I'm a CPAP User; How Often Do I Need a New Sleep Study?
Date Published
Quick answer: a repeat sleep study may be appropriate when there has been substantial weight change (typically 10 percent or more in either direction), new or worsening symptoms despite documented PAP adherence, a change in PAP device type from CPAP to BiPAP or ASV, persistent CPAP intolerance not resolved with mask or pressure adjustments, suspected change in OSA severity from comorbidity (heart failure, stroke, hypothyroidism), or before considering surgical or device alternatives such as Inspire therapy. Some insurance plans require periodic re-evaluation (often every 5 years for Medicare, varying for commercial plans) to maintain coverage of PAP supplies. The decision to repeat testing should be made with your sleep physician based on clinical change, not on a fixed schedule alone.
We're asked this question on a daily basis.
Usually, it's one of the following reasons:
1. You're a CPAP user and would like a new machine.
If your CPAP machine is more than a few years old, you may be interested in a new machine. Most insurances will cover a new CPAP every 3 to 5 years (learn more here).
In recent years, machines have become smaller, quieter and most now have wireless compliance monitoring so you can keep track of your progress (and no longer have to mail in your smart card if you need a compliance report).
In this case, your insurance company may require a new sleep study to show that you still have sleep apnea. If this is the case, you may be able to get by with only a home sleep test to confirm your diagnosis (learn more about HST here).
If, like many CPAP users, you dread the though of a night without your CPAP (you can't use HST equipment and CPAP at the same time), you may prefer to go to the sleep center for a 50/50 or split night study (learn more about different sleep study types here).
2. You've gained or lost weight
If you've had a significant change in your weight since starting CPAP therapy, you may benefit from a different treating pressure. Going into the sleep center for a titration study will allow you to have a full night's sleep while the technician adjusts your PAP pressure up or down to find one that eliminates all or most events.
Some people using CPAP therapy find that they lose weight immediately after starting therapy due to increased energy levels from getting more sleep. Read more about how CPAP can effect weight loss here.
3. You suspect you need a pressure change
If you're a seasoned CPAP user, you can probably tell when your pressure requirements change. If you're using a CPAP (not an autoPAP which automatically adjusts the pressure throughout the night, learn more about that here) and would like to change the pressure, you will need a new sleep study to determine the new pressure.
4. You want to try bilevel PAP therapy
If you are using CPAP at a high pressure or suspect that you may benefit from bilevel therapy, most insurance companies will require that you demonstrate CPAP intolerance during an overnight sleep study.
Typically, you will arrive for a full night titration study and will start with CPAP therapy until a high pressure is reached or if you become uncomfortable with the CPAP pressure. Read more about insurance coverage for bilevel PAP therapy here.
5. You're still experiencing symptoms even though you're using CPAP
If you're still feeling very sleepy during the day even though you're using CPAP therapy, you may not have a good treating pressure or may be suffering from another sleep disorder (learn more about different types of sleep disorders here).
In some cases, an additional sleep study to evaluate your pressure needs should be discussed with your physician. Alternatively, you could request a consultation with a sleep specialist (we can help facilitate consultations in Southern California here).
Are you a current CPAP user in need of a sleep study for one of these reasons? If so, contact us today to schedule your appointment!
Other posts you may find interesting:
Frequently asked questions
There is no fixed routine repeat schedule for asymptomatic adherent patients. Repeat testing is indicated when there is meaningful weight change (10 percent or more), new symptoms, device-type changes, persistent intolerance, or before alternative treatments such as Inspire therapy. Some insurance plans require periodic re-evaluation for continued coverage.
Possibly. A 10 percent body-weight reduction is associated with average AHI reduction of about 26 percent based on cohort data, which may allow a lower therapeutic pressure or, in some cases, allow discontinuation of PAP entirely. A repeat sleep study is the only way to confirm the new pressure requirement.
Often, yes. Most insurance plans require documented CPAP failure plus a titration study identifying appropriate BiPAP pressures. Some payers accept a clinical trial without re-titration; check your specific plan rules with your sleep physician and DME provider.
Recurrent symptoms despite documented adherence can indicate residual OSA at the current pressure setting, a new contributor (weight gain, alcohol use, sedating medications), or a non-OSA sleep disorder (periodic limb movements, depression, idiopathic hypersomnia). Discuss with your sleep physician; repeat testing may be appropriate.
Medicare requires periodic re-evaluation rather than fixed repeat testing -- specifically, an annual physician visit to confirm continued benefit from PAP therapy. Repeat sleep testing is required only when there is a clinical reason (weight change, new symptoms, device-type change).
Ready When You Are
Take a home sleep test in California
FDA-approved devices delivered to your door. Board-certified physicians review your results. 100+ insurance plans accepted.