Second sleep study

Physician wrote:

tiredandscared wrote:

SleepyCarey wrote:Is there a reason you're having your study at home rather than in a professional setting (i.e. a sleep clinic or hospital)?

Money constraints. It's much cheaper to just gather data from a home study and feed into a program. Than to make a more complex diagnostic test like a polysomnography.

My home study was more than adequate for the diagnosis, and it's accepted by insurance companies. Probably the only reason(s) to have a study other than at home is:

1. Restless Legs Syndrome
2. UARS
3. C02 retention
4. Excellent insurance coverage
5. You have no home for a home study

On the contrary... a polsomnography is far superior, as they can observe what's happening in your sleep and different aspects of your condition. A home study is more comfortable. But you have no idea of what's happening during sleep itself, and it can sometimes misrepresent your sleep. If the diagnostic machines were capable of data gathering for days, that would have made them more reliable. But they only give you one days worth of data, unobserved.


But I have no choice in the matter, since it's state funded healthcare. They reserve polysomnographys for people with severe problems.

tiredandscared wrote: On the contrary... a polsomnography is far superior, as they can observe what's happening in your sleep and different aspects of your condition. A home study is more comfortable. But you have no idea of what's happening during sleep itself, and it can sometimes misrepresent your sleep. If the diagnostic machines were capable of data gathering for days, that would have made them more reliable. But they only give you one days worth of data, unobserved.


But I have no choice in the matter, since it's state funded healthcare. They reserve polysomnographys for people with severe problems.

Superior ? Yes in that one gets more information. Useful in changing treatment ? NO. Treatment options are limited.

Physician wrote:

tiredandscared wrote: On the contrary... a polsomnography is far superior, as they can observe what's happening in your sleep and different aspects of your condition. A home study is more comfortable. But you have no idea of what's happening during sleep itself, and it can sometimes misrepresent your sleep. If the diagnostic machines were capable of data gathering for days, that would have made them more reliable. But they only give you one days worth of data, unobserved.


But I have no choice in the matter, since it's state funded healthcare. They reserve polysomnographys for people with severe problems.

Superior ? Yes in that one gets more information. Useful in changing treatment ? NO. Treatment options are limited.

The sleep study in a lab can tell when you are asleep and ignore false centrals. They can also tell what positions you are in, so they can see whether you are worse on your back, etc. And they are better at telling the sleep stages. I had an accurate diagnosis in less than 2 1/2 hours with a great titration the same night. Way better than a home study where the equipment may or many not be set up correctly, can't tell when and how I am sleeping, etc. And a titration in a lab has a much better chance of getting a good mask fit. I didn't have a single leak. She put the mask on me, and I rolled over and slept for over 5 hours straight. Awesome! It was the best possible start I could have had. It took me 6 weeks to master the same mask at home, so a titration study at home would have been useless.

Ok I got the home study equipment. It's just a standard 3 channel harness. With a cannula, thorax measurement piece with a microphone and a oximeter. It's also nonin. Let's hope I get accurate results. Im going to use some sedative antihistamines and melatonin. And hope i can sleep. Wish me luck. Im getting the sleep study results on Monday. Im hoping my AHI is low.

Managed to sleep with the equipment somehow. The nonin homestudy equipment is much less clunky than the embla. But not sure about the accuracy. Save for waking up 3 times and a bathroom break. I managed to sleep(with sedation) and snore aswell. So the results should be relatively representative. Not sure however, as the nasal canulla keept falling out.

Ok so I went to the doctor. This one was young and knew what she was talking about. She said that I had no signs of SDB. According to the data, I snored 20% of the time, and besides an artefact, there was no sign of significant desaturation. I asked her about UARS, she said the RERA, flow limitations were too low, to indicate UARS. She said it might be worse if if I sleept more on my back. But otherwise I should not have any problems. She examined my throat, and said the only indicative feature was that my tongue was larger than average, other than that.. she didn't find narrowness in the airway. She said if it was anything, it could be sleep maintence insomnia related to depression/anxiety or borderline supine/REM apnoea. My AHI was 1.4 on my side and 2.5 on my back. She instead offered to look at my sleep architecture. So now i'm going to us a device. Watch pad. To get a further diagnostic. I'll get the home study result on Wednesday, I forgot to ask the doc about them.

zoocrewphoto wrote:

Physician wrote:

tiredandscared wrote: On the contrary... a polsomnography is far superior, as they can observe what's happening in your sleep and different aspects of your condition. A home study is more comfortable. But you have no idea of what's happening during sleep itself, and it can sometimes misrepresent your sleep. If the diagnostic machines were capable of data gathering for days, that would have made them more reliable. But they only give you one days worth of data, unobserved.


But I have no choice in the matter, since it's state funded healthcare. They reserve polysomnographys for people with severe problems.

Superior ? Yes in that one gets more information. Useful in changing treatment ? NO. Treatment options are limited.

The sleep study in a lab can tell when you are asleep and ignore false centrals. They can also tell what positions you are in, so they can see whether you are worse on your back, etc. And they are better at telling the sleep stages. I had an accurate diagnosis in less than 2 1/2 hours with a great titration the same night. Way better than a home study where the equipment may or many not be set up correctly, can't tell when and how I am sleeping, etc. And a titration in a lab has a much better chance of getting a good mask fit. I didn't have a single leak. She put the mask on me, and I rolled over and slept for over 5 hours straight. Awesome! It was the best possible start I could have had. It took me 6 weeks to master the same mask at home, so a titration study at home would have been useless.

The home study detects sleep positions. Even if all tests are "normal" or "indeterminate", here's nothing wrong with the start poster empirically trying a PAP toy see if there's any benefit.

Ok i got the watch pad results.


Itmar watchpat
AHI: 10.8 ( Ahi: REM 20.4, NREM 9.
3)
AHI positions ( 7.7 supine, 14.5 stomuch, right side 7.7, left side 13.2)
Time below 90% : 0(I've recorded as much as 0.01 to 0.6% on worse days)
RDI: 17
Saturation average: 95( has been as low as 94)
Saturation nadir: 92(my lowest recorded nadir was 86-87)
respitory events: 18
Sleep time: 5.58 hours
REM latency: 87 minutes. ( I was on REM reducing antihistamine, so I have 5% less than normal)
Wake: 20 times
Sleep effeciency: 70%

Nonin Homestudy:
Ahi: 1.3
Supine ahi: 1.1
Oxygen saturation average: 96%
Oxygen Nadir: 82%(artefact)
Supine oxygen saturation: 96%
Supine Oxygen nadir: 89%
Respitory count: 14 (hypnoapneas)
Time spent below 90% : 0

You can see the massive difference. How the standard homestudy equipment is inferior at detection.

I'd say the Itmar is relatively accurate. Except that It's probably a bit worse since I didn't sleep on my back very much and I was on a sedative histamine. My AHI is probably a bit higher on worse nights. Watch pat is almost as accurate as a polysomnography. My advice always ask or opt for it during a diagnosis if polysomnography isn't available. Both standard homestudies (embletta and nonin) entirely missed it and are generally shit compared to watchpad and polysomnography.

Lucyhere wrote:My first study was done in a lab. I'm going to have a new sleep study, but this time in my own bed. My doctor said this will give her all the information she needs and there is no need to go to a lab. We are trying to determine why after many months I continue to take my mask off during the night although it is comfortable enough. It doesn't seem to be because of leaks.

Having a sleep study at home sure beats a lab as far as comfort is concerned. My experience at the lab wasn't wonderful.

My experience...let me make sure that it's understood as "experiences"...in fact 3 sleep studies over 7 years...2 were 7 years ago, the final two months ago were horrible...I felt rushed, pressured to get the mask on and go to sleep in all 3. The first two were awful which explains the gap of 7 years before I'd try again. I finally talked the Doc into letting me go home with the Airsense 10 and 5 weeks later, I'm so positive about what is going on that it's really frustrated me with the Docs and techs who apparently are just too rushed to care.

I'm hard headed, I guess...I knew I could beat this thing if given an honest chance under the right circumstances. I watched a buddy of mine in ICU with the respirator on for several weeks and said, "that's got to be a lot more difficult that this little CPAP machine"!

I still take the mask off at night, but it's down to 4-5 times...I guess you have to temper some expectations and "mask off and on" is not on the top of my list as long as I'm using it and getting rest.