Sleep lab doesn't read CPAP data ??? Huh?

[greenham]

I have the M series Auto CPAP w/ data logger. Having felt poorly of late, I asked my PCP for some insight and help. After the normal battery of blood/urine work, he suggested perhaps another sleep study as my last was about 1 1/2 years ago.

Looking at my data and working with you guys it seemed unlikely that a new study would indicate something that couldn't be seen on the data logger. So I asked if they could refer me to a sleep specialist first so that we could review the data together and maybe make a plan for how to proceed.

The dr's office called the sleep lab at the local hospital (same place I took the first sleep study) and they have never heard of such a device, and because I didn't buy the device from the DME they set up, that perhaps I should call CPAP.com and see if they have someone who will read the data because they can't.

They of course suggested another sleep study.

So here are my issues with this medical train wreck.

1) the data from the M series seems good, maybe not perfect, but a good Dr should be able to read it and reach some conclusions. The software I purchased says it's for medical professionals. (Encore Pro)

2) The sleep lab is in business to make money like any hospital procedure. Telling my Dr I need another one seems to reinforce that belief.

3) Insurance didn't cover most of the procedure the first time, and that was at the end of the year, so thinking they would cover it now isn't likely either.

4) I can't stand doing those sleep tests that I can't sleep at.

5) With an auto CPAP, it adjusts up as needed. I haven't maxed out my high end yet. My 90% mark is right down the middle of my high and low settings.

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CPAPopedia Keywords Contained In This Post (Click For Definition): auto cpap, cpap.com, DME

[Snoredog]

WHY would you want to go back to that same dysfunctional Sleep Lab?

You need to get out the phone book and call around to DME's who have EncorePro software who can read your M series SmartCard and pull a report.

Better yet, screw that idea, order Encore Viewer and card reader from cpap.com and do it yourself, then you won't need the hospital or the DME to find out where you are.

If your machine is set up correctly, you shouldn't have to do that, the AHI and leak information should be available right on the LCD display.

[6PtStar]

My sleep lab would not read my card either. Told me it was a service my DME should provide. My Doc did not have the program (I was his only sleep apnea customer (not Patient )). My DME still does not have the program or card reader so they were no help. That is why I bought my own. I now print the data when i go see him and put in his warm little hand and generally tell him what I did and why. He looks at the pages and says "OK, seems to be working".

Jerry

[greenham]

Snoredog,

That's my point. I have that software, and I have seen the data from it, w/ AHI as low as 1.5 per night avg 2.7 per night. My Primary care physician (PCP) called the same dysfunctional sleep lab and got the "no can do" come in for another test.

The Dr wants to rule out sleep problems before working more at my "fatigue" issue.

I told him, I have the data and it's fine. I just wanted to speak to a sleep Dr. to confirm all is indeed fine and send a report back to my PCP saying so.

[Insomniyak]

WHY would you want to go back to that same dysfunctional Sleep Lab?

You need to get out the phone book and call around to DME's who have EncorePro software who can read your M series SmartCard and pull a report.

Better yet, screw that idea, order Encore Viewer and card reader from cpap.com and do it yourself, then you won't need the hospital or the DME to find out where you are.

If your machine is set up correctly, you shouldn't have to do that, the AHI and leak information should be available right on the LCD display.

_________________

Snoredog, man you crack me up

Seems to me that you should be able to see the same thing from your data that a sleep lab, DME, or doc can, Whether you are having leaks, or events that would be causing a poor night's rest.

[-SWS]

Snoredog,

That's my point. I have that software, and I have seen the data from it, w/ AHI as low as 1.5 per night avg 2.7 per night. My Primary care physician (PCP) called the same dysfunctional sleep lab and got the "no can do" come in for another test.

The Dr wants to rule out sleep problems before working more at my "fatigue" issue.

I told him, I have the data and it's fine. I just wanted to speak to a sleep Dr. to confirm all is indeed fine and send a report back to my PCP saying so.

Well sometimes successful CPAP therapy can unveil yet other sleep problems---as counterintuitive as that sounds.

Take somewhat common restless leg syndrome (RLS), for instance. Some patients may not present RLS symptoms during the initial PSG portion or even during CPAP titration.

Those patients might not have progressed far enough through their sleep architecture to manifest or present RLS. Then successful CPAP therapy comes along, restores their sleep architecture, and allows previously obscured RLS to manifest. In that case all the APAP data in the world will not help.

[Insomniyak]

True, I'm takung for granted my partner would tell me if I was moving my legs alot in my sleep.

[ozij]

What -SWS said.

In addition, you may using medication that effects your sleep stages, as do some SSRI and statins. The sleep lab uses an EEG to track your sleep phases and see how normal (or abnormal) they are, and that too will not register on your machine.

Check out home sleep tests.

And maybe you can rig up a video camera to file you at night.

The data on the APAP, while fine for tweaking therapy, is specific and reliable enough for doctor to rely on.

It may be possible that 7 is now too low for you to start. Respironics machines find the right pressure by challenging the on their on - if your min. is just a tiny bit too low, the machine will go up and down up and down, about every 10 minutes.

I would consider upping the min. a bit, or ever a week or 2 on your 90% pressure.

AHI isn't everything.

O.
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CPAPopedia Keywords Contained In This Post (Click For Definition): respironics, video, AHI, APAP

[bryman34]

most sleep labs will not read results. you shold contact the dme provider you got the cpap set up through. they can read them off of a print out. i work for lincare and we have that same problem a lot. we have palm pilots that we download to and send them in to a 3rd party copmpany that sends results to your doctor its weird i know too many people in the mix, but they wont let doctors or cpsap sleep labs read them cause they might mis diagnose for the money, and with a 3rd party rep reading the results and sending them to insurance theres no way to let anyone have more money than they should

[DreamStalker]

[quote="bryman34"]most sleep labs will not read results. you shold contact the dme provider you got the cpap set up through. they can read them off of a print out. i work for lincare and we have that same problem a lot. we have palm pilots that we download to and send them in to a 3rd party copmpany that sends results to your doctor its weird i know too many people in the mix, but they wont let doctors or cpsap sleep labs read them cause they might mis diagnose for the money, and with a 3rd party rep reading the results and sending them to insurance theres no way to let anyone have more money than they should

[ozij]

but they wont let doctors or cpsap sleep labs read them cause they might mis diagnose for the money,

And people are supposed to entrust their lives to these doctors?

O.

[birdshell]

What -SWS and ozij said.

I started feeling really crummy after a year of CPAP therapy (used whenever I slept, even for a nap). I had no idea that I should have another PSG, but fortunately--sleep techs on Live Chat told me that I should.

Sure enough, I needed a 3-4 cm increase in pressure and...I had PLMD. So now, except for a couple of weeks of the previous, initial pressure due to a whacko RT at the DME provider--I'm doing much better.

We also know more about my brain... which does rule out some problems. I do take an SSRI, plus some other medications.

So, an APAP isn't the end-all and be-all of CPAP treatment. IMHO, there is definitely a place for APAP. I believe that the use of APAP would confirm the correct pressure and heard just last night that one of our own forum folk was given an APAP to use between the initial PSG and titration. Great idea, as one would be accustomed to the mask and air flow, plus the hose. Insomniyak--Noah, you would have benefited from that practice, I believe.

It turns out that the year of treatment helps to reduce tissue swelling in one's throat, so that the floppy bits encumber air flow and require a higher pressure. True, an APAP should take care of that issue.

Similarly, the first PSG and titration were unable to diagnose my PLMD because the apnea events were masking them. IOW, I would awaken from an apnea before the PLMD could be observed. (I barely slept enough at titration to BE titrated.)

So, let us recall that we are NOT experts. The problem really is, that so many of our medical professionals don't seem to be experts either--or at least, they do not share their expertise successfully. It seems to me that there are also problems with those unable to choose their own doctors and other medical professionals.


Karen,
Who really wishes Dyson
re-designed medical systems

[Wulfman]

I agree with what others have said.

But, some of my thoughts, which may have been covered in the other posts.......
Your pressure range may be too wide and your minimum pressure too low.
Eliminate any possibility that you're mouth-leaking/breathing.
Your pressure changes could be disrupting your sleep. Try CPAP mode somewhere between your "average" and "90%" pressure numbers.
Leak rates......if they're too high, your AHI numbers could be skewed.
If you're still snoring and leaking, that can affect your pressure numbers and disrupt your sleep.

Den

[Insomniyak]

So, an APAP isn't the end-all and be-all of CPAP treatment. IMHO, there is definitely a place for APAP. I believe that the use of APAP would confirm the correct pressure and heard just last night that one of our own forum folk was given an APAP to use between the initial PSG and titration. Great idea, as one would be accustomed to the mask and air flow, plus the hose. Insomniyak--Noah, you would have benefited from that practice, I believe.

Karen, I did pretty good borrowing a CPAP to get comfortable enought with everything, luckily my titrated level straight on since I went into REM 3 times and was on my back. I am lucky in that regard. Beleive me, I would be the first to hear if I had PLMD, I'd never hear the end of it the next morning, LOL.

[Snoredog]

[quote="greenham"]I have the M series Auto CPAP w/ data logger. Having felt poorly of late, I asked my PCP for some insight and help. After the normal battery of blood/urine work, he suggested perhaps another sleep study as my last was about 1 1/2 years ago.

Looking at my data and working with you guys it seemed unlikely that a new study would indicate something that couldn't be seen on the data logger. So I asked if they could refer me to a sleep specialist first so that we could review the data together and maybe make a plan for how to proceed.

The dr's office called the sleep lab at the local hospital (same place I took the first sleep study) and they have never heard of such a device, and because I didn't buy the device from the DME they set up, that perhaps I should call CPAP.com and see if they have someone who will read the data because they can't.

They of course suggested another sleep study.

So here are my issues with this medical train wreck.

1) the data from the M series seems good, maybe not perfect, but a good Dr should be able to read it and reach some conclusions. The software I purchased says it's for medical professionals. (Encore Pro)

2) The sleep lab is in business to make money like any hospital procedure. Telling my Dr I need another one seems to reinforce that belief.

3) Insurance didn't cover most of the procedure the first time, and that was at the end of the year, so thinking they would cover it now isn't likely either.

4) I can't stand doing those sleep tests that I can't sleep at.

5) With an auto CPAP, it adjusts up as needed. I haven't maxed out my high end yet. My 90% mark is right down the middle of my high and low settings.