Sleep Studies - how often?

[S-Dubya]

I've been on CPAP for nearly 6 years. In that time I have only had one sleep study, about a year after I started. I wanted to make sure it was working (it was). I am now wondering if doctors recomend that we get "checked out" periodically - every 2 or 3 years perhaps?

[WhiteBeard]

Sounds like you are way over due for a sleep study anyway! I have talked with some people that have Sleep Apnea and work at sleep centers and they get a sleep study done yearly, my doctor recommends a yearly sleep study, I guess it all depends on the individual and if they know how they are doing. If you have a data capable machine and you know your AHI's are always below 5 and you are feeling well and not tired, and are having no problems, then maybe you might not need to have a sleep study so often. But if you have no idea of how your doing, and you have questions about the effectivness of your PAP then maybe you might want to have a sleep study done more often. What does your Sleep Doctor recommend? Might want to check with him/her. Good Luck

[Goofproof]

I took my prescription, bought my APAP at CPAP.COM, got the software and reader, now a Sleep Study is unnecessary as I have one every night. Jim

[plr66]

Following on Jim's response, I have been wondering about the O2 issue, since our xpap machines don't measure that. My first oximeter night indicated an alarming number of minutes at less than 90%--which was the precipitant for my MD referring me for a sleep study. After I had been using my apap for several weeks, the oximeter was done again for a night, and showed huge improvement in the O2 so that it was not an issue. Do I need to invest in an oximeter to continue to monitor this myself, or can I assume that the apap has resolved that problem for the long run?

[2girlsmom]

My sleepiness came back at a year so they did another one. That was 2mos ago and I slept horribly. I go again tonight. I am going to push for something like an APAP so I can titrate at home if needed and dr is ok with this too but she wanted to see me n the lab again and get some better sleep from me (we're hoping anyway).

[Goofproof]

Following on Jim's response, I have been wondering about the O2 issue, since our xpap machines don't measure that. My first oximeter night indicated an alarming number of minutes at less than 90%--which was the precipitant for my MD referring me for a sleep study. After I had been using my apap for several weeks, the oximeter was done again for a night, and showed huge improvement in the O2 so that it was not an issue. Do I need to invest in an oximeter to continue to monitor this myself, or can I assume that the apap has resolved that problem for the long run?

Our XPAPs don't measure O2 directly but they do tell us the time we spend nightly in Apnea and the AVG length of the apnea. Basically, it's also a "Poor Man's" O2 guage. James Skinner's add in program, "Encore Analyzer", does that job really well. As long as those numbers are low you are getting your O2. They won't tell you if you have a lung disorder that keeps you from taking in the O2, but that's not Sleep Apnea. Jim

[GumbyCT]

I've been on CPAP for nearly 6 years. In that time I have only had one sleep study, about a year after I started. I wanted to make sure it was working (it was). I am now wondering if doctors recomend that we get "checked out" periodically - every 2 or 3 years perhaps?

If you are feeling good there really is no need other than cash flow for the sleep lab. I don't think insurance has a requirement to have an annual like the labs would like us to believe.

[snoregirl]

I will never have another sleep study if I can help it. Waste of money. Get an apap.

[Snoredog]

I will never have another sleep study if I can help it. Waste of money. Get an apap.

ditto! once you know from one what you have, there is nothing they can do about the other stuff seen on your report anyway, so if you get an autopap you don't need them anymore. If I need a new script my GP writes me a script for what I need.

[akramabed]

Our XPAPs don't measure O2 directly but they do tell us the time we spend nightly in Apnea and the AVG length of the apnea. Basically, it's also a "Poor Man's" O2 guage. James Skinner's add in program, "Encore Analyzer", does that job really well. As long as those numbers are low you are getting your O2. They won't tell you if you have a lung disorder that keeps you from taking in the O2, but that's not Sleep Apnea. Jim

I understand that O2 level should not go lower than 98% but isn't the amount of time spent with low level important as well. So what is an acceptable average apnea time to avoid low O2 per event and per night? My data shows overall average of 22.3 s (2.9 Min per night) from JS Analyzer, but looking at latest daily stats show me around 15s( 3 min/night). I was wondering if this is too long or ok? All talks about AHI below 5, but not about duration. If Apap is supposed to suppress the Apnea by raising the pressure then does it wait for 10 S then starts increasing pressure. This would indicate that having a high lower pressure on Apap is better. However to control Aerophagia ones needs to use lower min pressure.
Trying to find the right pressure range without hitting the threshold of Aerophagia while controlling the AHI as well the O2 level(Apena duration) is confusing. Any suggestions?

[Slinky]

98% 02 is not a necessity when you are sleeping. The criteria for 02 supplementation when hospitaliezed is <90%. The criteria for 02 supplementation during a sleep study is <=88% for a specified length of time which I have forgotten .. duh.

[rozenbob]

As a Pilot, the FAA (Federal Aviation Administration) required TWO Sleep Studies and a wakefullness study. Since receiving my Medical recertification, the FAA requires one Annual visit to a Pulmonologist to verify NO change/decline with my Regular Flight Physical and a New Sleep Study once every SIX Years!

[Snoredog]

I understand that O2 level should not go lower than 98% but isn't the amount of time spent with low level important as well.

I don't know where you got your information, but that is NOT correct. Anything at or below <89% is considered medically significant, anything above that is considered Normal. For starters your Wake baseline SAO2 level is needed, it is measured from a resting state while awake. You may only be 92 to 100% but nothing wrong if your resting rate is 94%. Then during sleep if you experience an apnea event that drops your level by 3%, it can take you from 94% to 91% and still be in the normal range, no big deal from a hypoxia stand point but the arousal may be an issue with the quality of sleep you get. It is when you have multiple events clustered together and/or very long events like an 80 second apnea that it can cause problems. An 80 second apnea could make your SAO2 level dive fairly fast, definitely want to avoid those.

Below is what your SAO2 levels should fall under:

DEFINITIONS:
APNEA = cessation of airflow for 10 seconds or greater.
HYPOPNEA =>50% decrease in airflow for 10 seconds or greater with a decrease in oxygen saturation of >3%.
APNEA/HYPOPNEA INDEX (AHI) = apnea plus (+) HYPOPNEA/hour of sleep.
RESPIRATORY AROUSAL INDEX (RAI) = AHI +snoring related EEG arousals/hour of sleep.
AHI/RAI** Scale =<5 events /hour = (none); 5-15 events/hour = (mild); 15-30 events/hour = (moderate); >30 events/hour = (severe).
Respiratory related sleep fragmentation: Sleep arousals due to respiratory events or snoring.
Desaturation = Drop in O2 oximetry distribution saturation by 3% below average saturation.
SaO2 scale: >89%=(none); 85-89%=(mild);80-84%=(moderate); <80% (severe).
EPWORTH SLEEPINESS SCALE =<10=(does not indicate EDS (Excessive Daytime Somnolence));10-15=(indicates daytime somnolence-not excessive);>16 (indicates EDS).
RESPIRATORY EFFORT RELATED AROUSALS (RERAs)=Sleep Arousals due to respiratory events characterized by pressure flow limitations in the airflow indicator channel without significant O2 desaturations.
StageIII and StageIV are combined and referred to as Deep Sleep.
Sleep Efficiency = Normal is >80%
As established by AASM/ABSM 1999.

Normal Sleep Architecture:
Stage1: 5%
Stage2: 50%
Stage3: 10%
Stage4: 10%
Stage REM: 25%

Stage3&4, REM decrease as we age.

[johnwayne81]

sort of a newbie here,
Received my machine in late may 08, started with a nasal mask and i did not get along very well with it because i am a mouth breather so i tried a chin strap but did not seem to help, was pretty frustrated. Went to a ff mask and i hate it! I had horrible gas for weeks and weeks, tried gas x and tried mylanta with simethicone and neither medication helped at all. I am determined to keep going but i am getting quite frustrated. I went back to the nasal mask and the gas has disappeared, ( my doctor said there was nothing he could do about the gas problem) but my only problem is that i am a mouth breather and i cannot keep my mouth closed. Has anyone tried (who is a mouthbreather) the nasal pillows? my pressure is 14 and he (dr.)said he could try lowering the pressure but is that going to work? i have moderate to severe sleep apnea but he was more concerned with my oxygen level which i thought he said went down to 78 Percent? seems awful low, could i just not use oxygen instead of the cpap machine? appreciate any input, thanks so much!