Work and Sleep Study Troubles

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
RogueWarrior
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Work and Sleep Study Troubles

Post by RogueWarrior » Wed Oct 29, 2014 1:36 pm

Hello, all. I'm new to the boards here, but I'm so stressed out I just really need some advice/suggestions/reassurance.

I was tested for sleep apnea for the first time about seven years ago by my PCP at the time. The first sleep study went poorly, not only was it miserable to attempt to sleep with wires hooked up everywhere, but I just barely didn't have enough apneas (or whatever they're called) to qualify me for a machine. A year or two later she convinced me to go again, and this time I barely had enough to qualify me, but not enough where they woke me halfway through to fit me for the machine. So I was going to have to go back AGAIN to take another one, and considering I was registering at "borderline", I figured "Forget it", and I didn't go. I know OSA is often weight related, and I just tried to focus on losing weight instead, hoping that would help.

Well, flash forward five, almost six years. I haven't had much success in the weight loss department - a little bit last year, around 20 lbs., but only after having probably gone up about 70 lbs. or so in that five year stretch of time. So overall, I'm probably about 50 lbs. heavier than I was back when I got those initial sleep tests done.

In the meantime, I finished my degree and found a job I love that I have been at now for approaching five years. It's a fairly active job, retail sales for furniture, so I don't have a lot of opportunities to doze off. I've tried to self treat as much as possible, switching to primarily side sleeping and, last year, purchasing an adjustable bed that allows me to sleep tilted up. I feel like those things help a bit, but I do still doze off on occasion, when I'm either working on customer issues at the desk or sitting around waiting on a customer to show up. (There's a lot of waiting in furniture and mattress sales, LOL). There are days when I feel drowsy and catch myself nodding off a bit, so I stand up and walk around, try to wake myself up, even get a bit of caffeine if I'm desperate (I usually stay away from the stuff, it tends to make me even sleepier when I crash and I gave up about 80% of my caffeine habit last year, around the time I had that 20 lb. weight loss).

Well, this was working just fine for the last four years, until my old manager got a promotion and moved on. My old manager mentioned it to me once because he had a customer say something, and I apologized and did my best to address it. It didn't come up again after that. I got a new manager, someone I can best describe as "weak", "timid", or a "company man". If upper management says "jump", he says "how high, sir?". And sure enough, within a couple months of him being here, "someone" reports me to HR for falling asleep on the job. I don't have evidence it was him, of course, but it seems highly unlikely that it would be anyone else, since no other staff changes had happened in the months leading up to his arrival. But then again, who knows. Maybe a customer DID say something. Maybe one of my fellow employees was just waiting for new management to try rocking the boat a little. Well, once HR got involved, they started watching me like a hawk, notifying members of the team to keep an eye out and watch me. So if I doze off, even for just a few seconds before catching myself and trying to wake myself up, someone's running to HR to report it.

So I've been doing this thing where they give me a paper, put me on an action plan of some sort, "what can we do to help?", yadda yadda. It basically feels like they're covering their you-know-what until they can fire me, so they won't have to pay unemployment when they do. I didn't really know what to ask for, I knew CPAP would probably be the only thing that would help, but until I could get into that doctor and do something it was implied that unless there was some "accommodation" that I could ask for, then I was going straight to disciplinary measures. So to stave them off a bit, my PCP signed paperwork stating that I not work after 9 pm, to help me get on a bit more regular of a sleep schedule (I work retail swing shifts, anywhere from 9:45 am to 10 pm), and then that they give me a device (something I found online called "Doze Alert", mostly marketed to truckers) that would alert me if I started to nod off, based on the position of my head. During this time I was playing phone tag with the doctor over this (and a couple unrelated issues, that she was stalling this because of - I'm looking to replace her, and am not at all happy with my treatment during this whole ordeal. She was basically holding this stuff over my head until I went in to do other tests that all came back negative. She's a very fat-shaming type of doctor, the kind who chalks everything up to your being overweight, and orders a billion tests to confirm it). Anyway, I eventually got a referral and an appointment with a doctor at the pulmonary center, who said "Okay, let's get you a referral for a sleep study", and filled out my latest set of paperwork from my job for me.

I played phone tag with the sleep study people, waiting for a call, calling again, getting a message, leaving a message. Took me a week and a half to get ahold of them. In the meantime at work, I'm trying not to sit down much or give myself many opportunities to doze off. But I am also recovering from a stress fracture on my foot, I work standing retail, and I weight 400 lbs. So one day my foot is giving me stabbing pains, I sit down for just a minute to try and take the pressure off of it, and I doze off for a couple seconds. I feel myself doing it, and I'm kind of doing that half-awake thing in my head, "Stop it, get up, move around, come on", but before I can get myself to stir and move around, I hear my sales manager call my name. The whole incident was probably five to ten seconds, he just happened to walk out at the right time.

Sure enough, about a week later (last Thursday), they pull me into the back office, and put me on temporary suspension. They give me paperwork to give my doctor again, because at this point they've "complied with my requests, but are concerned that it doesn't seem to be helping". I'm upset and angry, of course, but I try to keep it hidden. I leave work, I go home, make phone calls and get the sleep study scheduled (finally!) for last night.

Now, I don't have great experiences with sleep studies, obviously. So yes, I'm nervous about going in. But I usually don't have an issue falling asleep at home, or anywhere I have a comfortable bed, even if I have some anxiety. But last night's sleep study was just AWFUL. The beds are SO HARD, I just couldn't get any sleep at all. I sleep on a bed at home that is a medium-firm memory foam hybrid, so it feels very soft even though it's still supportive. On this sleep lab bed my hips hurt, my back hurt, no matter which way I turned it was a nightmare. I tried to sleep on my back because I knew the apnea episodes are usually worse when I'm ON my back (if I fall asleep on my back at home without the bed raised, I almost always wake up groggy and feeling awful), but eventually I gave up and tried sleeping on my side, or any direction that I could manage. I must have woken up at least 8-10 times last night, and the most I usually wake up is once, to go to the restroom. To make it worse, I didn't have enough episodes for him to come in and fit me for the device, and I'm afraid I didn't have enough episodes for my doctor to even say officially that I HAVE sleep apnea, and then I'm super scared for what's going to happen to my job. I really love my job, I've been there almost five years, I have good benefits, about to get more vacation time, all that stuff. I don't WANT to start over somewhere new, especially in this economy, and having been fired from my last job for falling asleep!

I have textbook symptoms of sleep apnea otherwise - daytime sleepiness, ESPECIALLY if I'm mentally inactive, like waiting for a customer, sitting through a training powerpoint, reading something I don't find interesting, or something like that. Driving sleepiness as well, unless I'm doing something to keep myself awake, like eating or talking to someone on the phone or something. There are times during days when I'm running errands and driving around a lot that I will actually find a shady spot in a doctor's office parking lot or something, and take a twenty minute nap just so I'm not so tired driving.

This has been a much longer post than I intended it to be, but I was just so stressed. Thank you to anyone who's made it this far, and I appreciate any feedback/advice/assistance you can provide. I've read about at-home tests, and not sure if I would qualify for that. Have also read about people taking Ambien to sleep, and maybe that would help a little with the anxiety, but I don't see how it would help with the discomfort from the brick-like beds they make us sleep on at the sleep labs. (It's the same way for me at a lot of hotels, or in a hospital bed as well). The tech kind of acted like it didn't matter anyway, that he didn't see much from the times I was asleep, but if I'm sleeping so uncomfortably/restlessly, can they really get an accurate reading? Ugh. This whole thing is just stressing me out sooooo badly!

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Wulfman...
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Re: Work and Sleep Study Troubles

Post by Wulfman... » Wed Oct 29, 2014 2:15 pm

Sleep Apnea is considered a "disability" by the ADA. Once you get your equipment and being treated by therapy, you shouldn't have any problems (theoretically). So, what you need in the meantime is a note from the doctor indicating that you're being evaluated for Sleep Apnea and that the employer should back the Hell off because it's a medical condition and can be successfully treated.

Then, you need to take a copy of that note to your supervisor and the HR department (if you have one) and keep a copy for yourself. And, document the discussions, etc......dates, times, names.

No guarantee they can't get rid of you, but there was a story recently about a policeman who won a $2 million award for being fired because of it.

Good luck.

Den

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mossytreesprite
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Re: Work and Sleep Study Troubles

Post by mossytreesprite » Wed Oct 29, 2014 2:16 pm

Wow, sounds like you're having a rough time. I'm new to this, so I can't comment too much on the technical side, but it sounds like if you couldn't sleep at the sleep lab, they may not have been able to get a good enough amount of data to make the assessment. I've had 2 of them, and both were pretty rotten nights, so I can relate. I would lean towards not bothering with a take home sleep study, since they aren't as sensitive as the lab studies, but at the same time, they are way less expensive and you might actually be able to fall asleep well enough to collect more hours of sleep data.

I'm sure there are others who can give you better and more advice, but I just want to wish you luck. I worry about my performance at work a lot. Honestly, the only thing that saved me over the past few years (before I knew about my sleep apnea problem) is that I started exercising regularly (4-5 times a week) for the past 2.5 years. It really helps with my depression as well, since medications never really worked for me, and I think the extra circulation and oxygen has been beneficial to counteract some of the apnea effects.

I hope you start feeling better!
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kaiasgram
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Re: Work and Sleep Study Troubles

Post by kaiasgram » Wed Oct 29, 2014 3:00 pm

Welcome to the forum RW. Don't give up. If your insurance won't cover another sleep study, can you afford a home study out of pocket? There are a variety of different home tests ranging in thoroughness and of course price. But one of the less expensive ones might be all you need to get a legitimate diagnosis. With the diagnosis you can then get a prescription for machine and supplies. Many folks have gone that route and done well -- assuming you have plain old garden variety obstructive sleep apnea, you can use free software from a good data capable machine to fine tune your pressure(s) for optimal therapy. Ask questions, we're here to help and support.

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borgready
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Re: Work and Sleep Study Troubles

Post by borgready » Wed Oct 29, 2014 6:09 pm

At 400lbs do yourself a favor and lose the weight. Once you kick the carb addiction of the first couple of weeks it gets easier. Kicking the addiction is hard. High calorie foods will make you sleepy and lazy. I even think sugar diabetes makes you tired. How old are you?

Yeah, your first focus should be losing weight. If your sleep apnea is not so bad that they are boderline on flagging you with sleep apnea be thankful. If you do start losing weight you, your sleep apnea might get worse as things deflate and get saggy.

What do you eat? Say good bye to breads and pasta. They give you the carb high that is so addicting and they pack on the pounds.

RogueWarrior
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Re: Work and Sleep Study Troubles

Post by RogueWarrior » Wed Oct 29, 2014 6:26 pm

Borg,

Thanks for the input, but believe it or not at 400 lbs I'm well aware that I need to lose weight. I'm also well aware that it affects the sleep apnea, and that by losing weight it will most likely improve. I've spent about the last twenty years of my life trying to lose weight and not being successful at it. That doesn't mean I'm not still trying, but my weight issues are more complex than just "cut carbs", there's a lot of psychology there that you're not aware of. I know I need to cut carbs, I know the intricacies of low-protein diets fairly well, and am well aware of the role that Type-2 diabetes can have on one's health. I also keep track of that sort of thing through my PCP.

My concern is that the sleep apnea is affecting my job, RIGHT NOW. That is my immediate concern, because without a job not only can I not pay my bills, I won't have health insurance, and I won't be able to afford food, much less healthy food, which will make it QUITE difficult to lose weight. So if you don't mind, I'd like to keep the discussion to the topic at hand - my concerns about the test itself, and the work situation. Thanks.

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palerider
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Re: Work and Sleep Study Troubles

Post by palerider » Wed Oct 29, 2014 7:21 pm

RogueWarrior wrote: I'm also well aware that it affects the sleep apnea, and that by losing weight it will most likely improve.
you're wrong about that, your apnea may improve,not change, or indeed worsen.
RogueWarrior wrote:
I've spent about the last twenty years of my life trying to lose weight and not being successful at it.
your apnea works against your being able to lose weight.
RogueWarrior wrote:
So if you don't mind, I'd like to keep the discussion to the topic at hand - my concerns about the test itself, and the work situation. Thanks.
it's time you quit making excuses and do something about it.

buy yourself a machine, preferably an autosetting one, from secondwind cpap, or craigslist, piece together a mask from amazon or ebay, and start getting some sleep.

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Julie
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Re: Work and Sleep Study Troubles

Post by Julie » Wed Oct 29, 2014 7:23 pm

Is there a reason why you haven't considered lap-band surgery - over and done with and you could get on with your life.

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Re: Work and Sleep Study Troubles

Post by library lady » Wed Oct 29, 2014 7:47 pm

Rogue Warrior,
I feel your pain. I have a suggestion if you've had difficulty losing weight and you are serious about doing that. I rejoined Weight Watchers in July, and have lost 30 pounds since then - still have a long way to go. They have a really easy program now where you don't have to track the foods you eat and count your food points. It's cheapest if you get a monthly pass - $42 a month. It's a little pricey, but a very good program that concentrates on healthy eating, and it does work if you put your mind to it. The support and encouragement you get from the meetings is fantastic. If you go to http://www.weightwatchers.com you there is a link to finding out where and when there are meetings in your area.

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kaiasgram
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Re: Work and Sleep Study Troubles

Post by kaiasgram » Wed Oct 29, 2014 7:55 pm

RogueWarrior, I hope you'll stick around. Not everyone here will feel the need to comment on your weight. Den especially had some good input about your employment concerns. Re your sleep study issues: Do you have a copy of your second sleep study, the one that showed apnea and qualified you for a titration study? i was just wondering if you have a doctor who would simply write a prescription for an auto-adjusting PAP machine (APAP) based on that report. This is how Kaiser does titration all the time -- everything is done at home, original sleep study and the titration. We can help point you to some good sources of gently used or open-box zero-hour machines that will help keep costs down.

There have even been some folks who came onto the forum without insurance and without a sleep study in hand, who bought a machine, did their own titration at home, and did great with the DIY route. It may not be ideal but it can sure work when you need it to. LIke I said earlier, if you have plain old obstructive sleep apnea it will work quite well, and if you have a more complicated type of sleep apnea you'll know pretty quick if you're monitoring your PAP therapy with software like SleepyHead.

Let us know what you think your next steps are and feel free to PM people -- most of us keep our mailboxes open.

Edit: Pugsy was just posting in another thread about this company that offers home tests ($249) and that includes issuing a prescription when appropriate:
http://1800cpap.com/home-sleep-apnea-te ... e-kit.aspx

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Last edited by kaiasgram on Wed Oct 29, 2014 8:11 pm, edited 1 time in total.

borgready
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Re: Work and Sleep Study Troubles

Post by borgready » Wed Oct 29, 2014 8:09 pm

Hey RogueWarrior,

How old are you? And answer that.

If your eating a lot of carbs, then that can make you tired. If you have sugar diebetes and you most likely do(type 2), that will make you tired and sleepy. Without sugar diabetes, High carb junk food will make you lazy and tired.

What are your psych issues? I think your biggest psych issue is carb addiction. Your a drug addict. I know all about that. You don't know how addicting carbs are untill you get off them for a while. Go without eating for a few days and what happens. Where do you break down first? Get thirsty? How do you deal with that? A sugary drink or eat something. When you start losing weight expect to be very thirsty as burning fat is water intensive. Don't grab that soda or juice.

Have you ever lost a lot of weight before? How much and what did you weigh.

So how do you know you have sleep apnea? You said your test are all screwed up because you can't sleep well in the studies and the doctors are borderline on deciding it. Well here is how you tell. Get a pulse oximeter, even if you have to buy it yourself, and wear it when you can dose off. See how low your O2 goes. The oximeter has to one that will record data, have an alarm, and accept the throw away probes as they fit on the finger the best without coming off.

Do you remember your dreams? Do you dream a lot that you remember them? What do you dream about?

My last question will be is are you on psych meds or other drugs?

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Moogy
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Re: Work and Sleep Study Troubles

Post by Moogy » Wed Oct 29, 2014 8:21 pm

I just want to offer some encouragement. I also fell asleep at work, driving, etc. Your bosses need a note from a doctor, but your doctor does not seem the least bit helpful. I hope you find a solution soon. Sorry about all the preachy posts above.
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palerider
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Re: Work and Sleep Study Troubles

Post by palerider » Wed Oct 29, 2014 8:24 pm

borgready wrote: If your eating a lot of carbs, then that can make you tired. If you have sugar diebetes and you most likely do(type 2), that will make you tired and sleepy. Without sugar diabetes, High carb junk food will make you lazy and tired.
blah blah blah blah deleted.
Roguewarrior, 'borgready' is one of those folks around here that it's best to just mark as a 'foe' and that way you don't have to look at their bs. as you're probably figuring out by now

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borgready
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Re: Work and Sleep Study Troubles

Post by borgready » Wed Oct 29, 2014 8:39 pm

Hey palerider,
Have we crossed paths before. I know you don't like my ideas on nigtmares and sleep apnea. It ain't just my idea. Google it.

No wait. Maybe you didn't take to my opinion on Robin Williams.

The truth is a drug addict don't wanna hear the truth. If your 300 or 400 pounds you have food addiction problems. Its so easy to make excuses and keep eating to curb your pains. If you got the fat gene then losing weight is even harder.

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Re: Work and Sleep Study Troubles

Post by chunkyfrog » Wed Oct 29, 2014 9:23 pm

I will add my support to that of the helpful ones here. I was in the same position, dozing off at work, getting written up, and having a sleep study. Unfortunately, here's where it got worse. I was in an HMO at work, and they basically faked the sleep study, falsely giving me a clean bill of health. For the next 17 years, I suffered, drank much caffeine, power napped in the john--every trick in the book, just to keep my job--in spite of the world's most toxic boss. I always poo-poo'd my hubby's claims that I was the louder snorer. The REAL sleep test proved he was right. "Yes, dear."

@borgready: high blood sugar causes cravings for exactly the foods a diabetic should avoid. It is not a willpower insufficiency; it's chemistry. Put that in your hat! If there is room in there with all the swelling.

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