Sleep Study Frequency

[donnm]

Does anyone know how often someone with sleep apnea should have a sleep study? I had my first polysomnogram in 2001 or 2002 and a second one in early 2004. The CPAP recommendation (10 cm) was the same both times. The CPAP is working fine, but it seems there should be a follow-up routine of some kind to see if the apnea is improving or becoming more severe.

[WAFlowers]

Personally I belive that I should have a mini sleep study approximately every 60 milliseconds (0.060 seconds). That is the response time of the PB 420e APAP.

OK, I guess this really didn't answer your question, but I sleep better knowing that the machine will recognize and respond to events and changing conditions.

[tater pie]

That's a good question. My sleep doc told me on my last visit that I probably would never need another sleep study. That seems strange to me.

[SnoozeHunter]

I had my first titration in summer of 2003 and didn't have another until September of this year. In my case, it was because I didn't follow up with the sleep doc when I was supposed to in 2004, although I did continue to use the bipap. He had me do another titration because I told him that I didn't feel any more rested than when I first saw him and I had developed some other symptoms that may or may not be related. I was very surprised at how much worse my apnea results were this time. I just had another one last night to verify the results of the one in September and also to see what would happen if the sleep study was done a little differently.

I know that doesn't really answer the question of how often sleep studies should be done, but my point is that they should probably be done when you and your doctor suspect that your apnea has worsened or that the machine settings are no longer helping you, and that would be based on how you feel physically. My insurance company was willing to cover the cost of another sleep study just two months after the last one as long as my doctor felt it was medically necessary.

SnoozeHunter

[wading thru the muck!]

Personally I belive that I should have a mini sleep study approximately every 60 milliseconds (0.060 seconds). That is the response time of the PB 420e APAP.

OK, I guess this really didn't answer your question, but I sleep better knowing that the machine will recognize and respond to events and changing conditions.

EXACLY!

[Guest]

EXACLY!

I give up. what is EXACLY an acronym for?

[donnm]

I appreciate the responses. Doesn't seem like there's much information out there about this issue.

[ProfessorSleep]

I appreciate the responses. Doesn't seem like there's much information out there about this issue.

Nothing standard, anyway, so it seems. I am supposed to see my sleep doc on an annual basis or call if symptoms get worse. A titration study would then be done, rather than a full sleep study. Meanwhile, I like WAFlowers answer - I purchased a 420E. So I'll let the sleep doc know when (if) I need him!

[chrisp]

You will find that the docs that RX APAP often say nnever. Docs that Rx cpap say every year or 2.

We know that it really depends on how much they can milk your insurance for

AUTOs RULE

:twis ted:

[Colorado Jan]

I don't have the perfect answer, but I would think you would need to be re-titrated whenever you don't feel as good from your CPAP or if you changed weight by more than 10-15 pounds or if you had other health issues that may impact the situation arise.

Just my guess.
'
Jan

[rested gal]

I like WAFlowers' answer!! 420E autopap and software is what I use, too.

I was very surprised at how much worse my apnea results were this time.

There's always the possibility that the results the first time were not correct. You might have had it "worse" even back then that what the first study came up with -- so much depends on how the study is conducted, what equipment they are using, perhaps different scorers. Both could have been "off", for that matter.

SnoozeHunter, are you the same person who posted some reports from your studies in the ASAA "sleep studies forum"? If so, I'd really, REALLY be questioning the ability of the clinic(s) you've been going to, to do a proper titration. Sounded like the titrations were not being conducted very well. I'd also wonder about a sleep doctor who wasn't questioning how those studies were done.

Read, re-read, and re-re-read what sleepydave was saying in that thread about the way your titrations were done:

Nov 09, 2005 subject: Very confused about sleep study results 2 page topic

If that was/is you, and if you're stuck with not being able to travel to a clinic that might handle your case better.....then... I believe if it were me (I'm not a doctor!) I'd be seeking a trial on autopap. The new Respironics BiPAP Auto, if I could get my hands on it.

I'd want a trial on autopap, if for nothing else than to see if I really, REALLY needed the kind of high pressure that was being prescribed from those studies... such as they were. A trial with autopap (ideally with a recording pulse oximeter for a night or two while using the autopap) might yield some valuable additional information.

Good luck, SnoozeHunter!

[SnoozeHunter]

Hi, rested gal!

Yep, I'm the same SnoozeHunter who posted results in the other forum. I appreciate your comments and advice. I'm not sure yet what's going on with my studies, ie why they were done the way they were and my doc's response to the results.

I am going to try to get an autopap machine and pulse ox recorder and try it at home if possible. Don't know exactly where to get those things yet, but I'm going to check around tomorrow when I get back to work.

I really dislike being in the position of questioning the doctor's opinion on my results and what treatment I should follow, but something seems off about the whole thing. I trust the guy who does the scoring (he's scored all of my sleep studies), but I'm pretty certain he's not there at night when the titration is done. The folks doing the titrations are good people, but they obviously don't have the level of expertise of sleepydave.

Finding an alternate sleep lab is on my to do list for this week. Hate to do that because this one is so conveniently located for me, but at this point I'm ready to start over with a new lab and a new family physician, as well.

Thanks again for your suggestions.

SnoozeHunter

[Kem]

My sleep study and titration study were in February and March of 2004. I was given the vpap II, yes, the II, not III. At the time I didn't know it was an older machine. Pressures were 15/11. This past January I again visited the sleep center and informed them I'd lost 25 lbs. The sleep dr. said this wasn't enough to warrent a pressure change on the inhale, but lowered the exhale pressure to 9. I asked about a new titration study and was told I'd "probably" never need one! Well, I've learned a lot since then and they'll have a new gal to deal with when I go back this January. Got to be your own advocate!

[donnm]

Thanks! Once you get the doc's approval, there's still the insurance to worry about.

[dsg]

[quote="Colorado Jan"]I don't have the perfect answer, but I would think you would need to be re-titrated whenever you don't feel as good from your CPAP or if you changed weight by more than 10-15 pounds or if you had other health issues that may impact the situation arise.


____________________________________________________________-

That's almost precisely what my sleep doc said a year ago. Personally, I would be extrmely happy to never go through the titration study again. I hated it. What my doc said in summary was "if it ain't broke, don't fix it!" (this will be the first of what I'm sure will be an insane number of times I rave about him).