Not surprisingly, my husband has sleep apnea
The result? Moderate sleep apnea. My husband averaged 17 apneas each hour. The NP reviewed different treatment options, we settled on trying the CPAP, and she sent a prescription to a DME.
Did it feel a bit transactional? Yes. But when you’re pretty sure about the diagnosis and just need to go through the bloody steps insurance requires to get help, does it really matter if it feels transactional? To me, no, but to others it might.
My husband has an eight-week follow-up appointment scheduled, but can schedule an appointment sooner if he has questions. These appointments will be billed to insurance or $99 out of pocket, although the company did not respond to emails asking if these appointments would always be with the same NP. He can also email their support team, which is answered by different agents.
Experts say D2C at-home sleep apnea tests are relatively accurate
Doctors have been using HSATs for over 15 years. Granted, the D2C options look a little different, but function similarly. In 2007, Dr. Carolyn D’Ambrosio, Professor of Clinical Medicine and Associate Vice Chair of Medicine for Education at the University of Miami, helped review HSAT efficacy for Medicare. “Sleep laboratories were not that available and they’re very expensive,” she says, pointing out people in rural areas had to drive hours for a lab test and would often have to miss work. “Were they really necessary?”
The answer: no. The report concluded HSATs are “decent” at detecting obstructive sleep apnea. And now, consumer HSATs are using similar technology. “These tests provide yet another way to look at sleep apnea,” says Dr. Husain, “They are a screening test and that means that if it’s positive, that’s great.”
At-home tests can produce false negatives
Where these HSAT or D2C tests fail, Dr. D’Ambrosio says, is if the test is negative. “It’s just not as detailed of a test [compared to a lab test],” she says. “If it says no sleep apnea, you shouldn’t trust it and then you have to get the in-laboratory sleep study.”
Patients can be bad at following through on a lab test if their HSAT is negative, Dr. D’Ambrosio says. Remember, if you’re taking a HSAT it’s probably because you or someone you know highly suspects you have sleep apnea, so you should suck it up and do an in-lab test if your HSAT is negative.
You may trade a deeper relationship for efficiency
Yes, D2C HSATs can be as accurate as one your doctor prescribes and can give you a quicker diagnosis. But Dr. Barone cautions on trading a deeper relationship with your doctor for efficiency’s sake. “You gotta remember, sleep apnea, if it is there, it’s a chronic condition” he says. “It’s not a thing that’s going to hurt you waiting one night or even one month. It takes years for that to have an effect.”
Waiting a few more weeks to meet with a doctor in person, he argues, may mean better long-term care. “No one loves wearing a CPAP machine and if patients don’t understand why they need it, what the implications are of not using it, and how to get it to optimally work, they’re much more likely to give up on it,” adds Dr. Husain. “I would like to think that you’re much more likely to get that information if you have a personal consultation with a physician as opposed to a short online conversation.”
