Opinion of home sleep studies

I was diagnosed with sleep apnea with a home oxomitry test. Based on that test my family Dr ordered CPAP therapy. (That’s the extent of the information provided to me) I’ve been doing a lot of reading to learn more about sleep apnea etc.. and I’ve read articles that say the type of test I had is not sufficient to diagnose sleep apnea. Was curious your opinions. I could ask for a full sleep study but not sure if I’m over reacting or what meaningful additional data it would provide, I’m sure it will be expensive. I just want to feel confident that my diagnosis is correct and that the treatment makes sense. Especially since I’m having such a hard time adjusting to the machine.

My belief is that any sleep study that relies solely on inferred blood O2 levels is insufficient to either diagnose or treat SA. There are other conditions that may cause low blood O2, and not all sleep apnea patients have therapeutically significant reductions of blood O2. On the other hand, it can be an indicator of SA issues, then when coupled with both a follow-up blood O2 and the detailed data from a full data xPAP, then a diagnosis of SA may be reliably made.

In the event that a blood O2 history is used to prescribe an xPAP, then diagnosing and treating other causes of low blood O2 may be delayed and be causing unnecessary delay in treatment. There are more comprehensive home sleep studies, I would rather start with that if SA is suspected than dinking about with baby steps while the patient feels like crap.

LizzyB wrote: ↑

Wed Apr 18, 2018 2:44 pm

I was diagnosed with sleep apnea with a home oxomitry test. Based on that test my family Dr ordered CPAP therapy. (That’s the extent of the information provided to me) I’ve been doing a lot of reading to learn more about sleep apnea etc.. and I’ve read articles that say the type of test I had is not sufficient to diagnose sleep apnea. Was curious your opinions. I could ask for a full sleep study but not sure if I’m over reacting or what meaningful additional data it would provide, I’m sure it will be expensive. I just want to feel confident that my diagnosis is correct and that the treatment makes sense. Especially since I’m having such a hard time adjusting to the machine.

Always ask for a copy of your sleep study. If you have run of the mill sleep apnea, the home sleep study along with an autoset machine should be sufficient to control and treat SA.

LizzyB wrote: ↑

Wed Apr 18, 2018 2:44 pm

I just want to feel confident that my diagnosis is correct and that the treatment makes sense. Especially since I’m having such a hard time adjusting to the machine.

Learn to use Sleepyhead and post a chart of a typical night. We can help you determine whether the diagnosis was correct.

Why did you have the home oximetry study? What symptoms had you been experiencing that lead to the study?

LizzyB wrote: ↑

Wed Apr 18, 2018 2:44 pm

having such a hard time adjusting to the machine.

What problems are you having? Lots of experienced members here who overcome big problems of their own. They would like to help you.

I’ve been complaining to my Drs for years about being so tired constantly, all blood tests look good, the only thing left to test it seems was my sleep. I’ve always been a really good sleeper in that I fall asleep quickly and stay asleep all night so I didn’t think sleep apnea would be the problem. But I will try anything to figure out why I’m so tired.

I did download sleepyhead but I haven’t be able to fall asleep yet, it’s only been a week but I feel very claustrophobic, my ears feel plugged, my throat hurts and that’s from about 2 hours or so each night as I try to fall sleep. It seems as soon as I start to drift off I wake with my heart racing and feeling like I can’t breathe. I upped my starting pressure to 6 from 4 based on advice from here which I think helped a bit but right now I’m more exhausted than ever and am questioning if I can do this.

Home oximetry alone is just a screening test. If it shows apnea, you definitely have it, but that's not necessarily the entire picture.

There are home sleep tests that give a LOT of data, that can help distinguish sleep issues, identify more than just OSA, etc. An example is the Itamar Watch Pat http://www.itamar-medical.com/. These devices are approved by the FDA and Medicare for home sleep studies. Since the majority of sleep apneas are obstructive sleep apnea, they are very good for diagnosing that, but may not be ideal for more complex sleep issues.

I was stuck with a home sleep study because that's what Kaiser does. They play the law of averages, and in most cases that's adequate--they only have to bring a small number of people into the lab for testing.

Personally, I was grateful. I would not have tolerated an in lab sleep test, and my OSA would STILL be undiagnosed. The home test was unobtrusive and has the advantage of being in your own bed and sleeping conditions. You are more likely to sleep deeply to get good data. And you are very unlikely to really need more detailed testing.

It's also whoppingly less expensive which is a big consideration now in the days of giant deductibles and co-pays.

LizzyB wrote: ↑

Wed Apr 18, 2018 4:16 pm

...but right now I’m more exhausted than ever and am questioning if I can do this.

you can do this. you're stronger than you think.

for most people, myself included, it was a struggle to get used to the treatment. don't think that you've been misdiagnosed as that rarely, if ever, happens.

stick with it, tell us the specific problems you are having and someone will come by with the right advice.

stick to it!

I had a home oxomitry test and passed it with flying colors. I have a deviated septum and could sleep OK on my left side. Six months later I was planning a left hip replacement and knew I would not be able to sleep on my left side. I went back to the sleep doctor and had a full blown sleep-over test. I failed miserably with an AHI of about 75.
Also insurance will pay something with a sleep study done but I can't imagine any insurance paying for CPAP eqpt w/o a sleep study. Medicare definitely would not pay.

My insurance would not pay for an in hospital sleep study first. So I did an at home sleep study which included a sensor belt, nasal cannula and pulse oximeter. My AHI was 20.8 with lowest desaturation 88%.

They recommended a sleep study with titration.

I think the home sleep study in my case did its job. I bet that I would have been worse if I was a back sleeper. But I always sleep on my side.

LizzyB wrote: ↑

Wed Apr 18, 2018 4:16 pm

bout 2 hours or so each night as I try to fall sleep

Even if you don't sleep, can you post the daily detail graph? It may give us a clue about what is wrong.

LizzyB wrote: ↑

Wed Apr 18, 2018 4:16 pm

I’ve always been a really good sleeper in that I fall asleep quickly and stay asleep all night so I didn’t think sleep apnea would be the problem.

Many people who have sleep apnea report something similar to this before they are diagnosed. Falling asleep quickly is a sign of sleep deprivation that often comes from untreated sleep apnea.

I had a take home test from Kaiser and I honestly did not buy it. The thing with Kaiser, is they have a computer grade your ahi score and a dr dosent even look at it. That's why I really didn't buy it. I was awake for the first 4-5 hours watching tv and moving my 02 sensor from finger to finger as it was uncomfortable. That caused my 02 to go gown to 81 percent even though it was not accurate. Based on Sleepyhead info, when you are awake your breathing patterns move all over the place and can be falsely flagged. I think that is what happened to me and of course Kaiser would not listen to me when I told them.

I then bought an 02 sensor and wear it every night. I do have a problem with my 02 but usually when I am laying down and not asleep its from 90-95 percent as opposed to 97-98 when standing. Pugsy is still working with me on trying to get it figured out what it may be. I tried a cpap and my 02 level actually went lower, most likely it was causing centrals using the cpap. Once I get better Im going to try to investigate it further and find out what is causing my low o2 level's. It could be OSA but I don't fully buy it yet.