JohnBFisher wrote:I learned that it behooves me to call and talk with the manager of the sleep techs before I visit a sleep center for a sleep study. I use this as an interview process. If I am unhappy with the level of experience of the sleep tech manager and/or their sleep techs (for example, if I found that none of them had done an ASV sleep study .. in my example) then I would find another sleep lab.
Then on the night of the sleep study, I come with information about my issue and discuss it clearly with the sleep tech.
While none of these steps should be essential, they do seem to help improve the quality of my sleep studies. And since I have the most to lose when they are not done well, I try to help nudge them along. Regardless of whose responsibility it might be to ascertain the skills of the sleep tech.
Well, I just had a very interesting chat with the sleep tech manager. It seems she concurred with my tech's evaluation and explained why. My sleep was VERY fragmented and it was difficult to ascertain why. When I WAS sleeping, my sleep was GREAT. Problem was I didn't STAY asleep, and they scored most of my events as post arousals rather than true Centrals. Incidentally, in REM, I had just as many- from what I've read in REM most cases of CSA and CA don't score too many in that stage. Anyway, seeing how Bi Level/ASV is the logical next step and this was my FIRST titration, they wanted to do things by the book and titrate me first with CPAP (according to the rules). This would guarantee that if I DO need ASV, that Bi Pap would follow first and they could then prove that ASV (if successful) was the 3rd and final step. This all of course to be sure insurance covers this VERY expensive treatment. Makes sense to me I suppose... and she also confirmed that my next titration will start with Bi Pap and then move to ASV. She didn't see how Bi Pap would help however... so I'm hoping ASV is the answer. I have faith they're on top of my treatment and doing what's necessary. Finally, we talked pressures in the meantime. She said 6 or 7 looked ideal for me, (she had my study in hand) and that even though after 4 or 5 nights of low AHI's at 7cm and on the 6th/7th night a spike, I should stay the course instead of confusing the hell out of my respiratory system. Guess I'll continue with 7cm tonight and see. Finally, not saying CPAP isn't needed in my case, but what can account for the fragmentation? Is everything POST? I have old injuries from a motorcycle racing incident (2004 and VERY BAD) that cause a really stiff neck, upper and lower back and I know I toss and turn to relieve pressure most of the night. Would muscle relaxers and/or Advil help in that area? Would this even be a cause of my centrals and the underlying issue that CPAP can't even begin to help? I would think getting deeper good sleep would help repair some of the muscle/soft tissue if only I had ENOUGH of it. Ugh.
Thanks all for bearing with me.
Z
PS: Important to note: During my titration she strapped a True Blue nasal mask to my face so tight (to prevent leaks) It felt like a scene from "Alien". Next time I wear my Aloha and chin strap. I can only assume that contraption caused SOME of the fragmentation?... I've never worn a nasal mask before.
