Sleep Study

[anrobe 34]

Hi everyone! I am working through my requirements but hope to have surgery in December or January. My insurance required very few things - a blood test, a NUT appointment, and a mental health eval. I'm almost done, with the NUT appt scheduled later this month. But, my mom is a nurse and she asked me if the insurance or my surgeon had suggested/required me to take a sleep study to see if I have sleep apnea. They did not. But, she said that it could be important before surgery to know if I have it or not - and that there could be bad results if I have undiagnosed sleep apnea and go under during surgery?

I talked to the surgeon's office today and they said that they didn't think I needed one based on my discussion with the surgeon at my earlier appointment but that they'd call an order in for me if it would ease my mind. It will ultimately be expensive for me given my insurance - at least $500 out of pocket but possibly up to $1000. That just doesn't feel ok to me financially unless it's really needed. I'd rather put that money into my out of pocket surgery costs (which will be about $2,500) and/or the things I'll need to be successful with surgery.

I was hoping to see if any of you had any thoughts or experience with the sleep study and whether or not you think I should get one.

In case it helps - I'm 5'2, 237 lbs. My husband says that I snore but he's never heard me stop breathing or struggle to breath (nor have I woken myself up with breathing issues. I don't seem to have most of the symptoms of sleep apnea except the snoring (which I did even before I gained all this weight).

Thanks in advance for any thoughts you might have to share!

Edited September 8, 2016 by anrobe

[heidikat72 935]

Typically, a lot of obese patients do have sleep apnea, some very severe. Severe sleep apnea can lead to problems coming to from anesthesia or also breathing problems while you are under including having your oxygen levels drop too low. Since you have discussed with your surgeon and he/she thinks you are low risk, you are probably fine. Even if you were to have mild sleep apnea, it shouldn't be a problem during surgery. The test would be a definitive answer, if that eases your mind. I had more symptoms of sleep apnea than you and my testing still indicated my sleep apnea was too mild to even bother treating.

[KristenLe 5,979]

@@anrobe Your insurance may not cover it if you don't meet medical necessity. Usually the Dr bases ordering on a few questions during your visit or on your history questionnaire. I don't think I'd have it done if the surgeon doesn't think there's reason.

[trekker954 421]

It was one of the comorbidities that assisted in getting my insurance to approve my WLS. I've never stopped breathing that I am aware, but I did snore for sure. So I had the sleep study prior to my initial WLS meeting. I think I just paid about $150 copay. The sleep studies are sort of a joke. They hook you up with so many wires and such, its near impossible to sleep and I get up often to pee, I'd have to hit the call button and wait. I'm surprised they got any data from me. But it was enough to say I had mild sleep apnea and that helped too as I said with the WLS approval.

BTW, a month out and my daughter reports she hasn't heard me snore at all.

Edited September 8, 2016 by trekker954

[highfunctioningfatman 2,675]

Ask your doctor for an overnight oximetry. They are typically less than $50 if you have to pay out of pocket. I do them all of the time at work through a company called Instant Diagnostic Systems. An oximetry is simple. A probe goes on your finger and a cord runs to a small machine that records heart rate and oxygen levels all night long. Once the unit is downloaded it will have a report that shows a graph for hr and another one for o2. When an apnea event happens your o2 level drops because the muscles in your airway relax as you sleep causing an obstruction in your airway. The bodies natural reaction is to increase heart rate to wake you up. Your graph with have a "sawtooth" pattern, especially on the heart rate side if you have apnea. Not as much information as a sleep study but in my experience it is an excellent tool for screening.

[anrobe 34]

Thank you all so much for sharing your thoughts and experiences! I really appreciate it!

[AML32 4]

Find a sleep lab in your area that offers home studies. They are a lot cheaper & more convenient but not as thorough. I've been in the sleep field for 10 years so feel free to ask me any questions. ????

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[higher 966]

I am sure I have sleep apnea - bedmates have observed me stop breathing in my sleep going back to before I was overweight at all. It was also observed during my endoscopy. My surgeon and I both wanted a sleep study pre-op but my insurance denied it on 3 appeals. That said - when I met with the anaesthesiologist at my pre-surgical appointment I told him I believed I had apnea and we discussed his method for dealing with that. He also examined and photographed my anatomy. It IS important to discuss this with your anaesthesiologist. They ARE used to working with apnea sufferers because many obese people have it, but definitely definitely raise the point.

I need to look into what the sleep study would cost me out of pocket, but for $500 I would go for it. A CPAP machine can help you sleep better and that in turn can help with your weight loss.

Find a sleep lab in your area that offers home studies. They are a lot cheaper & more convenient but not as thorough. I've been in the sleep field for 10 years so feel free to ask me any questions.

Sent from my SAMSUNG-SM-N910A using the BariatricPal App

Fascinating - can you get an rx for a CPAP based on a home study?

[KristenLe 5,979]

@@higher Usually - if the home study comes back positive you need a titration study before getting the CPAP. I don't understand how your insurance denied. They may authorize a home study and then if positive they'll do the other.

[AML32 4]

Typically yes, you can get a PAP script from just a home study but it depends on your insurance & referring physician. If your home study comes back positive, the doctor could write a script for an AutoPAP.

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