Fear around new sleep study...

[rogerconnelly]

After 12 years of very successful CPAP usage (much of that due to the support I got on these forums) I'm considering trying an oral appliance for my moderate sleep apnea (wouldn't it be wonderful to not have to CPAP up on travels - even if I only used the oral appliance for that?) - and so my sleep doc wants me to do another sleep study to get updated info - which makes total sense - but to be honest I'm pretty scared even thinking about trying to sleep overnight without my CPAP machine - have others experienced this?

I literally have not slept a single night this past decade plus without my machine - not even daytime naps. In fact, one of the things that gives me this fear is that the few times I have started to doze off on the couch or something like that I immediately apnea and wake myself up gagging - it's a pretty scary feeling. And so that's the image I have in mind for when I try to do this at home sleep study they want me to do - I'll start gasping right away - and just wake up over and over for as many hours as I can try to keep that up.

Am I over dramatizing in my own mind what sleep without CPAP will be for me at this point in my life?

Just hoping for a little reassurance here before I take the plunge - will try to do the first night (of two) tonight or perhaps tomorrow night - depending on where my anxiety is at.

Thanks up front for any experience others can offer here - Roger

[ChicagoGranny]

Am I over dramatizing in my own mind what sleep without CPAP will be for me at this point in my life?

IMO, no! I will never knuckle under to another sleep study. Does your stupid doctor think CPAP has cured you?

Sorry, you get no reassurance from me.

[Tec5]

Yes Rodger, it makes sense to attempt to get updated.
HOWEVER, if you are getting a home study - that's one thing. if you are getting an in-lab observed study that's another. (I know of no in-home titration study)

If this is at home you can decide to call a halt to the study anytime you want. If you are awakened by gagging or gasping, you should not punish yourself for the sake of updated information.

If this study is conducted in-lab, you can tell them (and they should be able to see) that you are in distress and stop the mask-free portion of the test, If they are going on to titration that information may be useful to your caregivers. Perhaps you should talk to the doctor or sleep tec - is this a titration study (wherein you will be wearing a mask)?

But by no means should you have to endure unnecessary distress.

[rogerconnelly]

Thanks Tec5 - yes, I am feeling fortunate that I can do this study at home. It's funny, when the doctor first asked me to schedule a new sleep study, I initially thought it would be "easier" for me to go to one like I did initially, in a clinical situation where someone watches you all through the night - I thought it would be reassuring somehow to know that someone was there watching - I guess that they wouldn't let me choke too much? But then as I thought more about it I realized it's always more comfortable to sleep at home - and I like what you've said here - I can take care of myself and if it's too much at any point I can stop and just put my CPAP on for the rest of the night - and who knows, maybe 3 hours of data will be enough for them - I don't have to "push myself" to go the whole night if there is any trouble

I appreciate the reassurance and reminder that I can practice good self care of myself as I go through this.

- Roger

[Tec5]

Best of Luck to you, Merry Christmas

[rogerconnelly]

For those following along here (or who might find themselves in a similar situation) - I did the first of two nights home sleep study last night and it was not nearly as bad as my mind had built it up to be

The at home equipment was very easy to put on - again, nothing like what I was wired up to 12 years ago at the doc office - and the hardest part of the evening was this strange belief that I wasn't actually falling asleep at all over and over again - thinking that I was just going to be laying there on my back all through the night until the sun came up in the morning - but meanwhile, somehow I was actually nodding off over and over again but just not realizing it - the first "sign" that let me know I had been sleeping a bit was suddenly my mouth was all dried out ("that's weird" I thought "just a second ago my mouth wasn't all dried out" - which made me realize I had dozed off for some unknown amount of time) - and then the second sign was when my chest "suddenly" hurt a little bit because I believe I had dozed off and was either gasping or holding my breath (i.e. apnea) but because of this strange "time travel" effect I hadn't even noticed I had dozed off again

So, other than the above "interesting" description of my night, I woke up with a slight headache (expected) and am feeling pretty lethargic today (again expected) - but all in all not the horrible experience I was anticipating and hopefully some good data got gathered last night.

My plan is to skip tonight and do my regular CPAP routine (to get some well deserved actual rest) then tomorrow night I'll do the required second round for the sleep study so I can send the equipment back via FedEx come Tuesday morning.

- Roger

[Tec5]

If you don’t mind my asking what equipment are you using for your home sleep study?
Is there some difference in equipment between the first night and the second?

PS, I’ve long felt that a single night snapshot study is not really adequate to characterize someone’s sleep, we all have the occasional really good night or really crappy night. A study should be representative of your “normal” night.

[rogerconnelly]

Hi Tec5 - sorry I missed this question from you back at the end of the year - the company that my doc ordered the sleep study from is called ReactDx (formerly BioSerenity). I can't remember now if there was a different name on the actual device I strapped to my chest those two nights - although I do remember that the app I installed on my phone to gather the data from that device was called "Accustom Home Sleep Test". Hope some of this is helpful to you

I just (finally) picked up my oral device today - so for the next week I'll be wearing it while using my CPAP to allow my teeth and jaws to get used to the appliance fit - then early next week I'll give it a try for a few nights without CPAP - exciting times for me - I'm sure I'll post a new topic here with my results not too far in the future.

[ChicagoGranny]

then early next week I'll give it a try for a few nights without CPAP

How will you know whether the mouthpiece is effective?

[RogerSC]

Hi Tec5 - sorry I missed this question from you back at the end of the year - the company that my doc ordered the sleep study from is called ReactDx (formerly BioSerenity). I can't remember now if there was a different name on the actual device I strapped to my chest those two nights - although I do remember that the app I installed on my phone to gather the data from that device was called "Accustom Home Sleep Test". Hope some of this is helpful to you :-)

I just (finally) picked up my oral device today - so for the next week I'll be wearing it while using my CPAP to allow my teeth and jaws to get used to the appliance fit - then early next week I'll give it a try for a few nights without CPAP - exciting times for me - I'm sure I'll post a new topic here with my results not too far in the future.

When I was asking about these, the way that my sleep doctor put it was that once I had an oral appliance, I should have another sleep study with it to see where I stood. I agree, you want to know the state of your therapy, and a sleep study is about the only way to get there. I never got further than a consult with a dental specialist that specializes in sleep apnea work, since she made the point that you shouldn't mix cpap with a dental appliance. Like using cpap most of the time, and just using a dental appliance when traveling, camping, etc. Has to do with the progressive jaw advancement that needs to have continuity, or you're back to square zero every time you re-start using the dental appliance instead of cpap. At least that what's I recall, it was several years ago. That was enough to keep me from going that way.

[ChicagoGranny]

Has to do with the progressive jaw advancement that needs to have continuity, or you're back to square zero every time you re-start using the dental appliance instead of cpap.

Seems like the device stretches connective tissues which shrink over time when the device is not used. Just guessing.

[alancalan]

I have had only one successful sleep study and I have been using a BiPAP since 2003. The doctor that did it then I after I slept a half an hour just set everything for 12 and 8 on the Sullivan BiPAP.

My internist and his partners are is very Progressive and they put sleep study rooms and a great RT, into their practice along with physical therapy rooms and PTs. So the titrating sleep study I did there was the best. I hardly slept the night before and I went for the sleep study and made it till 6:00 in the morning. I was amazed and they had to wake me up. So then I was driving home and I was on Middle Neck Road in Great Neck and I almost got into an accident because I wasn't focusing properly. I never got to the point, even before I got my BiPAP that I ever came that close to an accident but here I was deprived for 48 hours. I also have and always had squint the eyes but that's going to take surgically over the last few years because before I had the bypass with squinty eyes if they close just a little bit more you can't see so you're constantly fighting keeping them open. If you have big eyes it's not as much of a problem.

So, there is no question in my mind that a fully titrated sleep study is the way to go but have somebody pick you up or get an Uber to take you home and then go to sleep.

This new ENT doctor when I assumed I was going to be ready to get an air curve 11 in 2019, said he needed to do another sleep study and he would do the one at home and that it was a complete useless waste.

With these machines today you don't need a sleep study cuz it self-titrates with programs that read each day of your sleep experience, you know how well you're doing.

I went to a pulmonologist I had met and showed him the settings that I made up for they did in my intern to sleep lab with the RT there. He said that's fine and actually wrote it on his prescription pap. With these settings and the S8 or the S9 I don't know which one, I went from an average six, seven, eight, apnea events tonight, and when I used a Fisher Paykel full face mask I was up in the i-20s. Now I'm averaging between 0.5 and 1.5 a night it's pretty damn good. For some reason I seem to have a high leak rate.

Prior to my back surgery this past Novemberwhen I was in pain and sleeping on the recliner and through the surgery I was scoring between 6:00 and 9 apnea events maybe more while in that recliner. Once I got out of the recliner it went back down to 0.5 to 1.5. So these machines are pretty damn good, actually incredible.

So I am using iPap 15, Epap 7, PS 4 Ti max 2, Ti min .3. It is it works and I'm not tired anymore, I can drive it without any problem a few years ago in 2017 I drove from 10:00AM till 2:00in the morning from Delray Beach to Fayetteville North Carolina (the woman I went with drove for 45 minutes) and I was getting a little tired and fatigued but my eyes weren't closing. That's with these settings I don't even know what the Ti setting are for.

Dlcpa