What to Expect with a Diagnosis of Obstructive Sleep Apnea

You need to get an official diagnosis with a sleep study. This can be either a home sleep study or done in the sleep lab (usually your insurance decides which test to perform). Depending on the severity of the sleep apnea, a CPAP may be recommended.

CPAP set up—completed by either another sleep study to determine the best treatment for you (pressures, mask) or by setting you up with a local equipment company, who will work with you on an outpatient basis to accomplish the same thing.
- Titration study—in the sleep lab, all night with the machine.
- Auto CPAP—machine that automatically adjusts pressure based on how much resistance it is meeting in the back of your throat.
Compliance requirements (for a CPAP)
- Insurance requires that you “prove” you are using the CPAP before they’ll pay for it or any supplies.
- You must use the machine for at least 4 hours for at least 21 out of 30 days (70%). You have 90 days to meet this criteria. The CPAP computer records this information.
- The 4 hours of use is total in a 24-hour period, and does not have to be while you are sleeping.
- You must see the sleep medicine department for a follow-up appointment within 31-90 days after getting the machine.
Supplies
- Supplies come from the equipment company. (see other handout for contact information)
- Insurance pays for supplies on a set schedule (see “DME” handout for more details). They will purchase a new CPAP machine every 5 years, for example.
- Mask fit—equipment companies will help you with mask fit and let you change the mask out for the first 30 days. Contact your equipment company if you need help!
- Supplies should be cleaned regularly to increase their “lifespan”.
Follow up
- Besides that first office visit, we like to see you a minimum of every 2 years to check in.
- Supplies need to be re-ordered (a new prescription) every year.
Possible additional testing
- Another sleep study shouldn’t be required unless you are having problems.
- Overnight oximetry is a way we can check oxygen levels (probe on your finger you wear at home) and gives us a quick way to see if your machine is helping like it should.