How often do you think you should have a new sleep study?

[dave21]

I think for all of us to be monitored properly by the medical profession we should have regular Sleep Studies to check that things haven't changed.

For me I've gone 4 years since my first Sleep Study which in my opinion is way too long, I'm called back once per year to see a Sleep Nurse (the doctor has never once seen me at the hospital) and I get asked two questions

1. How do you feel? Do you feel tired?
2. Can you fill out the http://www.britishsnoring.co.uk/sleep_a ... 48ac1e48c7 - Epworth Questionnaire

Why should we have a new titration from a Sleep Study once a year?
1. Our conditions change
2. For OSA patients we may gain weight or lose weight
3. We change machines
4. We change masks
5. You may develop other illnesses that could cause compliance problems
6. You might be so scared you'll lie to the doctor that you're still using CPAP when you're not

If nobody looks at our stats from our machines, how does the medical profession know
1. We're compliant in staying on the treatment?
2. Compliancy is working to reduce our Apneas?
3. Our Apneas/Hypopneas have not increased?

I think the problem with the medical profession today towards Sleep Apnea is they diagnose the illness and suggest ways to treat it, then you're on your own. For most because Sleep Apnea is because of lifestyle changes, e.g. eating more, drinking more, it's considered almost similar to a smoker.

Personally I'd love to have another sleep study to show the medial profession how well I'm doing. This would also ensure onward training of medical professionals and continuous learning and improvements in the technology and profession as a whole.

How often do you think you should have a new sleep study?

[BlackSpinner]

Why waste money on sleep study when you are feeling fine and your data is with in the appropriate range?
If you have fully data capable machine it will give you all the needed data, all the doctor could do is lend you an oxymeter to make sure your O2 levels stay good, but if they didn't you would feel crappy anyway.

[dave21]

Why waste money on sleep study when you are feeling fine and your data is with in the appropriate range?

This might differ in some countries but in the UK it's free, you just have to have one scheduled by a doctor. I believe in the US it's covered by insurance? Maybe there's something still to pay.

If you have fully data capable machine it will give you all the needed data, all the doctor could do is lend you an oxymeter to make sure your O2 levels stay good, but if they didn't you would feel crappy anyway.

If we have access to our machines and educate ourselves then I complete agree with you. The problem is as most of us find that most of our doctors don't like to give us the software to access the information ourselves, and likewise don't access the data regularly to see how we're complying.

Complexed Sleep Apnea can become a problem with CPAP with people having more Central Apneas than Obstructive Apneas if we're not careful, if that happens then its possible to get similar symptoms to obstructive apnea over time. Thankfully for most of us here if our doctor hasn't give us access to the data and doesn't check it, we've been able to get access to it ourselves through forums like CPAPTalk and the wonderful sharing community we have here, but think about the hundreds of thousands maybe millions of people out there that don't have access to this resource and are in a similar boat in not being checked regularly for changes in our conditions.

[Komodo]

Everyone should be monitoring their daily results, either with the LED on their machine or with the software. (software is MUCH better!!!) If they're doing fine, that's all well and good. If they spot a trend of higher or lower AHI's, or leak rates, they need to either tweak the settings themselves or see their doctor. When that doesn't work, THEN, they need another sleep study. One month or ten years, the time frame doesn't matter.
In my case, it was only 10 months between my first, and second, sleep studies. Three months sooner than my next appointment with my sleep doc!

I see no need for a new sleep study JUST to tell me I'm doing fine.

[LSAT]

If you are feeling good and regularly or periodically monitor your data, there is no reason for a new study. In my area a study is $2500-$3000. Whether you pay or the insurance pays, it is not needed.

You should add...NEVER...to the poll.

[JeffH]

I agree that never should have been included in the poll. Eleven years after getting my first sleep study I had another one that was a complete waste of time and money. I probably will never get another one.


JeffH

[kteague]

Personally, I think if ALL machines were data capable it would reduce the need for repeat sleep studies to those with continued problems and MAYBE those who have not had one for several years.

Why should we have a new titration from a Sleep Study once a year? - For the vast majority that would be an unnecessary expense. For most of the situations you mentioned, they could fall under "those with continued problems" and length of time would not be a determiner of the need. As far as non compliant patients, if the first study didn't make them take this seriously, why would the second? It would explain to doctors why that patient is not responding to their best efforts to control their blood pressure, etc., but wouldn't make the patient change, nor make follow-up treatment any more responsive.

This would also ensure onward training of medical professionals and continuous learning and improvements in the technology and profession as a whole. - Not my responsibility, nor criteria for medical necessity.

Now, all that said, I do think too often patients, including those with data capable machines, are allowed to flounder needlessly when it is obvious CPAP hasn't resolved their sleep issues or daytime symptoms and further investigation is needed. My history makes me sensitive to that. I've kinda lost track of all my sleep studies over 10 years - at least half a dozen. Wish I hadn't needed them. Sure wouldn't have wanted to have them all done if there wasn't a need or at least more than a "yep, you're doing fine" value.

[Hawthorne]

I had my second sleep study (really a retitration)in 2008, 5 years after my first study (PSG and initial titration) in 2002.

I initiated it because I was feeling more fatigued again, although I have software and a data capable machine and always have a very low AHI.

First of all, it took almost a year to get the study and it did not go well. I hardly slept at all - maybe 3 hours (worse than my first one) and I had my own mask!

When I FINALLY saw the Sleep Specialist, he said that, if I was extra fatigued, it was not because of my sleep apnea. Things were fine there. How could he tell from such a poor study???? I asked for an new prescription so that I could get some comfort settings that were not available when I got my first machine. I had already bought a new auto and software online, on my own during that year long wait but, in Ontario, the Assistive Devices Program will pay 75% of a new machine, if it is 5 years old and you have a new prescription. I was hoping to get a good backup or main use machine from an Ontario DME (with some financial help) since my "old boy" is more than 5 yearsld and is just a blower. He said I would get a new prescription when my old machine was broken beyond repair. If it didn't happen soon, I would need another retitration to get a new prescription - probably another year long wait.

I had pursued other possible fatigue causes, since I have Rheumatoid Arthritis, which has a fatigue factor, both from the condition and from the meds.

I am in Canada so the sleep study is free (paid for in our taxes) but to wait so long is quite useless.

I have no real faith in sleep studies any more at all. This last retitration, resulted in a lower setting (according to the Specialist) but they only got my AHI to 4.2 I know that's OKAY, but I was, and still am, getting AHIs below 1 almost every night.

When he gave me the "reset pressure" order for the DME it said - "set machine at 9 cm plus or minus 2"! I have used a narrow auto range for over 2 years now (10.5 to 13 cm) with that great data, a 90% at 12 cm and an average pressure of 11.2 cm. My original titration (7+ years ago) was 10 cm.

During the almost 1 year wait, I had a 2 week in home auto titration done at home which said that my pressure should be set at 11cm!

I do a lot better on my own and don't have to wait almost a year! I can use my auto to do a titration when I feel the need. I also have an oximeter with software so I can check my own Co2 level by myself as well.

Almost all of what I have learned about managing my sleep therapy is from the very helpful people on this forum so I will probably forego sleep studies unless it appears absolutely necessary!

[BlackSpinner]

Why waste money on sleep study when you are feeling fine and your data is with in the appropriate range?

This might differ in some countries but in the UK it's free, you just have to have one scheduled by a doctor. I believe in the US it's covered by insurance? Maybe there's something still to pay.

If you have fully data capable machine it will give you all the needed data, all the doctor could do is lend you an oxymeter to make sure your O2 levels stay good, but if they didn't you would feel crappy anyway.

If we have access to our machines and educate ourselves then I complete agree with you. The problem is as most of us find that most of our doctors don't like to give us the software to access the information ourselves, and likewise don't access the data regularly to see how we're complying.

Complexed Sleep Apnea can become a problem with CPAP with people having more Central Apneas than Obstructive Apneas if we're not careful, if that happens then its possible to get similar symptoms to obstructive apnea over time. Thankfully for most of us here if our doctor hasn't give us access to the data and doesn't check it, we've been able to get access to it ourselves through forums like CPAPTalk and the wonderful sharing community we have here, but think about the hundreds of thousands maybe millions of people out there that don't have access to this resource and are in a similar boat in not being checked regularly for changes in our conditions.

It is free in Canada too but that doesn't mean it doesn't cost money to the system. My having useless sleep studies reduces the amount of money available to others. Also a sleep study in the US cost something like $2000 - $5000. You can get a really good data capable xpap machine, several masks, card reader and software for that money. I am really surprised that the insurance companies haven't clued into that.

[Uncle_Bob]

in the UK it's free, you just have to have one scheduled by a doctor. I believe in the US it's covered by insurance? Maybe there's something still to pay.

In the US it can be covered by insurance to various degrees, i would have to pay 20% of any sleep study. In the UK its not free, its paid for as part of the the taxation of your earnings which goes towards to NHS.

[rosiefrosie]

I don't feel sleep studies are that accurate anyway. You are asked to spend a night in a strange room, in a strange bed with wires hooked up to you, with a camera watching everything you do and asked to sleep. How easy is that? Yes, I do feel that an initial sleep study should be done and then everyone should be given a data capable machine to monitor and help provide the proper treatment to prevent apnea. If problems come up and more is needed than the data capable machine can provide then another sleep study may be indicated. So maybe you need to add this answer to your survey also.

rosie

[Wulfman]

There ain't no "free lunch" (or sleep study or healthcare). SOMEBODY is paying for it. The more people who take advantage of it, the more it costs everyone else.

Assuming there are no other serious complications that present themselves (Central Apneas or other heart/lung/brain related disorders), with a data-capable machine and the software, a person with "garden variety" Obstructive Sleep Apnea should never have to have another sleep study.


Den

[GumbyCT]

There ain't no "free lunch" (or sleep study or healthcare). SOMEBODY is paying for it. The more people who take advantage of it, the more it costs everyone else.

Assuming there are no other serious complications that present themselves (Central Apneas or other heart/lung/brain related disorders), with a data-capable machine and the software, a person with "garden variety" Obstructive Sleep Apnea should never have to have another sleep study.


Den

Agreeing the Den and the others above.

I will add that everytime YOU are in the bed - someone who has not yet been diagnosed cannot be diagnosed BECAUSE you think it is FREE? This is NOT a good idea.

Get a recording oximeter and a data capable machine and twirl your own dials

[LSAT]

[quote="Wulfman"]There ain't no "free lunch" (or sleep study or healthcare). SOMEBODY is paying for it. The more people who take advantage of it, the more it costs everyone else.


I absolutely agree...and this also goes for the people that are getting supplies each month from their DME whether they need them or not......hey..."it's not costing anything, it's free!"

[brazospearl]

Sounds like we need a survey choice for "when the data indicates a substantial change is needed." Seriously, why bother if the data shows things are going well? What would we learn from a new study? If things aren't going well it's another matter entirely, and there's no time frame appropriate for that. Just sayin'.
Brazospearl