One year -- whazzup with these numbers?

[RubySnooze]

In a bit of early freakout. In-home sleep study is scheduled for next Monday, Tuesday and Wednesday nights. Have no idea how I will keep leaks at acceptable level. Or even sleep, for that matter! At least I'll be at home in my own bed. Gotta be better than in a lab, right?

((heavy sigh))

[OSAHell]

Hi RubySnooze,

Glad to see that you finally have your sleep study scheduled! Unless I'm mistaken, home sleep study are always done without xPAP, it a diagnosis study to see how is your sleep without therapy. A study with a xPAP (titration) has to be done in lab so the sleep tech can adjuste the pressure "live" and find the right pressure/machine. Did your doc say that you would have to use your CPAP during your home sleep study? Also, normaly they ask that we stop therapy a week before a sleep study, did your doc or the person who called to scheduled your sleep study talked about that? If not, I would make sure to called them and ask about it.

EDIT: One of the disavantage of home sleep study is that they often don't record sleep stages. They are good to diagnose sleep apnea but lack sleep architecture infos, unless you have a more advanced home sleep study (with much more wires than the most commun one).

[RubySnooze]

Unless I'm mistaken, home sleep study are always done without xPAP....Did your doc say that you would have to use your CPAP during your home sleep study? Also, normaly they ask that we stop therapy a week before a sleep study, did your doc or the person who called to scheduled your sleep study talked about that? If not, I would make sure to called them and ask about it.

EDIT: One of the disavantage of home sleep study is that they often don't record sleep stages. They are good to diagnose sleep apnea but lack sleep architecture infos, unless you have a more advanced home sleep study (with much more wires than the most commun one).

Hiya OSA,

Doc did say I will be using my own machine during the sleep study. Apparently I should have received a packet of papers at my first appointment (didn't); those are being mailed to me. Maybe there is more info in there.

No suggestion to stop therapy a week before the study. Doc even said he doesn't care what I do between the first appointment and the middle of September when I see him again.

I will be going to their office Monday evening in my jammies. Assuming they will hook me up and show me how to do it myself the following two nights. I have to return the equipment at the break of freakin' dawn Thursday morning.

That's all I know at the moment. If I find out more before Monday night, you can be sure I'll share.

[OSAHell]

Doc did say I will be using my own machine during the sleep study. Apparently I should have received a packet of papers at my first appointment (didn't); those are being mailed to me. Maybe there is more info in there.

Ok, I guess I was mistaken... But first time I heard of a home sleep study with a xPAP!

No suggestion to stop therapy a week before the study. Doc even said he doesn't care what I do between the first appointment and the middle of September when I see him again.

Since you'll be using your CPAP there's no point in stopping the therapy.

I will be going to their office Monday evening in my jammies. Assuming they will hook me up and show me how to do it myself the following two nights. I have to return the equipment at the break of freakin' dawn Thursday morning.

The fact that you have to go there in "jammies" probably means that they have to install lots of wires and they will be monitoring your sleep stages. I had 2 sleep study, both at home without xPAP, but the first one was the "basic" one with no sleep stages (about 10 wires). They gave me 10 minutes instruction and a suitcase with the machine and wires and sent me home. The second one was the a more extended version and I had to go there in jammies and they took nearly an hour to hook me up with nearly 30 wired before sending me back home... but this one did monitor my sleep stages.

That's all I know at the moment. If I find out more before Monday night, you can be sure I'll share.

Cool, I'm really curious about "this" sleep study!

[RubySnooze]

I had 2 sleep study, both at home without xPAP, but the first one was the "basic" one with no sleep stages (about 10 wires). They gave me 10 minutes instruction and a suitcase with the machine and wires and sent me home. The second one was the a more extended version and I had to go there in jammies and they took nearly an hour to hook me up with nearly 30 wired before sending me back home... but this one did monitor my sleep stages.

Were these one night studies or several night studies?

[OSAHell]

Were these one night studies or several night studies?

One night each and one year apart from 2 diff sleep doc.

[RubySnooze]

Have been focused on getting face healed from tape abuse before the three-night in-home sleep study Monday. I'm planning to tape up super well for those three nights, so want to start as un-irritated as I can. Might switch tape brands / styles those nights in case I can avoid allergic reactions.

Here are the last few nights:

Aug 11
Pressure 8.5 / 8.5
Swift FX no tape
Longest sleep segment: 5 hrs 33 mins



Aug 12
Pressure 8.5 / 8.5
Swift FX no tape
Longest sleep segment: 3 hrs 27 mins



Aug 13
Pressure 8.5 / 8.5
Swift FX no tape
Longest sleep segment: 2 hrs



Aug 14
Pressure 8.5 / 8.5
Swift FX
Test run of Nexcare Gentle Paper tape, in innovative "x" application , until 2:15
Longest sleep segment: 1 hr 30 mins

[OSAHell]

Hi RubySnooze,

Did your new doc specify any pressure setting for your 3 nights study?

[RubySnooze]

Did your new doc specify any pressure setting for your 3 nights study?

Not yet. Never got the packet of papers. ((sigh)) Unless something comes in the mail Monday, I won't know anything more 'til I get there Monday evening.

[RubySnooze]

Aug 15
Pressure 8.5 / 8.5
Swift FX
Nexcare Gentle Paper tape in "x" application
Longest sleep segment: 2 hrs 46 mins

Starting to think this "x"-ing of the tape might be helping. The tape is not stopping all air. I think I'll try a different tape applied in the "x" design tonight.

[RubySnooze]

The home test is not going as smoothly as I'd hoped.

Went to to office last night and got hooked up. It's two bands around the torso (one up under my pits, one around my waist), a wrist band, two sensor thingees in each nostril (wires taped to my cheeks), and a finger pulse oximter (taped to finger). All hooked to a bulky unit clipped to the band at my pits.

Kept telling the tech I sleep with nasal pillows and how can they possibly fit on top of the nostril sensors? That won't be a problem she said. Probably 20 times.

The first night the unit is preset for you and you have to be in bed, all hooked up, with your mask and machine on, by 10 p.m. when the machine kicks on. I cautiously crawl into bed with wires everywhere at 9:55.

First problem: no way are nasal pillows gonna work with two sets of wires up my nose. Not even close. Hubby tries to call the sleep center, but they very conveniently don't accept calls or messages at night. Frantic discussion and and we decide to give up on the nasal pillows and crack out the Quattro FX. Ooops, I'm all wired up on top of my pajama top. No way to get out of this top and into a hoodie but if I use the FX I'm gonna have to protect my face and head from the friggin neoprene.

Onto next plan. Dig through the closet wearing a ton of equipment with wires catching on everything looking for the Buf I bought when I was first dealing with the neoprene allergy. Finally locate Buf, get it skinnied over my head (yow, it's tight), crawl back into bed, hubs helps me into the Quattro, and we hook to the machine.

Next problem. The main unit that's attached to my pit band is supposed to have a blinking light. Tech warned it will probably keep me awake all night if I don't put a piece of tape over it. Not mine: it's only blinking occasionally. Doesn't matter where you put it, how tight the pit band is, no connections are loose...it's just gonna light up when it feels like it. Hubs reaches for the phone -- oh yeah, they don't take calls at night.

Well screw 'em. If this thing isn't working right, not our fault. We will move forward like the sleep warriors we are.

By now my stress level is beyond redlined. And I'm laying in bed tangled in wires and weighed down with heavy equipment with a Buf strangling me around the neck. The Quattro won't seal against all the wires and tape on my face, so we shut everything down again and remove the padacheek liner. I grab the opportunity to swallow a second sleeping pill. Quattro back on. Feels uncomfortable and leaky, but we're going with it.

I do manage to get some sleep. Probably because medication level was high. Sleep equipment shuts itself off automatically at six. When I woke up later than that, I ripped all the equipment off as fast as I could. It's laying in a tangly heap in my closet. Will have to unsnarl everything in a bit so we'll be able to figure it all out again tonight.

So what the heck is going on with these Sleepyhead numbers?? I'm going to give you Sunday night's numbers (last night before sleep study) followed by last night's numbers (first night of sleep study). My charts have never looked like this; how is this even possible?

Aug 16
Pressure 8.5 / 8.5
Swift FX with x-style taping until 5 a.m.




Aug 17
Pressure 8.5 / 8.5
Quattro FX and a boatload of equipment

[Pugsy]

You need more pressure with the full face mask than you do with the nasal pillow mask.
Very common to see this happen. What might work for nasal pillows won't work with a full face mask.
Very possibly also related to sleep position...bet you were on your back for last night????
It's also very common to need more pressure when on our backs.
The really dense OA clusters...good chance they are REM stage sleep related where it is also common to need more pressure.
So the triple whammy....supine, REM and full face mask....and the 8.5 pressure just couldn't deal with things.

[RubySnooze]

You need more pressure with the full face mask than you do with the nasal pillow mask.
Very common to see this happen. What might work for nasal pillows won't work with a full face mask.
Very possibly also related to sleep position...bet you were on your back for last night????
It's also very common to need more pressure when on our backs.
The really dense OA clusters...good chance they are REM stage sleep related where it is also common to need more pressure.
So the triple whammy....supine, REM and full face mask....and the 8.5 pressure just couldn't deal with things.

Ha...you are right on all counts, wise apnea woman!

I got no direction from the doctor or the sleep tech on machine settings. The paperwork asks what your machine is currently set at; that's the only time it came up. Would you be inclined to call and ask them if I should try a higher pressure? Or just give 'em three nights like this, so they'll have plenty to look at?

Thank you so much for taking and look and letting me know what's going on, Pugsy!

[Pugsy]

I don't know what they are thinking of accomplishing with this home study with your machine so I don't know what to do about the pressure being sub optimal in this situation.
So I am sort of scratching my head here trying to think what should be done.

I am thinking that maybe we should open up the apap range and let the machine do what it wants to do.
If I remember right we were somewhat worried about centrals and if you don't have any now...then there's no way to know if they are real or not. That's what that chest belt is for...to help determine if the centrals are real or not.

I know we were worried about the fragmented sleep and if you continue with current settings and that high AHI then they will just likely say ....reduce the AHI and you should sleep better but we already know that in your situation it isn't that easy.

Might call them and just ask what they hope to gain and see what they say.
It's obvious that these settings aren't working but I am afraid that if you don't change them then everything will get blamed on pressure being too low.

[RubySnooze]

I don't know what they are thinking of accomplishing with this home study with your machine so I don't know what to do about the pressure being sub optimal in this situation.
So I am sort of scratching my head here trying to think what should be done.

I am thinking that maybe we should open up the apap range and let the machine do what it wants to do.
If I remember right we were somewhat worried about centrals and if you don't have any now...then there's no way to know if they are real or not. That's what that chest belt is for...to help determine if the centrals are real or not.

I know we were worried about the fragmented sleep and if you continue with current settings and that high AHI then they will just likely say ....reduce the AHI and you should sleep better but we already know that in your situation it isn't that easy.

Might call them and just ask what they hope to gain and see what they say.
It's obvious that these settings aren't working but I am afraid that if you don't change them then everything will get blamed on pressure being too low.

Apologies for being completely and irretrievably jaded, but if I call the doctor's office I will inevitably get some low level worker bee who will try to pass along my message to the doctor and his response back to me without having a clue what I'm talking about. I am just too freakin' tired to play that game.

You are so correct: this test is gonna be a total waste if things go on like this. I am thinking I'll open up the APAP and let it go the next two nights. If the doctor is furious later...oh well. That's what he gets for not explaining anything, not giving me any input on pressure, having a tech who assures me that the nasal pillows will be a piece-o-cake. Now that I'm giving it serious thought, he's got one foot on a banana peel and will be lucky if I don't hurt him.

I should probably go back and look at those numbers from the days we had the pressure open. Maybe 8-20 or something will be the best setting?

Again, sorry to be such a grouch, but man I am sleep-deprived and exasperated with doctors who can't be bothered to listen.