Three Sleep Studies in 3 months??????

[MoSleep]

Hi
My first sleep study was 3-31. The tech had trouble getting a good pressure but decided that it should be set on 17/3 with a bipap machine. I went to the DME and was set up with the bipap and an Ultra mirage full face. In that study I was left with 62 CSA per hour and 2 hypos, while on the bipap. After 2 months I had not been contacted by my family Dr., the sleep lab or the DME. Nothing was explained, there was no follow-up of any kind. I got concerned and called my family Dr. who understood my concern and set me up with a consult with a new sleep doctor. The new Dr did not trust the results of the first sleep study so set me up with the second sleep study. A call today (1 week after the study),informed me that the techs had a lot of trouble finding the right pressure, but settled on 8/4, the study found me with 60 CSA per hour, and 17 OSA per hour while on the machine the Dr was not happy and wanted another study. So tonight I am spending another night wired up and sleeping in a strange bed. I don't know what they expect to find, but it seems that it will be very similar to the first two tests. Next question is what are they going to do about the severe CSA while on the machine. What is causing them and what can be done to get the numbers down?
Any advise or comments are welcome. I have reviewed Christinequilts posts and appreciate that information.
Maybe tonight will be better.

[christinequilts]

As you've seen from my post Centrals can be tough to beat- I wish they could figure something better out for mine then leaving me at 30+ per with BiPAP ST. Most people do not have this much difficulties with centrals so when you consider CSA is rare to start with and you add in resistance to treatment with BiPAP ST doctors don't have a lot to go on because there haven't been enough cases to do any research.

You may want to talk to your doctor about trying a different brand of BiPAP ST- I do horribly on VPAP's. It is so bad that I might as well not use it all but put me on a Respironics BiPAP (Synchrony or old model BiPAP STD) and I'm much happier. I also did well on a Quantum PSV which was an older style hospital grade one my sleep lab lent me for my first month. The theory is that since my central are so tough to treat to start with that the VPAPs just do not stop enough to make any differennce (and I've tried 3 different VPAP II STA's). From what my doctor, DME, and ResMed & Respironics reps said my situation is pretty unsual- as in they had never seen so I would guess your doctor hasn't considered it. I will also tell you that I have gotten a little better with over time- I have the software for my Synchrony and a year ago I was triggering around 75-85% of breaths and now I am usually around 85-90%.

After 6 months on BiPAP ST my doctor & I decided to add in Provigil to help with the sleepiness from continuing to have so many centrals. It works pretty good and did improve the quality of my sleep some because it let me do more during the day so I was literally more tired at night. A few months ago we added low dose Ritalin as needed since it is much shorter acting which has allowed me to reduce the amount of Provigil I take.

Hopefully you will have a very experienced tech tonight who can figure something out for you.

[Denny]

How does your insurance company deal with all of these sleep studies? do they pay for more than one?

I went to one but had a hard time getting to sleep in a strange bed with a camera on me while attached to 900 wires. Go figure.

I had a harder time sleeping after seeing the sleep study cost 3700 dollars. When my dad did his, they sent a machine home and he did it in his own bed and it cost a fraction of what mine did.

In all honesty they could just issue you an autocpap and then have you download the info from it and then give you the option of staying on auto or setting it to cpap mode at a single setting if that works.

I have found that you really have to keep a close eye on the costs diagnosing and treating apnea or it can really get out of hand in a hurry and still not have you fixed.

[battlin_blazes]

I just had my third study also, more like six months for me though. This one to find out why the therapy is not working. The result the technician came up with was " I'm not sure what the dr was thinking when he set your pressure at nine it clearly shows on your card reading from the apap that in rem sleep you were running a pressure of 11. so by him setting you at 9 your body is throwing you back out of rem sleep which is the most important part of sleep because your pressure setting is wrong. Go home and change your pressure and if you don't feel better in two weeks call me direct and I'll look things over again we may try 12 or 13 pressure setting. The sad part is i trust this technician more then I trust what the Dr. is doing he seems way more knowledgable then the Dr. So we`ll see here in a couple three weeks how thing go..... boy I miss the auto!!! Also added a day sleep study this time.... boy how much more fun can we have!!!

[MoSleep]

Well last night went about the same as the first two, with the exception that there is to be no charge for # 3. Tried a couple of masks, bipap, cpap even added oxygen. Still could not get a good pressure that would stop the apneas. Still left with severe CSA even on the machine. The tech said she was not able to talk numbers and the Dr. would likely be calling for a consult as the CSA was in the severe range. Tech had me stay on the bipap since it was stopping most of the OSA.
So I guess I have some more tests to go through to try and isolate the cause of the CSA and then find a way to stop them.
Do appreciate the info on the forum. Thanks for the responses. When and if I get some answers about central apneas I will share them with the forum so we can all learn a bit more about CSA.
Thanks
Dave