pressure needs are substantially higher than at other times of the night. If I didn't use a machine that could auto adjust the pressures (that's what apap mode does) then I would have to use a substantially higher pressure all night with a cpap machine to take care of those stubborn events in REM sleep.
In my case that would mean using 18 cm all night instead of using 10 most of the night and letting the machine go to 18 as needed for brief periods of time. Trust me.....10 cm is a whole lot easier to use than 18 cm.

Secondwindcpap.com will require a RX unless you live outside the US. Now you might be able to sneak by with an order and a promise to send the RX and once you get the machine...I don't think they will try to repossess it if they don't get a RX.
If you have a friendly primary care doctor he can write the RX if he just would. It doesn't have to be from a sleep doctor.

Like I said..there are ways to get a machine without RX...or maybe use someone else's RX...got a friend or family member who might have a RX?

Craigslist can be iffy but I have done it....but then I know my machines and I know fair market value.

Check out my SleepyHead tutorial (link in my signature) for an idea about how and what the software does.
Without the data we have no idea if the pressures used are effective or not.
I screened my sister and her husband using my apap machine....she didn't have OSA despite all the symptoms but he did (which he still blew off)....For someone who is wanting to both self diagnose and self treat...data is very important.

Send me a PM with where you are located and I will look through the Craigslist ads in your area to see if I spot a machine that would work for what you want.
Also...I may have a lead on a machine from a forum member...let me check on the status of what he might have.
It's someone I would trust to buy from if I was in the market...I will let you know via PM about that.

Oh...can you normally breathe through your mouth okay during the day or do you have chronic nasal issues forcing you to mouth breathe? I might have a mask you can just have but I need to know about mouth breathing first.

[Pugsy]

Basically, is it ok to treat the presumed issue without proper diagnosis? I mean, hypothetically if I got a sleep study wouldn't they just prescribe a cpap machine anyway? Seems like going directly to a cpap machine is logical...

Am I wrong? or am I missing something?

There's a myriad of sleep disorders besides OSA...having some sort of sleep study may or may not help isolate other potential problems. I would be remiss if I didn't point that fact out...but that doesn't mean I wouldn't help you.
Heck...I have done what you are wanting to do...with my sister and her husband and my own brother. It may not be "perfect" but it's better than not doing anything and I understand that sometimes in life we don't always get to do "perfect" and I also understand that sometimes those sleep studies aren't "perfect" either. My own in lab sleep studies were far from perfect due to several factors...and the titration sleep study to find the right pressure was a joke.

[cathyf]

One thing that you should check out is whether you can do a home study for cheap/free. In the case of my community hospital, when they set up the sleep lab they got the hospital auxiliary to buy the ApneaLink, and they use it for free screenings. Free for everyone that they suspect might have apnea -- rich, poor, insurance or not. Of course it DOES generate revenue for them, in that every time they have an insured patient who shows significant desats and/or significant AHI they schedule a sleep lab study...

So check around your community. If you live in or near a major metropolitan area, especially look at nearby teaching/research hospitals. But even out in the sticks, if your local community college has a nursing program call the department chair and ask if he/she knows of any resources.

If you don't have apnea, you may be able to rule it out without spending much money at all -- then you can move on to look for other causes of your sleep problems.

[Pugsy]

Check your private message box please. I sent you a couple of PMs with some ideas.

[chunkyfrog]

You can ask your dentist to write a RX, after describing your situation.
I personally feel that no one can afford to NOT see the dentist once in a while.
There are also charitable organizations that might be able to help.

[archangle]

Some risks of self diagnosis and treatment:

Not managing to find the proper treatment for you. In a lot of ways, it's not rocket science, but you do have to consider a number of things.
Don't think you can just get an auto CPAP and let it do everything for you. Even auto machines need the right settings and need to be monitored.
The pressure can cause central apnea and make things worse.
You won't have "professional" help for your problems.
You might have some other medical condition other than apnea, and may end up not getting treatment for some condition that you otherwise could have cured.

Some people do successfully do self treatment, but it's not entirely risk free.

Unfortunately, the state of "professional" treatment is really bad, so you can suffer from some of these problems even if you do go the official route.

[jsand5048]

Oh...can you normally breathe through your mouth okay during the day or do you have chronic nasal issues forcing you to mouth breathe? I might have a mask you can just have but I need to know about mouth breathing first.

I can normally mouth breathe during the day and i do not have chronic nasal issues. I live in the NYC area, specifically in the bronx borough. I sent a couple of PM's back to you, thanks so much!

[jsand5048]

One thing that you should check out is whether you can do a home study for cheap/free. In the case of my community hospital, when they set up the sleep lab they got the hospital auxiliary to buy the ApneaLink, and they use it for free screenings. Free for everyone that they suspect might have apnea -- rich, poor, insurance or not. Of course it DOES generate revenue for them, in that every time they have an insured patient who shows significant desats and/or significant AHI they schedule a sleep lab study...

So check around your community. If you live in or near a major metropolitan area, especially look at nearby teaching/research hospitals. But even out in the sticks, if your local community college has a nursing program call the department chair and ask if he/she knows of any resources.

If you don't have apnea, you may be able to rule it out without spending much money at all -- then you can move on to look for other causes of your sleep problems.

I've called around a few places to see if they do anything for free or subsidized and one of the hospitals does a program but i need to get a requisition request from a doctor at a specific hospital and they'll do 2 sleep studies for $400, but that doesnt include the price for the machine.

[jwerley]

"Unfortunately, the state of "professional" treatment is really bad, so you can suffer from some of these problems even if you do go the official route."

I was about to add something like the above quote from archangle to my reply......IMO I have not received optimal treatment for nine years now and still have to mostly self treat. If not for the help on this forum I don't know where I would be right now.

[jsand5048]

"Unfortunately, the state of "professional" treatment is really bad, so you can suffer from some of these problems even if you do go the official route."

I was about to add the "above" to my reply......IMO I have not received optimal treatment for nine years now and still have to mostly self treat. If not for the help on this forum I don't know where I would be right now.

Thats very comforting to hear