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07 October 2009

There are no words . . .

. . . to begin to state how angry i am.

I remember the last time i was this angry. 1991. Someone i trusted very much did something i saw as a betrayal & i felt it in my entire body. That is the feeling (my entire body is experiencing the anger) that i currently have.

A "sleep study" sounds so innocuous, doesn't it?

Part of the problem is that i didn't research this enough. "Sleep labs" no longer do what i consider a sleep study, but i didn't know this.

Many years ago someone i know had one done. He went into a sleep lab (part of a hospital, i think) & was hooked to a lot of wires & stuff & after about 7 hours of sleep they were able to tell him the extent of his problem. I think they said that he stopped sleeping because of obstruction about 700 times that night. And they were able to show what happened to his brain waves & heart rhythm as a result. I don't remember the rest of his story, but i think what happened was he was fitted with a machine & another study was done to be sure it was working properly.

That is what i expected.

However, insurances have gotten involved & hijacked this process.

Now what is done is they allow you to sleep two hours (because the "average sleep cycle" is about 2 hours) then they wake you & put you on a CPAP machine. That way insurances don't have to pay for 2 sleep studies (& the company can sell you a machine or get a kickback when they refer you somewhere that sells these things).

I have insomnia, & it is the absolute worst is if i'm woken up about 2 - 3 AM. If that happens i'm usually awake until 5.30 or 6. Regardless, i have long known that my best sleep happens between 6 & 8 AM & if i miss it i am very, very tired. Which is why the (useless) early AM waking i'm having (i have no need to be awake at 5.30 or 6) is part of the reason i am so, so, so very tired.

Yesterday i was rather nervous about the whole process. And the building (tho i know the area fairly well) was very hard to find. I'd already faxed the info & documents they needed & they wanted copies again which i found insulting - why waste my time having me fax something they will recopy? And because i was so nervous this didn't help. I tried not to have a chip on my shoulder & particularly tried not to take it out on the tech who was simply following protocol.

Yesterday was one of the days i was absolutely bone tired. If i had been headed for my ILs yesterday would have been one of the days i was asleep by 10, which is unusual for me. But, being i was in a strange place & uncomfortably hooked to wires & all AND had far too much light in the room, i fell asleep by about 12. But then they woke me at 2 AM to put me on a CPAP (continuous positive airway pressure) because they said i "snored" & that my O2 sat level dropped to 92 (i made him give me that info this AM). But it is not unusual for me to have a 92 level when i'm awake. (Wikipedia reports that levels from 95 to 100 are considered normal, but levels down to 90 are common.) Merely the fact that they woke me then precluded any more sleep for me for the next 4+ hours because of the way insomnia works for me - & i told them that in the medical info they requested. It didn't help that i had an obnoxious thing strapped to my head (as well as all the other wires) that was trying to make me breathe on its schedule, not my own. And it was noisy with the type of noise that makes me very anxious.

At 4 AM i told him he might as well send me home, but he said i would have to fill out "early termination" papers (i.e. - insurance would see it as a failure & not pay & i'd be liable) so i had to lie there until 5.30 when he determined i might as well go home. It was misery. I tried both EFT (emotional freedom technique - a tapping thing) & EMDR (eye movement desensitization & reprocessing) with prayer to calm down & try to relax & to diffuse my anger.

Let me say, anyone with a history of dissociative disorder or childhood abuse should be very careful before doing this or not do it at all. I am much healed (& the upside of this is to show how much better i am, praise God) but if i were at my functioning level of 8 or 10 years ago i would now today be in a psych hospital.

So i had real issues this AM. I tried very hard not to take it out on the tech who was only following (a stupid) protocol. I asked him what percentage of folks are woken to be put on the CPAP machine.

His answer?

"Um, all of them."

! ! ! ??? ! ! !

"Well," he continued after seeing my reaction, "people only come here if their doctor suspects something. We just confirm it."

Ok, i do accept that if, as said, 9-10% of the population have sleep disorders & only the folks suspected of having these issues are referred for a sleep study, that a much higher than normal population will have issues that indicate the need. BUT NOT 100% ! ! !

What is more, he said that they go by "positive symptoms." In other words, because i have some amount of snoring (about 10% of the time & on a scale of 1 - 10 for loudness, Duane puts it at a 3), & because my O2 stats dropped by about 4 points, i fell into the qualification to have the machine attached. He also implied that the whole point of this test is to "confirm" the things i've already told the doctor. In other words, my word or that of Duane is not enough, it has to be reported by a "qualified" source.

MY take on this is that 2 hours is not a reasonable amount of time to assess this. But, he told me, that is the amount of time "the insurance requires" before they attach the machine. In other words, they followed a by-the-book standard protocol that in no way takes into account my physiology & sleep patterns. They simply have to wait the required 2 hours & attach the machine.

I think a sleep study should be just that - do an assessment of the way i sleep. This wasn't even close to a normal way of sleeping. I probably could have overcome the wires & leads. But there was a window in that room with blinds that was as big & as bright as my FIL's huge TV. That alone, not to mention all the bright LEDs on equipment in the room, was enough to prevent me from sleeping anything like normal. It feels to me that this is set up to make folks fail.

I got to my ILs about 6 AM, took a shower to wash out the yucky stuff with which they attached the leads, & slept for about 3 hours. It didn't help much, but i'm getting a second wind now.

I take some responsibility for this by not researching it more thoroughly. And for not stressing to the tech more firmly that i cannot be woken at 2 AM. That info was in the paperwork, but i should have reiterated it more firmly, verbally. I did state that, & he said that most folks don't want to come back for a second night. And i did get that. I would not want to return, either. But i should have been more proactive about it. Truth is, i didn't expect they would see any reason to wake me & that it would not be an issue. I didn't understand that they don't really do any eval, they just wait the 2 hours & then attach the machine to everyone.

At this point i believe we have learned less than nothing & Duane & i are out $195 (the co-pay) for this useless test. And really, what was i expecting from something that is based on conventional medicine?

I'm an angry, tearful mess today. Ah well, tomorrow's another day.



David said...


WannabeMommy said...

Ugh... so sorry you had to go thru all that. What a waste it sounds like!! Insurance companies are the devil, I say!

Well, maybe it will make you feel better to head on over to my blog because I have a little something for you! :-)

Stacey said...

I'm so sorry you're dealing with insomnia PLUS all of these frustrations! Hoping today was a much better day.

Rosemary said...

What an awful experience! I'm so sorry for this happening to you and then you end up even more exhausted after it all. Jeez, I didn't realize this what such a ripoff. I really thought sleep studies were beneficial and not just commercials for CPAPs.