When do I need an in hospital study done

I have been on cpap machine for 6 months with oxygen
I am still having apneas now they say I am having both obstructive and central apneas
I have changed masks because the nasal mask I had kept leaking
They just did another oximetry test without oxygen and I normally use oxygen with my cpap
They said I'm having a lot of central episodes and want me to come in to do a sleep study
Can't they figure out what I need thru the home studies??? Or is it time to go into sleep center and have myself monitored???

Home studies don't deal with central apnea, but...

Can you tell us what your pressure settings are now? All too often they were entered much too low to be effective at all, so it would help us to help you to know that.

I'm thinking some of the astute data folks here could add some insight if you posted your data. Some questions come up with centrals. Are they even significant? If they are few in number, were while waking or awake, the presence of centrals may not matter. Does one have complex sleep apnea, where events contain a mix of obstructive and central events? Some modes of treatment are better at treating complex apnea. Does one have pressure induced centrals? Some are sensitive to pressure and centrals appear with treatment. Then it needs to be figured out if a lower pressure can control their obstructive events without triggering centrals, or is a different machine needed to assist in breathing? And, does one actually have central sleep apnea? Several health issues can make this more likely.

If it were me and the machine data indicated centrals were significant, if at all possible I'd want an in-lab study. Not that this can't be assessed or treated without one if necessary, but the info gained in the lab could make your picture clearer faster. Providing info requested here is a reasonable first step in deciding if there is indeed an issue needing further evaluation.

EDIT: The fact that your provider says there are "lots of centrals" would make me lean toward going ahead and getting the in-lab study done.

They're a pain to do, but IMHO a good sleep lab interpreted by a competent doctor of NP is the best form of testing - if your insurance covers it or you can afford it.

Good oximetry is vital as is the full range of sensors to detect all sleep disorders in one go.

However, titration studies can be useful but I'm less in favor of them. Mine was inconclusive and I ended up refining my APAP settings on my own using Sleepyhead like many here.

If your insurance will cover it I strongly recommend an inpatient study at either a privately owned testing facility or in a hospital. I had a 2 night study done last year in a hospital; a company from Louisiana tested me; my PSG was done in late May 2014 and my titration was done in early June 2014. I've never done a home study; I would go to an outpatient testing facility or to a hospital for an overnight study. Many testing facilities are doing split night studies; my doctor ordered a 2 night study which I insisted on having since it had been 7 years since my last study. If your insurance will cover it go to an outpatient testing facility or to a hospital and be tested there.


Stevoreno_55
01/28/15