second study show minimal apnea

[trish07]

Looking forward to your comments....I had my first sleep study little over 4 years ago. Was totally compliant with cpap. Great right, well not so fast. My machine started to fail so called the sleep Dr to get a new script. Since I hadn't been back to the doc he would not write a scrip without another study. So last week I went for a split study and received the results today. Now mind you I am pretty disorganized so I do not have all the readings of the first sleep study. But basically I was having 39.7 apneas an hour. Dr diagnosed me at moderate to severe.
My results today were 4.9. so he says in a word I've improved. I ask how can that be...Maybe you've lost weight, no, I've gained 6 pounds since then. Maybe using the machine has strengthened your throat muscles.
The bottom line here is they indicated the insurance will not cover any of the cost for a new machine. You have to be at 5 to qualify. Now couldn't they come up with that 1 little point...
So the questions is has anyone else encountered this, I am totally frustrated as I know damn well how I feel on the machine and how I felt before the machine. 5 years ago I had so many little symptoms that disappeared after Cpap.
So since I had a good night at the second study I'm screwed. Thoughts anyone???

[Pugsy]

Very odd indeed.
By any chance did you use your machine the night before the recent sleep study or had it totally failed a while back...or was it just acting sick but still working?

[trish07]

Well really didn't want to give this up, but the machine had failed on two occasions recently, so was thinking it was failing. THEN went on vacation and left it in the rental car. UGH

[Pugsy]

Ah....I take it that means that you hadn't used the machine for several nights prior to the repeat sleep study. If you had used it the night before there's a small chance you would have had maybe some residual help from the past usage but if it had been many days..that help would be long gone.

So what do you want to do? Your insurance isn't going to want to pay for a new machine.
How have you been feeling since going without your machine? Do you want to go ahead and use the machine despite what the sleep study says? There are ways to get machines but you have to pay for them yourself...but it doesn't always have to cost an arm and a leg.

What machine were you using?

[trish07]

Well I've had a few good nights in the last two weeks. Some not so good to where I feel fuzzy, dizzy upon waking and extra tired. But did not always have all great nights on the machine. I had a PR system one with humidifier with Resmed nasal mask. Funny, I tend to look better off the machine, less red and puffy around the eyes.
Not real sure where to go from here. May have to keep some detail on my sleep then decide if I buy one on my own. Very confusing at this point.
I see there are members posting used machines and may look into them. The best thing would be that the DME looks at the first study as well and approves the new script. Will have to wait and see.

[Pugsy]

No immediate rush then. You can think about it and see how you feel and what happens with DME.
Then decide. There's almost always someone selling something around here. If you decide you want to try another machine and have to buy out of pocket send me a PM and we will see what's available at the time.
There was a really good deal on a Respironics full data cpap machine...model 460 with humidifier and all the accessories...low hours for $140 but I think someone is snatching it up if I read the thread correctly.

[kaiasgram]

trisha, you mentioned that your sleep study last week was a split-night study. Did they put you on a machine that night?

[trish07]

Sleep study no machine from 10:30 to 1:30am. On Cpap from 2:00 to 5:30. I saw the doc today for the results but I don't have copy of the numbers yet. Hopefully tomorrow they'll have them for me.

[9forus]

Have you talked with your insurance or just Taken the doctors word. My apnea was classified as mild but with my heart condition they went ahead and treated it. No mention if insurance not covering it for mild sleep apnea.

[Pugsy]

Why did they put you on the cpap machine if there wasn't enough apnea events during the first half of the sleep study?

[kaiasgram]

Sleep study no machine from 10:30 to 1:30am. On Cpap from 2:00 to 5:30. I saw the doc today for the results but I don't have copy of the numbers yet. Hopefully tomorrow they'll have them for me.

OK, so now I'm having trouble understanding how you met criteria during the split-night study for cpap titration during the second part of the night if your AHI during the untreated portion was below 5.

When I read your first post I wondered if someone got mixed up and accidentally reported that 4.9 was your AHI for the first three hours when it was actually your AHI during the second half of the study when you were on the machine. (Was the doctor who read your recent sleep study report the same doctor who suggested that using your machine has strengthened your throat muscles to the point where you no longer need cpap ?)

Very weird situation! It will sure be interesting to see both the original study report and last week's report.

[jencat824]

Don't know if this might work, but could you see another Dr. for a second opinion? Sounds like they could have made mistakes during your study. For example, why did they put you on CPAP for the 2nd half of the night if you didn't need it?

Something just doesn't sound right about this. Especially the part about your 'throat muscles'???

Jen

[trish07]

Yes Pugsy it was the same doctor. I thought that statement was absurd. I asked him if that was the case how long would it last. He said he didn't know. I will post results in the next few days of both studies. However I did read that constant snoring causes a vibration/ weakens the tissue in the throat that can then lead to apnea. So could the reverse be true that with using the machine 4 years with no snoring help/reverse the condition for period of time?

I'm assuming the tech did as she was told to do, meaning splitting the study.

I noticed the tech in the office who looks like he evaluates the sleep studies, I may try to get through to him to ask some question of the accuracy of the numbers. With tact of course.

[Pugsy]

Normally a split study involves the first part of the night without the machine and the machine is added only when criteria is met for the diagnosis.
Normally if criteria isn't met (and the criteria can vary with the doctor) they don't even put the cpap machine on.

No, I don't see 4 years of therapy strengthening the tissues in the throat so that the airway no longer collapses and the OSA miraculously goes away. I have read of a possible residual effect that lasts for 2 or 3 days after stopping using a machine but even that is a possible thing and not a certainty. Just something I read that might happen but no hard fast proof that I have ever seen.

[zoocrewphoto]

Normally a split study involves the first part of the night without the machine and the machine is added only when criteria is met for the diagnosis.
Normally if criteria isn't met (and the criteria can vary with the doctor) they don't even put the cpap machine on.

This is what I was told when I went in for a split night study. If I met the criteria within a certain time frame, they would start teh titration phase. Otherwise, it would be a two night study. It sounds like you really need an all night diagnosis sleep study since most people are worse during REM sleep and there are more REM cycles later in the night. And if you are worse on your back, sleep on your back as much as possible.

I would challenge the sleep study results since you either met the criteria and qualify for the cpap machine. Or you didn't meet the criteria YET and they should not have stopped the diagnosis phase.

If that fails, go to a different doctor who will review both sleep study results and take into consideration how you did on the cpap machine and how t his second study was messed up.

A couple years ago, my mom wanted a new sleep study as she wasn't feeling good with her machine, and her machine was7 or 8 years old with no changes in pressure settings over that time. Medicare refused to pay for a new study as her last study was only a few years old. She used my full data machine for 2 partial nights, one at her current setting of 10 (ahi was low, but teh events were LONG), and one night at 10-13 to see what the machine wanted to do. She took the old sleep study summary and the two reports from my machine to my new sleep doctor (I had just done my 2 month followup). He reviewed the data and prescribed a new full data machine set for 10-15. She s much happier, and it did not require a nw sleep study. Just a doctor who was willing to look at the info and decide that she needed an improvement.