Help: I can’t wait until May 16th for my sleep study

[Senortocino]

IMG_7385.jpeg (157.05 KiB) Viewed 2939 times

Thanks to my Apple Watch,I have known since December 2024 that I have sleep apnea. On February 8, I was sedated with propofol for a surgical procedure in the hospital. Since then, the number of sleep disturbances have practically tripled. I am exhausted all of the time and stay home doing nothing. My sleep study is scheduled for May 16 and I would really like to get it done sooner so that I can end this nightmare. Even though I have shown the attached report to several doctors, they have shown no sense of urgency.

Please, I need some advice. Thanks in advance.

[Pugsy]

How about $199 for a home sleep study?
https://www.cpap.com/products/home-slee ... appy-sleep
It's a basic no frills test and doesn't measure sleep stages but to get sleep stages there is a different test that costs around $500 that can be got elsewhere but a doctor's RX is needed.

[Senortocino]

Thanks for the suggestion. I did mention that to my doctor, and he said that they need a very specific kind of sleep test, although he didn’t go into detail as to what kind it was.

Based on another post I saw in this board, I’m considering getting a used machine as a spare, until I get my real one through insurance.

[GrandmaA]

What do the doctors offer as an explanation for the sudden onset of "sleep disturbance" after the surgical procedure? Propofol should have no lasting effects whatsoever. Possibly changes in how you sleep since the surgery (like positional changes transmitting something different to the watch), or if they put you on new meds or you have sleep disturbance due to pain. Regardless, the fact that you are so exhausted suggests the change is real, whatever the mechanism, and they are right to do a study. But I also concur May is a very long time to wait when you're feeling this bad. If it were me, I'd maybe do both. Pay for the home study out of pocket if I had to, if only to satisfy my own curiosity if the doctor won't accept it, but my guess is the doctor saying he wanted something specific means he has some idea of what the problem is. Too bad he didn't go into detail with you.

As for going ahead and getting a machine out of pocket to self treat, you shouldn't have to resort to that but here we are. The doctor won't or can't do anything to speed up the study. Maybe if you do the home study you can convince him to get you on therapy right away so you'll feel better, then in May do the test he wants and he can then tweak or change the therapy to suit the result.

Sometimes you have to be a squeaky wheel, make him understand you're not just whining that you feel tired, but you are unable to function and it's seriously impacting you.

[amenite]

Thanks for the suggestion. I did mention that to my doctor, and he said that they need a very specific kind of sleep test, although he didn’t go into detail as to what kind it was.
...

Aside from the mystery test type mentioned by your doctor, is there some chance this "procedure" is itself triggering the sleep disturbance? I mean, was it a colonoscopy or were they removing nasal polyps or something? I don't need to know what it was, I'm just suggesting that the Propofol seems an unlikely trigger.

[Senortocino]

No, I don’t mind. It was a shoulder relocation, which is a simple brief procedure. During the procedure, they actually had to stop the propofol and give me ketamine instead. One of the doctors told me later that I had stopped breathing under sedation andrecommended that I see a doctor for sleep. I’ve done some research online and there are several articles that document sleep apnea complications with the use of the drug. And honestly, I can’t think of anything else that might’ve triggered this. I had sleep apnea already but, as it shows very clearly on my Apple Watch reading, the number of respiratory disturbances Practically tripled from that moment forward.

[Senortocino]

What do the doctors offer as an explanation for the sudden onset of "sleep disturbance" after the surgical procedure? Propofol should have no lasting effects whatsoever. Possibly changes in how you sleep since the surgery (like positional changes transmitting something different to the watch), or if they put you on new meds or you have sleep disturbance due to pain. Regardless, the fact that you are so exhausted suggests the change is real, whatever the mechanism, and they are right to do a study. But I also concur May is a very long time to wait when you're feeling this bad. If it were me, I'd maybe do both. Pay for the home study out of pocket if I had to, if only to satisfy my own curiosity if the doctor won't accept it, but my guess is the doctor saying he wanted something specific means he has some idea of what the problem is. Too bad he didn't go into detail with you.

As for going ahead and getting a machine out of pocket to self treat, you shouldn't have to resort to that but here we are. The doctor won't or can't do anything to speed up the study. Maybe if you do the home study you can convince him to get you on therapy right away so you'll feel better, then in May do the test he wants and he can then tweak or change the therapy to suit the result.

Sometimes you have to be a squeaky wheel, make him understand you're not just whining that you feel tired, but you are unable to function and it's seriously impacting you.

Yes, I have tried to be this squeaky wheel, which is definitely not my style, but I’ve obviously not been squeaky enough. My original appointment with specialist was on April 24, and I got it moved forward to March 17. I can’t even imagine how long I would have to wait for the sleep study if I kept my original appointment.

Yesterday I actually tried to reach out to the hospital for the very first time. I called their patient advocacy number and left a voicemail. I would like to think that I’ll get a call back early next week. I’ll call back if I don’t hear from them by then.

I’ve been very surprised if not shockedthat none of the doctors that I have contacted have had any ideas or suggestions. I was hoping that they might become the squeaky wheels for me.I really appreciate your advice.

[Senortocino]

Maybe I was wrong about the sedation that was applied. Does this screenshot indicate that the ketamine given before the propofol? Would that change anything?

[GrandmaA]

No, I don’t mind. It was a shoulder relocation, which is a simple brief procedure. During the procedure, they actually had to stop the propofol and give me ketamine instead. One of the doctors told me later that I had stopped breathing under sedation andrecommended that I see a doctor for sleep. I’ve done some research online and there are several articles that document sleep apnea complications with the use of the drug. And honestly, I can’t think of anything else that might’ve triggered this. I had sleep apnea already but, as it shows very clearly on my Apple Watch reading, the number of respiratory disturbances Practically tripled from that moment forward.

I had a family member the same thing happened to. She stopped breathing while sedated for a procedure and was told afterward to see a doctor for a sleep study and was diagnosed with sleep apnea. So you definitely had it already. But either it has worsened suddenly, coincidentally since the procedure, or the Apple Watch is picking up some different vibration or something and interpreting it more strongly now. Maybe a coincidental software update around that same day that changed how it's analyzing things. Who knows? I get a feeling it's an unsolvable mystery. But the fact remains you feel terrible, and you very likely know the cause (bad sleep) and the solution. I wish your doctors would be more helpful. This is really frustrating. Long delays for medical tests are a problem.

[GrandmaA]

Maybe I was wrong about the sedation that was applied. Does this screenshot indicate that the ketamine given before the propofol? Would that change anything?

I wouldn't think so. Ketamine also would not stay in your system very long. A single dose of both those one time would be very unlikely to have a lasting effect. More likely might be positional change due to the procedure itself. For example, when I had my hip replacement, I had to sleep flat on my back for a couple of weeks. I'm normally a side sleeper but could not sleep on either side right after the surgery. I know now that I have sleep apnea even sleeping on my side, but my AHI is just mild. I wonder if I had done a sleep study during those two weeks sleeping on my back if I would have registered moderate or severe.

[Senortocino]

No, I don’t mind. It was a shoulder relocation, which is a simple brief procedure. During the procedure, they actually had to stop the propofol and give me ketamine instead. One of the doctors told me later that I had stopped breathing under sedation andrecommended that I see a doctor for sleep. I’ve done some research online and there are several articles that document sleep apnea complications with the use of the drug. And honestly, I can’t think of anything else that might’ve triggered this. I had sleep apnea already but, as it shows very clearly on my Apple Watch reading, the number of respiratory disturbances Practically tripled from that moment forward.

I had a family member the same thing happened to. She stopped breathing while sedated for a procedure and was told afterward to see a doctor for a sleep study and was diagnosed with sleep apnea. So you definitely had it already. But either it has worsened suddenly, coincidentally since the procedure, or the Apple Watch is picking up some different vibration or something and interpreting it more strongly now. Maybe a coincidental software update around that same day that changed how it's analyzing things. Who knows? I get a feeling it's an unsolvable mystery. But the fact remains you feel terrible, and you very likely know the cause (bad sleep) and the solution. I wish your doctors would be more helpful. This is really frustrating. Long delays for medical tests are a problem.

Thanks again for your feedback. It really helps to know that I’m not alone in this.

I wish I were pushier. Maybe I’ll sign up my daughter-in-law to be my advocate.

By the way, how do you respond so quickly to these posts? Do you get some kind of notification?

[Senortocino]

Maybe I was wrong about the sedation that was applied. Does this screenshot indicate that the ketamine given before the propofol? Would that change anything?

I wouldn't think so. Ketamine also would not stay in your system very long. A single dose of both those one time would be very unlikely to have a lasting effect. More likely might be positional change due to the procedure itself. For example, when I had my hip replacement, I had to sleep flat on my back for a couple of weeks. I'm normally a side sleeper but could not sleep on either side right after the surgery. I know now that I have sleep apnea even sleeping on my side, but my AHI is just mild. I wonder if I had done a sleep study during those two weeks sleeping on my back if I would have registered moderate or severe.

At first, we thought the same thing. I have always been a side sleeper both right and left. But for the first couple of weeks after the surgery, I had to lay on my back because of my shoulder. But as soon as I was able, I started sleeping on my side again, but it made no difference. Do you think the couple of weeks might have made all the difference?

Thanks again for following up.

[Pugsy]

Looks like the Ketamine was given about 3 minutes prior to the dosing of the propofol
18:14 vs 18:17

I have no idea if either one of those med (or both of those meds) is the culprit in the big change you have seen

[Nocibur]

Will you be using Medicare to cover this?

Get a recording oximeter. It will tell you everything you need to know.

[Nocibur]

... he said that they need a very specific kind of sleep test...

You should have politely responded:

"Yeah my **** is special too. Gimme the MF HST."