More confused than ever-tried 10 and NO apneas. Go to PSG???

[2girlsmom]

I have a PSG tonight because the last PSG where they changed my pressure to 14 I slept horribly and they didn't get very good data. I had that PSG because I was at 10 before that and was still tired. I did not have my Elite then so I had no nightly data to go on, just the tiredness that came back.

Yesterday I put my machine on 10 because I've been sleeping so horribly at night with the high pressure. I napped and no apneas but I wanted to sleep all night long to see how a full night at 10 would be. I had NO apneas. None. I had an AHI of 3.2 which was just the HI bc the AI was 0.0. This is the best night I've ever had on my Elite since getting it a couple months ago.

My problem is I feel stupid going tonight if maybe my tiredness wasn't even my pressure needing increased. I don't want to take up a bed there and waste everyone's time. I suppose they may see some PMLD if I actually sleep decently enough for them to get data. I woke up so much the last time I didn't get much REM.

I was still tired at 10 before, so they may see something, but I feel silly going in now after seeing that great night at my old pressure. What should I do?

[2girlsmom]

OK, I just went back and looked at my data and the last night I tried 10cm I had 3 apneas an hour on average but they were in clusters. So clearly I should go and see what is going on. 10 doesn't work every night for me, apparently.

[WhiteBeard]

2girlsmom
If your not sleeping good and your having problems with your PAP, since your already scheduled for the sleep study, you might as well get it done, maybe they missed something? Did you ever have any Centrals? If so maybe they are causing you problems. Hopefully this time they will get your treatment right. Heck I ended up having six sleep studies in 18 months before they finally got my treatment right! I went from CPAP to BiPAP to VPAP ASV with O2. Just keep pressing till thinks start working for you! After all it is your health, your dealing with! Good Luck to You

[Hawthorne]

I fI were you, I would go for the PSG tonight. Hoepfully you will get a better sleep than the last one and, hopefully, a more accurate titration.

Good luck!

[2girlsmom]

I just hope they see *something* going on at 10 since clearly some nights I do poorly at that setting. I will be really, really tired for tonight. I'm making myself sit up all day and not sit still for long. I have a ton of housework to do so that should help.

Yes, the doc said there were some centrals at my last psg. I'm not sure if they happened at 12 or 14.

[rstcso]

Good luck tonight, 2girlsmom. Thanks for the information you passed to me. I've been watching the details and the night the DME lowered my pressure to 9, I had four apneas. I took it back to 10 and only have had one per night since.

[2girlsmom]

I'm glad I could help.

I just hope I sleep tonight. I almost dozed off earlier when watching a TV show with my kids so I should be tired for tonight.

[rested gal]

Don't you dare drift off to sleep today!! Wait 'til you get there!!

[birdshell]

You KNOW there is something wrong, so please do not think that you are wasting time or keeping someone else from a bed. Often (believe it or not) someone doesn't show up for their PSG without even cancelling, so chances are there may be an empty bed anyway.

Further, having slept poorly at my first titration, I can understand your inability to sleep well that night. Further studies should be more productive as well as easier for you. I remember thinking that if I definitely COULD be used to the mask and pressure if I had a couple of weeks to acclimate to them. The mask tickled just as when I'd first worn glasses, and after a week or so--no more tickles.

I was also diagnosed with PLMD, that did not show up at my first PSG nor at the titration. My friend, who is a tech, explained that the apneas were no doubt masking the PLMD. With my titration experience, having only one really good sleep cycle, it was also not detected.

So, take care of YOURSELF! It is just as an airplane emergency procedure: you put on your OWN oxygen mask FIRST, as if you pass out you cannot take care of your children and put theirs on their faces.

Go to that PSG, and...I hope you have some awesome insurance. Actually, the repeated PSG phenomenon is sometimes necessary, from what I have read on the forum. At least you are getting this problem nailed down; and by doing so, you will be better able to take care of your two girls.

Karen,
Who doesn't mind the PSG now...except for the wires...

[2girlsmom]

Well, as for my insurance between 2 eye surgeries for the toddler and an ear tube removal surgery for the older kiddo, we have met our maximum OOP of $3000. Scary, huh? So this PSG, like the last, will cost me nothing. I get $5000 in DME a year so a new machine is no biggie either. I feel very blessed even though my OOP max is so high we do have better coverage than some do.

I'll update tomorrow. I am feeling really tired, so PLMD could be a possibility since my numbers were so good last night. I'll just have to wait and see!

[nightjar]

I'll update tomorrow. I am feeling really tired, so PLMD could be a possibility since my numbers were so good last night. I'll just have to wait and see!

Good luck--it sounds as if you'll be able to sleep. Hope they find something in all that data that will help you. Sure hope it's just a simple titration problem, too!

nath

[echo]

2girlsmom, don't you dare cancel

Obviously the 10 wasn't cutting it before, and though you might be feeling better for one or two nights, it still sounds like this is not an open-and-shut case of OSA (though I'm no doc!). As others said, it could be central's (which you can get at higher pressures), it could be PLMD, or other things.

In any case, as you know make sure to get some sleep during the study. You have one big advantage now: since you are used to sleeping with the CPAP and the mask, whatever they measure will probably be pretty accurate. In my opinion, people have screwey titration results just because it's the first time sleeping with the whole setup. Just make sure you get some sleep

Oh, and make sure they DO let you use your own mask. Don't let them give you any issues with that (oh our machine can't work with non-resmed masks or whatever). ok ok your quattro is resmed, i'll shut up now.

Good luck at the PSG!

[2girlsmom]

I am all packed and ready to go. I need to leave in about 10 minutes. I was hoping I'd get to see my husband before I left. My girls are at grandmas and when I left my 5yo had a coffee candy in her mouth. I informed my mom they probably had caffeine in them so she might not want to give her any more if she expected her to sleep. I said do whatever you want but know that no one will save you tonight if they won't sleep. Hubby has to leave at 6am for work and I know I won't be back here in time (45 min drive).

I have reading material and benadryl in my bag. I am going to take one when I get there before I go in. I HAVE to sleep. I hear benadryl can cause restless leg so I will just take one.

I'll post as soon as I can. I may be at my mom's in the am for a while but I'll definitely post in the afternoon! Thanks so much for all the help you guys!

[2girlsmomnotloggedin]

quick post from my mom's. I went home this am to shower and my pc would not turn on so I'll try to get somewhere later for a better post but they are putting me back at 10. i dont know what to think bc i have bad nights at 10. they said try for a week and then we'll talk autopap ugh. I am just tired of being tired. i'll get to the library this afternoon when my hub gets off work and give a rundown of my night. lol

[2girlsmomnotloggedin]

Well, I slept a little better I think because I do remember having a decent length dream. I could tell my pressure wasn't as high as it was before (14) when I woke up to use the bathroom. Apparently they started at 7 and went to 10 or 11. 10 was when I was "doing the best" according to the resident that called me with my results. I asked how the apap part went... at some point they unhooked me from the VPAP III and brought in a Resmed Auto Vantage or something like that. When I woke up the tech asked me how I felt on the APAP as opposed to the CPAP but honestly I woke up a lot more than at home, and of course was woken up to end the study so it was not near a normal night of sleep (whatever that is anymore )

Either the APAP was set 7-11 or they titrated me from 7-10, I can't remember. According to the resident I did better @ straight CPAP at 10cm than I did on the APAP. I asked what the average APAP pressure was and get this, she says to me "there is no way of knowing what exactly that machine did" WHAT??? You mean to tell me she really thinks there is no way to know what pressures it ran at??? I wish I had brought my card, I could have shoved it in there and captured the data She asked "so do 10 for a week and then if you aren't better we'll talk about an APAP". I said I was at 10 before all of this and was tired at 10. She said I still snored at 10--and the snoring is why I went to 14 in the first place because the theory then was that the snoring was fragmenting my sleep.

I am pretty frustrated but I guess I'll play the game and do 10 for a week. I am just frustrated with it all. I guess I could see what 10 will do for me and if I have a lot of apneas on a regular basis I could see about an overnight oximetry. The bad thing is, some nights at 10 are really, really good. So I'm just not sure what to make of it. I forgot to request my report before I left so I'll have to call back on that and get that on its way so I can really get an idea of what actually happened.

I hope this makes sense. It all seems weird to me.

My home pc seems to be broken so I'll try to get back here to the library tomorrow (hubby is off all day) but we may be able to borrow my brother's laptop or something. gotta have my internet fix now and then you know.