I failed the Sleep Study

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Enchanter
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I failed the Sleep Study

Post by Enchanter » Sun Apr 26, 2015 7:34 am

I did not sleep one bit in the study. It was odd. The guy put a CPAP on me after a few hours. He said that my oxygen levels were going low when I took a couple of naps. Truth is I didn't take any naps, he just thought I did. He kept telling me to try to get some sleep. Worst thing is I took 2 pills of GNC Melatonin. I usually swallow 1/2 a pill or 1 pill to help me get some sleep. I took 2 this time, because after I took the first, it just wasn't happening. I figured if I doubled up, then I'd get the test done. It didn't happen. I was wide awake the whole time.

It's not comfortable in there. The beds are bad imo, and having all those cords attached to your body sucks. Furthermore that CPAP machine felt really awkward and I wanted it off. He thought it would help me fall asleep.

So he said they'll just call me in again to have another study. I don't think this is going to work... If 2 Melatonins don't work, I don't think anything will work. The only other possibility would be to not sleep for 36 hours and show up exhausted. Even then, I don't know if I'd be able to fulfill that perfectly. So I'm running out of solutions.

I'm really in a bad state of mind right now. I did everything I thought I needed to do to get some sleep. I didn't drink caffeine, I exercised mildly and early. I took 2 pills. I wasn't even CLOSE to falling asleep.
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Re: I failed the Sleep Study

Post by BlackSpinner » Sun Apr 26, 2015 8:17 am

The fault is with the doctor in not prescribing ambien. There is no effect (or minimal which can be adjusted for) on the sleep study to take ambien.

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Re: I failed the Sleep Study

Post by SleepDisturbed » Sun Apr 26, 2015 8:40 am

Now you have an iron clad case to get a sleep aid (I think!). I would insist on that next time.

If the tech put you on cpap, I would think that meant he was pretty sure you had OSA. So the next study may be for titration, because you couldn't sleep enough to dial it in. Check with you sleep doc on that for sure.



Hang in there, I went through three sleep studies. First one determined I had severe sleep apnea, but the tech didn't have enough time to put me on cpap and do a titration. On my second study, for titration, I literally did not sleep at all, so it was a bust. The third one they gave me Xanax. I slept like the dead for 8 hours, and got a great titration done.

After the second one, I was so ready to toss the whole thing, but I stayed the course, and I am so happy I did! So there is light at the end of that tunnel ( and no, I don't mean the headlight on the train ).

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Re: I failed the Sleep Study

Post by robysue » Sun Apr 26, 2015 8:50 am

Enchanter wrote:I did not sleep one bit in the study. It was odd. The guy put a CPAP on me after a few hours. He said that my oxygen levels were going low when I took a couple of naps. Truth is I didn't take any naps, he just thought I did.
Truth is the EEG evidence showed you were asleep. Seriously. The tech does NOT guess when you are and are not asleep.

And if he put you on a CPAP, that meant the O2 levels were dropping precipitously as soon as you were asleep. Which is what you've been saying was happening all along. So now that there's hard evidence that you have a problem with your O2 levels during sleep, you want to claim you didn't sleep a wink?

He kept telling me to try to get some sleep. Worst thing is I took 2 pills of GNC Melatonin. I usually swallow 1/2 a pill or 1 pill to help me get some sleep. I took 2 this time, because after I took the first, it just wasn't happening. I figured if I doubled up, then I'd get the test done. It didn't happen. I was wide awake the whole time.
2-4 times as much melatonin as usual can do some pretty strange things. It's possible the extra melatonin created even more problems.
It's not comfortable in there. The beds are bad imo, and having all those cords attached to your body sucks. Furthermore that CPAP machine felt really awkward and I wanted it off. He thought it would help me fall asleep.
Welcome to the world of sleep tests and PAP machines. We told you it was not going to be easy.

As for wanting the CPAP off: That describes many a new PAPer sleeping with a CPAP for the first time. Or, in my case, for the first 6-9 months of PAPing. I wanted the damned thing off my nose every single night for months. But I buckled down and put the unwelcome thing on my nose night after night after night after night after night. In spite of the growing insomnia monster. I did it because I knew if I gave up (even for one night) that I'd never stick the bloody mask on my face again, and that in the long run that would make my life more miserable (as the OSA deteriorated) than doing the hard work to make this crazy therapy work.
So he said they'll just call me in again to have another study. I don't think this is going to work...
Having you come in for another study may indicate several things:

(1) You didn't get the usually required two hours of fractured sleep. (But you did sleep SOME if the tech says you did---he has the EEG evidence on his side.)

(2) There was inadequate time to properly titrate you after the tech put the mask on you. If you didn't fall asleep much (or at all) after the mask was put on your nose, then the titration part of the test would be considered "inadequate"

(3) You never hit REM sleep with or without the PAP and they want and need some data on what happens when you hit REM.

(4) Some combination of all of the above.

If 2 Melatonins don't work, I don't think anything will work.
Too much melatonin can cause paradoxical reactions---i.e. too much melatonin can make it harder to get to sleep and to stay asleep.
The only other possibility would be to not sleep for 36 hours and show up exhausted. Even then, I don't know if I'd be able to fulfill that perfectly. So I'm running out of solutions.
No. You're ignoring two very viable alternatives:

(1) Call the doc's office and tell them that you had a very difficult time getting to sleep and staying asleep. Tell them what the tech told you: That you took a couple of brief naps, that he tried the PAP out on you due to low O2 levels during the naps, and that he expects that you need another sleep study. Then ask the doctor to please prescribe one dose of a prescription sleep aid for you to use on the night of the study.

(2) While talking to the doc, ask whether a home sleep study would be an acceptable alternative to another in-lab sleep study. With a home study, you still have most of the silly wires to deal with, but at least you are in your own bed and sleeping on your own schedule rather than someone else's schedule. Home studies don't gather as much data as a full in-lab study does, but many times they are run over 2 or 3 nights, and they do gather enough data to establish whether you have repeated obstructive apneas and hypopneas during your sleep and whether you have significant O2 desats as a result of the respiratory events.

And then there's also this potential alternative: If the doc believes there's enough evidence of OSA, he could prescribe an APAP set fairly wide open for a week or two of auto-titration. And then look at the APAP's data to figure out a recommended pressure setting. And the week or two of APAP data might also be able to determine whether you objectively sleep better with a PAP than without a PAP.

NOTE: My guess is that you're going to have a somewhat difficult adjustment period to PAP in regards to the subjective quality of your sleep. In other words, it's going to take you a long time to get comfortable with sleeping with a mask on your nose. And while you are learning how to do that, you may very well feel like your already bad sleep becomes even worse. But the subjective view of your sleep is only part of the picture. Until the OSA that's leading to the desats is dealt with, you won't ever feel any better because your sleep will remain both objectively bad and subjectively bad.
The only other possibility would be to not sleep for 36 hours and show up exhausted
Most likely this strategy would backfire on you. Once you are overly exhausted it can be even harder to actually fall into a decent sleep.

I strongly suggest that the strategy for the next sleep test is to spend a week or more trying to get your natural sleep schedule aligned with the lab's sleep schedule. In other words, spend a week or two forcing yourself to get up at 6:00AM regardless of how much or how little you've slept, and stay up (no daytime naps) until midnight every night. And disengage from all the electronic stuff by 10pm every night. If you do that for a week or two, it may become easier to fall asleep a bit after midnight in the lab.
I'm really in a bad state of mind right now. I did everything I thought I needed to do to get some sleep. I didn't drink caffeine, I exercised mildly and early. I took 2 pills. I wasn't even CLOSE to falling asleep.
Get the sleep study report. My guess is that you slept more than you think you did. You may not have slept much, but you did sleep SOME.

Note: Insomniacs are notorious for NOT being able to tell when they are asleep and when they are awake. Seriously, there have been a number of scientific studies that show insomniacs regularly mistake Stage I and Stage II NREM sleep for Wake. In other words, insomniacs often believe they are AWAKE when the EEG data and other data indicate they are ASLEEP.

Don't give up: You'll get through this one way or another. But be honest with the doc and tell her that you feel as though you didn't sleep at all last night and that if another study needs to be done, then you will need to have some kind of sleeping aid prescribed.

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Last edited by robysue on Sun Apr 26, 2015 9:22 am, edited 1 time in total.

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Re: I failed the Sleep Study

Post by 49er » Sun Apr 26, 2015 8:59 am

If the doc decides that a titration in the sleep lab would be the best option, when asking for sleep medication, please request around 5 pills. That way, you can try it out ahead of time to make sure it is going to work satisfactorily.

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Re: I failed the Sleep Study

Post by Hopefullady » Sun Apr 26, 2015 9:07 am

Enchanter,
It sounds like you were anxious.
Anxiety comes from fear. (Maybe afraid you wouldn't sleep!)
And fear plays off itself and gets bigger and bigger until we're frustrated.

The answers are all inside of you.
You CAN stay up for 36 hrs and show up for your next study exhausted, if that's what you need to do.

I talk to God and ask for help (gently) and say prayers - and that helps me sleep.
Let yourself be gently cocooned in the loving arms of a Power greater than you. He knows what you need.

Let go.

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Re: I failed the Sleep Study

Post by Enchanter » Sun Apr 26, 2015 9:32 am

robysue wrote:
Enchanter wrote:
And if he put you on a CPAP, that meant the O2 levels were dropping precipitously as soon as you were asleep. Which is what you've been saying was happening all along. So now that there's hard evidence that you have a problem with your O2 levels during sleep, you want to claim you didn't sleep a wink?

Robysue. You have to understand what I'm trying to say. I remember being wide awake the whole time. I mean I guess it's possible that my brain was technically asleep according to the test, but part of me was awake. But if you had me swear to tell the truth, I'd say I was 100 percent awake the whole time, much in the same way I'm awake most nights until really late. I remember everything and don't remember being asleep at all. Remember, what it says and what I feel are 2 different things. I didn't sleep a wink according to me and I remember being up all night 100 percent, but who knows maybe the test says I was asleep for 1 or 2 seconds. If I was asleep it was so small, that I didn't notice. It could have been less than a split second. You have to believe me. I felt wide awake the whole time.
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Re: I failed the Sleep Study

Post by Enchanter » Sun Apr 26, 2015 9:36 am

BlackSpinner wrote:The fault is with the doctor in not prescribing ambien. There is no effect (or minimal which can be adjusted for) on the sleep study to take ambien.
I was firm with him. I told him there was a strong chance that I wouldn't sleep. He said that most people sleep a couple hours and that I probably would too. I think the doctor didn't listen to me. I told him 2 or 3 times that it would be a problem and he kind of brushed it off.

The guy there said that it was a bad test. What is weird is that the guy at the sleep lab thought I napped for a short time because he said my oxygen was low. So when it was time to go home, I asked him about my oxygen, but he wouldn't talk about it at that time. He just said the test was no good and we need to do it over. He wouldn't talk about the oxygen. But he must know something since he did mention it early on in the night before he put the mask on me.
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Re: I failed the Sleep Study

Post by BlackSpinner » Sun Apr 26, 2015 9:38 am

But if you had me swear to tell the truth, I'd say I was 100 percent awake the whole time, much in the same way I'm awake most nights until really late.
That is the thing about being asleep - you are not awake to store the memory.

My ex swore that they didn't sleep at all at night. However there was a big "rumble" in the street below (about 100 young men fighting) that I called 911 for. My ex never knew about it, slept right through it.

Note the techs are not allowed to give out information. You slept enough for him to become worried and put the cpap on.

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Re: I failed the Sleep Study

Post by yaconsult » Sun Apr 26, 2015 9:39 am

robysue has covered it all - masterfully. It is not at all unusual for people to swear that they did not sleep a wink during their test only to find out that they did. All the equipment you were hooked up to can not be fooled. They were monitoring your brain activity, your respiration, your blood pressure, your eye movement, your leg movement, and they recorded you in the bed with a video camera. The people in the sleep lab do this testing to all kinds of people every night and use specialized equipment designed for the purpose. Wait until the sleep test report is available to you. It will tell you exactly how much you slept and many other aspects of your night. Please be a bit patient and look at what comes out of the test.

It is not that unusual for people to have to go back a second time and there are a number of reasons why this will could be necessary. Again, wait for the followup discussion with the doctor and what his recommendations are. Discuss your concerns with him and let him advise you of the best way forward. Best of luck to you!

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Re: I failed the Sleep Study

Post by SleepDisturbed » Sun Apr 26, 2015 9:47 am

I felt wide awake the whole time.
We sometimes literally CAN'T tell that we fell asleep. We have almost all had the experience of KNOWING we didn't sleep a wink, when others around use were subjected to a few hours of really obnoxious snoring noises!

So please realize that the tech, who can observe our brain waves, has objective evidence recorded in the computer of how much we slept, when we slept, and what type of sleep we had. What we feel subjectively, about this and a number of other things in life, is often NOT the best evidence of what is really happening.

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Re: I failed the Sleep Study

Post by robysue » Sun Apr 26, 2015 10:04 am

Enchanter wrote: The guy there said that it was a bad test. What is weird is that the guy at the sleep lab thought I napped for a short time because he said my oxygen was low. So when it was time to go home, I asked him about my oxygen, but he wouldn't talk about it at that time.
The tech is legally NOT supposed to tell you anything about the test. He is NOT a doctor and cannot make formal medical diagnoses.

However, if some pretty strict conditions are met in the data early enough in the night, the tech is allowed to decide the data looks bad enough to warrant putting the patient on CPAP for the rest of the night. This is not something the tech has much discretion on: Either the conditions for a "split study" are met and the tech puts the mask on your nose or the conditions for a "split study" are not met and the tech does NOT put the mask on your nose.

Clearly having OSA is not, by itself, a condition for the tech to stop the diagnostic part of the test and move onto titration; most people with run of the mill moderate to low-end severe OSA don't wind up meeting the conditions for a split study and have to return for a full titration study. But seriously low O2 desats while asleep are enough of a reason for the tech to move onto the titration stage of the test.
He just said the test was no good and we need to do it over. He wouldn't talk about the oxygen. But he must know something since he did mention it early on in the night before he put the mask on me.
Again: The tech is legally NOT supposed to tell you anything at all at the end of the night since he is NOT a doctor.

And whether the test must be repeated or not depends on what the doctor thinks of the data gathered, not what the tech thinks. If the doc thinks the test's data is good enough to diagnose OSA (or any other condition), the diagnostic part of the test will not need to be repeated. If the titration phase of a split study is not successful, then the titration part of the study may need to be repeated. Or the doctor can simply prescribe an APAP with a pretty wide range for a couple of weeks and do the titration that way. It's up to the doctor to decide whether the test needs to be repeated.

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Re: I failed the Sleep Study

Post by palerider » Sun Apr 26, 2015 10:08 am

*PLEASE* put aside what you think you know, and LISTEN, REALLY LISTEN to Robysue.

everything she's telling you is correct.

you may not want to believe it, but it is all 100% correct.

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Re: I failed the Sleep Study

Post by Madalot » Sun Apr 26, 2015 10:11 am

palerider wrote:*PLEASE* put aside what you think you know, and LISTEN, REALLY LISTEN to Robysue.

everything she's telling you is correct.

you may not want to believe it, but it is all 100% correct.
Yep -- I second this.

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Re: I failed the Sleep Study

Post by Pugsy » Sun Apr 26, 2015 10:17 am

palerider wrote:*PLEASE* put aside what you think you know, and LISTEN, REALLY LISTEN to Robysue.
I third it.

If they put you on a cpap machine during the night then you met whatever criteria that lab uses to initiate cpap therapy....and you need it. There are strict guidelines and criteria that have to be met before changing to the cpap machine therapy. You may not think you slept enough to meet anything but you did and it's documented in the data that all those wires and sensors collect.

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