Remmers Sleep Recorder vs. Sleep Study

SWS on another thread provided on another thread a link to the Remmers Sleep Recorder.

http://www.21stcenturydental.com/Remmers.htm

This was how I was diagnosed with my OSA. The sleep doctor (whom I didn't meet) sent a report to my GP with a recommendation that a Prescription for a CPAP or APAP be prescribed. Miraculously, the doctor wrote a prescription citing both. The RT at the DME provided me with my Remstar Auto! Pressures 7-15 cm.

Not having the wonderful experience of many of you in a true sleep study, I am wondering other than the rediculously low cost of $150 Cdn for the study, if anything was missed. Would sleep study in a clinical setting with titration be a better scenario? If the Remmers sleep recorder is a good alternative why isn't it used more - my guess from reading previous threads of costs of sleep studies tell me that there is too much money at stake and the Remmers doesn't provide a big enough margin (my apologies if I am dead wrong - cynical side may be showing ) or that Remmers is not as good a tool as a sleep study in a lab?

Well into my third and closing in to 4 years of treatment, I am feeling better and better every morning (why it took so long - I am not sure) I guess I was that sleep deprived!

I would guess that it would do very well for vanilla cases of OSA. It may not be as helpful if the user had some SDB (Sleep Disordered Breathing) complications - but a good doctor would I am sure, only recommend using the machine if he was reasonably confident the user was vanilla OSA.

The reality of self diagnosis, is that it is likely to be the only way many people will ever get a sleep study. I believe most sleep centers are booked out months ahead.

DSM

In reading of your concerns, I thought to represent the "portable monitoring" industry and say that your case is exactly the reason we have been laboring for over a decade for the legitimate recognition of these simple, scientifically validated devices as an alternative to ignorance, entrenched traditions, expense and inconvenience to the overall patient population.

We manufacture the Remmers Sleep Recorder, in use at hospitals, clinics, home care companies and dental offices. As of recent, Medicare boldly declared for coverage of home testing, in contrast to the attitudes of prevailing commercial payers and industry associations. Expect for a cascading effect for acceptance.

To answer your plight, we agree- there should be an easier way for you to call a practitioner, get a device and obtain your results. Currently, the use of portable monitors is selective among a small community of early adopters who are fortunately self-motivated to be informed of the supporting literature and dedicated to serving their patients.

Hey, I'm just an xPAP patient, no ties at all to the medical profession or the sleep products manufacturers or providers. The only problem I see w/these at-home sleep tests is that they can not detect the myriad of other sleep disorders that can occur concurrent w/OSA. I think they are great screening tools.

The only problem I see w/these at-home sleep tests is that they can not detect the myriad of other sleep disorders that can occur concurrent w/OSA. I think they are great screening tools.

Yes and here in Quebec, Canada that is the FIRST sleep test you get. If that doesn't answer all the questions and make a difference THEN you get the big expensive sleep study. But first it is a machine and an oxymeter to take home. Most people can be diagnosed and titrated cheaply that way. Why waste sleep lab time on garden variety OSA or titration?

I had both my PSG's done at home and both were right on the money. I was given the choice of a sleep lab study or at home study. I opted for the home study. ..I prefer the comfort of my bed to the sleep lab. The at home study picked up everything that the lab would have picked up and I slept seven hours the first study, with only two interruptions. The second study, eight hours, with only one bathroom interruption. By that time I had adapted to CPAP therapy. There's no need to go to a sleep lab, the home studies are just as accurate and much more comfortable. JMHO.

Dan

sleepngo wrote:I had both my PSG's done at home and both were right on the money. I was given the choice of a sleep lab study or at home study. I opted for the home study. ..I prefer the comfort of my bed to the sleep lab. The at home study picked up everything that the lab would have picked up and I slept seven hours the first study, with only two interruptions. The second study, eight hours, with only one bathroom interruption. By that time I had adapted to CPAP therapy. There's no need to go to a sleep lab, the home studies are just as accurate and much more comfortable. JMHO.

Dan

Home studies can not pickup brain activity and apnea events due to the central nervous system. They are fine for OSA - obstructive sleep apnea, however, still could miss important other events. Also the lab folks can observe sleep disturbances and correlate that with the readings on their equipment...

Some of our more experienced folks can weigh in on this for a more accurate response.

Hi Fredman, my sleep study recorded 35 centrals, but when pressure reached 12cm, they were eliminated, the RT concluded they were sleep related. The equipment I used also recorded brain waves, that may have indicated they were sleep induced centrals. My second study was done after nasal surgery, which lowered my pressure to 10cm, my data capable auto and Bilevel machine, both indicate they were right. I down load my data, just about every day to check my stats and to make adjustments. Most of my adjustments are Biflex or SP related, the Ipap and Epap have basically remained the same sense my second PSG home study. When checking my data, the titrated pressure of 10cm seems to be right on the money.

Dan

costs of sleep studies tell me that there is too much money at stake

Unfortunatly that would be the case.

I have used Embletta PDS which uses the same tools and software (somnilogica) as the sleep lab in terms of SDB. With a proxy we can perform either EKG or EEG monitoring.

I have ordered the Phillip/Respironics PDX which has the SDB tools as well as EKG+EEG.
(have not used it yet)

Both these units also provide a lead to the leg to monitor for PLM's.

No exp. with Remmers

With Auto Titration technology, we can/have successfully identified and titrated for all forms of OSA's including CSA.

This can be done at a third of the cost of a "Gold Standard" sleep study.

I come to the conclusion that when you find a way to save people millions of dollars, people must loose millions of dollars.

sleepngo wrote:Hi Fredman, my sleep study recorded 35 centrals, but when pressure reached 12cm, they were eliminated, the RT concluded they were sleep related. The equipment I used also recorded brain waves, that may have indicated they were sleep induced centrals. My second study was done after nasal surgery, which lowered my pressure to 10cm, my data capable auto and Bilevel machine, both indicate they were right. I down load my data, just about every day to check my stats and to make adjustments. Most of my adjustments are Biflex or SP related, the Ipap and Epap have basically remained the same sense my second PSG home study. When checking my data, the titrated pressure of 10cm seems to be right on the money.

Dan

Thanks Dan! My home study had a candula for nasal air flow, a strap for the chest, an oximeter for O2, a microphone taped to my throat for snoring...can't remember if there was anything else with it...certainly no EKG stuff or anything to record brain wave stuff.

A $150 home study is definitely the best route. This is one way we can get more of the undiagnosed millions to a diagnosed and treated state. Don't forget more than 90% of the cases are simple OSA with no other sleep complications.

Let's get them diagnosed and treated using data-capable CPAPs. Once their therapy is optimized, the doctor can have a discussion with them about residual symptoms and decide if a follow-up in-lab study is necessary to diagnose other sleep issues.

while in the hospital, followinge a heart failure i did 3 sleep snores while on cpap, prior to dischage i had an sleep study done in the lab. all in a 5 week period. my o2 dropped to 60% without o2 connected upon discharge i was given a pres. for cpap , but misplaced it . the clinic at fmc here in calgary said there was no record of the pres.
now 4 mos. later i am doing a remmers sleep snore at home { the results of the clinic study said i slept a total of 1hr.) does this make sense to anyone,
tired and cofused