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September 28, 2010 6:41 PM   Subscribe

Where can one get treatment for a sleep disorder without insurance?

My boyfriend has had a longstanding issue with getting sufficient sleep. He has ADHD, as well a sleep apnea. He has diagnosed himself with Circadian Rhythm Disorder, and regularly is still up when I am getting up to go to work. He barely ekes enough sleep to get by, and does better when he can take medication such as Ambien. Now that he is living in NY, I have been urging him to look into treatment. Unfortunately, he is job hunting, and has precious little money, and no insurance to boot. Does anybody have any recommendations on a sleep center that will accept patients without a doctor's referral and without insurance? Any and all suggestions are appreciated.
posted by computech_apolloniajames to Health & Fitness (9 answers total) 2 users marked this as a favorite
 
He might want to try one of those cheap little rubber apnea-specific mouthpieces you can get from eBay; in my experience, those things can be astonishingly effective.
posted by darth_tedious at 6:55 PM on September 28, 2010


Awake in America might be able to help.
posted by availablelight at 7:03 PM on September 28, 2010


Melatonin from Trader Joe's and Breathe Right strips usually work for everyone, but he could look on CL for clinical trials or sleep studies.
posted by Ideefixe at 9:21 PM on September 28, 2010


Ambien has gone generic and is really cheap now, if he can get a doc to write for him.
posted by dancestoblue at 9:53 PM on September 28, 2010


First, call your local sleep center and ask for non-insured pricing. SA is a serious condition and until he can get treatment he can try a couple of things. Most SA sufferers don't have symptoms when they sleep on their side as the blockage is from gravity pulling down on membranes in the throat. I have SA and have migrated off CPAP since I've been able to teach myself to sleep on my side. There are a few tricks to doing this, you can google the tennis ball trick for details. You can also try the mouthpiece darth_tedious mentions, although I think its easier to sleep on your side than with something in your mouth but YMMV.

Delayed sleep and insomnia are difficult to crack. I also have delayed sleep. I find having a set hour where I unplug from anything that might make my mind go off or blood boil (news, web forums, violent video games, etc) helps a lot. At that time I usually take some melatonin and go to bed and read for 30-60 minutes and fall asleep. In worst case scenarios I take Ambien, but I find tolerance builds up very quickly and its not something to take casually because of side-effects (being stoned out of your mind and doing stupid things if it doesn't put you to sleep).
posted by damn dirty ape at 8:08 AM on September 29, 2010


Response by poster: Thanks for the answers so far, everyone. He cannot take melatonin, as it gives him terrible side effects. He already sleeps on his side, so the apnea is not an issue as far as we know, but I wanted to mention it.

Ambien is one of the only drugs he can take that allows him to sleep without side effects. I am not aware of Ambien being sold as a generic. He has no insurance, so he would have to look into a clinic doctor that would be willing to write a scrip. He's bought it off the int'l market in recent years, but that seems to be tougher to be had nowadays.

I will look into the Awake in America. I've also contacted a couple sleep centers in town to see if they can work without someone without insurance.
posted by computech_apolloniajames at 9:47 AM on September 29, 2010


You don't need to contact a sleep center to get an Ambien prescription. A GP can do that. You can call the local GPs in your area and ask what the non-insurance price is for an appointment. You can also check out your local state or country resources to see if he qualifies for any low-income healthcare benefits.

Also, OTC alternatives to melatonin that might help are valerian root and L-Theanine. I've had a lot of success with L-Theanine, it a precursor to GABA, which is the brain's relaxation neurotransmitter. 200-400mg can be very relaxing. Its sold OTC and can be found at retail stores like the Vitamin Shoppe. Its also pretty important to cut out caffeine or at least minimize it to a green tea/soda or two a day, not a coffee or two.
posted by damn dirty ape at 10:20 AM on September 29, 2010


Self-treating for sleep apnea with widgets and pillows is a terrible idea. (Sleep apnea doesn't just cause interrupted sleep; it can cause death through stroke, etc.) I'm curious as to what indication there is that sleeping on his side is clearing it up--for a lot of people, that will reduce or eliminate the sounds and visible evidence of snoring, but won't stop the actual, dangerous apneas at all. CPAPTalk is a pretty good forum that may have resources for general help for people without insurance.

Best wishes to him.
posted by wintersweet at 11:53 AM on September 29, 2010


Yes, he should see a professional ASAP, but in my case, my own sleep study verified that sleeping on my side eliminated my apnea events. If he can't see someone for 6 months then it can only help him to sleep on his side.
posted by damn dirty ape at 12:26 PM on September 29, 2010


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