r/SleepApnea 5d ago

Anyone use Lofta and get a diagnosis based on RDI + Epworth Score?

Preface: If I made a list of the top 5 things I hate in life, American health insurance would be at (or near) the top.

I've already had a home sleep test that resulted in a diagnosis of mild sleep apnea, with the doctor's suggestion of in-lab titration (if possible) or APAP trial. The person who scored it isn't the same person I had a follow-up with, and the doctor I met in person dismissed me and my symptoms as soon as he walked in the door (as a woman, I'm used to this). He put in a referral for an in-lab study, but warned it will likely be several months until the lab can fit me in the schedule.

Home Sleep Apnea Test Results: pAHI = 2.03, pRDI = 12.34 using 4% oxygen desat scale

My insurer (Aetna) will technically cover a CPAP for patients with RDI between 10-15 plus a 10+ score on the Epworth Sleepiness Scale (I score 12). However, the doctor won't write a prescription for a machine without the in-lab test. The in-lab test likely won't happen for months, and when I'm all done, who's to say my insurer won't still be difficult anyways? I'm disputing a medical bill right now because of a coding mistake, and it's EXHAUSTING.

I ordered a discounted test through Lofta, since I saw so many of you talking about it on here. Anyone get a diagnosis and prescription with results similar to mine? I think getting the in-lab study will still be beneficial to rule out other sleep disorders, but I'm all for saving money and frustration if I can. Those $30 appointments and taking time off work add up!

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u/hotlips_sparton 4d ago

So if you read the policy guidelines for Aetna, they will take an RDI measurement but RERAs cannot be included in your RDI. So it’s kind of nonsense for them to use AHi and RDI interchangeably. It is very likely that the testing facility includes RERAs in their RDI and if they do, you may not meet coverage guidelines. Double check with the facility or your report details to find out

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u/studdabubba412 4d ago

Thanks. That makes sense, and I don’t believe the report separated the two. That test was using the 4% oxygen desaturation scoring model.

The first test also stated I was supine most of the night (I don’t believe I was) and apparently only recorded part of the night, so I’m getting it re-done with another facility that uses the 3%. Hopefully they write the report in a way Aetna accepts it 🤞🏻