New -- home study tonight

[TNT]

Hi. Great forum. I've decided to go ahead with testing for sleep apnea, and I've learned a ton on this forum.

I'm a 53 year old male. I've been suffering from a lot of the typical symptoms for years, and since I magically (so it seems) gained 100 pounds recently they've gotten a lot worse... I'm beyond tired all the time (and usually getting hit like a ton of bricks at some point during the day), snore like an industrial machine, up multiple times during the night, etc.

About ten years ago, a psychiatrist mentioned getting a sleep study done. One thing didn't lead to another and I never had the test done. Over the years, some other doctors have mentioned getting tested, but they never made it seem like a serious or high priority issue. It was sort of like, "here's a bunch of pills, and, by the way, if you ever get a chance, might want to think about a sleep study." Even a doctor last spring who was certain I had apnea acted like it wasn't all that important.

A few weeks ago, I got a physical from a new doctor. We spent the hour mostly talking. At the end, she said "You really need to have a study done and you should do it as soon as possible." Okay. Alas, the insurance balked at a lab study, but will pay for a home study.

After some weather and other delays, the kit has arrived.

Question: the doctor ordered a three night study. Is that pretty normal? I see the doctor tomorrow, so I figured I'd ask her about it then. I'm just wondering if that seems standard.

Anyway, we'll see what happens from here.

[Julie]

Normally you'd get 2 nights in a lab - one for tracking the extent of your apnea and the 2nd for a titration of how to set up the machine (pressures) for you to use. But at home, he may want 3 nights to get a good correlation of things, rather than just depending on one night... you probably do have a relatively serious case by now and it's important to get things right before setting you up. Normally, sleeping on your back would provoke more apnea events - not a good thing, but in a lab, they'd have you sleep that way for a certain amount of time to get a baseline idea of how bad they get then, and I suggest not that you sleep on your back for a whole night, but maybe for a few hours (note which ones so they can compare the time with results) and get someone to wake you to turn over for the rest of the night. If you have trouble not sleeping on your back in general, get hold of either foam wedges or pillows or something to keep you off your back otherwise, whether while testing or not. Also, make a point of not having coffee or alcohol or hot stuff (food for many hours prior to sleeping as if you have esophageal reflux - often accompanies apnea - you don't want it to interfere with the test by arousing you (with or without your awareness) when sleeping... it may happen anyway, but I would try to keep it down (as raising the head of your bed x 4-5" on blocks would do, but don't bother with that for the test either).

[Janknitz]

Is your "kit" a real sleep study with probes on 2 or more fingers and sometimes something to wear on or around your chest, or is it just a recording oximeter (probe on only one finger)?

[TNT]

It's a single finger sensor, a chest sensor worn around the chest and a breathing sensor between the nose and mouth. It's an Accusom from Novasom.

[Janknitz]

Interesting. I see they regularly do 3 night tests. You should get a pretty accurate reading that way.

[HerbM]

I don't understand how "two finger probes" would make it a "real sleep study".

My real IN LAB sleep study only had on pulse oximeter on a single finger.

[Janknitz]

Read here: http://www.itamar-medical.com/WatchPAT.html

They can get a surprising amount of data.

[Gary_UT]

A few weeks ago, I got a physical from a new doctor. We spent the hour mostly talking. At the end, she said "You really need to have a study done and you should do it as soon as possible." Okay. Alas, the insurance balked at a lab study, but will pay for a home study.

After some weather and other delays, the kit has arrived.

Question: the doctor ordered a three night study. Is that pretty normal? I see the doctor tomorrow, so I figured I'd ask her about it then. I'm just wondering if that seems standard.

Anyway, we'll see what happens from here.

My insurance was the same way.

Had to do the home study, get the results, then the doctor ordered an overnight study at the lab.

They approved the lab study after that. Make sure they approve the study before hand, otherwise they may not pay.

Gary

[Janknitz]

If you have "run of the mill" OSA, there's really no need for a lab test after a home study. These home study machines are fine for diagnosing OSA. If there are indications of other problems like complex apnea, RLS, PLMD, or sleep behavior disorders, then that's another matter. It's also very possible and practical to be titrated at home on an autoPAP machine.

You aren't being "cheated' by "only" getting a home study. You are getting a very good picture of your real sleep in your own bed and sleeping conditions. The technology is very good for diagnosing OSA, and therapy will "tell the tale". If you are getting good improvement of health markers from treatment, then the diagnostics did their job. If you are not doing well even with treatment, then further assessment in lab may be indicated. The home tests also can flag symptoms which may warrant a more detailed in-lab study like excessive movement in sleep.

Personally, I was much happier going to sleep with a few probes on my fingers in my own bed than being wired up, gooped up, having to sleep in a strange bed while people watched me. I'm positive I never would have gone through with that. and my OSA would remain untreated.

[TNT]

I suppose the home study is okay. I haven't asked the doctor how we'll proceed if I do test positive

Still, I'd have much rather gone to a clinic. My doctor mentioned that sometimes during a lab study, there will be enough evidence of apnea early on to interrupt the study and proceed with a CPAP test.

Instead, it's three nights of sleeping with equipment that isn't all that comfortable, plus waiting for results, etc. I'm also a little concerned that the finger sensor fell off over night and the base unit was still glowing bright green as if there wasn't a problem.

That said, it'll probably be faster overall this way... from what I understand, getting a test in a lab around here takes over a month to schedule.

I'm just getting a little frustrated. I don't want to have sleep apnea, but if there's a machine that manages to control the misery I've been having, then lets get on with it.

[Janknitz]

Maybe that's the benefit of doing the home study for 3 nights instead of 1--if something isn't correct one night, it may be the next. Be forewarned that even if you are diagnosed and prescribed a CPAP, it will be a game of "hurry up and wait."

There are multiple steps involved--having someone read the results, write a report, communicate that report to your doctor, your doctor has to figure out what to do, then you have to go in for an appointment at which point you may need to do a titration at home or in the sleep lab, then more interpretation, report, see your doctor for the prescription, find a DME (or decide if the one you are referred to is any good), Insurance authorization for your equipment, fight with the DME to avoid getting stuck with a brick.

THEN, you finally have your equipment, so NOW the fun begins, learning to sleep with it. This is when patience is truly a virtue!