The best news, almost

I made it through the red tape more quickly than I expected and have been cleared by my insurer for a CPAP machine. The supplier will even come to my house. This is welcome news.

Here’s the bummer: the process took just long enough that I’m now up against a week’s vacation, and they probably can’t squeeze in delivery of the machine before I leave. I’m on the wait list just in case they get a cancellation. So, in all likelihood, I’ve got about 10 more days of sleep deprivation to endure, plus however much longer to adjust to the machine.

Still, this is far ahead of the schedule I expected, and I should count my blessings that therapy even exists. Oh, how people must have suffered before there was one.

This also means it won’t belong before I can bore you with actual data of apnea events per hour by day (the machines nowadays collect it and I’m pretty sure I can get it).

Other updates:

1. I tried extended release Ambien (6.5mg) two nights ago while traveling. Hotel sleep usually sucks, so I was hoping this would do the trick. I still woke to consciousness with many apnea events between 3AM and 6AM. WTF?!

2. A reader who used to work for “a leading health insurance company” said he did an analysis of CPAP coverage policy about a decade ago. He concluded, at the time, that it would be cheaper not to require a sleep study (which are very expensive) and to let doctors prescribe CPAP machines, then evaluate the data over the next few months. This is plausible because many people get sleep studies and CPAP machines and then stop using them, effectively wasting a lot of expense.

This study had no impact on coverage policy. Had it been in place, it’d have saved me about 10 weeks of delay.

Assuming the analysis is correct, why would an insurer leave money on the table? Some possibilities, all pure speculation: (a) Maybe it would have devastated sleep study labs and maybe they had some clout because they’re needed for other diagnoses. (b) Maybe the savings would be small relative to the headache of changing the policy. It’s not the low lying fruit. (b) Maybe the evidence supporting this idea is thin (it seems like it would be) and insurers don’t want to risk encouraging even a low level of diagnostic errors.

3. I started using the Provent therapy last night. Possibly coincidentally, I do not recall a single apnea event (I’m not claiming there weren’t any, just that I slept through them all). However, I wasn’t on a therapeutic level of Provent, just a training level. Even the training level creates some back pressure though, so maybe it can help a little (?). Confounding the results: (a) I was on Ambien, (b) I was extremely tired from my trip, having sleep poorly the night before (see #1), worked out for the first time in a month, given a talk, and met with tons of people at Ohio State University (tiring for an introvert).

I’ve got three more training nights of Provent before I’m on the real deal. I’ll get a handful of nights of experience with that before I get a CPAP machine — good opportunity to gather info about whether Provent would be helpful for traveling.


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