Just had a titration study - what’s next?

[MindAwakeBodyAsleep]

I’m a 36 yo male, 5’10” 280lbs, high blood pressure. Finally caved to my doctor’s advice, had a home study done which revealed both obstructive and central sleep apnea (if I recall correctly my AHI was in the 90s). I need to ask for a print out of it (unable to give more details until I do).

The doctor said the usual treatment is CPAP but that CPAP is not sufficient for central sleep apnea and could make it worse. He said I’d most likely need BiPAP or ASV.

The doctor ordered a titration study lab study, the respiratory therapist said I should try to sleep on my back I’m usually a side sleeper but I with some effort I was able to stay on my back throughout the night.

I was started on a nasal mask (pretty comfortable) and fell asleep but could feel my mouth periodically opening and I was reflexively shutting it, the sleep tech came in to switch in a full face mask which was less comfortable than the nasal mask and then I vaguely remember one or two more times she came in to tighten straps to fix leaks.

When I was awoken at the end of the test she said I tolerated it well and stayed on my back the whole night. I inquired about any centrals she said they did occur but said any more info would have to come from my doctor after he reviewed it.

I have an appointment in a couple weeks to go over the results.

Is there anything I should be researching before hand (i.e. masks for side sleepers)? Are there any specific questions I need to be sure to ask (besides making sure I get a copy/print out of all the info)?

Any input/advice would be greatly appreciated!

[LSAT]

Wait for the results..a certain number of centrals can be expected and will not cause problems.

[Julie]

It's important to realize that the back sleeping was for them to get a worst-case scenario, but that back sleeping is otherwise not good for apneas as it produces many more than side sleeping does... for future reference.

[zonker]

I’m a 36 yo male, 5’10” 280lbs, high blood pressure. Finally caved to my doctor’s advice, had a home study done which revealed both obstructive and central sleep apnea (if I recall correctly my AHI was in the 90s). I need to ask for a print out of it (unable to give more details until I do).

welcome to the zoo. you'll get some good help here, but not from me. i mean to say bilevel or vauto or any of that stuff doesn't mean much to me. soon, folks will be along to help you out.

what julie said is true. they were testing "worst case" as apnea, particularly for me, if far worse on my back.

and you are correct, you want that printout. it's yours legally and can help moving forward. once you get it, redact your personal info and post it here, if you don't mind. that way the experts will know exactly what's going on.

good luck!

[TropicalDiver]

When I was awoken at the end of the test she said I tolerated it well and stayed on my back the whole night. I inquired about any centrals she said they did occur but said any more info would have to come from my doctor after he reviewed it.

I have an appointment in a couple weeks to go over the results.

Is there anything I should be researching before hand (i.e. masks for side sleepers)? Are there any specific questions I need to be sure to ask (besides making sure I get a copy/print out of all the info)?

Any input/advice would be greatly appreciated!

Yes. I am assuming you are in the US -- if not, then my answers would be a bit different. I would start by learning:
a) Which DME(s) my insurance company works with;
b) How my insurance handles PAP (i.e., rental -- for how long, when does it convert to ownership, etc.) as well as deductible and co-pays;
c) About the masks you used and what you liked (or didn't) about each one;
d) About the different brands (ResMed vs Respironics) and the different models;

The model will depend on your results -- if you are having lots of centrals, then you will likely end up with something like the ResMed Aircurve 10 ASV or the ResMed Aircurve 10 Vauto (or similar models made by Respironics.)

At the doctor's appointment:
a) Ask for a copy of your sleep study and titration results (ideally including what machine and masks were used in the titration).
b) Start thinking now about what questions you might have.
c) Set up a path to having a good mask result -- this means one that meets your clinical needs, fits well, and is relatively comfortable (given the situation). I personally tried at least ten masks.
d) Ask what you should expect and when they want you to check with them?

[Okie bipap]

It looks like you will need either a bi-level or ASV machine. The two major brands of these machines are Philips Respironics and ResMed. Pelple tend to swear by one brand or the other and swear at the other brand. Everybody's needs are different, and they prefer different things. I have never tried a Philips machine, so I cannot make a comparison. One thing that gets a lot of attention around here is calling a ResMed bi-level machine a "bipap". "Bipap" is a registered trade mark of the Philips Respironics company. To be on the safe side, I refer to all of these machines as bi-level, which a correct description of either machine. The hardest part of getting started is findng a mask that is comfortable enough to sleep in. Many people here on the forum have been able to train themselves to keep their mouth closed when sleeping and have successfully used either a nasal or nasal pillow mask even though they breathe through their mouth. I have not been able to do so, and have always used a full face mask.

[zonker]

Pelple tend to swear by one brand or the other and swear at the other brand.

datalaughing.gif

you funny man!