Titration tomorrow night, Oct. 6th, any advice?

[MichelleFL]

Well tomorrow's the night. Needless to say I am worried and pray I can make it through this thing.. Any advice to make it go smoother and also a question. Can the tech start my flow at a low setting similar to what I would have with an auto? Also can they set the exhale to almost nothing and or like an auto have it calculate what I need? Am I going to be forced with constant pressure for inhale and exhale? Hopefully I will fall asleep faster as I now take Meclizine for dizziness that I was not taking on the first test..Makes me super tired. Thanks!

[betsy946]

I'm a newbie myself (almost one month on machine) - but I felt incredible after my titration - went to work the next day, told everyone to "get me a tie-dyed shirt and call Jerry Garcia because I felt great!" Just a joke My first sleep study showed lots of fragmented sleep - the tech that reviewed my file told me to come in really tired...my very best wishes to you. I'm a different person now.

[Georgio]

Don't dread it and worry about it being much worse than it is! Think of it as your initiation to a life choice that will lead you down a road of feeling much better and with a higher quality of life! You've done a great job of preparing yourself by all the research you've done here. You are ready for it, and you know what to expect.

Don't worry about the equipment or pressure settings they use. You'll get what I imagine is a pretty standardized test proceedure similar to everyone's. They used ramp pressure to help me get to sleep. I didn't have exhale relief (although you may), but that's ok....it's just one night....and I think most would tell you it's sole benefit is added comfort and an aid to compliance.

I think you are much better prepared than I was because I knew very little. The first experience with the mask was very similar to snorkeling, and that's what I tried to visualize I was doing...snorkeling in the Keys and watching tropical fish. The air pressure felt about like if I was riding my motorcycle at about 40 mph with my mouth wide open! Maybe it will help if you visualize that.

Get some sort of exercise on Monday. Go in early, get relaxed and do some reading before you start, and go to bed around your usual time. Be sure you get some sleep, you can do it.

I know I speak for all of us, we are happy you didn't, "Decide to wait".

Georgio

[den942]

Best thing to do, and least likely to happen, is don't worry about it. I thought I was awake way more than asleep but
they thought things went just fine.

[Hawthorne]

I'm very glad you have decided to go ahead and get titrated! You have been given good advice already so won't add anything.

They will start your pressure low and raise it in response to events and oxygen saturation levels and other things that will be monitored (you know - those straps and electrodes). You don't need to worry about starting out with a high pressure. They will take you to a high enough pressure to deal with as many events as they can, aiming to get your AHI at least below 5. If you're sleeping well, they may be able to get a really good setting for you.

Just think of pleasant things when you get all wired and masked up and get ready to sleep.

You will be fine!

We look forward to hearing how it went on Tuesday.

[Slinky]

I ask the sleep tech, but also provide him/her w/a written request to be tacked on the paperwork you will have to fill out for copies of the full scored data summary report w/condensed graphs as well as the sleep doctor's dictated results ASAP.

I'd ask the tech whether I will have any say in what equipment will be ordered (scripted) for me. If the tech doesn't know, write that question on the paperwork you have to fill out. Indicate you will want to come to a MUTUAL agreement w/the scripting doctor on just what equipment will be ordered.

Ask that your script be given directly to you rather than FAXed to some local DME supplier so that you can shop your local DME supplier options yourself to find one w/a lenient mask exchange policy and an RT (respiratory therapist) you feel you will be comfortable working with. If your script is really generic and you have a definite opinion on what equipment you want if you have a good rapport w/your family doctor you can ask him to re-write your equipment order (script) for exactly what you want (w/in reason).

Ask the tech if the sleep doctor or anyone will be going over the results of your sleep evaluation (if that hasn't been done) AND this titration w/you before your equipment is ordered.

Ask how long it usually takes for you to receive your results and your equipment.

Usually they will start out at a low pressure and gradually increase and decrease as needed according to the results they see w/each increase/decrease.

Now is the time to call your insurance company if you haven't done so to ask what local DME suppliers they are contracted with. Hopefully you will have the option of more than one as it will give you some bargaining/negotiating room to get the equipment you want depending on how specific your equipment order (script) is.

[DreamDiver]

On my first titration, the sleep techs let me try out four or five different masks in the sleeping position with the pressure on the morning after the titration. It might be worth it for you to ask. Research what's available on cpap.com prior.

You may also want to consider making sure the sleep doc knows what you want: a fully-data-capable auto xPAP with the software and reader. Anything less will give you fewer options with your therapy down the road. You have a choice. Don't let the DME bully you into a cheap machine that won't tell you anything but compliance data.
Get a list of DME's that are available in your area for your insurance. If there is an AWAKE group in your area, ask members which is the best DME and go with that.

Get the original prescription and make sure you keep it. Only copies go to the DME.

Get a full copy of your PSG report like Slinky said. The sleep center will likely need to send the DME a copy of your PSG too.

Have I missed anything?

[plr66]

I may be reiterating what's already been said, but now that you have prepared all your questions and list of needs, it is your approach and attitude to the study-night that is most important. You know what to expect in terms of the bizarre array of wires, straps and mask and hoses. Now be done with the apprehension, rumination and speculation. Just purely work on positive thoughts that this is an exciting opportunity to complete an experiment that WILL restore your health and ability to feel good again! Trite but true that "it ain't what life throws at you, but your attitude toward it" that counts and that predicts how you will adapt and cope. (or something like that... )

Not preaching. But my experience was one of curiosity and fascination with it all when I walked into the study room. It's amazing, and I was lucky that my tech shared the enthusiasm with all my questions about how they do what they do while I'm all wired up. It actually was kinda fun.

Now yes I will admit that being a person who doesn't take meds or do drugs......that dose of Ambien sure did feel like a blast of nitrous oxide that a dentist once used on me, haha! Didn't hurt at all!

So try to work on looking forward to all of it as a gift that you're lucky enough to be a part of. It works.

[ozij]

Nothing much I can add to all those great tips, Michelle. I just want to say that I'm glad you didn't decide to wait.
Good luck.
O.

[plr66]

PS--It is my belief that the sleep and titration study would be one part of the whole process where you would do best to put away all your control issues as well as you can, and allow the tech to just do the job. Obviously, let the tech know what worries or bothers you; call him/her in to adjust anything if needed, and ask whatever questions you have. My tech(s)--I actually had two different ones for the study nights--were really smart, really helpful, attentive, and knowledgable. Just trust that you are in good hands, let worry evaporate since you are in no position to direct the show anyway keep a sense of humor about it all--and look forward to seeing the printed results in the morning.

Sorry if I'm belaboring the point.

[alnhwrd]

I went into mine very apprehensive, didn't think I would be able to sleep at all. The techs were excellent, very professional, which helped put me at ease and I had the first decent sleep in years. Hopefully you will have a similar experiance. After I am done typing, I will cross my fingers for you!

Alan

[DreamDiver]

Okay - A little third-grade humor...

One thing is for sure during the titration - you won't be likely to pick your nose in your sleep on video.



Good luck with the titration, MichelleFL!

[MichelleFL]

Thank you so much everyone, I am so glad your here to help me along with this! {{GROUP HUG}} Yesterday was the worst day of my life and this is what's driving me to, "get hosed"... I only worked a 5 hour shift at my pharmacy yesterday and told my 2 teenage children that we would do more school clothes shopping after I got home from work. I could not believe how EXHAUSTED I was!! But I pushed myself anyhow and off we went to the store. I am usually energetic and on the move and have to wait for my kids to catch up to me.. But yesterday I was hanging on to that cart for dear life and taking baby steps just to get through the store. Brain fogginess was at an all time high and if my kids so wanted they could of put a motorcycle in the cart yesterday and I would of said, fine sure you can have it! Thank God they are both good kids and only put in the cart what they should of.. But my daughter looked back at me a LONG ways away and said come on Mom why are you so slow today??? *sigh* Hopefully that will be a thing of the past! Today I was painting their bathroom and I am ready to go to sleep for the night! lol

[MichelleFL]

You may also want to consider making sure the sleep doc knows what you want: a fully-data-capable auto xPAP with the software and reader. Anything less will give you fewer options with your therapy down the road. You have a choice. Don't let the DME bully you into a cheap machine that won't tell you anything but compliance data.

Thank you DreamDiver, my insurance already told me that they do not cover the reader... If the doctor put's it on the prescription do they have to cover it??

And I think the software comes with the machine right? I am pushing my equipment provider for the ResMed S8 II AutoSet with integrated humidifier and if all goes well tomorrow night I will be using the Nasal Aire II for my mask of choice.. I cannot actually believe my sleep center has the mask there to try!

[cflame1]

Whether or not you can afford/choose to purchase the reader, it is still better to get a machine that is capable of getting the numbers (fully data capable) than not. A lot of the current machines will show you data on the LCD, and if it doesn't, a lot of the DME's will gather your numbers and give you a report (for a charge).