Sleep (apnea?) Consult process and insurance coverage?

I had an overnight polysomnography at a clinic in British Columbia, Canada. I expect that the procedure and the experience are widely the same, with variation. You get taken into a room told to get into sleep attire, and then you are prepared for the sleep assessment. Your scalp will be scrubbed with alcohol pads to clean flaky skin and oils and lead pads will be stuck to your scalp. Also your chest, back, arms, and legs. There is/should be a camera on the wall in front of you to record limb movement, sitting up, turning over. If it is only the one night (some labs require two nights, one with no PAP treatment, the next with full titration), you'll be awakened near 0200 and asked to don a mask and headgear, and you'll be allowed to return to sleep. During this second phase, the technician will adjust flow settings to your mask to help to 'splint' your airway....IF....it was shown that you do have hypopnea or apnea during the first few hours prior to donning the headgear and starting the titration.

Something like this will happen, again with some variation from lab-to-lab. In a few days, you'll be asked to consult with a sleep physician or a respiratory therapist to go over your results. If you have very mild apnea, you should not be pressured into accepting PAP therapy. If you have many central apneas, you might benefit from an ASV, or adaptive servo-ventilator, about twice the cost of a PAP machine. If your apnea is assessed as falling into the 'moderate' or 'severe' range (I was blown over to learn that I had apnea after all, but it was also severe!), you really should investigate the nature of your new diagnosis and what risks it presents if you do nothing. Otherwise, be prepared to pay between $1000-$1300 for a machine that can deliver the type of therapy that is indicated for you. Additional costs will be the tube from the machine, the headgear, and then the mask over the mouth and nose, or just over the nose, or just a soft bar with nasal 'pillow's that get stuffed up your nostrils a short distance....many varieties of masks, and you'll want to try at least two. Some eventually use two different types in rotation to get the best therapy.

I hope that helps some.

Hello @tallbackhip, I had an overnight sleep apnea study done at the Rochester Mayo Clinic in July 2018. It was similar to what @gloaming described with the leads placed on my chest and back and a couple on head (can't remember specific location but they didn't shave any hair off off my head. They were really sensitive to make you as comfortable as possible for the sleep study. All of the leads were connected together at a plug which you had to disconnect if you needed to use the bathroom at night. They do monitor you sleeping as @gloaming mentioned and halfway through the night they wake you up to switch masks. When you wake up and get dressed they provide some coffee, juice and breakfast snacks. If I remember correctly, I had an appointment with the sleep medicine doctor the following morning around 9am or so to go over the sleep study results with their recommendations.

I was on Medicare along with my health insurance and think a good portion of the cost of my first CPAP machine was covered as durable medical equipment. I think the catch22 is that you have to have follow up appointments to make sure you are still using it the first year. Mayo Clinic has a great sleep medicine shop where I purchased my first CPAP machine. They go over all of the different types of masks recommended for you by your doctor and you can try them on in the store before purchasing.

@johnbishop
Thank you
My initial appointment is during the day.
I'm traveling from a time zone 4 hours different.
Do you believe I can have an overnight sleep study on a Tuesday night, if the initial appointment is Monday?
I may have to try call them.
So far I don't see a way to contact anyone thru the electronic health record, which they call a portal.

@tallbackhip if you have Mayo Clinic Patient Portal setup, there is a message option that let’s you send messages to your doctor or care team. I would definitely call them if you can’t send a message to ask about the overnight study.

Follow up
I met with a sleep specialist and several options were discussed.
Home sleep study, overnight sleep study, etc.
Insurance coverage turned out to not be a concern.
The visit and solutions we used were excellent, I am grateful to work with Mayo Clinic,
Best wishes