Didn't sleep enough during sleep study?

[ps4treksteve]

Hi,

I was wondering how common this may be:

- I had a at home sleep study and failed it miserable - diagnosed with major sleep apnea (I think something like an AHI of 73???? - really bad)
- I went for the second sleep study at a sleep study site, where I used a cpap machine in an attempt for the sleep tech to identify the pressure needed, etc.
- The next day, I was told I did not sleep long enough to gauge a pressure and the test would need to be re-done - this time having my primary care doctor issue sleeping pills.

Is that a common issue? My concern is that I really slept the same at the site as I do at home (except I am more comfortable of course at home) - which has always been my problem - it is enormously hard for me to go into a deep sleep - I feel like I remember every minute of the night. My eyes are closed most the time but I never seem to cross over into a deep enough sleep for a very long period of time.

So, even if I get sleeping pills for the third test and the technician is able to get the pressure I need, I am starting to think the sleep apnea machine will not be the "cure all" I really hoped it would be and allow me to go into a deep sleep quicker and stay there longer since it did not really seem to make a difference during the second sleep study. .

Sorry I am new to all these stuff so any inputs or thoughts will be welcomed.



Thanks,
Steve.

[kteague]

So, even if I get sleeping pills for the third test and the technician is able to get the pressure I need, I am starting to think the sleep apnea machine will not be the "cure all" I really hoped it would be and allow me to go into a deep sleep quicker and stay there longer since it did not really seem to make a difference during the second sleep study.

Your experience in the sleep lab is not unusual. I'll just address the above statement. The reason you need another study is because you didn't sleep enough to determine a therapeutic pressure. They start a titration at a low pressure and incrementally raise it until they find a pressure that works to stop the apneas. You never reached an effective pressure, so there was no reason to expect the machine to have helped you sleep better in the lab. Once you are using a machine at a proven effective pressure consistently over a period of time and you have adjusted to all the new sensations, then it is reasonable to expect your sleep to improve. Hope this helps you have more confidence in going forward and finding some relief through treating your sleep apnea.

[tedtomato]

yes, those issues are very common.

When I had my home sleep study, I only slept about 3.5 hours. I just couldn't sleep with all those sensors.

I was then put on CPAP for 6 months, and then we decided to do a full sleep study. I actually did sleep for 6 hours during the PSG, including a section with CPAP, but I was used to it by then.

Personally, I would get used to sleeping with a mask/CPAP before doing any sleep study or pressure tuning, as it could be a waste of time otherwise.

[ajack]

you need to sort out what machine you need, so I'd go with the sleeping pills.

[Comfortably Numb]

you need to sort out what machine you need, so I'd go with the sleeping pills.

I totally agree. I find it curious that most sleep study personnel (doctors included) project the attitude at first that you shouldn't do anything to enhance your "sleep experience" prior to the study. Then we end up with situations like those described in the OP. I knew going in that I'm an anxious person and don't sleep well in new places, let alone a hospital situation. I also know that when the element of performance is introduced, I become even more resistant. So prior to my in hospital sleep study, I popped two blue Xanax (2 mg.) about 2 hours prior to bedtime. While I was waiting for the nurse to wire me up, I excused myself for a few minutes and went down to my car for 2-3 good chugs of chardonnay. I had a wonderful titration study and all has been great ever since. To each his own, but at age 69 I know myself pretty well. The medical community has an agenda that largely controlled by issues of liability. Sometimes we have to work around these issues.

[Okie bipap]

you need to sort out what machine you need, so I'd go with the sleeping pills.

I agree. I used Ambien during my sleep study and titration study.

[kteague]

nonsense
sleep studies are way too expensive for too little value for mere titration

We don't know if a sleep study is too expensive for this patient. They may have good insurance coverage, or they may be rich. They have not told us that the study would be a financial burden for them. My point here was to explain why the provider feels the need for more information, not a defense of the merits of a lab study vs home titration.

and you have to wait way too long to schedule them

Wait time for a sleep study depends a lot on location. Being available to fill a schedule cancellation can make the wait minimal. Even at the same clinic my wait times have been anywhere from a couple days to a few weeks. Time is not automatically an issue, just a question to be answered.

it is hard for anyone to sleep in a strange bed strange pillows strange lights strange environment the first night
which makes sleep lab studies data marginal and worse when they want you to sleep when it is convenient for them not when you can sleep well

Yes, the sleep study environment is less than ideal, and there's a good chance it will not be a perfect representation of every night's sleep. Fortunately, it doesn't take a full night to get some results. Those results may end up needing tweaked in real life, but some good information can come out of even a less than perfect test.

many doctors have the patients titrate themselves by slowly raising pressure and checking results
you sure dont need another expensive marginal sleep study to determing therapeutic pressure
unless you have something seriously wrong you dont need a sleep study at all
a good two belt inhome test will tell enough to determine if you need a study or not

They stated they had an at-home diagnostic study. As to titration, the method you describe is a bit old-school. These days IF a doctor is directing a home titration it will most likely be with an auto titrating machine that can generally find the pressure need in a few nights. When all we were dispensed were fixed pressure machines, the back and forth with finding a more effective pressure could be beyond frustrating and time consuming. While most people with garden variety OSA will do just fine with a home titration, those who are outliers will not have access to the same volume and variety of data collection. Home titration is certainly a viable option for most, just a choice one should make being fully informed that it could result in finding you still need a lab titration.

[kteague]

well mine take several months to get an appt...... and they may get it wrong as our needs change from day to day, by sleep stage, by sleep position, and many other factors

xxyzx, I don't doubt any of your experiences dealing with your providers. Many of us have battle scars from trying to navigate this system known as the sleep industry. I just want to point out that it's hard when we have been through some things and want to spare someone else the problems to not project our experience as the whole sleep industry picture when it is but one piece of a very large puzzle. There's a fine line between sharing a word of wisdom and being an alarmist, and we don't always get it right. Most of us incline toward particular types of posts, those where we feel our experience might be of some value. I am still working to recognize when my fervor may be more of a distraction than a benefit if not put on a short leash. For instance, my "thing" is limb movements. I see a potential diagnosis of PLMD behind every bush - or at least behind every mention of restless sleep. I tended to over-share, giving every what-if scenario they might ever encounter. It was like I was compulsed to make sure they were fully informed just in case they didn't come back for another round of discussion. Unfortunately, some folks were burdened with way too much info on a subject that turned out to not even be relevant to them. Just suggesting you - and every one of us - might want to reassess how much we really need to share, and when we do share, make sure it is clear we are speaking of our experience, not necessarily what they will encounter.

[poppi2]

[quote="xxyzx"...

... There's a fine line between sharing a word of wisdom and being an alarmist, ...[/quote]
KT, I think you do an excellent job of being on the correct side of the line.

[chunkyfrog]

KT, and poppi--you are correct.
First time mothers-to-be often hear the very worst childbirth horror sories--(frequently enhanced for effect?)
Same with cancer survivors--often talking to the wrong person can be very traumatizing.
Perhaps the most accurate thing we can share with newbies is that "typical" only exists in a classroom;
and people who have been hurt have VERY good memories.

[ajack]

not everything is bitter and twisted or black and white, there is a DME on apneaboard giving out free advice, to help people they aren't getting money from..

[kteague]

prove me wrong

No one wants to prove you wrong about your personal experience. It is what it is. Any number of people can say they shared a similar experience. Others can say their experience was vastly different. I had one sleep doctor (of 3) who was willing to go to the moon and back to find answers for me. I'm not sure why so many of your posts end with a personal challenge, but if it is tiresome to witness I can't imagine how tiresome it must be to live in a state of contention. I would certainly rethink my style of involvement if I felt an environment kept me perched on the precipice of agitation. Yes, some here have been beyond snarky to you. I don't know quite how to turn the dynamic that exists around at this point. All I can suggest is that you try being less contentious, and others try to not be so trigger happy. My first response to your post was not confrontational. I merely stated my perspective with no personal attacks. Yet even so we ended up at "prove me wrong". While I am one who is naturally inclined to align with the underdog, I'm also one who knows how to get out of the way before getting bit in the fray. Sorry you think every conversation is a challenge. But that's on you.

To the OP, I apologize for tainting your thread with this discourse. Hope you get on to having successful CPAP treatment.

[palerider]

maybe because the libtards keep saying i dont know squat and insulting me

Only because you're the worst kind of idiot.

sorry but DMES AND SLEEP LABS ARE EVIL PEOPLE who unfortunately we must deal with at times
prove me wrong

I've never been to a DME, or a sleep lab, and yet, I've been doing something you can't do... successfully treat my apnea and get good sleep... and I've been doing it for eight years.

There, you're PROVEN WRONG.

[palerider]

i am treating my apnea correctly by insisting on the correct treatment for my actual problem

the bureaucratic delays with my insurance reflect on the health care system after yobamamama effed it all up

i will get the correct machine
and my apnea will be even better treated

sounds like lame excuses for your obvious, abject failure.

[palerider]

more libtard lies and bullshit

i have not failed

the system failed me by letting a sleep lab tek make an erroneous diagnosis and write an Rx on my family doctors name that he did not know about

i am getting the right treatment albeit delayed by bureaucrats

sounds like more whining excuses for failure to me.