Ensuring we have a good center for titration study

Husband diagnosed with Severe OSA and just about to get a CPAP titration study.

Trying to learn as much as possible about CPAP and the whole process so we can maximize chance of success for us.

How does a patient evaluate whether the center the Doc uses is a good place to get the titration done? (Having done more research now, I recently realized that our diagnostic sleep study was lacking in many metrics and I'm not fully confident in the center or the doctor actually). Given that there are so many machines on the market and face mask types, I want to ensure that my husband will have a very wide selection of(CPAP, APAP, BPAP, and VPAP?) top rated machines and several choices among every possible face mask type at the study/fitting/titration. But does that even matter? Are there other criteria that any experienced folks thing are important ? Are there specific things I can ask the doc or the center prior to hubby's appointment to decide to stick with them or switch providers/centers? Does the machine, mask, (and other parts?), that hubby gets a prescription for, get limited to the ones that he tries at the sleep center?

Thanks,
D

http://maskarrayed.wordpress.com/

It's not 100% up to date with the very latest machines and masks (by a few months, not years), but gives a very good overview of the process otherwise.

Also at the link Julie provided make sure to read the tab page "what you need to know before you meet your DME".
Titration labs don't normally dictate brands of machines unless the entire facility covers all aspects from diagnosing to dispensing equipment which really has some potential drawbacks to it.
Best to get your equipment from a place of your choosing....see that link I mentioned for further explanation.

dkeller wrote:I want to ensure that my husband will have a very wide selection of(CPAP, APAP, BPAP, and VPAP?) top rated machines and several choices among every possible face mask type at the study/fitting/titration.

I think I am reading this differently from the others. At the Sleep Study location itself, I would be surprised if you have any choice in machine and a limited number of masks they will try.

In both of my studies, the machine was there and is monitored and adjusted from a control panel in another room. The first study (8yrs ago) they tried 3 FFM when we got to the mask time (after 3hrs of no mask). The first two didn't fit well and the 3rd was good since I fell asleep very quickly and didn't wake up until it was over.

The latest study (July last year), they actually fit me with a mask before we started so there would be less of a hassle once that part of the test started. Again, there was a single machine that they control from another room.

Where decisions are made as to what type of machine, RX is after the study and typically done by the sleep Dr, but then a lot depends on what your insurance covers as to who the DME is, and what they offer.

Being informed as to what is available is very important at the DME point and the two posts above cover that.

I was recently diagnosed and had a titration study, in December. Before I went for the study though, I made some enquiries about the facilities at the various clinics, how they were set up, the process they used and so on.

I decided to go with a clinic that, while part of a hospital, was far enough away to be quiet; was on a residential street with little traffic; was set up like a bedroom, so I could go about my normal pre-sleep routine and not feel like I'm on a surgeon's table (and with a proper bed, not a hospital bed); and importantly, one that had good reviews online.

I ended up settling on the choice of two clinics, discussed both with my doctor and he confirmed one of them as being very good and wrote me a referral to it as normal.

I found that while you're woken up semi-regularly during the study to fit different masks etc; it was easy enough to get back to sleep each time and it was quite comfortable - to the point where when woken up at 6am at the end of the study, I was able to put in a full day at work and actually felt more energetic in the afternoon than usual - despite the sleep interruptions during the study.

So, in a nutshell- shop around for a clinic that looks comfortable and has a good reputation, and don't be afraid to seek advice from your normal doctor.

A picture of the bed that was at the center where I had my sleep test last.



The test unit was a resmed.

You should feel lucky that you even have a choice. Here in Australia AFAIK the specialist you see determines where you have the tests.

My last study was in a very old hospital wing, no window in the room, no tv, an uncomfortable single bed with crappy pillow. Oh I forgot to mention that the bathroom was shared. I had to practically beg them to let me have a quick shower so I could wash the goo out of my hair as I had a 2 hour drive home.

Then there are the prices of equipment! The DME's maybe expensive, but not as bad as Aussie prices

You can talk to them on the phone, and request a tour.
I can't imagine the place I went to refusing.

Thanks for the helpful comments and the link to the blog.

A follow up question:
If there is only one machine at the tritation, how does the center know/decide to give an Rx for a CPAP vs. APAP vs. BiPap? Or is it always an open Rx for the patient to decide and somehow figure out what is best via trial an error of various machines that we rent and return or test somehow?

Sorry if this is an ignorant question

D

Not sure how other sleep centers work, but the place I used had a single machine that could be set to be whatever the study in question needed it to be (not a recognizable brand, although the unit I now have can basically do that). The tech ran it from the "control room." Unfortunately, the way that most insurance works, it can only be, on a given night with a given doctor's order, the thing you have to fail before you can go on to the next thing you have to fail in order to get the thing you really need. Three studies later! So you might want to ask how that situation, should it arise, is going to be handled for your situation.

Good luck - hope it's more efficient in your case!

mgaggie wrote:
Here in Australia AFAIK the specialist you see determines where you have the tests.

Not true - I chose my sleep centre. If you go as a public patient then perhaps so, but if you have private cover or are willing to pay a private clinic, you get full choice.

siliconeseal wrote:

mgaggie wrote:
Here in Australia AFAIK the specialist you see determines where you have the tests.

Not true - I chose my sleep centre. If you go as a public patient then perhaps so, but if you have private cover or are willing to pay a private clinic, you get full choice.

I wasn't given a choice of going public or private. I would of been willing to pay to stay in a better place than I did.