Another sleep study?

[lwieland11]

Hi all -

Went for a sleep study last week. Tech told me my new pressure was 19. Told me that twice. My sleep doc emailed a few days after the study to say that the results were in and that the study was inconclusive and unsuccessful in determining a new pressure. She said I would need another study done, this time including a Bipap. Not sure why the tech didn't switch me to Bipap during the night I was there. Not sure why I was told my new pressure was 19 either if it wasn't. Very confused and disappointed. Do sleep centers ever redo sleep studies at their expense if they made a mistake? Any thoughts? I'm not financially able to redo such an expensive procedure. I could barely afford the one they just did. Any thoughts?? Thank you.

[LSAT]

Hi all -

Went for a sleep study last week. Tech told me my new pressure was 19. Told me that twice. My sleep doc emailed a few days after the study to say that the results were in and that the study was inconclusive and unsuccessful in determining a new pressure. She said I would need another study done, this time including a Bipap. Not sure why the tech didn't switch me to Bipap during the night I was there. Not sure why I was told my new pressure was 19 either if it wasn't. Very confused and disappointed. Do sleep centers ever redo sleep studies at their expense if they made a mistake? Any thoughts? I'm not financially able to redo such an expensive procedure. I could barely afford the one they just did. Any thoughts?? Thank you.

You have an autoset machine. If you use the free Sleepyhead Software, you can tell by the data what your pressure should be and if you need a bipap.

[kteague]

The titration on a bilevel is different than a straight CPAP. By the time one determines the higher pressures are not optimally effective, it's likely too late in the study to restart with the bipap and get enough meaningful information. If another titration is not feasible for you, I would suggest a few things. First, I agree that you should make use of any existing information to get a clearer picture so you can make informed decisions. And get copies of your study report - not just a summary page. There may be some clues in the report that will let you know if the issues can be resolved without a different machine. Just as an example, if your report shows that a high pressure was needed only when on your back, you could take measures to make sure you cannot roll onto your back. However, if you need that high of a pressure, you might find a bilevel more comfortable and gives some leeway for possible increased pressure needs over time. Even so, a bi-level machine can be successfully titrated at home, and if it's an auto adjusting machine, it's even easier. You will already have a starting point guideline from your report. Don't feel rushed into a decision you can't afford. There's some data gurus on here who can help walk you through this, so for now, see where the whole body of information directs you.

[bonjour]

Work with your Dr. Indicate that with the 19 the tech mentioned that you would prefer to get a BiPAP because the pressure is at the high end of CPAP. I did reiterate that compliance was not an issue as I used my CPAP ALL the time. It would help if you could show him elevated AHIs and detailed charts. (Mine were 8-12 AHI at CPAP 18-20)

I was recently (end of November) in a similar position and he suggested a CPAP at 19 may be ok for me. I said since I was getting a new machine I'd rather have the flexibility of BiPAP for the next 10 years I'd likely have this machine. He recommended BiPAP at 25/21 To call if I have issues and to adjust when I saw him. I'm currently in Auto 12 min 25 max with my 95% at 15 and an AHI under 1 frequently.

[D.H.]

Since you were try to determine a new pressure, I assume that you have an old pressure.

What was it?

[Southerngent1]

I actually ended up taking 3 sleep studies.

My score was/is a 92. The first sleep study was spent on testing one half of the time and trying CPAP the second half. The 2nd study was spent trying traditional Bipap and the 3rd study trying an ASV machine.

The hospital where the clinic is located was willing to work with me on a 24 month payment option with no interest.

[SewTired]

No, they do not redo studies at their expense. They make judgements based on the data that they have. Since the tech suggested that you need a new pressure of 19, I would contact the doctor. Leave a message saying that you simply cannot afford another study AND buy a machine. Ask her to prescribe an bipap since 19, as was suggested by the tech, is almost the maximum of the cpap.

You don't say how you are paying for this. It may make a difference if you are paying out of pocket, insurance or Medicare and whatever deductible is going to be applied. If you are tight for funds and have a high deductible, you might be better off looking for a used bipap for now.

Finally, make sure that the bilevel you get is an AUTO so that you can maximize your therapy.

[lwieland11]

D.H. -

Current pressure is 13. AHI is very high though so it's not doing much good probably because I have gained weight. The sleep study tech told me that the pressure has nothing to do with how much you weigh. I don't think that's right or is it? The subject came up because when she told me I needed a 19, I told her of a friend of mine who weighs close to 300 lbs. and he's only at 17. I weigh about half that and 19 seemed way high.

[chunkyfrog]

Severity has NOTHING to do with the pressure needed to prop open your airway.
"Severity" is measured by the NUMBER of events you have--PERIOD!
Higher pressures can be needed by ANYONE, regardless of age, weight or AHI.
Set your machine on Auto with 20 as the maximum. You can use your old 13 as the minimum-for now.
Download Sleepyhead, and start analyzing how your apnea looks.
Look at your pressure graph, and your 95% Pressure mean.
Also look at your central apnea figures.

[D.H.]

D.H. -

Current pressure is 13. AHI is very high though so it's not doing much good probably because I have gained weight. The sleep study tech told me that the pressure has nothing to do with how much you weigh. I don't think that's right or is it? The subject came up because when she told me I needed a 19, I told her of a friend of mine who weighs close to 300 lbs. and he's only at 17. I weigh about half that and 19 seemed way high.

The correlation between severity and the pressure needed is a loose one, but not a non-existent one. For instance, if you have severe Sleep Apnea it's very unlikely that your pressure would be 5, and if you have mild Sleep Apnea it's very unlikely that your pressure would be 15. At this time, the needed pressure is not considered a measure of severity, but that could change at some point.

Since your machine is an automatic, why not raise the minimum to 14 and set the max at 20 (the highest it goes). Then you can see if you ever get near to 19.

BTW, I set my max to 20 (min 13.5), but seldom go above 15.

[LSAT]

-

Current pressure is 13. AHI is very high though so it's not doing much good probably because I have gained weight. The sleep study tech told me that the pressure has nothing to do with how much you weigh. I don't think that's right or is it? The subject came up because when she told me I needed a 19, I told her of a friend of mine who weighs close to 300 lbs. and he's only at 17. I weigh about half that and 19 seemed way high.

There is no relationship between weight and pressure. The sleep tech is correct.

[Julie]

Settings are based on how much pressure is needed to keep your individual airway open and that depends on various factors, but has NOTHING to do with severity of apnea which is caused by other factors. Some people don't understand the relationship (or lack thereof) and should certainly learn the difference before posting.

[Krelvin]

Settings are based on how much pressure is needed to keep your individual airway open and that depends on various factors, but has NOTHING to do with severity of apnea which is caused by other factors. Some people don't understand the relationship (or lack thereof) and should certainly learn the difference before posting.

+1

[Bron Yr Aur]

My first round of sleep studies in 1999 was not a bad experience. However, my last round would have been a nightmare if I could have gotten to sleep. The tech was barking directions at me all night. I never got to sleep. So, I had no breathing incidents. The Dr. had ordered a split study, which they did not do. The Dr. then declared he had no support for continuing CPAP & I could not use it until I went for another sleep study. (Of course I ignored him). I went to a different sleep lab which was not as bad. However, I still had trouble sleeping due to the tech chatting with the person in the next room all night. I think the quality of service in sleep centers has plummetted, like it has in many fields. My opinion is that this has become a moneymaking endeavor, with little concern for the quality of the product (a useful, accurate sleep study). It seems they are cutting corners on things like sound insulation and efforts to duplicate a person's normal sleeping conditions, things they were attentive to in the past. In both facilities, they expected me to go to sleep much earlier(8 -10 PM) than my usual time, and wanted me out at 5 AM. Maybe this board should start rating sleep labs, to put pressure on them to raise their quality.