Home sleep study vs hospital sleep study

General Discussion on any topic relating to CPAP and/or Sleep Apnea.
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winnie
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Home sleep study vs hospital sleep study

Post by winnie » Mon Mar 23, 2015 8:45 pm

I'm confused and not sure whether I need CPAP. Here is a timeline of the events that have confused me:

Six months ago: Did a home sleep study on recommendation of pulmonologist I had seen about pneumonia

Three months ago: Had a hospital sleep study done -- I think this was ordered at the same time as the home study

Two months ago: The home sleep study results finally came back. GP told me I need CPAP and referred me to DME

Qne month ago: Got loaner Resmed autset 9 from DME and started using it and getting used to it

3 days ago: I Decide to buy Airsense 10 Autoset for her, and DME orders one for me (says it takes up to 10 day to arrive)

Today: GP's office calls and says hospital sleep study results are in and tells me to make an appointment to discuss them. I ask the secretary what the results are, and explain how I am about to buy a CPAP machine. She says she doesn't see anything in the report about apnea or CPAP. Just something about a lot of leg movement. She gives me the next available appointment with GP -- in one month! I finally convince her to ASK the doctor whether I should go ahead and buy the CPAP machine. She says she thinks she can get a message to him within 2 days .

If this time line seems strange, keep in mind I am in Canada where health care is free but extremely SLOW (if not emergency)

So I'm confused and strangely disappointed that I might not need CPAP. I was hoping all these great things would happen because of CPAP, such as losing weight, etc.
I'm also kind of hooked on looking at the previous night's results on Sleepyhead every morning.

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Wulfman...
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Re: Home sleep study vs hospital sleep study

Post by Wulfman... » Mon Mar 23, 2015 9:05 pm

Well, winnie......

Have you felt better using the loaner?
Will the insurance (government) pay for it anyway?

In reality, all it is is "air" while you're sleeping.


Den

.
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
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Julie
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Re: Home sleep study vs hospital sleep study

Post by Julie » Mon Mar 23, 2015 9:07 pm

Wish you'd have put this in the same thread as your previous notes so we could see at a glance where things have been...

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winnie
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Re: Home sleep study vs hospital sleep study

Post by winnie » Mon Mar 23, 2015 9:31 pm

Wulfman... wrote:Well, winnie......

Have you felt better using the loaner?
Will the insurance (government) pay for it anyway?

In reality, all it is is "air" while you're sleeping.


Den

.

I think I have felt better with the loaner. But maybe i'm imagining things. The insurance (private "extended health" insurance) has already given approval to pay 95% based on the home sleep study which showed "mild to moderate" OSA.

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winnie
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Re: Home sleep study vs hospital sleep study

Post by winnie » Mon Mar 23, 2015 9:35 pm

Julie wrote:Wish you'd have put this in the same thread as your previous notes so we could see at a glance where things have been...
I have posted in several threads. Here is a Sleepyhead output from a few days ago:

Image

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Wulfman...
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Re: Home sleep study vs hospital sleep study

Post by Wulfman... » Mon Mar 23, 2015 9:57 pm

Looking at that report, I would say that you DO have Obstructive Sleep Apnea that needs to be treated with this therapy.
I think that secretary you talked to is either full of crap or was thinking she was talking to someone else or was looking at the wrong information.


Den

.
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05

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Too tall
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Re: Home sleep study vs hospital sleep study

Post by Too tall » Mon Mar 23, 2015 10:11 pm

winnie wrote:I'm confused and not sure whether I need CPAP. Here is a timeline of the events that have confused me:

Six months ago: Did a home sleep study on recommendation of pulmonologist I had seen about pneumonia

Three months ago: Had a hospital sleep study done -- I think this was ordered at the same time as the home study

Two months ago: The home sleep study results finally came back. GP told me I need CPAP and referred me to DME

Qne month ago: Got loaner Resmed autset 9 from DME and started using it and getting used to it

3 days ago: I Decide to buy Airsense 10 Autoset for her, and DME orders one for me (says it takes up to 10 day to arrive)

Today: GP's office calls and says hospital sleep study results are in and tells me to make an appointment to discuss them. I ask the secretary what the results are, and explain how I am about to buy a CPAP machine. She says she doesn't see anything in the report about apnea or CPAP. Just something about a lot of leg movement. She gives me the next available appointment with GP -- in one month! I finally convince her to ASK the doctor whether I should go ahead and buy the CPAP machine. She says she thinks she can get a message to him within 2 days .

If this time line seems strange, keep in mind I am in Canada where health care is free but extremely SLOW (if not emergency)

So I'm confused and strangely disappointed that I might not need CPAP. I was hoping all these great things would happen because of CPAP, such as losing weight, etc.
I'm also kind of hooked on looking at the previous night's results on Sleepyhead every morning.

Are you kidding? If your AHI is below 5 you don't need it and thank God you don't.
System One RemStar Pro with C-Flex+ (460P)

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Wulfman...
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Re: Home sleep study vs hospital sleep study

Post by Wulfman... » Mon Mar 23, 2015 10:15 pm

Too tall wrote:
winnie wrote:I'm confused and not sure whether I need CPAP. Here is a timeline of the events that have confused me:

Six months ago: Did a home sleep study on recommendation of pulmonologist I had seen about pneumonia

Three months ago: Had a hospital sleep study done -- I think this was ordered at the same time as the home study

Two months ago: The home sleep study results finally came back. GP told me I need CPAP and referred me to DME

Qne month ago: Got loaner Resmed autset 9 from DME and started using it and getting used to it

3 days ago: I Decide to buy Airsense 10 Autoset for her, and DME orders one for me (says it takes up to 10 day to arrive)

Today: GP's office calls and says hospital sleep study results are in and tells me to make an appointment to discuss them. I ask the secretary what the results are, and explain how I am about to buy a CPAP machine. She says she doesn't see anything in the report about apnea or CPAP. Just something about a lot of leg movement. She gives me the next available appointment with GP -- in one month! I finally convince her to ASK the doctor whether I should go ahead and buy the CPAP machine. She says she thinks she can get a message to him within 2 days .

If this time line seems strange, keep in mind I am in Canada where health care is free but extremely SLOW (if not emergency)

So I'm confused and strangely disappointed that I might not need CPAP. I was hoping all these great things would happen because of CPAP, such as losing weight, etc.
I'm also kind of hooked on looking at the previous night's results on Sleepyhead every morning.

Are you kidding? If your AHI is below 5 you don't need it and thank God you don't.
Did you even look at this report she just posted? The "treated" AHI in this report is 7.33. That's NOT below 5.0.


Den

.
(5) REMstar Autos w/C-Flex & (6) REMstar Pro 2 CPAPs w/C-Flex - Pressure Setting = 14 cm.
"Passover" Humidification - ResMed Ultra Mirage FF - Encore Pro w/Card Reader & MyEncore software - Chiroflow pillow
User since 05/14/05

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winnie
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Re: Home sleep study vs hospital sleep study

Post by winnie » Mon Mar 23, 2015 11:41 pm

Wulfman... wrote:Looking at that report, I would say that you DO have Obstructive Sleep Apnea that needs to be treated with this therapy.
I think that secretary you talked to is either full of crap or was thinking she was talking to someone else or was looking at the wrong information.


Den

.
I also wondered if she was looking at someone else's report. For one thing I don't think I move my legs much when I'm asleep, at least at home. I usually have two dogs sleeping on my legs. I tend to wake up in the exact position I went to sleep in.

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Julie
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Re: Home sleep study vs hospital sleep study

Post by Julie » Tue Mar 24, 2015 4:19 am

Winnie - If you have PLMD (and a fair number of Cpap users do) then overnight your legs do a kind of rhythmic walk over and over, if not necessarily very strongly, without you're being aware of it, but not knowing your dogs I can't comment otherwise... You do want to talk to K. Teague about it if you have it though... she's kind of our expert on that.

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winnie
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Re: Home sleep study vs hospital sleep study

Post by winnie » Sat Mar 28, 2015 12:11 am

Well, I'm still waiting to hear from the DME about the machine they ordered in for me. I've still got their Resmed autoset 9 loaner.
And I'm still waiting to hear from my GPs office about what the hospital sleep study says, and whether or not I should go ahead and buy a new machine. I think I'm just going to go ahead and buy it. My extended health has pre-approved it (based on the home study) and will pay 95%.

Here is Sleepyhead output from earlier in the week. AHI is >5, but it is usually < 5. I think I was sleeping on my back for part of this night. Is it possible that you might need CPAP is you sleep on your back, but not if you sleep on your side?

Imagemarch 24 by pug_gramma

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winnie
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Re: Home sleep study vs hospital sleep study

Post by winnie » Sat Mar 28, 2015 12:15 am

I don't know why the right side of the picture is cut off. If you click on the picture it takes you to flikr and you can see the whole thing. The OA events happened early in the morning--on the right side of the graph.

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Morbius
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Re: Home sleep study vs hospital sleep study

Post by Morbius » Sat Mar 28, 2015 2:35 am

Yeah, this whole thing isn't making a lot of sense.

You have "mild to moderate" sleep apnea (AHI ~15 +/-) but aggressive PAP leaves an AHI of ~7?

The PLMs could be causing the respiratory "events", but PLMs tend to be in the first part of the night, so those salvos at the end of the night is like ???.

Let's see what the events on the sleep studies are. If your OSA is mild to moderate I'm thinking those events are largely hypopneas (or positional) so we need to rethink this whole think.

If you U/L your D/L to Dropbox breath-by-breath analysis can be performed.

What is your STOPBANG?
Last edited by Morbius on Sat Mar 28, 2015 4:49 am, edited 1 time in total.

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SleepDisturbed
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Re: Home sleep study vs hospital sleep study

Post by SleepDisturbed » Sat Mar 28, 2015 3:18 am

If I had that data (and it was a typical night) I would think about increasing the minimum pressure to 7, the maximum to 15 and then seeing what happened. You seem to be bouncing off the max ceiling a lot and you are spending almost no time down low.

Results from the lab sleep study could, of course, point to a different approach entirely. I would get that info asap.

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Julie
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Re: Home sleep study vs hospital sleep study

Post by Julie » Sat Mar 28, 2015 4:12 am

I agree - raise your min. pressure to something you can actually breathe at (4 is the default low for machines and pretty useless) to get a more balanced, or realistic read-out.