Disastrous sleep study last night!

[Vampira]

Hello!
I've been using CPAP faithfully since 2003. I have never felt really rested and refreshed, but the CPAP has helped a lot. My pressure is 12cm on a ResMed Elite S8 with the Ultra Mirage II nasal mask. It was coming up on 5 years - my insurance will allow a new machine every 5 years. My blood pressure has been creeping up lately ( I am overweight and lacking exercize for a few months since winter started.) My weight hasn't changed drastically however. My sleep is often disturbed and I have some trouble staying asleep lately, so I mentioned all this to my sleep doc, and she ordered a new sleep study at the hospital sleep lab. (Hoping to get a BiPap).
The tech at the lab told me I had to sleep for 2 hours without a CPAP or the insurance won't pay. That, for me, is equal to torture. I feel absolutely horrible if I fall asleep on the couch or anywhere without my CPAP on. She told me just for 2 hours, and I assumed I'd get a mask on later. Well, I knew I'd have a problem.....I absolutely could not get to sleep or even start sleeping. It was so awful without it. I kept thinking they would come in and give me some relief. Nope. When it was time to get up, I was told I never got to sleep until very late morning ( I felt that!), and it was never deep-stage sleep, only light sleep. Obviously, they couldn't get the data they needed, and they said I have to do it again because there weren't enough severe events. I told the tech I purposely avoided sleeping on my back during the test because it is unbearable. I remember several moments of feeling like I was breathing thru a clogged straw last night, and my throat is raw.
I am so disappointed. What I don't want to do is sleep without CPAP again. I feel horrible today.
Was it my fault? I never go to sleep without my CPAP. Usually I can at least fall asleep in 30 minutes. I could NOT get to sleep and felt like I was hardly getting any air or breathing right. I think I sabotaged my own study by not enduring the severe apnea that occurs with back sleeping and REM sleep my previous sleep studies show.
I just pray they let me use a CPAP for the next one. Sorry so long.....I wish I knew what I should have done. Maybe some sleep studies just go badly.
Vampira (47 year old female with OSA)

[SleepyToo2]

Vampira, the 1st thing you should do is check with your insurance company. I haven't reached 5 years myself, but I would question the need to have a 2nd basic study especially if I could show my data.

You say you have an Elite? Have you ever had the card read for you? If not, you should either download and install the Sleepyhead software so that you can review your data and print it out your self, or take your card to the DME and have them read it and printout a set of reports for you. Your sleep doc can then talk with your insurance company. Hopefully, they will see sense. Unless it is the tech being rather silly.

[Vampira]

Thanks SleepyToo2...
I have a feeling I will be talking to my sleep doctor about this. I have sent in the data cards when requested by my sleep doctor by postage-paid mail, but never saw the data, or got to keep the cards. For the most part, my sleep has been OK. When I mentioned to her on my recent visit that it's been about 5 years since my last CPAP machine, and my sleeping is a little disrupted lately, she suggested a Bi-Pap. She said it would be best to get a sleep study before she ordered me a Bi-Pap blindly.
I am so tired and forgetful, but the tech admitted she made a mistake by not coming in to tell me I guess they weren't getting data/not enough events. She did say my sleep doctor was going to yell at her. I was in no condition to think clearly at 6AM. I really think she was trying to tell me she was partly to blame. (A little hard to understand with her accent too.) I just couldn't understand why I had to go all night without my CPAP. I think I should have told her I was diagnosed with mild to moderate OSA, but severe during REM sleep and while on my back. Maybe the tech at the lab was waiting for me to sleep, but it never happened. I gotta insist on CPAP next time. I can still have events on my back with CPAP!
The worst part was that I had to work today at a financial institution...thank god it was slow...I was a mess!

[cosmo]

Would it help to mask up first for a few hours then do the test without?

On a few occasions while starting out, I took off the mask after waking up and wanted a little break. Ended up falling asleep without it.

[johnthomasmacdonald]

YEs, I can see why they need to confirm that you really have sleep apnea since EVERYONE would want to sleep with a cpap machine shoving air down their nose if they could get it

[Vampira]

That's what I think....if I could start off with the mask, I could fall asleep.
I have vivid dreams and nightmares almost every night - I must have more than light sleep normally. Without that CPAP, I can't breathe well at all lying down. I don't think I could take more than a few breaths while going under without struggling for air. If they let me use CPAP to start, maybe the next sleep study will be useful. Too bad it was a waste.

[Vampira]

YEs, I can see why they need to confirm that you really have sleep apnea since EVERYONE would want to sleep with a cpap machine shoving air down their nose if they could get it

Hahahahahahahaaaaaaa!!! Only people with sleep disorders TRULY understand!

[jweeks]

I am so disappointed. What I don't want to do is sleep without CPAP again. I feel horrible today.
Was it my fault? I never go to sleep without my CPAP. Usually I can at least fall asleep in 30 minutes. I could NOT get to sleep and felt like I was hardly getting any air or breathing right. I think I sabotaged my own study by not enduring the severe apnea that occurs with back sleeping and REM sleep my previous sleep studies show.

Hi,

I think what you went through was just plain silly. I believe that this is insurance company protocol. While it might be OK for someone new that hasn't been diagnosed, there is little value to you sleeping without CPAP when you know that you need it. I have had 2 studies like this. What I wanted was to get re-titrated. However, the insurance company wanted me to start without CPAP, and then after 4 hours of sleep, they would try CPAP. I didn't get 4 hours of sleep the first time because I was tossing and turning. The 2nd time, they wouldn't raise the pressure high enough for me to get to sleep. Finally, I had a new study with a new doctor in December. Despite taking a sleeping pill, I still barely got any sleep without CPAP, but at least they did get some good data, and got me a new titration.

-john-

[Vampira]

It sure felt like insurance company protocol. The tech told me it was because of the insurance every time I protested not being able to use my mask.
I just hope the next night I spend there is enough for the insurance co. and I don't have to suffer as much. My throat is still sore after 2 days.
When I am in touch with either the sleep doctor or the sleep lab, I'd like to find out if the study I just had was useful at all. I was so out of it, I don't really understand what the tech meant when she said you have to do another one.
I feel like it killed a few brain cells too. Sheesh....I just realized I've been using CPAP every night for 10 years now. Laying down for bed in ANY position sure feels better with that mask on and the CPAP helping us breathe.
Thanks for all the input!

[viking67]

I, too have been through this and I agree with John, it's silly. And torturous. They call it "re-proving". Medicare guidelines they say. Sleep tech told me that a way to avoid this is to never let 5 years go by without a sleep study. Like every 2 - 3 years I need to come in for a "re-titration". Not sure of all this exactly but I think I remember it that way. Something about 5 years passing even on CPAP therapy, and you have to re-prove. Nightmare.

[Vampira]

viking67 -
I am sure glad to have been reading all these posts on the forums. I will certainly not let 5 years go by again if that is how they work it. I was just reading old posting on another site from a 68 year old who also never sleeps without CPAP and had a heart attack in the past. When he was told he needed a new sleep study or Medicare wouldn't pay - he was also made to sleep an entire night without CPAP and had the same problems. Much, much riskier for him having had a heart attack previously!
I guess if you manage to sleep without the CPAP - they get the proof that you are having severe events, but if you keep waking up all night every time your airway cuts off - you are SOL!

[Todzo]

sleep testing needs reform

[archangle]

Any doctor who sends someone to a sleep study without a sleeping pill "just in case" deserves to be flogged.

The uncaring doctor will say something like he wants to get results without drugs, but what happens too often is he gets results without sleep.

[ChicagoGranny]

They call it "re-proving". Medicare guidelines they say.

It was posted on here last week with links to Medicare documents something different. It said if your doctor will sign that you have been using CPAP for a few years then a diagnostic study is not required by Medicare.

I think the problem here is the medical profession does not always understand the Medicare rules.

Disastrous sleep study last night!

Post by Vampira on Sat Jan 26, 2013 3:14 pm
Hello!
I've been using CPAP faithfully since 2003.

Vampira, That is absolutely shitty what they did to you a faithful CPAPer.

I hope you get some ammunition and raise hell with the doctor.