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Unnecessary sleep study?



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So I just went in and met with the nutritionist and NP yesterday and went over a ton of stuff I’m actually getting excited and feeling like I’m IN the process! So I’ve got 4 more months for my insurance and when I went yesterday I got orders to do blood work which I know is standard. But the NP told me to get a sleep study and ordered that also. As of now my BMI is like 40.7 or something so I technically don’t need any comorbidities- which is good because I don’t have any. She told me to start practicing good habits and healthy lifestyle but that I actually can’t lose any weight leading up to surgery cause it would knock me out of the 40 BMI and then I would NEED 2 comorbidities. So I get that. But she said she wants me to do the sleep study “just in case” like as a back up to just help my case against insurance. The thing is, it’s going to cost me almost $2,000 and more importantly I don’t have sleep apnea.. I’ve never had it and I don’t want to pay $2,000 to do it in order to “help” my case- and then it turn out I don’t have it and wasted my time and a lot of money. I appreciate that she’s trying to help me and have me covered from all angles but I really don’t think this would be beneficial. Any thoughts, suggestions, experience? I would really appreciate it!

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Double and triple check with your insurance and the bariatric program you are having surgery with that it's not necessary for surgery (get it in writing even) then say no thanks. Some programs will not proceed without it whether or not you have comorbidities. It's a prerequisite for surgery. It was for me. I had no comorbidities. Your level of obstruction predicts chances of issues with general anesthesia and sleep apnea can form at any time whether you had in the past or not.

Safe Journey 🎈

Edited by GreenTealael

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I am surprised it is that much. Maybe that is the cost for going to a sleep center. Can you check if there is a sleep center that lets you use a device at home. I am sure that would be much cheaper and should give nearly as good of results. I had that and it was hundreds not thousands.

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My insurance wouldn't pay for sleep lab test. So I had a home sleep study and paid $100 copay. I was reluctant to do sleep study thinking it's unnecessary. Guess what...I was diagnosed with severe sleep apnea.

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I also recommend seeing if you can get the at-home test. I had moderate sleep apnea and didn't know it. Several years ago I had a different surgery and they had trouble getting me breathing on my own after the procedure - and only did after an emergency re-intubation. My WLS went much more smoothly because the anesthesiologist knew about my apnea and somehow compensated for it. No problems waking me up at all. So, it may ultimately help, even if you don't think it will.

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Wow! Lots of good information! @notmyname @Bari_KS @2Bsmaller18 @GreenTealael
Thank you so much for taking the time to respond! Lots of things I didn’t really think about. I will look into it further and email my consultant!

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If your insurance won’t cover the home sleep study you still need to call the home study companies. I know one company (Novasom) charges $300 as their cash pay price. Be sure to ask the company if they are in network (if your insurance will cover it). You can also call your insurance and ask what companies are in network then tell you physician.

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My surgeon requires a sleep study for every patient regardless of other factors. I will be doing a home study, and it's included in the general fee I'm paying for all of the pre-op appointments, classes, counseling, etc. (none of which are covered by insurance, unfortunately).

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Is it 2000 because you haven't met your deductible yet? Because you'll have to pay your deductible in order to have the surgery. So whether you pay the 2k deductible for the sleep study or the surgery it will all be the same. That being said my son did an at home sleep study and we didnt have to meet the deductible for it.

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