Tell us about your sleep center experience

Howdy cpaptalk'ers,

BubbaHill introduced himself and said he wasn't really sure what to expect when from his coming visit the the sleep center. I think this is a common concern and I haven't really seen anyone give good content and advice on this topic on our website or on that other website.

Anyone willing, can you please relate your experience? What are the basic steps they take you through? What was good about it? What should someone watch for?

If that other website does give good information on this topic, feel free to link to it. This is important, lets get the word out here!

Also, if she has time next week, I may ask the manager of our Sleep Lab to write up a little bit on it.

Hi folks,

My best friend Bill, was diagnosed with sleep apnea before I was. If it wasn't for him, I would not have know to be tested for sleep apnea.

Bill was asked to write his story for the American Sleep Apnea Association's website.

Bill’s Story: It Was a Big Deal, After All

I had actually known I had sleep apnea for a number of years; I just didn’t do anything about it. My wife would tell me that I stopped breathing during the night and that she would lie awake counting the seconds until I started to breathe again. I thought I was sleeping through the night, so I never really gave it a lot of thought. Anyway, what’s the big deal? So I snore and stop breathing. At least I’m getting some sleep.

I did know I was often tired by the end of the day--and during the day. If I went to lunch with a group of co-workers, I would usually migrate to the back seat and take a five- or ten-minute nap on the way back from lunch. I would snore the whole ride back to the office. They were amazed that I could go to sleep at the drop of a hat—and annoyed, too, about the snoring.

A few years ago I went for a routine physical, and my doctor asked me at the conclusion if there were anything else she needed to know. I told her I had sleep apnea. She asked me how I knew, and I told her about my wife’s account of my sleep habits. She then asked me if I ever fell asleep while driving. I confessed I had mastered the art of taking a quick nap at traffic lights on the way home from work--but I’d wake up before the light turned green. This really got her attention, and she pulled out a business card from her desk for a sleep specialist.

Several weeks later I found myself checking into a sleep clinic for the first of two evenings. I was wired astronaut-style with a number of electrodes. The individual wires all terminated into a box about the size of a computer mouse which was then connected to a larger cable connected to the recording equipment. (This disconnect feature came in handy later in the evening when it came time to use the restroom down the hall.) I slept in what looked like a standard hotel room. There was a small video camera mounted in the corner of the room on the ceiling (to let the sleep center compare the printout of my breathing—or lack thereof!--with any tossing or kicking in the night). I woke up the next morning, and the technician told me she had been monitoring two patients that night and didn’t pay much attention to either of us but she thought at a glance I had a pretty serious case of apnea. My actual "log" of activity that documented the entire evening was stored in a computer, and from that the center would generate a report.

The next night I returned, knowing that the diagnostic study must have shown I had apnea, and spent the night in the same room with the same number of electrodes, and the same technician wired me up. The only difference is this time I used an apparatus called a CPAP (Continuous Positive Airway Pressure) machine to keep me breathing; this study would determine what CPAP pressure I needed to control my apnea. I have a full beard, so the tech used the nasal pillows instead of the standard mask as the whiskers on my face probably would have prevented me from getting a good mask seal and would have caused mask leaks. I thus used a "Y shaped" deal that actually fit into my nostrils with round accordion-shaped "pillows" to route the air into my nose. I spent the night connected to the computer again while the technician was able to control the CPAP machine via remote control and experiment with different settings to see which ones worked best.

Waking up that second morning in the lab was amazing. I felt like a ten-year old who had polished off a pot of coffee. I couldn’t believe how completely refreshed I felt! It was truly like the difference between day and night.

A couple of weeks later I was in the specialist’s office, and he read me the results of the first night’s diagnostic testing. I had experienced an arousal (a mini wake-up call from the brain to resume breathing) 592 times during the night. This averages out to about 45 seconds of sleep at a time. My sleep was so interrupted, I rarely had any dreaming sleep, so no wonder I remembered dreaming only a couple of times a year! The doctor actually sat straight up in his chair when he got to the blood oxygen levels. A normal level is 95%+. Mine had desaturated or dropped to almost 50% during the night. He said, "This is serious. This can kill you." He noted that I had probably been sleep deprived for about fifteen years. You may wonder how anyone could put up with this sort of thing on a nightly basis. The answer is simple: if you don’t know it’s going on, you don’t realize it is a problem. And you become used to the sleepiness and all the other problems sleep apnea causes, and you don’t know it’s possible to feel any different.

Another week or two went by and I received my bi-level machine. A bi-level differs from a CPAP in that it has two pressures: the higher inhalation pressure keeps me from having apneas, and then the pressure drops to allow me to exhale more easily. (The results of the second night’s testing were used to set the machine’s pressures before it was delivered to me.) My case was such that the sleep study revealed I would need this type of machine. My machine is also fitted with a humidifier unit that uses distilled water to keep my nasal passages from drying out as I sleep. The whole thing is about the size of a shoe box.

I am pleased to report that after two-and-a-half years, I have had little trouble with my machine. I have traveled all over the United States and have been to nine foreign countries with it. My unit features self-tapping voltage selection--in other words it will run on any available power, all I need is an adapter on the existing power cord to plug into the wall. I have run into two fellow travelers with similar machines at airport security checkpoints and even a store clerk with a machine as I purchased a container for my humidifier unit.

I will admit me with the headgear and the machine is a sight to behold…a real "babe magnet." Yet with it, I can be assured a good night’s sleep wherever I go. I also don’t snore anymore. And my wife is very pleased with that change.

Untreated sleep apnea is a big deal, after all.

Howdy,

That's a super article, thanks Ted!

Thank you for the reply. I'm feeling easier about it now.

After reading more about sleep apnea, I'm finding this may account for other issues with my health.

Is anyone familiar with the relationship between cpap and claustrophobia? Also, what is the noise level of the machine?

For me, The events leading up to being tested for Sleep Apnea took place over a number of years! Back in 1994, while staying with my folks in Florida, they told me that I sounded like my breathing stopped when I was sleeping. Then, over the next 9 years I started dozing while at work, or driving. My first thought was a tumor or something and my first reaction to my wife telling me I was falling asleep while driving was to deny it! Possibly out of fear of admitting something was wrong?
Anyway, one day I fell asleep right after turning onto an exit on the interstate and ended up on top of a snowbank! That scared me into realizing that I was going to end up killing someone if I didn't get it checked out. Made an appointment with my doctor for the very next day. She said it sounded like Sleep Apnea and sent my info to the sleep center that day. Within two weeks, I was scheduled for a sleep study.
In looking back, I think I was more concerned with what they wouldn't find than what they would! When I arrived at 8:00 PM as requested, they assigned me to a room and told me to settle in and relax, watch TV, read, etc. When I felt I was nearing my bedtime, to ring the buzzer and they would come and prep me. At that time, I was always so tired, I could fall asleep while turning a page!
When I buzzed and they came in with the prep cart, I thought "oh no, all those wires won't fit n me!" Well about 20 minutes later, I found out they did! I asked the technician if people really fell asleep with all those wires on! She assured me that I would fall asleep. And she was right, although it didn't seem like a peaceful sleep, especially that darn red light coming from the Blood Ox clamp on my finger! I felt like ET!
Anyway, it felt like I was asleep for an hour when they woke me up to put a CPAP mask on me. They put the mask on, then started to put a chinstrap on and I asked them to try it without the strap as I was feeling very claustrophobic. They agreed. NOW I was lying in bed, a cross between ET and Darth Vader!! Well, they woke me up once more to increase the pressure, but told me I was doing fine sleeping with my mouth closed so they didn't insist on the chinstrap.
When I met with my Sleep Doctor the next morning, he showed me the graph of what I assume where Apnea's. I didn't ask many questions, but he indicated that the ups and downs on the graph were so tightly spaced that it was a thick bar across the chart until thy put the mask on. Then they became spaced out, and then he showed where they adjusted the pressure and the ups and downs were very far apart.
I agreed to spend the day in the hospital sleep center to participate in a study they were doing which also meant I'd have to reamain when I went back 100 days later, but it was worth it to me to help out any way I could.
The scariest part of all of this ended up dealing with the local DME and my medical insurance company, who (lucky for me, in writting) First said tey would cover the cost of the CPAP, THEN told me that our plan only had coverage for 100 days rental of DME! I threatened them and they ended up covering it, but I've paid for everything out of pocket since.
I know this is very long already, BUT in closing, I would encourage anyone who has the slightest suspicion that they or someone they know suffers from Sleep Apnea, PLEASE see your doctor. Many times the effects build up and while you may not be falling asleep while at the wheel of a car, truck, bus, etc now, you MAY be next week!
Getting diagnosed and going on CPAP more than likely saved not only MY life, but my wife's, Grandchildren, and any number of inocent people that I met every day while driving!

Is not different from one described at the beging, except my 2 overnight studies have streched over a period of 6 months due to long waiting list for Stanford Sleep Clinic. I didn't know what to expect first night and was amazed by number of wiress applyed to my body. What shoked me to the point of thinking to stop whole process before it began was PES (esophageal pressure monitoring). MD most likely told me they are going to use PES but what did I know what that means. It took enormous effort on technicians part to have that (really and honestly) small cathether showed through my nose down to esophagus. But I lived and sleept somehow and PES actualy "discovered" additional 9 arousal episodes per hour. Second night study was a breeze because I knew what to expect and there was no need for PES.

BubbaHill wrote:Thank you for the reply. I'm feeling easier about it now.

After reading more about sleep apnea, I'm finding this may account for other issues with my health.

Is anyone familiar with the relationship between cpap and claustrophobia? Also, what is the noise level of the machine?

Different machines have different noise levels. The newer the quieter I believe.

I am not sure on the claustrophobia. I blame the apnea for my acrophobia. For many years I would wake up feeling like I was falling. I became acrophic, when I had not been. After several years on cpap I no longer woke up startled fearing that I was falling, and my acrophobia has decreased. I think my body used that particular fear to wake me up when my breathing stopped. This is just my opinion, but I am convinced this is why I developed my fear of heights.

Hello

I still remeber my 1st sleep study....I was so fatuiged from sleep deprivation that I found myself nodding off or groggy trying to keep awake. They had prompt me to finsh filling out the paperwork and stay awke long enough for them to get the wires stuck on me frist!!!

I wasn't too clusterphobic due to the fact I was sleeping in a small room with a camera in it looking at me. I guess if one's tired whatever the surrounding of the sleep lab didn't bother me. Once I had a big room for and later found out at my 1st sleep study the bigger rooms were for those who aren't bulk billed patients.Bulk billed or not I still got reasonable sized room!

2nd study with CPAP, slept like a gem for the frist time in long time, I woke up jumping full of beans. Only problem was with nasal mask...Been a flat nosed patient the mask slide off so they tighten it , but later it was on too tight and lost the skin off my face! [how painful, Ilost the skin completely!]

But the next night without the CPAP machine, "CRACK!!!" oh boy, my aching head....sleep apeona had recurred during the night without the machine. In less the few weeks I was settling with sleeping with CPAP for the frist time ever. Then later on nose op and made it somemuch better to able breath thru my nose for 1st time in my life. I spent alot years with completly blocked off nose.

it was strange breathing thu my nose for the frist time ever!!! [The operation in late 2002]

I've had two sleep studies. I have only two pieces of advice. The first is that if the clinic doesn't provide prescription sleeping pills, bring your own. The last thing you want is to go to a clinic and be unable to sleep. I understand that Ambien is the preferred sleeping pill for these things.

At the first clinic, they prescribed Ambien for all their patients. I tried to get to sleep for 45 minutes without success. I then took the Ambien and was off in slumberland about 20 minutes later.

I had the titration test at a different clinic. They do not prescribe sleeping medication there, but you can bring your own. I knew that in addition to the million wires, there would also be the CPAP machine. I realized I would never get to sleep without an Ambien.

I figured it would be no problem. I called my sleep apnea doctor for a prescription. I discovered that it is his policy never to prescribe sleep medication for his apnea patients. He wouldn't even give me one pill for the study, but he doesn't have a problem if the clinic provides it. I still don't understand this.

Finally, I called my regular doctor and begged an Ambien prescription from her. I paid $11 for one pill.

Even with the Ambien, I didn't get to sleep until 2AM and slept only three hours. Without it, I doubt I would have slept with the CPAP at all. (I still hope to get used to the CPAP. I know I'm going to have to use it without sleep medication.)

The second thing I should mention is that I slept better WITHOUT the heater and humidifier. I only fell asleep after they were turned off. This was my idea. The tech wouldn't have turned these off if I hadn't asked for it.

The reason was this. I feel a little claustrophobic in the mask. I knew I was breathing, but when the air was warmed and humidified, it didn't feel like there was any air going into my nose. That felt weird, like I was suffocating. When the air was a little cooler, I could feel it. In the back of my mind, that reassured me I was actually getting air.

Ambien works wonders in the sleep lab. I used to tell my patients that if the ambien didn't work, that I would be in to hit them over the head with a frying pan. lol

ted

I should add a PS to my comment on humidifiers. I live in an area that is humid and indoor humidity rarely drops below 60% in the absence of A/C. I'm sure that's a big consideration.

I had my first sleep test in June of this year and the doctor did not and I did not know to ask for a sleeping pill.

It was a Sunday night, raining and me with two bad knees carrying my case and my pillow and trying to get into a sleep center by having to phone someone to "buzz" me in. I called the wrong extension, got some "lady" on the other end who told me to go around to the back entrance. Hobbling to my car with my junk I drove to the back, went in (still raining) and the guard there said I had to walk all the way around......boy was I angry. I got back into my car (still raining and my knees are killing me) and go back to the original entrance and called (the right # this time) and they "buzzed" me in. Needless to say, I was really frustrated and when I reached the sleep floor there was no one in sight....no tech, no patients...no one. I felt like I was in the "Twilight Zone". Finally after 10 minutes waiting the Tech came (he had been w/patient way down the hall) and put the video in and told me to change, started wiring me up like a Firecracker on the 4th of July and was telling me what to expect.

Well, strange place, strange bed, noisy air conditioner did not help when I settled down for a long wired up night. I tossed, turned (knowing someone was watching) and could not sleep. On top of it all, I had to call out "David" 6 times that night to have him unwire me so I could go to the bathroom. He gave me 2 benadryls but they did nothing so when he came into my room at 5:30 a.m. and said that I had slept for 2.5 hours I was shocked. I was so exhausted and frustrated because they could not do the tiration part of it and went home and went to bed. I had to go back a couple of weeks later and take the test all over again.

This time it was a Tuesday night, I got a prescription for Ambien and there were many more patients there and more techs. I got a female this time and she wired me up, gave me several masks to try out and then when I chose the Activa, took the pill and konked out for the night and selpt until 6:00 a.m. FINALLY, after two tests they found that I have severe SA and put me on CPAP and Activa.

After a month of CPAP (which I could not stand the constant pressure) they put me on an Autopap and now I have a ResMed Auto, Mirage Activa and Swift Pillow masks. It took me 6 weeks to finally sleep through the night and have been having a good night's sleep now for 3 months.

I notice the difference of being more alert, no more heart pounding middle of the night anxiety feelings, no more, so tired in the daytime at work even though I still get tired after work (I am 65 and still working) but get my second wind when I get home and stay up sometimes until 11:00 p.m. now. All I can say is that sleep therapy has made a HUGE difference in my life and I am very thankful for it.

Sorry this is so long but I wanted anyone who has to go through this to know that you are not alone in this and your experiences. We have all gone through something like it and have struggled to conquer this. It takes a ton of patience and determination but in the end its well worth the effort.

Good Luck and this list is wonderful with help, support and encouragement.

Judy

The ambien works well, only be sure to take it early. In the one sleep study I had in which I was given the ambien it was probably around 1 am. The sleep techs generally kick one out about 7am. I almost had several accidents on the way home because I did not take the ambien into account.

My first sleep study was in 1983. It was in the only sleep center in our city. There are now at least 3, probably more. I like the current conditions much better. In my first study an monitor was inserted nasally. I discovered I had a faulty septum when it would not go down one side of my nose. I was hooked up so that I could not get up to use the bathroom, and had to use a bed pan.

I am glad that now the electrodes are more easily disconnected!

I've snored for over 30 years, ran the wife out of the bedroom about 7 years ago, but always felt I slept like a log. It's only been the last year of so that I have had a feeling I wasn't getting enough sleep and was coming home from work looking forward to a short nap. After all, I'm 59 and figured I was due to slow down a be a bit sleepy at the end of the day. My wife doesn't nag but she "urges" frequently, and to avoid another "urge" I agreed to take the apnea test. I started out with some little thingy hooked to my finger overnight to monitor my blood oxygen and woke up several times during the night to see how I was doing. I started out at about 91, all relaxed and ready for a good nights sleep...I noticed at one point I was down to 61, but hey I was in dreamland and didn't have a clue what normal was to begin with so all was well. Obviously 61 was not good and the following week I was booked into the hospital for the full test. I actually laughed out loud at the poor technician as he told me no sleeping aids would be allowed, jammies were required or they would provide me with a gown, and I would have to sleep on my back with more wires tied to my body than the inside of a fiber optics cable. First of all I have never slept on my back in my life, secondly I have never wore pajamas and thirdly I have had to take Ambien for about 3 years now to even get to sleep. I laid there for about 3 hours trying to find a comfortable spot on that rediculous hospital bed and thinking they really need me to go to sleep or this is a lost cause. I managed about 2.5 hours sleep and woke up with my jammies up around my neck, back so sore I couldn't move and two or more wires jerked loose and flopping around my neck. They then scheduled me for the next phase the following week where I would attempt the same routine except this time on the commercial grade cpap with a mask. Again no meds so around 1:00 A.M. I must have dozed off but awoke at 3:00 with the bridge of my nose feeling like somebody had whacked it with a hammer. I had no problem with all the extra air being forced down my throat. Did find out though that I had to keep my tongue locked in place or I started puttering like a toy tractor in the sand box. I told the tech that there was no point in going any further cause my nose wouldn't handle any more of that mask and had horrible thoughts of being diagonsed with apnea and having to look forward to bone grafts to repair damage to the nose on a regular basis due to that dumb mask. I wanted out NOW. So, I packed my Walmart sack and went home at 3:30 A.M. Talked to the doc the next day and yep, I had apnea...how convenient I thought, was thinking this guy sure resembled the old snake oil salesman. Thought sure i could hear a "quack" in the background as he was telling me all this technical data and how I should be set up with a cpap. But, at my wife's "urging" I went ahead and called a recommended vendor and had that dude delivered. So far so good I think, have had some problems getting the right size mask and haven't tried anything but the Mirage Aptiva but at least the bridge of my nose is happy. I'll whip this machine one way or another but still kinda wonder if I wasn't sold a bill of goods based on the apnea tests as administered.

Hanging in there,
papasmurf