Author Topic: CPAP, Insurance won't allow sleep study?  (Read 7346 times)

Offline old head

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CPAP, Insurance won't allow sleep study?
« on: February 04, 2018, 04:22:00 PM »
So, my dad, my brothers all have sleep apnea and have CPAP machines.  Wife says my breathing is erratic, I fall asleep easily during the day.  Snore loud and alot.

I went to the doc and he requested a sleep study, my insurance said they wouldn't pay for it as I don't have any other health issues. 

I will go back to the doc and see what options are, but any suggestions for home sleep study?

CPAP machine  how do you choose?  I see you can buy one without a prescription and they don't seem all that expensive.

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Re: CPAP, Insurance won't allow sleep study?
« Reply #1 on: February 04, 2018, 04:52:18 PM »
CPAP machines come in two flavours, fixed and auto. A fixed machine will ramp up to a fixed level, and an auto machine will set a level based on the number of "events" it detects while you're asleep. An auto machine can also be set at a fixed level.

I recommend having a sleep study. The initial number of events (where you stop breathing) will be indicative of what level the machine should be set at in the beginning. After a while, your doctor can then recommend what level to set it at. An auto machine usually will ramp between 4 and 20. Eventually it will settle on a level that minimises events. Once this level is known, you can set that as the max level to reduce random increases to 20, when you may only need to go to 10.

You should be able to rent one for a few months to a) get used to it, and b) find the level you need. Auto units cost more than fixed level ones.

For the machine, get one that has the ability to lower the setting when it detects your awake. If you wake up in the middle of the night for some reason, you want it to lower the level to minimum until you fall asleep again.

Get one with a heated hose, and a humidifier. Don't skimp.


Offline wrbix

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Re: CPAP, Insurance won't allow sleep study?
« Reply #2 on: February 04, 2018, 04:53:12 PM »
Probably just an aside and/or conjecture.....but in my decades of medical practice I don�t think I ever saw a NEGATIVE sleep study, making me wonder if it was an overdiagnosed condition. Wonder if the insurance coverage pendulum has therefore swung towards refusals of late.
Just conjecture.
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Re: CPAP, Insurance won't allow sleep study?
« Reply #3 on: February 04, 2018, 04:54:45 PM »
Also, the sleep study will determine whether you need a full-face mask or just a nose mask, etc.

I can stress enough how important the study is.

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Re: CPAP, Insurance won't allow sleep study?
« Reply #3 on: February 04, 2018, 04:54:45 PM »

beetle

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Re: CPAP, Insurance won't allow sleep study?
« Reply #4 on: February 04, 2018, 05:09:09 PM »
Probably just an aside and/or conjecture.....but in my decades of medical practice I don�t think I ever saw a NEGATIVE sleep study, making me wonder if it was an overdiagnosed condition. Wonder if the insurance coverage pendulum has therefore swung towards refusals of late.
Just conjecture.


My sleep specialist says she has never seen a negative result either, but the data can speak volumes. If you only have 3-5 events per hour, that's fairly normal and probably should've diagnosed as sleep apnoea.  If you have 57 events per hour, like I did, then it's a no-brainer.


Offline Lannis

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Re: CPAP, Insurance won't allow sleep study?
« Reply #5 on: February 04, 2018, 05:13:57 PM »
Nobody in our family has the issue, so I can't speak specifically to sleep studies ....

.... but if it's as important as the guys with sleep apnea issues say it is (and I have no doubt it is), then just get it done (or have it done at home), and don't worry about whether your Medicare or VA or NHS or Medicaid or Blue Cross or whoever is going to pay for it ... just go ahead with it!

I've done that for other conditions, and found that if you go in and tell them it's "Self Pay", you might be surprised at how reasonable it can be ....

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Offline ITSec

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Re: CPAP, Insurance won't allow sleep study?
« Reply #6 on: February 04, 2018, 05:20:29 PM »
While I don't have the condition myself so far, I've spoken with many who have, and read a fair bit. I also have a fair bit of experience arguing with health insurers.

Seems to me the sleep study should NOT be treated as a diagnostic step, but as a test to determine the method of treatment. The diagnosis is already in place; but just as with many other conditions a test may be necessary to determine the best method of treatment and the level of care or strength of prescription required. Ask your physician if this matches his/her view of your health.

You don't establish insulin doses without blood tests. You shouldn't set CPAP treatment plans without appropriate testing either. Be persistent with your insurer using that argument. It may also mean a lower costs for your CPAP gear and supplies in the long run.

As Lannis said, if you do have to pay for it yourself, ask the lab what the lowest charge they have negotiated with an insurance company might be - and offer to pay that amount, without them having to bill and wait. Lots of health service providers are very willing to consider such arrangements, as long as they don't have to wait for payment.
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Offline Lannis

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Re: CPAP, Insurance won't allow sleep study?
« Reply #7 on: February 04, 2018, 05:40:42 PM »
... if you do have to pay for it yourself, ask the lab what the lowest charge they have negotiated with an insurance company might be - and offer to pay that amount, without them having to bill and wait. Lots of health service providers are very willing to consider such arrangements, as long as they don't have to wait for payment.

Sometimes you have to do a little convincing, since most offices are shocked SHOCKED I tell you that you just want to pay on the spot and done.   Most doctor's offices have 1 or 2 doctors, 3 nurses, and 16 people to manage insurance, Medicare, accounts receivable, billing, payment plans, deductibles, co-pays, and all that stuff ....

Again, don't let your health wait on all that.

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Offline Rick in WNY

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Re: CPAP, Insurance won't allow sleep study?
« Reply #8 on: February 04, 2018, 06:00:49 PM »
Sleep study is a good thing. My wife just had one a few weeks ago. She was concerned because both her parents have a CPAP.

Turns out she has elevated blood pressure, not breathing issues. But we wouldn't know that unless she'd had the sleep study.
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Orange Guzzi

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Re: CPAP, Insurance won't allow sleep study?
« Reply #9 on: February 04, 2018, 08:19:25 PM »
Why do you need a doctor to tell you what you already know?  Go on Craiglist, look up CPAP and pick one out.  There are hundreds for sale.  No prescription and cheap. 

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Re: CPAP, Insurance won't allow sleep study?
« Reply #10 on: February 04, 2018, 08:26:39 PM »
Nobody in our family has the issue, so I can't speak specifically to sleep studies ....

.... but if it's as important as the guys with sleep apnea issues say it is (and I have no doubt it is), then just get it done (or have it done at home), and don't worry about whether your Medicare or VA or NHS or Medicaid or Blue Cross or whoever is going to pay for it ... just go ahead with it!

I've done that for other conditions, and found that if you go in and tell them it's "Self Pay", you might be surprised at how reasonable it can be ....

Lannis

I tried that.  The Smarty pants at the little window said she had know idea how much it would cost.  I told her she had plenty of time to figure it out because I am not keeping my appointment.  Leaving them with an empty room for the night.  Funny, I can go to McDonalds and make a special order with 16 year old newby behind the counter and they know how to price it and get the order right.  I hate the medical world.  It is full of fraud.  Based on the assumption that we are in the hands of experts. 

Offline Shorty

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Re: CPAP, Insurance won't allow sleep study?
« Reply #11 on: February 04, 2018, 08:45:23 PM »
I  saw a CPAP forum, and it looked like it used the same template as WG uses. I found it amusing, because, just like we list our bikes below, those guys listed their CPAP machines, ramp levels and other details... :grin:

I found this link to CPAP without a prescription. I personally use a RESmed machine. My insurance would not pay for my sleep study, but they did allow the doc to give me a home test kit. It was nothing more than a little machine the size of a pack of smokes, a cannulus, and hose to connect to my nostrils.

Here is the link:   https://www.easybreathe.com/CPAPRX-Overview-80.html?utm_source=bing&utm_medium=cpc&utm_campaign=Desktop%20-%20Manual%20Bing&utm_term=cpap&utm_content=Plus%20CPAP%20-%20Manual    Good luck!

CPAP forum:   http://www.apneaboard.com/forums/Forum-Main-Apnea-Board-Forum
« Last Edit: February 04, 2018, 08:49:55 PM by Shorty »
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Offline Guzzistajohn

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Re: CPAP, Insurance won't allow sleep study?
« Reply #12 on: February 04, 2018, 08:49:58 PM »
If you have osa getting the machine could save your life. Do it.
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Offline Lannis

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Re: CPAP, Insurance won't allow sleep study?
« Reply #13 on: February 04, 2018, 08:50:36 PM »
I tried that.  The Smarty pants at the little window said she had know idea how much it would cost.  I told her she had plenty of time to figure it out because I am not keeping my appointment.  Leaving them with an empty room for the night.  Funny, I can go to McDonalds and make a special order with 16 year old newby behind the counter and they know how to price it and get the order right.  I hate the medical world.  It is full of fraud.  Based on the assumption that we are in the hands of experts.

Yep.   Dealing with the money/insurance/billing part of almost any medical establishment is like dealing with the DMV when you hand them an Australian title and customs paperwork and want it transferred to you.   You have to explain it to them, or find the person who CAN deal with your issue. 

On the technical (not the business) side, I've known my doctor since we were in school together, and I have no doubts about his competence.   There's not many people I'd trust to stop my over-revving heart with an injection, count six seconds, and be ready with the paddles if it didn't start on its own (in the right rhythm this time) .... !

Lannis
« Last Edit: February 04, 2018, 08:53:27 PM by Lannis »
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Online antmanbee

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Re: CPAP, Insurance won't allow sleep study?
« Reply #14 on: February 04, 2018, 08:51:04 PM »
Sleep apnea is most common in people with excess weight. Losing weight and getting to a low BMI usually helps considerably. Also acid reflux  is a contributor. Raising the head of your bed with some blocks 4-6 inches will allow gravity to keep the acid in the stomach. You still lay on a flat mattress only it is slanted down ward several degrees. Cut out all dairy (milk, cheese, yogurt, ice cream, sour cream, etc) including packaged foods with dairy proteins to eliminate excess mucus. It has been working great for me. No CPAP needed and I stopped snoring. I lost about 35-40lbs. All this will cost you nothing.

Offline leroysch

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Re: CPAP, Insurance won't allow sleep study?
« Reply #15 on: February 04, 2018, 09:06:47 PM »
  I hate the medical world.  It is full of fraud.  Based on the assumption that we are in the hands of experts.

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Offline Chesterfield

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Re: CPAP, Insurance won't allow sleep study?
« Reply #16 on: February 04, 2018, 11:51:12 PM »
I thought we had the best medical care in the world? My Dads 2 day stay in the hospital for hip replacement has turned into 7 days plus he is has been in rehab for 2 weeks and likely 2 more because the surgeon was overly aggressive and tore muscles and blood vessels in his groin. It was a 3 month wait to have the surgery. My experience with some physicians lately has been suspect. I am not impressed.

Offline SemperVee

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Re: CPAP, Insurance won't allow sleep study?
« Reply #17 on: February 05, 2018, 10:30:28 AM »
 OR ***   You can be fitted with a durable medical device mouth guard as that was my choice - and it has 95% taken care of my occasional snoring and moderate apnea.   Manufactured to custom fit by a dentist.
« Last Edit: February 05, 2018, 10:31:54 AM by SemperVee »
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Offline Dilliw

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Re: CPAP, Insurance won't allow sleep study?
« Reply #18 on: February 05, 2018, 03:00:15 PM »
CPAPs and sleep studies are a racket!  I know because I'm a CPAP user and my DR is a friend of mine.  He lights up when someone thinks they have sleeping problems (or when there's a Workman's Comp case but that's his other racket).  He set up his own sleep study center in his office once he figured out how much the local "sleep study center" was making!  Did I say it was a racket???

http://www.sleepguide.com/forum/topics/sleep-apnea-as-a-diagnosis-a


I just went online and bought an autopap with cash.  I buy all my supplies that way too.  The site I use, cpap.com, requires a prescription but as you've found out others don't.

I don't see any reason why you couldn't "roll your own" CPAP setup.  I would go with an autopap and set the initial range between 7 and 11.  I would then go with a full face mask, give that setup a few nights and DON"T be a quitter.  Full face masks are the hardest to get used to so if you can handle that setup then you are good to go.  It takes a few sleeps to get the hang of things and about a month to get addicted.  After a couple of weeks you should be able to figure out if you need more pressure or not.  With the autopap you will be able to feel the difference between those pressures and will quickly know what's the best for you.

But be warned, these things are addictive!  Once you start sleeping prolong periods of deep, dark REM sleep you won't want to go back.  And no more hangovers!  I'd say that's been the biggest side effect for me as my drinking has increased significantly :)

I would suggest either ResSmart Auto by 3B (about $400 online) or the Intellipap by DeVilbiss (that's the one I have) for about the same when it goes on sale.  You need a humidifier (an option on the Intellipap) and just get the basic tube.  Then start with the Fisher & Paykel Simplus Full Face.  It's a no frills full face for less than $100 and it's the best of the cheap masks.  That setup should run you less than $600 delivered.  Not bad given that they will make you do two sleep studies at about $2k each then make you rent a crappy CPAP or Bi-PAP for about $200/mo for a year and make you buy your supplies from a local medical supply and pay huge markups.

Disclaimer.  I'm not a doctor and don't play one on TV.  I'm sure you know the actual value of a post on a motorcycle forum recommending medical equipment!
« Last Edit: February 05, 2018, 03:19:43 PM by Dilliw »
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Offline Pop

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Re: CPAP, Insurance won't allow sleep study?
« Reply #19 on: February 05, 2018, 05:31:48 PM »
I have had a Cpap since 1989. Working 12 rotating shifts left me completely exhausted. The bit about helucinations and wake dreaming almost cost me my job and my life. I still hate to wear the apparatus but would not try to sleep without it.
You have to get tough with your insurance. Call your states med board. Don't give up. Sleep apnea is a killer.
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Offline FrontRangeRider

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Re: CPAP, Insurance won't allow sleep study?
« Reply #20 on: February 05, 2018, 07:29:05 PM »
Like others have posted, sleep apnea can kill you or seriously shorten your life.  While it is most common in folks who are overweight, it also can happen to those of us who are physically fit and with a healthy BMI.  I use a ResMed S9 Autoset (auto CPAP) set with a range of 6-12 cm/H20 pressure range.  My quality of life definitely improved when my doctor diagnosed my condition and I was prescribed a CPAP machine.  There is a wealth of information at apneaboard.com; recommend you visit that site and register for an account so that you can ask questions.


Offline Lannis

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Re: CPAP, Insurance won't allow sleep study?
« Reply #21 on: February 05, 2018, 08:03:54 PM »
I thought we had the best medical care in the world? My Dads 2 day stay in the hospital for hip replacement has turned into 7 days plus he is has been in rehab for 2 weeks and likely 2 more because the surgeon was overly aggressive and tore muscles and blood vessels in his groin. It was a 3 month wait to have the surgery. My experience with some physicians lately has been suspect. I am not impressed.

There are good and bad doctors just like there are good and bad lawyers, engineers, mothers, artists, politicians, DMV office managers, pilots, Army colonels, and trumpet players.

If you need one, find a good one.   We all know there are bad ones around, no need in complaining about it and saying "It's all bad here, isn't it?"   It's not.   There are perfectly competent doctors around that can make your life better and longer ... like finding any other competent professional, you've got to go do it ....

Lannis
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Re: CPAP, Insurance won't allow sleep study?
« Reply #22 on: February 05, 2018, 10:32:05 PM »
Like othersr have posted, sleep apnea can kill you or seriously shorten your life.  While it is most common in folks who are overweight, it also can happen to those of us who are physically fit and with a healthy BMI.  I use a ResMed S9 Autoset (auto CPAP) set with a range of 6-12 cm/H20 pressure range.  My quality of life definitely improved when my doctor diagnosed my condition and I was prescribed a CPAP machine.  There is a wealth of information at apneaboard.com; recommend you visit that site and register for an account so that you can ask questions.
:1: I also use and recommend the same model.

Although a full sleep study was available to me if needed, the take-home monitor proved adequate to diagnose my problem. I recommend that too.

I was picky in choosing my machine, actually switching clinics to avoid a poorly designed model. Consider using the ResMed Airlift nasal pillow instead of a full mask.

Do work with a competent physician.

It turned out I don't need the humidifier (that comes with my unit), since my uncontrollable nasal drainage does the job!

It's a great device, well worth your time and money to get right. I've lost a lot of weight since mine was prescribed, and might not really need it now, but it still seems to help me get a good night's sleep, and I'm glad to use it.

Offline O

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Re: CPAP, Insurance won't allow sleep study?
« Reply #23 on: February 06, 2018, 07:21:19 AM »
:1: I also use and recommend the same model.

Although a full sleep study was available to me if needed, the take-home monitor proved adequate to diagnose my problem. I recommend that too.

I was picky in choosing my machine, actually switching clinics to avoid a poorly designed model. Consider using the ResMed Airlift nasal pillow instead of a full mask.

Do work with a competent physician.

 :1: to this.  My insurance would have paid for a sleepover study, but my sleep disorders Dr. first sent me home with the portable test (nasal cannula, electrodes, and O2 finger sensor).  Try this route first.

You generally only need a full face mask if you're a mouth breather, so definitely consider just nasal pillows if you can.

While not quite as bad as Beetle's experience, my breathing was stopping about 27 times an hour, and my O2 saturation percentage was down to the high 70s (high 90s needed for proper brain/heart health).  I was 35 and not overweight when diagnosed.

The CPAP is a pain in the ass, but completely worth the trouble.
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Offline John Ulrich

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Re: CPAP, Insurance won't allow sleep study?
« Reply #24 on: February 06, 2018, 09:02:28 AM »
I've been a user for 7 years and have sleep well for 7 years now!
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Offline john hooper

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Re: CPAP, Insurance won't allow sleep study?
« Reply #25 on: February 06, 2018, 01:20:07 PM »
As it says above you can get a good idea wether  you need a cpap machine or not via the use of an o2 sensor to access your blood oxygen  levels through the night, when i was diagnosed the consultant looked at my results (the worst he had ever seen) and issued  me with a machine. Sleep apneoa can kill it's  important to get treatment  as soon as you can, I've  never regretted  it.

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Offline Griso8V

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Re: CPAP, Insurance won't allow sleep study?
« Reply #26 on: February 06, 2018, 02:17:02 PM »
I have pretty bad sleep apneia.  I was found to have pretty bad apneia after the sleep study. 
My symptoms prior to the CPAP machine where ongoing daily sleepyness and fatigue, and the worst was really bad heart burn. :coffee:  I had no idea what was going on.  I tried diet, stopped eating anything that would cause heartburn, including wine and beer, nothing helped.  Oh, and I snored like crazy. 
At the time I was in very good condition, running training for a marathon.  Not over weight.  Finally, had the study done and got the Cpap machine.  They told me that it would take a while for the CPAP to have an affect.  WRONG:  The first day after the first time I used the CPAP I felt rested, in about a week the heartburn went away.
So, as far as I am concerned, CPAP's and sleep apneia is NOT a racket!  I feel much better now on the CPAP.

Offline craigclu

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Re: CPAP, Insurance won't allow sleep study?
« Reply #27 on: February 06, 2018, 03:50:12 PM »
Do it....  My sleep study attendant told me that if I was better looking, I could be a sleep apnea poster boy.  You gradually drift into worse and worse sleep over time and forget what a refreshed, truly rested deep sleep feels like.  They had a hard time waking me in the morning and it was like I was coming out of a coma.  It was very dramatic.  I noticed on the 45 minute drive home that I could even see better with individual leaves flickering in the trees.  It was life changing.  That was 10 years and I haven't had a single night without a CPAP.  It's awkward for things like rallies and camping but there is usually a workaround to be figured out.
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Re: CPAP, Insurance won't allow sleep study?
« Reply #28 on: February 06, 2018, 04:15:22 PM »
You generally only need a full face mask if you're a mouth breather, so definitely consider just nasal pillows if you can.

I'm a mouth breather, as my son is fond of pointing out, because my nasal congestion/drainage is so bad. But I use the nasal pillow without a problem. Just blow your nose before putting it on (the standard recommendation anyway).

I was dubious about the prospect of keeping my mouth closed while I slept, but it's no problem.

When I get up in the morning I find I don't usually want to take off the CPAP, since I breath so much better with it. In my case, part of the advantage is that it keeps the drainage from being a problem.
« Last Edit: February 06, 2018, 05:11:30 PM by Moto »

Offline V7Record

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Re: CPAP, Insurance won't allow sleep study?
« Reply #29 on: February 06, 2018, 06:59:53 PM »
Even if you use a nasal pillow and find you are opening your mouth (which can cause severe drying) they have chin straps to keep your mouth closed.  Looks crazy but is comfortable.  Another benefit is I can fall asleep in minutes rather than lying awake for an hour or more.

 

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