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Afib and Sleep Apnea
I have been diagnosed with AFib for two years and sleep Apnea for about 8 years. Now Medicare is requiring me to have a new sleep study in order to continue using my CPAP and for them paying for supplies. I had a home sleep test last week which did not go well at all - slept very little (they say they require at least 5 hours of sleep) and was anxious all night feeling like I was having tachycardia. I would be surprised if I had even two hours of solid sleep.
The sleep tech told me I can have one repeat home test and then they could require a lab sleep test (if any of you have done that you will know how stressful THAT is trying to sleep in the lab!). Of course I was worried about how the test would come out because I'm at the low end of nightly apneas and Medicare requires a certain score (I don't know what) to qualify. I wonder if they have lowered the threshold to qualify? I know that AFib and sleep apnea go hand in hand so I'm worried about what will happen if now I don't qualify after 8 years of being treated. Can they just leave me out in the cold so to speak? Will be seeing the sleep dr. next week to discuss this at home test I did. Of course no one has said how it came out yet.
Aneta, February 15, 2020 12:18pm EST
Hi Wiggles, I am sorry for you had to come through such an experience. Do you feel better since then? Have you had that meeting with your doctor to learn what are your results?
Hope you are feeling better now. Has this diagnosis changed your life a lot since you've learn about it? 8 years is long time...
Looking forward to hearing from you,
PS: I am sorry for my English, I am not a native speaker but I do my best.
kayh315, February 16, 2020 11:57am EST
i also have afib and sleep apnea.. have had cpap for at least 12 yrs and tonly time i had to take a 2nd sleep test was when my pulmonologist wanted me to get a newer machine.
my cardiologist is adamant about my using my cpap due to increased risk of stroke, so i am surprised they are threatening to quit paying for it.. cheaper to continue paying for cpap than hospital costs if you have a stroke! i recently had just a TIA and 3day hosp stay + tests.. bill was $54000 (thankfully ins covered!)..
Sorry you have to deal with all this.. hope you get it straightened out soon!
Wiggles, February 17, 2020 9:17am EST
Yes I did manage to get a new home sleep study done and it continued to show mild sleep apnea (thank goodness! - when are you ever glad you have something?). I was very surprised it showed anything because I didn't sleep well that night (and I am at the low end of apneas) - the tech said they had to have at least 5 hours of sleep to have a valid test and I'm sure I didn't "sleep" five hours! Oh well it's over and done with now so nothing to worry about. I have been trying to let others that I know who have sleep apnea that they should be aware they may be required to do a new test in order to stay current with Medicare paying for supplies. You don't want a surprise when you go to the medical supply store to re-stock and they tell you you can't have any!
bfboca, February 18, 2020 5:12am EST
Hi Wiggles. Re: getting retested to retain Medicare coverage for CPAP. If a retest is required for coverage, did you also find out how many years after one's first test is this necessary?
Elise, February 19, 2020 9:02am EST
I've been on Medicare for 11 years. During that time it has paid for all my CPAP supplies and two new machines. I see my sleep doctor annually and I have never had to have a second sleep test.
https://www.medicare.gov/coverage/continuous-positive-airway-pressure-devices suggests that as long as your doctor sees you regularly and documents your need for CPAP Medicare will cover CPAP expenses.
Wiggles, February 20, 2020 11:22am EST
bfboca, I don't think the retesting requirement was tied to how many years since my original test, it seemed to be that since I was tested (7-8 years ago) the requiremen/score to qualify as having sleep apnea had changerd and I had to "requalify." No, it made no sense to me. The medical supply company where I have always purchased my supplies told me the necessity for retesting had changed about 5 years ago but they (the supply company) had apparently not paid any attention to it but now they were being required to (makes no sense either!). Elise, I have always gone in yearly to the doctor to renew my "prescription" so that I could continue with Medicare paying for supplies. I too got a second new machine a few years ago and new supplies regularly. The doctor (actually has PA that I see) told me last fall when I was in for the annual check up that "maybe" the medical supply store would soon tell me that I was going to have to have a new sleep study to continue qualifying. That didn't happen until I went in the in January and sure enough, no supplies until I underwent a new sleep study. Anyway I qualified, just barely because I am in the "mild" category which makes me wonder if I really need it!
Thumper2, February 21, 2020 9:06am EST
I sometimes wonder if this whole CPAP thing is some kind of racket. I've complained here about taking sleep studies and never getting any useful knowledge or advice from the pulmonologist and neurologist who ordered them or from the medical supply store folks. I finally ordered an overnight study for which I wore an oximeter. It recorded the oxygen level in my blood overnight (while not wearing my CPAP). Since it never dropped into undesirable ranges, I decided I did not need my CPAP and stopped wearing it. I have never felt better or worse, whether using a CPAP or not. I do believe that some folks really need a CPAP and/or benefit from it. One of my friends from church has received this "re-test" message. She believes she has very mild sleep apnea, but that the CPAP is helpful for her. She got some advice about looking on Amazon or other places for equipment, if she needs new tubing or face masks or whatever.
bfboca, February 22, 2020 5:55am EST
Hi Thumper. Re: CPAP - is it a racket? I use a CPAP and wonder that too. I guess I somewhat put my mind at ease that if the Medicare wonks pick up all the charges it must be legit. The medicare department does not go out of its way to spend money contrary to many many other departments of our government. My sleep study 3 years ago stated I had moderate sleep apnea at 26 events per hour. So I started the whole CPAP procedure back then and unfortunately don't feel it does my sleeping any better nor has it reduced my paroxysmal afib events any per year. I continue to use it but continue to be skeptical. I must admit if I were the one paying for it I would have cancelled out in the first 3 month trial period. I know many CPAP users rave about it, including Mellaine, and how wonderful their sleep has improved. I'm not in that happy camper group. Bob
lmaj, February 22, 2020 9:23am EST
Sleep apnea not only affects your heart, it affects all vital organs in the body. So any lowering of oxygen levels can be harmful to so many areas of your life---heart as well as kidneys, brain, liver, lungs. That is why it is so crucial to lower the apnea episodes and keep oxygen levels at the optimum level throughout the night so all these organs can operate at optimum levels. I would not just aribtarily ignore what has been diagnosed. Mild can turn to moderate--so I recommend being really diligent in keeping up with the monitering.
Elise, February 22, 2020 9:54am EST
There is no doubt in my mind that my CPAP has saved my life. And not a lot of doubt in my mind that years of untreated sleep apnea not only made me miserable, exhausted, grouchy, and cognitively impaired but also contributed to or caused my arrhythmia issues. I'll give up my CPAP when they pry it out of my cold dead hands 🙂
I'm happy there are those of you who have no apnea or only mild apnea, but if you have any significant degree of apnea, CPAP treatment is the furthest thing from a racket there is.