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Sleep Apnea Evaluation - Unexpected Requirement



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So as I was being prepped for my pre-sleeve endoscopy, the Anesthesiologist was chatting me up about what to expect and he asks "Do you have sleep Apnea?" and I say "not that I know of...", he presses on "Have you had a sleep study?", me "nope", "Hmm - Well you are now!". Sure enough, the day after the endoscopy (which went perfectly, thank you) my WLS center calls and says they are requiring a sleep study for me. I understand why, Sleep Apnea is a risk the Anesthesiologist wants to know prior to surgery, so he can know what to expect during surgery, and I totally appreciate why that is important and I respect it.

What I am stressing about is, going through the study, possibly being diagnosed with Sleep Apnea, the expense and distraction of getting the CPAP machine setup in my house (ok I admit it, I am little freaked out when "installation" people come in my home, much less my bedroom - I know get over it - but it does kind of freak me out) and then have my surgery and no longer need all of this stuff; time, worry and dollars lost. That is assuming that weight loss resolves the apnea. I am self-pay and while I know I snore, I don't have the other symptoms; like difficulty waking, being sleepy during the day or headaches. This is an additional expense that I am worried my insurance won't cover all of the costs and the test and equipment may cut into my funding for the surgery itself.

Anyone else go through the test as a pre-requisite to surgery and then not need the equipment two months later?

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I have to have a sleep study as well - I was tested three years ago (worst night of my life) and was told I did not have sleep Apnea but I've put on about 40 lbs since then.

I talked to the Sleep Doc and we both agreed that it was best to have the test for the same reasons you were told - for the Anesthesiologist.

BTW - I told the Sleep Doc that even if I had Sleep Apnea I probably would not use the CPAP machine. He understood - also said that if I did have it when I loose the weight I would probably not need the CPAP

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Yep, that is the frustration, hey spend all these dollars on a test and expensive equipment, but you won't need it in 2 months!

I have read that some (obstructive? ) apnea is unrelated to weight, but I imagine I would have had it before if that were the case. ..

Only time will tell as I am making my appt like a good patient, I want my surgery to have the best odds and keep my Docs happy with me :-D

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In my case of jumping through hurdles I found out I had sleep apnea. I was sleeved 3/14, as of today I'm 20 lbs lighter. My sleep study dr told me at a recent follow up dr if I loose 20 more lbs within 5 months I need to reschedule another sleep study to get my pressure re evaluated.

Generally once you loose 25% of your body fat within 6 month time frame you have to meet with your dr and they will determine if you need to stay on. Good luck!

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I had a sleep study and was very surprised that I only had mild sleep apnea. They recommended sleeping only on my sides and to lose weight. I'm 150 lbs over weight! I snore so badly my husband wakes me up sometimes so I was really surprised it wasn't worse. So I didn't need a cpap machine. Hope yours goes just as well! You insurance should cover the cost of a sleep study for the most part if you have symptoms of sleep apnea. They can bill it because of your symptoms and not because the anesthesia provider wants you to have it in prep for bariatric surgery.

Unfortunately it will cost you what ever your deductible is so it prob would cut into the money you've saved for surgery. I totally understand that! It is very important to know if you've got it because if they send you home after surgery and you have undiagnosed and untreated sleep apnea you are at a higher risk of death post operatively. No one wants that!

Edited by beeteroo

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Thanks Survivingsleever and Beeteroo !

I have made my appointment and will get this going, my surgery is June 11th so I want to have this completed. I guess I thought I want going to need it. Beeteroo, you and I sound very familiar, my husband says I snore, but he doesn't think I stop breathing. I have woken up gasping though, but I had attributed it to some bad reflux I have had since getting to be 300 lbs... I realize now I was just hoping to get the surgery and the benefit without having jump through hoops... bad little patient!

Oh yeah, I had my HR double check and it is covered!

Edited by SnohoGal98296

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I don't know if your particular insurance covers the sleep study and cpap supplies if needed. Most insurance companies do cover both the study and cpap if needed because it is medically necessary. They must show reason for needing sleep study and you have that. Then if you need a cpap it is a life-saving device. My insurance covered all except a small co-pay. I get supplies every couple of months. The study itself makes some people uncomfortable. You typically have 2 sleep techs at the sleep center that set you up. Wear comfy pajamas 2 piece loose top and bottom is best. Your hair needs to be squeaky clean because you will have an adhesive placed on your head in several places. I felt like predator. The will also run sensors on the rest of your body. Some places let you watch tv others don't. It sounds kind of crazy but it's no biggie. All the sleep techs I have had have been great. It's just another necessary part of the process right?

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I am a sleep tech for a large hospital. We require all WLS applicants to get a sleep study. Most of the time after a significant weight loss cpap is no longer needed. However genetics play a role, so you may be thin with a narrow airway or a large neck and still have sleep apnea. Age also plays a role. The older you get the more your muscles lose tone and are more likely to collapse while your sleeping (sleep apnea).

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I have sleep apnea and there is no installation guy coming in lol I'm just laughing because the thought is funny , it's a relatively small machine, smaller and acts like a humidifier with a mask and hose, you pug it in and wear the mask, before you actually get it, the calibration it, hope that helps, I actually sleep soo much better with it ;)

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I have had 2 sleep study's, just very uncomfortable trying to sleep. I picked up my CPAP from a local office and they went thru everything with me. The oxygen machine I had first was brought to my house and my insurance rents them. I had them show me how it worked in the living room, it was big and bulky my daughter wheeled it into my bedroom.

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I plugged my own CPAP in. It's just a little humidifier thing with a mask.

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I have sleep apnea and there is no installation guy coming in lol I'm just laughing because the thought is funny , it's a relatively small machine, smaller and acts like a humidifier with a mask and hose, you pug it in and wear the mask, before you actually get it, the calibration it, hope that helps, I actually sleep soo much better with it ;)

Oh that is good to hear! I have seen other posts and comments on the sleep centers website where they talk about it having to be setup by installers and calibrated. .. sounds like it is easier then they make it out to be, whew! That is a huge weight of of my chest!

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So an update. ..

The sleep center failed to pre qualify me on my insurance so the claim has been rejected as "medically unnecessary". Needless to say they are scrambling to fix the issue, insurance says it should have been an at home study, I don't even know that was an option, I was jumping the hoops for surgery approval and missed that tidbit. What I have I gained? One of the most miserable nights of sleep ever and no medical report to provide to my Surgeon. My surgery center is not pleased with the sleep center and is being very helpful. .. Will know more on the 19th...

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Update I I

Ok so the Doc says I have severe obstructive sleep apnea with low oxygen and failure to up oxygen levels after an apnea event, plus hypo ventilation. So I am waiting to be fitted with a fashionable CPAP machine as we speak. Lovely.

The only thing I can do is turn around my attitude, so I am happy that we have discovered the problem, that the office is working my insurance issue and that I may experience what I have read can be life changing sleep after receiving this machine. And guess what? I get to install it myself :-D

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