home study advice

[zackds]

i got a prescription for a sleep study and im probably getting a home study done
im actually not sure what questions to ask or what the pros/cons of a home sleep study are
can anyone here give me some advice on what to ask/look for when getting a sleep study done?
can a sleep study determine if you have uars or is it only good for actual apnea?

[Pugsy]

The only definitive 100% for sure test for UARS is a sleep study done in a lab with the Pes device being used.

Home study totally useless for UARS diagnosing.

[Stom]

The only definitive 100% for sure test for UARS is a sleep study done in a lab with the Pes device being used.

Home study totally useless for UARS diagnosing.

The need for invasive PES testing to diagnose UARS is rare according to Principles and Practice of Sleep Medicine, 6th ed.

These subjects presented repetitive short (“transient”) alpha electroencephalographic arousals lasting 3 to 14 seconds that regularly interrupted the abnormally high inspiratory efforts. Standard PSG recordings of these subjects evoked the diagnosis of UARS from the presence of these repetitive transient arousals, increases in snoring just before the arousal, and an increase in inspiratory time and a decrease in expiratory time, which were determined with the use of well-calibrated sensors. No significant change in Sao2 was seen, and the respiratory disturbance index was low (<5).

A nasal pressure cannula and, in rare, doubtful cases, esophageal pressure monitoring must be included in all sleep studies to confirm the diagnosis of UARS.

The vast majority of home sleep tests ("Type IV", 1 channel minimum, "Type III", 4 channels minimum) lack many of the channels you'd find in an in-lab PSG, such as EEG and EOG, but some have them, along with effort bands and nasal canulas to measure airflow (A "Type II" Home Sleep Test, minimum 7 channels)

If you think you have UARS, or anything other than simple apnea without any complicating health factors, an in-lab test is going to provide more data for a positive diagnosis. Because a *lack* of apneas is one of the criteria for being diagnosed with UARS, a negative ordinary home test for sleep apnea (an AHI of less than 5) may tell you nothing about whether or not you have UARS.

[Pugsy]

The need for invasive PES testing to diagnose UARS is rare according to Principles and Practice of Sleep Medicine, 6th ed.

A nasal pressure cannula and, in rare, doubtful cases, esophageal pressure monitoring must be included in all sleep studies to confirm the diagnosis of UARS.

The only definitive 100% for sure test for UARS

You probably don't have all the history that I have with the OP here so I have a bit of an advantage there but with this OP....I don't think that anything less than "100 % for sure" is going to satisfy him and that's why I said what I said.
I could be wrong but he's more of a black and white kind of guy and not someone who is okay with gray uncertain areas with maybes.

[Snoregone Conclusion]

The only definitive 100% for sure test for UARS is a sleep study done in a lab with the Pes device being used.

Home study totally useless for UARS diagnosing.

The need for invasive PES testing to diagnose UARS is rare according to Principles and Practice of Sleep Medicine, 6th ed.

These subjects presented repetitive short (“transient”) alpha electroencephalographic arousals lasting 3 to 14 seconds that regularly interrupted the abnormally high inspiratory efforts. Standard PSG recordings of these subjects evoked the diagnosis of UARS from the presence of these repetitive transient arousals, increases in snoring just before the arousal, and an increase in inspiratory time and a decrease in expiratory time, which were determined with the use of well-calibrated sensors. No significant change in Sao2 was seen, and the respiratory disturbance index was low (<5).

A nasal pressure cannula and, in rare, doubtful cases, esophageal pressure monitoring must be included in all sleep studies to confirm the diagnosis of UARS.

The vast majority of home sleep tests ("Type IV", 1 channel minimum, "Type III", 4 channels minimum) lack many of the channels you'd find in an in-lab PSG, such as EEG and EOG, but some have them, along with effort bands and nasal canulas to measure airflow (A "Type II" Home Sleep Test, minimum 7 channels)

If you think you have UARS, or anything other than simple apnea without any complicating health factors, an in-lab test is going to provide more data for a positive diagnosis. Because a *lack* of apneas is one of the criteria for being diagnosed with UARS, a negative ordinary home test for sleep apnea (an AHI of less than 5) may tell you nothing about whether or not you have UARS.

As much as a type III study may not be definitive, depending on the details, the data may be sufficient to interpret as a basis to treat as such: the SNAP Diagnostics take-home sleep study I took (Premera requires a cheaper home study first unless certain requirements are met) showed I had an AHI of .9, and an RDI of 6.2 (IIRC) with a statistic with a name that it seems is unique to their study that picks a 10 minute sample and calculates that, where it was 49.x/hour in my case. Combine the RDI with the rest of the data and reported symptoms and... seems I’m the lucky bum in the family that doesn’t have OSA, but can’t sleep readily, either! Oh, and the desats are not *quite* to the 88% magic number I see bandied about, but over half the recorded time it was at 90%, and any of the nights they could have scored were better nights than many: data not as precise as a sleep lab, but good enough to have the insurance company’s external reviewing people approve for things. Learned from this that Medicare rules treat AHI and RDI interchangeably, and what tipped things over the edge were the daytime sleepiness and fatigue symptoms along with brain fog (forgot terms they used).

As long as I get the results I need and coverage, the exact label doesn’t matter to me: I (my climbing partner, too) have seen clear evidence that using a machine is beneficial, subjectively and objectively. Compliance will be easy, even though things are not ideal: it beats natural reality easily.

[Stom]

You probably don't have all the history that I have with the OP here so I have a bit of an advantage there but with this OP....I don't think that anything less than "100 % for sure" is going to satisfy him and that's why I said what I said.
I could be wrong but he's more of a black and white kind of guy and not someone who is okay with gray uncertain areas with maybes.

Ah, yes, that does make sense. But I'd add that this forum is also used by people doing research on their sleep issues, and they don't all post questions, instead using the search function to explore existing threads, as people are so often urged to do by veteran posters, so even though your answer was technically accurate, and apparently well tailored to the OP, it could unintentionally mislead the average person searching the board who doesn't benefit from such a black and white answer, an answer that, without your explicitly stated context, implied that PES testing is common and necessary for the routine diagnosis of UARS when it is not.

[Pugsy]

Ah, yes, that does make sense. But I'd add that this forum is also used by people doing research on their sleep issues, and they don't all post questions, instead using the search function to explore existing threads, as people are so often urged to do by veteran posters, so even though your answer was technically accurate, and apparently well tailored to the OP, it could unintentionally mislead the average person searching the board who doesn't benefit from such a black and white answer, an answer that, without your explicitly stated context, implied that PES testing is common and necessary for the routine diagnosis of UARS when it is not.

Ahhh...you thought I was implying that Pes device sleep studies was common? Quite the contrary.
Please don't put words in my mouth that I didn't say.
I wasn't implying anything...just stating the facts.

And when I respond to a question I can't possibly always answer in such a manner to totally cover the whole world reading the question.
There are times when I simply can't write a novel to cover all potential bases and this was one of them.

[Stom]

Ahhh...you thought I was implying that Pes device sleep studies was common? Quite the contrary.

I'm just saying what it looked like to me, and what it may have looked like to others, before you posted your explanation. I'm not saying you intentionally meant to imply anything. After reading your post about PES I had to look up UARS in a medical textbook to find out more about PES and inadvertently discover that use of PES not common. When we say, for example, that a PSG is the definitive test for sleep apnea (or "the gold standard") we don't mean it is a rare test that mostly isn't needed, so I was surprised that PES is definitive, but no longer necessary for most UARS diagnosis.

So, maybe others wouldn't get the wrong idea, but I certainly did and it took a fair bit of legwork on my part to find otherwise.

[Pugsy]

I'm just saying what it looked like to me, and what it may have looked like to others, before you posted your explanation. I'm not saying you intentionally meant to imply anything. After reading your post about PES I had to look up UARS in a medical textbook to find out more about PES and inadvertently discover that use of PES not common. When we say, for example, that a PSG is the definitive test for sleep apnea (or "the gold standard") we don't mean it is a rare test that mostly isn't needed, so I was surprised that PES is definitive, but no longer necessary for most UARS diagnosis.

I can't possibly know what goes through other people's minds when I offer a response.

You did exactly what anyone else should do after reading my reply or any reply anywhere for that matter...go looking and researching and learning for yourself. I much prefer that people educate themselves instead of my spoon feeding information to them.

Now when I can't possibly cover all potential bases in my responses and you feel that more explanation would be helpful...how about just adding your comments without commenting about mine and I will shut my mouth.
I do that often...doesn't mean there is anything wrong with what someone else has said but just that I think that further explanation would be maybe helpful and I do it when I have time. I try not to demean what someone else has said in the process because I felt that further explanation might be needed.

Someone took the time to respond and if it was brief and maybe lacking in thoroughness doesn't mean their response is any less valuable.

What I said was the truth. If you felt you needed to offer further information on it...fine and dandy...just don't bitch about my response in the process...that's all I am asking. If you had left me out of your response I wouldn't have said a damn thing about what you said.

[palerider]

I'm just saying what it looked like to me, and what it may have looked like to others, before you posted your explanation. I'm not saying you intentionally meant to imply anything. After reading your post about PES I had to look up UARS in a medical textbook to find out more about PES and inadvertently discover that use of PES not common. When we say, for example, that a PSG is the definitive test for sleep apnea (or "the gold standard") we don't mean it is a rare test that mostly isn't needed, so I was surprised that PES is definitive, but no longer necessary for most UARS diagnosis.

I can't possibly know what goes through other people's minds when I offer a response.

With some, I think it's tumbleweeds.

[Stom]

What I said was the truth. If you felt you needed to offer further information on it...fine and dandy...just don't bitch about my response in the process...that's all I am asking. If you had left me out of your response I wouldn't have said a damn thing about what you said.

Not trying to pick a fight with you, Pugsy. What you said was factual. So was what I added. I think we both agree on that.

[Stom]

With some, I think it's tumbleweeds.

Do you claim anything in my post RE UARS is factually incorrect?

I mean, it's rather familiar to see you drop in just to make a personal attack against me without actually adding anything of value to the thread, and especially opportunistically timed on your part when I may have inadvertently offended Pugsy, but have you considered contributing something material to the thread rather than just vitriol?

[LSAT]

With some, I think it's tumbleweeds.

Do you claim anything in my post RE UARS is factually incorrect?

I mean, it's rather familiar to see you drop in just to make a personal attack against me without actually adding anything of value to the thread, and especially opportunistically timed on your part when I may have inadvertently offended Pugsy, but have you considered contributing something material to the thread rather than just vitriol?

If you would read posts more often you would know that next to Pugsy, PR contributes more than anyone on this board.

[Stom]

[If you would read posts more often you would know that next to Pugsy, PR contributes more than anyone on this board.

Note what is missing from your post? Any denial of what PR just did.

You can't actually deny that PR just dropped in with a drive by insult and didn't add any anything material to the thread.

This isn't something I was going to expound upon, but you are specifically trying to justify PR's sometimes bad behavior by pointing to his sometimes good behavior. If an ordinary user did what PR just did I suspect you'd think differently. PR manages to get away with being a bully much the same way longtime coaches do, where their perceived value to an organization causes people to overlook otherwise inexcusable behavior.

PR does have a history of many decent contributions, but often times his contributions consist of nothing but negation, where PR just tells someone, often a new poster, that they are wrong, without actually adding the relevant information about what he claims is correct. PR is also a frequent bully who knows that you and others will defend him, even when he's in the wrong as in this instance, and has run a number of new posters out of the forum. He's managed to leverage his contributions into a consistent way to get out of being held accountable for his bullying.

[palerider]

With some, I think it's tumbleweeds.

Do you claim anything in my post RE UARS is factually incorrect?

I mean, it's rather familiar to see you drop in just to make a personal attack against me without actually adding anything of value to the thread, and especially opportunistically timed on your part when I may have inadvertently offended Pugsy, but have you considered contributing something material to the thread rather than just vitriol?

If you would read posts more often you would know that next to Pugsy, PR contributes more than anyone on this board.

Things like that don't matter to someone who *always* has to be *technically* right, no matter how wrong and irrelevant they are.