Sudden wake-ups, rapid heart rate, clammy hands?

[Nat213]

My boyfriend has been having this reoccurring night time wake up where he wakes up always within the first hour of his sleep. I am really concerned and I wanted to know if anyone knows what may be going on. So he is 47, very active, healthy eater, healthy weight. He wakes up out of his first sleep cycle and says that his heart rate starts flying and the feeling is awful. I was up with him the other night and after it happens he is very unsettled and cannot get back to sleep for a while since he is nervous over it.  At the time it happened his hands were both all cold and clammy and his heart rate was fast but I checked his blood oxygen level with an oximeter and it was normal (97%) I also checked his blood pressure about 5 minutes after his wake up and it was high (150/90) but then took it again 10-15 minutes later and it dropped back to a normal 130/70 and his heart rate also eventually dropped back to its regular around 50 bpm. I believe this is anxiety related and he HAS seen sleep doctors. All have said it is NOT sleep apnea. No one has done any type of sleep test on him, he does not have health insurance. Due to these issues I am concerned. If it is anxiety then O.K we will deal with it.. he has been dealing with work issues for a few years now. I am concerned about his physical health and well being and I want to make sure he is ok. It happens once a month to possibly a few times a week so its pretty irregular.
He hasn't seen a doctor for over a year. This has been going on for 2-3 years now and he did see a doctor about 1.5 years ago while this was happening and they checked his heart and said that it was very healthy

[aspen2]

I am confused.  How have the doctors determined that it is not sleep apnea, given that he has not had a sleep study?