Sleep Apnea, CPAP, and Healthshare Ministries

Are you a member of one of the following healthshare ministries?

• Christian Healthshare Ministries
• Altrua
• Liberty 
• Samaritan 
• Aliera
• Christian Care Ministry/Medi-Share
• Solidarity Healthshare

Christian healthshare ministries emerged as a faith-based counterpart to Obamacare's government-mandated healthcare rules. These organizations allow people of faith to pool their resources and care for each other in a compassionate way that is in line with their religious beliefs. We frequently provide care for the sleep apnea needs of healthshare ministry members. This article is intended to serve as a guide for members to quickly and effectively get assessed and treated for sleep apnea.

How common is sleep apnea?

Sleep apnea is very common. The American Academy of Sleep Medicine estimates that 1 in 4 adults between the ages of 30 and 70 has sleep apnea. 80% of people with sleep apnea are not yet diagnosed. 

Can sleep apnea lead to other medical problems?

Yes, if not properly treated sleep apnea can cause:

• High blood pressure
• Heart disease
• Stroke
• Type 2 diabetes
• Depression

How do I know if I'm at risk for sleep apnea?

Typical symptoms include:

• Chronic snoring - this is the most common symptom BUT not all patients with sleep apnea have been told that they snore.
• “Witnessed apneas” - your bedpartner hears you stop breathing in your sleep. Research shows that you have at least an 80% chance that you have obstructive sleep apnea with this symptom. 
• Waking up gasping for air
• Chronic trouble staying asleep
• Waking up to start your day and not feeling refreshed
• Excessive daytime sleepiness, i.e. the tendency to doze or nod off when you don't want to
• Fatigue, i.e. overall lack of energy
• Impaired focus and memory
• Morning headaches
• Feeling hot and sweaty in your sleep
• Nighttime acid reflux

Typical risk factors for sleep apnea include:

• Being overweight or obese
• Having a narrow airway
• Having a neck size >17" if you're a male or >16" if you're a female
• Smoking
• Alcohol use near bedtime
• Use of medications with sedative or muscle relaxant properties

Screening Questionnaires

• The following screening questionnaires have been found to be helpful in predicting whether you might be at risk for sleep apnea:

• STOP-Bang
• Epworth Sleepiness Score
• Fatigue Severity Score

Be careful, though, because questionnaires are only meant as screening tools; they can't predict sleep apnea with 100% accuracy. 

The First Step: A Sleep Apnea Test

If you think you're at high risk for sleep apnea or your doctor has recommended a sleep study, then the next step is to schedule a sleep apnea test. As a healthshare ministry member, being mindful of cost and a good steward of the ministry's resources is important to keep the organization sustainable. In-lab sleep studies are much more expensive (and less pleasant) than home sleep apnea tests; the vast majority of people are suitable for home sleep tests. Certain people with advanced heart or lung disorders may be better served with in-lab studies. 

The Next Step: A Treatment Plan

After your sleep study, you will want to review the results with a qualified provider and formulate a treatment plan with him or her. CPAP is the gold-standard treatment and most patients will start with this. CPAP machines use air pressure to splint the back of the throat open and prevent airway collapse. When adjusted properly, all snoring and apneas should resolve and you should notice an improvement in your sleep quality and daytime energy. 

The adjustment of the machine is called the "titration" and can be done in a sleep lab or at home with an auto-titrating CPAP machine, also known as APAP. An APAP titration is the more convenient and cost-effective method. 

Healthshare Ministry Coverage for Sleep Studies and CPAP

It has been our experience that healthshare ministries cover 100% of the costs for sleep apnea testing and treatment as long as you don't have sleep apnea as a "preexisting condition" (see discussion below). 

You will need to pay out of pocket for the expenses and then submit an itemized invoice for reimbursement. Please see the invoice below as an example of the typical paperwork you need and costs:

 Sample Invoice for Sleep Apnea Services

You will also periodically need to replace certain parts: the air filter in the machine, tubing, mask, and water chamber all need to be updated at specified intervals. Healthshare ministries typically will reimburse you for these necessary parts.

Preexisting Conditions

It is our experience that healthshare ministries typically do not provide coverage for the costs associated with managing preexisting conditions, in other words, medical problems that you had been diagnosed with prior to joining the healthshare ministry. 

If you have already been diagnosed with sleep apnea, here are some tips for containing costs:

• Focus on APAP 

• If you get a fixed-pressure CPAP machine, you'll have to have an in-lab "titration" sleep study to find the correct pressure setting for you. These sleep studies can cost several thousand dollars, much more expensive than a quality APAP machine. 

• Check with Your Fellow Parishioners

• Does anyone have a used APAP machine that they might be able to give you? As a sleep doctor it pains my heart to say this, but there are a lot of machines gathering dust in people's closets right now.

• Shop Refurbished Machines

• Check with your local DME company or shop one of the online retailers that specialize in used machines to see if there are any options that you can afford. I recommend avoiding purchasing machines on Craigslist given the lack of quality control and accountability with those transactions.

• For New Machines, Stick to Online Resellers

• For new equipment, you'll typically get the best pricing from online durable medical equipment (DME) companies like Singular Sleep. Brick-and-mortar resellers often charge 2-3 times more than online DMEs for the same machine. 
• New CPAP/APAP machines do have advantages over used equipment. The newest generation of PAP machines allows your provider to monitor your treatment and make changes to your machine's settings remotely to ensure that it's comfortable and effective. 

At Singular Sleep, we support the mission of healthshare ministries and would like to offer their members 10% off home sleep studies. Simply enter the promo code SHARECARE in the Additional Information section of the Home Sleep Apnea Test Order Form and email a photo of your valid member ID to info@singularsleep.com.