What does everyone thing about the new guidlines for Medicare approving home sleep studies

SJAWAKE wrote:

What does everyone thing about the new guidlines for Medicare approving home sleep studies

The home studies are going to be unattended, meaning no one will be watching while the data's recording. As a sleep tech, I can tell you I've never had a patient that didn't pull off at least ONE wire and needed me to fix it. Certain wires can be done without, but some wires are crucial to getting results. I wonder how many studies will have to be redone one or several times because the pulse ox fell off or the flow sensor....However, I do think it's great for the people who cannot get to sleep labs because of transportation or anxiety issues.  I think, absolutely, the home studies have their niche, but an attended study is irreplacable. Of course, I may be biased.  

Donna

I am neither a doctor nor a sleep tech, but I definitely have doubts about the accuracy of the take-home test kits. I did one of those at-home tests a few years ago, and was told I exhibited 'no signs' of sleep apnea. Just recently, I went in for a real sleep study, and was diagnosed with severe sleep apnea, with an AHI of 51. There are a lot of things that could explain the different results, such as:

1. A wire or sensor came loose, producing erroneous data.
2. I didn't have SA back then, but managed to develop it later.
3. The first doctor was pressured by my HMO not to diagnose SA.
4. The second doctor had a financial incentive to diagnose SA.

However, none of those explanations seem very likely to me. I have exhibited signs of SA for at least the past 8 years, and the first (at-home) sleep study came only after my girlfriend at the time observed me stop breathing on more than one occasion, and insisted that I get it checked out. It was also after I nearly got fired for falling asleep at work. So I find it exceedingly unlikely that the first diagnosis (or lack thereof) was correct. As far as wires coming loose or sensors falling off, I was fairly paranoid about that happening and went to great lengths to make sure that didn't happen. When I woke up the next morning, everything was intact. As  far as one or both of the doctors lying for financial reasons, well I wouldn't put it past an HMO to suppress a diagnosis in order to save a few bucks (as short-sighted as that is, considering the many nasty effects on your health that can result from untreated SA). However, considering all the symptoms I've had, I really don't think my current doctor is lying. The diagnosis actually fits the facts for a change.

So, in my estimation, either the take-home testers are just a horribly inadequate tool for diagnosing SA, or my HMO just decided to cover it up. I suspect maybe a little bit of both: the HMO wanted me to just go away, so instead of getting me a proper sleep study, they sent me home with a take-home test kit, knowing full well it was much less likely to lead to a diagnosis. I should have pushed at that point, but I was tired of fighting them every step of the way.

Having said all that, I think take-home kits are better than nothing, especially for people who don't have access to a sleep lab. However, at-home testing should NEVER be the last word on the subject. In other words, if the at-home test fails to produce conclusive data, more testing should be done.