My wife had been after me to get tested for sleep apnea for years.

A couple of years ago, my GP referred me to a sleep clinic. I played phone tag with them for a couple of weeks, then got ticked off and gave up trying to reach them.

Recently, I've found a bunch of friends are on a cpap and it has changed all of their lives. This spurred me on to check things out again. I got a referral to a local sleep clinic.

Some of my friends had described sleep clinics that were as nice as hotels. The one I went to was like a broom closet. The beds were old hospital beds with crinkly vinyl mattresses. What a joke.

Friends had their sleep study, a follow up appointment and were put on the machine all within a few days. This has taken weeks for me.

Finally, I had my follow up appointment last Wednesday. In light sleep, I stop breathing 31 times an hour, 52 times during rem. He sent me for chest and sinus xrays, blood tests and a sleep study (to check air flow) the same day. This time the study was at a different clinic where the beds were at least comfy. The technician told me I'd hear from Home Care in a couple of days.

The cool thing was that after one night with the cpap at the clinic, I felt great for a couple of days!

This morning I called to find out what company I should be chasing, as I hadn't heard from anyone yet. I haven't heard, because they haven't sent the referral out yet! What a joke!

Hopefully I'll get hooked up with the Home Care people soon so I can start sleeping.

gravlguts wrote:

My wife had been after me to get tested for sleep apnea for years.

A couple of years ago, my GP referred me to a sleep clinic. I played phone tag with them for a couple of weeks, then got ticked off and gave up trying to reach them.

Recently, I've found a bunch of friends are on a cpap and it has changed all of their lives. This spurred me on to check things out again. I got a referral to a local sleep clinic.

Some of my friends had described sleep clinics that were as nice as hotels. The one I went to was like a broom closet. The beds were old hospital beds with crinkly vinyl mattresses. What a joke.

Friends had their sleep study, a follow up appointment and were put on the machine all within a few days. This has taken weeks for me.

Finally, I had my follow up appointment last Wednesday. In light sleep, I stop breathing 31 times an hour, 52 times during rem. He sent me for chest and sinus xrays, blood tests and a sleep study (to check air flow) the same day. This time the study was at a different clinic where the beds were at least comfy. The technician told me I'd hear from Home Care in a couple of days.

The cool thing was that after one night with the cpap at the clinic, I felt great for a couple of days!

This morning I called to find out what company I should be chasing, as I hadn't heard from anyone yet. I haven't heard, because they haven't sent the referral out yet! What a joke!

Hopefully I'll get hooked up with the Home Care people soon so I can start sleeping.

You pick a home care company and tell them to contact the lab. They SHOULD want your business and if they are a respectable home care company, then they will be willing to do a big of legwork for your business.

My sleep study took place in an actual hotel ... a Sheraton Hotel. The University of Pennsylvania Medical Center actually leases an entire floor of the hotel, and the room was attractive and the bed was comfortable. It took me more than a few weeks before I got my CPAP machine ... it seemed like a long time!

RAM - I get the feeling it doesn't work that way here in Ontario.

Bud - That's incredible! A heck of a lot better than a broom closet!


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In the face!

gravlguts wrote:

RAM - I get the feeling it doesn't work that way here in Ontario.

Bud - That's incredible! A heck of a lot better than a broom closet!

Ah, I didnt see the Canada reference.

In any future, if you cant choose your DME company, then watch carefully for the reimbursement.

In a move that has the potential to alter CPAP reimbursement, CMS is “proposing to prohibit payment to the supplier of the CPAP device when such supplier, or its affiliate, is directly or indirectly the provider of the sleep test that is used to diagnose a Medicare beneficiary with OSA,” according to information published in the Federal Register.

This isnt official now, but its past due, in my opinion.

RAM_Sleep wrote:

RAM CMS is “proposing to prohibit payment to the supplier of the CPAP device when such supplier, or its affiliate, is directly or indirectly the provider of the sleep test that is used to diagnose a Medicare beneficiary with OSA,” according to information published in the Federal Register.
This isnt official now, but its past due, in my opinion.

I certainly hope they rush that referral now...sounds like it will truely make a difference for you!

RAM:  this is already a regulation in my state.

embryopathy wrote:

RAM_Sleep wrote:

RAM CMS is “proposing to prohibit payment to the supplier of the CPAP device when such supplier, or its affiliate, is directly or indirectly the provider of the sleep test that is used to diagnose a Medicare beneficiary with OSA,” according to information published in the Federal Register.
This isnt official now, but its past due, in my opinion.

I certainly hope they rush that referral now...sounds like it will truely make a difference for you!

RAM:  this is already a regulation in my state.

Wow. Thanks. I didnt have any idea. The article that I read was released on July 16th and claims that the changes arent likely to be finalized until August. In any event, im glad that some states have already changed.

In forming final policy, the proposal will have to go through a comment period, which ends August 29, before issuance of a final regulation takes place. With the complexity of the issue, final regulations aren’t expected until at least the end of September, according to Stribling’s estimates.

Here is the entire article, for anyone interested:

In a move that has the potential to alter CPAP reimbursement, CMS is “proposing to prohibit payment to the supplier of the CPAP device when such supplier, or its affiliate, is directly or indirectly the provider of the sleep test that is used to diagnose a Medicare beneficiary with OSA,” according to information published in the Federal Register.

Previous payment policy has already stated that the test cannot be performed by the same entity that is the supplier. However, says Clay Stribling, JD, an attorney with the Health Care Group of Brown & Fortunato PC, an Amarillo, Tex-based law firm, “that would open the door in a lot of cases for companies that have the same ownership—even though they are different legal entities—to one of them doing the testing and the other doing the CPAP provision. This [proposal] presumptively would end some of those situations where the same owners owned the sleep testing side and the CPAP side—now they are going to be considered affiliated companies and those relationships would presumptively go away.”

The proposed policy is open for comments and may need to offer further clarification on portions of the proposal, particularly relating to the definition of “affiliate.” “They will either have to clarify that through additional rule-making or give us some additional guidance when they come out with the final rules as to what affiliate means for this purpose,” says Stribling. “It could be as broad as any company with any common ownership with the DME supplier or it could be a threshold of how common the ownership has to be.”

In forming final policy, the proposal will have to go through a comment period, which ends August 29, before issuance of a final regulation takes place. With the complexity of the issue, final regulations aren’t expected until at least the end of September, according to Stribling’s estimates.

Information about comments on the proposal can be submitted as follows:

Electronic comments may be submitted via www.regulations.gov/search/index.jsp. Follow the instructions for "Comment or Submission" and enter the file code CMS-1403-P.
Comments may be sent by mail to the following address:
Department of Health and Human Services
Attn: CMS-1403-P
PO Box 8013
Baltimore, MD 21244-8013

Comments may be sent by overnight mail to the following address:
Department of Health and Human Services
Attn: CMS-1403-P
Mail Stop C4-26-05
7500 Security Blvd
Baltimore, MD 21244-1850

Yes, it sounds like good old Ontario and their sleep medicine mess!  I have just had another sleep study (retitration) after almost 6 years on cpap.  Getting to the specialist and getting the sleep study and waiting for the followup is ridiculous.  Like you, after seeing my GP for a referral,  I finally called the specialist's office and they had not had the referral - after 3 weeks.  That was in October.  Got an appointment in March.  Had the sleep study in April instead of the set date in June, by going on a cancellation list.  The beds WERE old vinyl covered hospital beds.  It was so cold I had to keep asking for blankets!  The tech didn't know if the air conditioning was on or not!  I hardly slept at all.  I am now waiting (since April) for the followup appointmetn with the speciailist in late August.  It will be just short of a year since I started all this.  Forutnately, mine was a retitration and I had been on cpap for that 6 years.  It was no better the first time though!  In my case, I have to see the specialist, in August, to get a new prescription and, hopefully, a new machine.  I was able to choose my own provider back 6 years ago.  Actually, I ended up, back in 2002, getting my GP to call the specialist and get my pressure.  The GP then wrote the prescription and told me to shop around for the machine.  I hope I get to shop around this time as well.  Prices can be different.
What's this Home Care? Is it a provider of cpap equipment where you live?

I've now spoken with them. The clinic said Home Care, but it is The Sleep Management Group. Google will bring up their info. I'm going to the one in Oshawa.


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In the face!

Reading threads like this over the past year, there seems to be a great disparity from test center to test center, regardless of whether it's in a hospital or not.

My test was done over a year ago in a small town hospital near where I live in central Massachusetts.  As with everything about this particular hospital, I expected the worse, but received the best care I've ever experienced.  The room was in a corner of the hospital that use to house a 4 bed patient room.  The room was furnished like a hotel with a double bed, and had all of the things you'd find in a hotel room, with the exception of the tile floor.  The ceiling appeared to have a large skylight in the middle, except instead of a window, there was a TV camera instead.  The staff of 2 technicians that evening were exceptional.  All in all, it was far from an unpleasant experience.


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My life was restarted on June 29th, 2007

57 yr. male
pre-CPAP apnea-hypopnea index (AHI) of 64
ResMed S8 Escape w/humidifier
ResMed Mirage Swift II nasal pillows system
Prescribed for a 6 but I like to fool with things, and prefer 7

gravlguts wrote:

... I got a referral to a local sleep clinic. ... Friends had their sleep study, a follow up appointment and were put on the machine all within a few days. This has taken weeks for me.

Finally, I had my follow up appointment last Wednesday. In light sleep, I stop breathing 31 times an hour, 52 times during rem. He sent me for chest and sinus xrays, blood tests and a sleep study (to check air flow) the same day. This time the study was at a different clinic where the beds were at least comfy. The technician told me I'd hear from Home Care in a couple of days.

The cool thing was that after one night with the cpap at the clinic, I felt great for a couple of days!

This morning I called to find out what company I should be chasing, as I hadn't heard from anyone yet. I haven't heard, because they haven't sent the referral out yet! What a joke!

Hopefully I'll get hooked up with the Home Care people soon so I can start sleeping.

Good for you for listening to your friends and your wife!!! I'm sorry to hear the conditions were so bad during your sleep evaluation but it sure sounds like the sleep doctor is a pretty good and thorough guy and you're in good hands. Nice to hear that your titration study was done at a more comfortable sleep lab!! And GREAT to hear how well rested you were after your titration!! Maybe your family doctor can light a fire under the sleep lab to get your equipment order to the DME supplier or at least get a copy himself so he can write the script. Good luck!!!


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Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

I decided to push things a bit yesterday and dropped in to the supplier's office.  The Dr's office still hadn't sent over the rx. In fact, the lady told them that she personally had told me it would be two weeks before I received my rx and she didn't understand why I was there.

I had never spoken with this person.

3 minutes later, the phone rings and it is the same lady..."oh, I have his rx here in front of me...I don't know how he knew it was done"

Man, are these people bright, or what?

Long story short....I checked out all the machines and learned a bit about masks while I was there. I'm booked in with a respirologist to get fitted on Saturday.


_________________
In the face!

That's excellent news! So Saturday and Sunday you can get finally some good ZZZZZZZZ's!

Need a follow up!

Neil

Hi, all!

Grav, does sound like a nightmare, but I'm glad things are smoothing out for you.  

I did a sleep study a few years back which was negative.  I'd like to believe it WAS negative, since it was done at a well-respected hospital  - Univ. of Michigan.  Then again, my COPD was not nearly as bad as it is now - probably a direct connection, as is GERD - all three are a recipe for trouble.  My latest sleep study was comfortable.  I was a bit leery about sleeping on my back in a regular bed due to my GERD, but fortunately, I had no problems, except of course, the reason I was there in the first place...I had severe sleep apnea.  A couple weeks later, the sleep study called me back 'reminding me' of my appt. (I hadn't heard from the doc yet), for a titration study.  I even failed CPAP!  (you know, gotta study for those tests, right? <G>).  So...my doc decided to put me on bipap - a fact that I learned while hospitalized with my 5th (this year) pneumonia - presumably aspirant.  I tested it in the hospital, then went home and got a machine a few days later.  

So far, so good!  My daughter said I don't snore anymore, I'm not as restless and I fall asleep post haste.  I find I'm falling asleep now without sleeping pills - something I've needed in the past due to constant waking up throughout the night.  I try not to eat too close to bedtime, but I need a snack (diabetic) so try to make it high carb and small; we're hoping the bipap will halt the pneumonias.  Sleep apnea = waking up gasping = introducing stuff into your lungs = aspirant pneumonia.  I also fine I introduce bigger stuff when I wake up choking and coughing with lungs burning (stomach acid and stuff) but bipap MIGHT stop this by pressuring in both while breathing in and out.  I've had a couple coughing episodes , but I don't kknow about the waking up gasping part until we see how well the bipap is working.  BTW, I have a smart card and my doc's office told me they don't read it, it's for the tech to read (the bipap company tech).  Huh?  Everything I've read here on this board shows that the doc reads the card which tells him/her how many times I stopped breathing in the night, how many hours I've used the machine, and so on...what use is this to a repair tech????  ::sigh::  I'll have to call the home care place and ask.

Grannymac

I've had around 6 sleep studies over the years. The first round was with an ENT that I didn't like and never got the CPAP. Now around 7 years later and 4 more sleep studies, I have one.

The first sleep lab I went to was in a University Hospital and was quite nice. They were like little dorm rooms at a college.
The next was at the ENT office, they had great beds and cable TV. The last ones I did was at a professional building in a shopping center. No cable TV, but the room was bigger and overall comfy.

For the CPAP arrangements, my ENT made all them for me. All I had to do was sit back and let it happen.

LT