Misleading sleeping study result

[wkwchau]

Right after my first post-CPAP treatment sleeping study two weeks ago, the technician adjusted the pressure level of 8cm on my CPAP in the morning. After reading the detail report of the study this morning, I find out why I did not feel much improvement after increasing the level from 7 to 8cm. Here is what the technician did during my study. She started the pressure of 4 and then increased the pressure by 1 cm after every 90 minutes or so. By the time I woke up, the pressure level was 8 and she told me that I should use that the pressure level. According to the report, my AHI was 3.2 when the pressure was 8cm, which was measured during my final hour of sleep. From my previous sleeping study, my apneas occurred mostly between 1-4am so I think the study result is inconclusive. It seems that the result of any sleeping study highly depends on how the technician run it!

Since my arousal index is 21.4, comparing to the normal of less than 5, my doctor told me that I may need more pressure. He did not tell me which pressure I should use, but instead prescribing my an APAP with the range of 6-12cm. My question is should I get an APAP, which the insurance won't cover after my recently purchase of a CPAP, or should I slowly change the pressure level to find the effective level by myself based on my subjective feeling?

[BP]

I would ask your doctor what pressure you should use for you cpap. I would reiterate to him that you don't want to purchase an apap out-of-pocket.

An apap isn't better, it just attempts to give you the correct pressure based on what it detects to be going on during the night. For those with higher pressures it allows them to use less pressure when it's not needed.

Good luck,
BP

[WillSucceed]

My question is should I get an APAP, which the insurance won't cover after my recently purchase of a CPAP,

Ontario's Assistive Devices Program will not cover the new APAP as they have already contributed to CPAP. You get their help once every 5 years.
However, your company insurance program may cover the APAP if you can convince them that the CPAP did not work for you. You would have to base this on not being able to tolerate the higher pressure that the Dr. has prescribed.
BP wrote:

I would ask your doctor what pressure you should use for you cpap

I think that this is good advice. Before going the route of purchasing APAP out-of-pocket or, fighting with the insurance company to pay for it, you could try CPAP at the appropriate pressure. CPAP pressure is usually set at the highest pressure that you needed during the sleep study -this is the pressure required to keep your airway patent when your muscle tone was the most floppy. For many of us, this pressure is uncomfortable but this is a highly individual thing.
I wold consider asking the Dr. for the proper CPAP pressure and seeing if you can tolerate that pressure. You may have to make small increases in the machine pressure over several days/weeks to get to the proper pressure. If, after reaching the proper pressure, you find that you cannot tolerate it, an APAP could be the next step.

[wkwchau]

Thanks for the replies.

One of the reasons my doctor prescribed me the APAP is my complaint about aerophagia. Anyway, I will contact my doctor to get the pressure level for my CPAP and to see whether I can tolerate it.