RESULTS - New Sleep Study and CPAP Audit - Update, Kinda

[2flamingos]

Finally - I saw a REAL sleep dr! Four years after my dx and getting my machine! Went to my PCP last Wednesday (day before Thanksgiving) for my semi-annual visit and had my list of stuff - mostly stress related, but also had on there the whole day time sleepiness thing. He referred me to a (his) sleep doc, and has his nurse make the appointment. Due to a cancellation she was able to get me in yesterday (Monday after THanksgiving). After talking about several issues, including daytime sleepiness and showing him reports from my PAP and my Zeo, he said he wanted to do a new sleep study and CPAP Audit. When we are done I site down with the scheduler who asks when I would like to do it. My response is ASAP, why not. She looks at the calendar, calls the lab and says - "y'all still have an opening tomorrow night?"

So, I go TONIGHT. Already preregistered (No co-pay), confirmed appointment with Lab; so all I have to do is show up at registration at 6:00.

Apparently someone up there thought I really needed to do this! My first study took a bout a month from Dr visit to study. This one, less than a week - a holiday week, no less.

Dr is even talking about possibly a new machine.

I'm happy, but a bit freaked at the same time. The only times I have had anything medical go this quickly and easily were emergencies.

[chunkyfrog]

Take your own pillow and best fitting mask, maybe an extra blanket.
Mask will need to be such that they can get the breath sensor up under it.
Sleep tight--or however.
Don't worry, probably just an opening--how fortuitous!

[Xney]

Bad sleep could be considered an emergency (by me)

[Slinky]

Congratulations! Sleep well. Here's wishing you a great and accurate titration study along w/a new fully data capable APAP.!!!

[2flamingos]

Sleep study - Audit done!

I hate that the Tech's can't give you any information! The only thing they told me this morning was that my pressure had been adjusted to a straight 14 - no auto, no A-flex, no nothing. Does make me feel a bit better about my "knowledge" knowing that the straight setting is dead center of where I had last set the auto range (12-16). Unfortunately, I don't go back to sleep doc until December 13. Not sure if I can get a copy of the results before then, but will give it a try.

I feel like I slept relatively well - when I slept. The bed was not really comfortable (read hard as a rock), the plastic mattress cover was annoying, and then early morning I got cold - so I awoke more times than I do at home.

It was funny to me that the Tech's were surprised with the accessories I had and brought (hose stand, tube wrap, and chin strap - didn't have the heart to tell them about my Zeo ), that I had changed my own pressure, and that I had a second machine at home. I kept saying "what part of I am serious about this do you not get?"

I expect sleep doc to give me an rx for Nuvigil when I go back. All I know is - I want better sleep, and to not be sleepy during the day.

[chunkyfrog]

I think of myself as a pap geek.
I'm alive, I thrive; I will survive.
Word.

[2flamingos]

Results were actually pretty good. I had chnged my settings a little over a year ago to 12-16, and study showed straight 14 worked well. I did, however, have 9 centrals. They tried BiPap for a while, but it made no real difference, so back to CPAP at 14. . Lowest O2 was 92, highest was 98, and Mean was 95. Sleep Efficiency was 90%. I am assuming that is all pretty good - at least sounds good to me. Oddly, I had SEVERE PLM - 71.5/hr. Doesn't happen at home (if so, I would think my partner would notice, or the dog would not be albe to sleep between us at the foot of the bed). PLM arousal index was 62.1

Now, I am getting a new machine - APAP, so I can use the 12-16 settings if I want to (which is how the rx was written). I have already talked to the DME my "new" sleep Dr suggested, who is suggesting the ResMed 9 Autoset. Is there a better one out there that I should consider? I currently have an M-Series Auto (with BIG old Smart Card). Dr mentioned a new F&P that uses a thumb drive (supposedly software is included on the thumb drive). Thumb drive or SD, doesn't really matter to me, just want to be able to check ALL data that I can. Suggestions? Also, I have a Zeo, so it would be nice to import/combine data to see any correlation between events and sleep stages, etc.

I am also considering trying the Elan mask. Any feedback on that?

Thanks in advance for any comments or suggestions!

[chunkyfrog]

Since Circadiance offers a free 30-day return policy;
and Cpap.com has the élan on sale right now, you might as well try it.
Note some DME's may not carry it and their return policy needs to be assured up front before you buy.
Some people find the SW Advance to be more stable than the élan;
both are light and cool, but require a bit of fussing to keep a seal.
(I actually got a 0.0 leak night before last and a 6.0 last night, although 12-17 is more common)
I have been using the same cushion for over 2 months, hand washing it each morning.

[2flamingos]

One thing I forgot to include - I am VERY lucky in that my insurance covers DME 100%, provided I use a local provider. SO, I only order on-line when I want/need something that may not be covered by my insurance (or I just don;t want the wait and hassle).

I will say this, my new sleep dr has approved me for just about any and every supply I can think of, AND is extremely happy that I take an active interest in my treatment. He was pleasantly surprised when my study showed that I had chenged my setting to basically what I needed - 14 is dead center of what I had set it to.

[Pugsy]

Avoid the F & P machine. Software is difficult to obtain and manage and besides..it doesn't separate centrals (all you get are Apneas and Hyponeas).
Plus the the reports suck visually.

Get the S9 AutoSet....you won't have any regrets with it at all.

[kteague]

... Oddly, I had SEVERE PLM - 71.5/hr. Doesn't happen at home (if so, I would think my partner would notice, or the dog would not be albe to sleep between us at the foot of the bed). PLM arousal index was 62.1

It's good to have a more complete picture of your sleep, and to know you are pretty much on target with your CPAP settings. I'm not knowledgeable enough about centrals to know if your number is acceptable or not. But it seems like your limb movements are a likely culprit in your daytime sleepiness. Hopefully your doctor will address those. I would suggest before you take medication to control them that you get a better picture of potential influences, particularly having bloodwork for iron studies (to include ferritin level) and other related tests. Augmentation sometimes happens on the dopamine agonists commonly prescribed, and having a ferritin level on the lower side of the normal range is thought to be a commonality is those with PLMD. So just in case, resolving any issues before medicating may be a pre-emptive wise move.

Limbs movements can be as small as a flexing of the big toe, so it is possible for them to escape notice of the bed partner. Not sure if the sleep doc would do it, but you could call in advance of your appointment and ask if during your next visit they can show you some of the video where the movements are present so you can see what they look like. I had one doctor do that, but I've seen a few others who did not, so it's probably not the norm. Never hurts to ask. Or video yourself to see. Best wishes as you go forward.

[2flamingos]

KT - thanks for the suggestions. Doc ordered a bunch of blood work, including Iron and B-12. If everything is ok, I don;t go back until March or April.

Pugsy - Thanks for the info. Iwas not particularly considering the F&P, just mentioning he suggested and hoping for a comment like yours. THe one neat thing he said was that it uses a thumb drive, and the sofware is included.

[DiverCTHunter]

Now, I am getting a new machine - APAP, so I can use the 12-16 settings if I want to (which is how the rx was written). I have already talked to the DME my "new" sleep Dr suggested, who is suggesting the ResMed 9 Autoset. Is there a better one out there that I should consider? I currently have an M-Series Auto (with BIG old Smart Card). Dr mentioned a new F&P that uses a thumb drive (supposedly software is included on the thumb drive). Thumb drive or SD, doesn't really matter to me, just want to be able to check ALL data that I can. Suggestions? Also, I have a Zeo, so it would be nice to import/combine data to see any correlation between events and sleep stages, etc.

The two most popular APAP machines around here are the ResMed S9 Autoset and the Phillips-Respironics SystemOne 60-series RemStar Auto.

[msradar65]

Go for the S9 Autoset. You will love it. I know I love mine. Don't forget the climateline hose!!!

[StuUnderPressure]

Go for the S9 Autoset. You will love it. I know I love mine. Don't forget the climateline hose!!!

I would also order it with the "Cleanable tub" for the H5i Heated Humidifier.

Just as soon get everything you want up front.