How can Sleep Lab determine pressure when I hardly slept?

[Wulfman]

The sleep test would confirm whether you slept and how long in each stage, but the patients seldom get a copy of the study so they can say whatever they want. They are the judge, jailer and jury, we are the prisoners. Jim

If we let them do it.

So you think people regularly falsify medical documents to say someone slept when they didnt?

They don't necessarily have to "falsify" the documents, but they can (and DO) prescribe whatever pressure they damn well feel like. My titration stopped at 16, but my sleep doctor wrote 18 cm. on my prescription.

Splain THAT one to me......

Den

_________________

Easy, they can go within 1-2 cm if you're still having breakthrough snoring or some hypopneas.

Anyway, I can see the draw of the APAP for those who like to try manage their own treatment, however I strongly caution those of you who are trying to attain the 0 AHI. You may be over titrating yourself. However I digress, that is a topic for a different thread.

What about the sleep lab "over-titrating" a person to get rid of those residual events? Wouldn't that be trying to achieve a "0" AHI?
("breakthrough snoring or some hypopneas")

As I said, my titration stopped at 16 with a few remaining events and I was prescribed a pressure of 18 cm. BUT, when I got home with my own machine (Pro 2) and in my own bed and was able to REALLY sleep, I found that a pressure of 10 cm was able to produce an AHI of less than 1.0.

Den

[Snoredog]

oh they hypnotise you when you first see the sleep doctor, you are still under during the PSG, you only come out of it at the DME

[Guest]

Wulf, first off, sorry didn't have time to sign in.

<<<<<Akcpapguy

Most labs do not try to titrate you down to 0 AHI, well I will atleast reference the 2 labs I worked in. Most have flexible titration protocals that the techs follow while they are titrating you.

When I say you may be over titrating yourself, I am refering to the APAP falsely recording compensatory pauses after an arousal (which may not be respiratory related, and cannot be treated with CPAP), and increasing the pressure.

When you are talking about Hypopneas in a Sleep Lab setting and then talk about Hypopneas that the APAP records, you are really talking Apples and Oranges.

I have had cases where a patient was titrated up to 10cmh2o and then 10 minutes before they were wokeup they were having a Hypopnea every 45-60 seconds. So they probably ended up on a pressure greater than 10 cmh2o.

I agree with you assesment that 1 night of titration does not make a good data point. However it once again rolls around to the insurance companies, how many of them do you think would pay for a 2 week attended titration. Most of them won't even pay for the APAP rental for an unattended 2 week titration, so unfortunately this leaves someone holding the bag for the cost. In the case of the DME I work for it's the DME who sucks up the cost.

[Wulfman]

Wulf, first off, sorry didn't have time to sign in.

<<<<<Akcpapguy

Most labs do not try to titrate you down to 0 AHI, well I will atleast reference the 2 labs I worked in. Most have flexible titration protocals that the techs follow while they are titrating you.

When I say you may be over titrating yourself, I am refering to the APAP falsely recording compensatory pauses after an arousal (which may not be respiratory related, and cannot be treated with CPAP), and increasing the pressure.

When you are talking about Hypopneas in a Sleep Lab setting and then talk about Hypopneas that the APAP records, you are really talking Apples and Oranges.

I have had cases where a patient was titrated up to 10cmh2o and then 10 minutes before they were wokeup they were having a Hypopnea every 45-60 seconds. So they probably ended up on a pressure greater than 10 cmh2o.

I agree with you assesment that 1 night of titration does not make a good data point. However it once again rolls around to the insurance companies, how many of them do you think would pay for a 2 week attended titration. Most of them won't even pay for the APAP rental for an unattended 2 week titration, so unfortunately this leaves someone holding the bag for the cost. In the case of the DME I work for it's the DME who sucks up the cost.

Thanks for your input. I tend to agree. Since these machines are based mainly on air flow interpretation, there can often be false positives on some of these events. I personally found that I wasn't a very good match for an APAP.....although I DO believe they serve a purpose and many people seem to have good results with them.

Thanks again,

Den

[Guest]

Yup, I will agree with you, they are serving a great prupose for those who can tolerate them. And I myself couldn't tolerate one, so I won't agrue with you there either.

Besides I hate to argue with a fellow Wyoming man, I spent a couple years in Clearmont while my parents lived there. My Sister and Brother-in-Law live in Cody, and my parents are currently in Buffalo.


Darin

[Wulfman]

Yup, I will agree with you, they are serving a great prupose for those who can tolerate them. And I myself couldn't tolerate one, so I won't agrue with you there either.

Besides I hate to argue with a fellow Wyoming man, I spent a couple years in Clearmont while my parents lived there. My Sister and Brother-in-Law live in Cody, and my parents are currently in Buffalo.


Darin

Darin,

I'm 30 mi. south of Cody.....where they found the last known colony of black-footed ferrets in the mid 1980's (the captive breeding program worked and they've been re-introducing them everywhere else....except back here)

Seems there's quite a few folks in Alaska with ties to this area.
(and hoseheads, too)

Best wishes,

Den

[gasp]

UPS batteries have their place, but most don't have the raw power for the long haul. A one or two hour outage ok, but for long term outages 45 or more AMPs are needed 65 is real nice, as long as you don't have to carry it. Jim

[Shannon]

I would have the sleep study done over again but at a different sleep lab

[Guest]

Thanks for the sharing of opinions here.