Sleep lab only records 62min of 158min of titration? rrr??

[ApNoob]

I got a copy of my spit study and found that the lab had me on CPAP starting at 2:52 am but didn't start recording the titration levels until after 4:30! So, there was 158 minutes of CPAP "treatment" and only 62 minutes of titration data.

I asked the lab and their response was to say a lot and never actually say anything about the missing titration data, though they try to imply that the didn't record the data because I was not in consolidated sleep.

Is that the way sleep labs normally operate? Or does something seem fishy?

[oceanpearl]

Have you seen any black helicoptors flying around your area??

[DreamStalker]

I got a copy of my spit study and found that the lab had me on CPAP starting at 2:52 am but didn't start recording the titration levels until after 4:30! So, there was 158 minutes of CPAP "treatment" and only 62 minutes of titration data.

I asked the lab and their response was to say a lot and never actually say anything about the missing titration data, though they try to imply that the didn't record the data because I was not in consolidated sleep.

Is that the way sleep labs normally operate? Or does something seem fishy?

Hmmm ... maybe from the family Catostomidae?

Like I said before ... seems like they botched your study ... but what do I know?

[ApNoob]

Have you seen any black helicoptors flying around your area??

Well, yes, actually. Though I suppose they might just be dark olive green --Hueys mostly...

So, what is your position? That labs normally only record titration data for 62 minutes out of 158? If your joke is that I'm paranoid then that would have to be your basis.

I'm not trying to be paranoid but I am looking for feedback. How the heck would I know what is normal for a sleep study? I've only had one so I need to make sure what seems off to me isn't some standard sleep lab practice that I'm ignorant about before I try and make a big deal out of it. There is a scene in Red Dwarf where a character makes such a mistake:

The lowly Arnold Rimmer is invited to dine with the ship's captain. Trying to look suave and commanding at dinner, he haughtily sends his Gazpacho soup back to the kitchen to be heated up because the wait staff have had the gumption to bring it out cold. Later he finds out that Gazpacho soup is supposed to be served cold. His gaffe haunts him for the rest of his life--and them some...

I'm trying to avoid such a gaffe!

@ DreamStalker:

I think you are right. I'm trying to educate myself. It is kind of intimidating arguing with professionals to tell them they must have made a mistake. They know a lot more than I do about sleep studies, but that doesn't make them right all the time. So I have to be careful and try and know what I'm talking about so that I don't make stupid accusations and so they can't pull the wool over my eyes.

(Arguing I'm good at, but I try to make sure I have my facts right. I really don't want to be an a**--though I admit I can come off that way sometimes. I find it hard not to dash off a letter with the same level of argumentation I'd use in a forum--but I suspect that might not be productive )

[Slinky]

They need a minimum amount of sleep for evaluation to determine if you are even eligible for titration, regardless of whether the order is for a split night study. For most insurance purposes that would be a minimum of 2 hours of sleep for evaluation before they could begin titration unless you displayed SEVERE signs of apnea.

I "think" (and I am not a medical professional) that they can't and don't start titrating UNTIL you are asleep and it is the leads on the skull that indicate WHEN you are asleep. Hopefully one of our RTs or RPSGTs who frequent the forum will see your post and more accurately respond.

You really have to forgive our sense of humor and our attempts at humor in the forum from time to time. No harm was intended, I'm sure.

[ApNoob]

They need a minimum amount of sleep for evaluation to determine if you are even eligible for titration, regardless of whether the order is for a split night study. For most insurance purposes that would be a minimum of 2 hours of sleep for evaluation before they could begin titration unless you displayed SEVERE signs of apnea.

I "think" (and I am not a medical professional) that they can't and don't start titrating UNTIL you are asleep and it is the leads on the skull that indicate WHEN you are asleep. Hopefully one of our RTs or RPSGTs who frequent the forum will see your post and more accurately respond.

You really have to forgive our sense of humor and our attempts at humor in the forum from time to time. No harm was intended, I'm sure.

Nope, not offended by the humor (my smiley face response should show that). But, the basis of the joke seemed to be that I might be grasping at straws without saying why that might be.

As to the sleep time for eligibility for titration, that had already occurred in the first half of the study with no mask. The seemingly missing 94 minutes came from the 158 minutes of treatment time (with CPAP) of which there is titration data for only 62 minutes.

I understand that the the 62 minutes after consolidated sleep is the, perhaps, most important data but the pressure levels for the first hour and a half weren't even recorded in the titration histogram. And if I understand CPAPs there had to be a pressure level for that time since they turned on the pressure as soon as they put the mask on me. So something seems to be missing but I also admit that I don't know what the standard protocols are for titration recording--and the worst oxymitery and apnea occurred during those unrecorded titration pressures--that or they lied about when they put the mask on me and I wasn't on CPAP during that time. (I my memory of the night is a bit scattered )

[Slinky]

I'm fresh outta ideas. Except - request a copy, not just of the dictated results (1-2 pages) but also the data summary report (about 5-6 pges, w/some graphs) if that is not what you are working with.

I "think" (and I am not a medical professional) that they can't and don't start titrating UNTIL you are asleep and it is the leads on the skull that indicate WHEN you are asleep. Hopefully one of our RTs or RPSGTs who frequent the forum will see your post and more accurately respond.

So maybe you didn't get back to sleep w/the CPAP for those first 2 hours???

I hope you get some answers, ApNoob.

[ApNoob]

I'm fresh outta ideas. Except - request a copy, not just of the dictated results (1-2 pages) but also the data summary report (about 5-6 pges, w/some graphs) if that is not what you are working with.


So maybe you didn't get back to sleep w/the CPAP for those first 2 hours???

I hope you get some answers, ApNoob.

Thanks,

You are right on two counts. I ddin't sleep much in the first 90 minutes and I did get the data report. That's why I'm so perplexed. The titration pressure histogram (graph) starts after 4:30 but they supposedly put me on CPAP around 3.

I understand why the the dictated results wouldn't necessarily talk about that but I'm assuming that the pressure should at least be recorded and be reflected in the titration data histogram from the moment they put the CPAP mask on me. I further understand that they might sumarize only the relevant portion of that titration time for the interpretation but I'm assuming that the doctor and/or the scoring technician should determine what section of titration data to use, not the recording technician , so the data should (I think) be recorded but apparently wasn't.

So far they have skipped around the issue in all the responses I've received from them, never directly answering whether they recorded the full titration time nor whether such full recording is part of the accepted standard or not. They've neither confirmed, denied not even admitted that they are neither confirming nor dening

Sigh...

[Slinky]

DOES sound fishy, doesn't it? Ah well. Here's wishing you good luck! Keep us informed.