Horrible CPAP Titration

Hello, All! This is my first post though I have been reading the forums for a while and they have been quite helpful!

All my life I have never slept well. I have a couple of health issues which contribute but in the past 5 years, sleeping has been my enemy. I range from crippling fatigue to relentless insomnia. Three years ago I had an in-lab sleep study. However, right afterwards I lost my job and was unable to pursue any further treatment even though I was diagnosed with OSA (AHI 15.2)

Fast forward to about 2 months ago. My new doctor suggested I do another study. I did the at home study and was again diagnosed with OSA (AHI 25.1.)

Last night I went for my titration and it was a HORRID experience and I want to share it with someone(s) who would understand why I am so upset and frustrated.

I arrived at 8:30 and was immediately suited up in all the garb. I have terrible allergies so a Full Face Mask was recommended. I started off with a FP mask which seemed to be alright in the testing. My primary issue was with my sleep tech. She was very friendly when I arrived and we chatted while she applied all the wires. She told me many times that if I was uncomfortable in any way to please let her know because she wanted it to be a good experience for me. I was really tired from a busy day at work so I elected for lights out at around 10:30PM. It was definitely not very comfortable but I tried to make the best of it. It was leaking air into my eyes. Due to my allergies I have issues with my eyes anyway and it was really irritating my eyes quite a bit. I called out for the nurse as she had told me to do and it took her several minutes to arrive. By the time she did my eyes were watering so bad I could barely see out of them and they were very swollen. I explained what was going on to her and she said "well that's normal" which I highly doubted. I asked her if we could please try another mask. She sighed very loudly and said well I guess. She went and got the same mask just a smaller size. I was having the same issue. She then proceeded to pull it so tight that it was very painful. I yelped out and she hatefully said "well I don't know what you expect!!" I was very upset by this. It was not a comfortable and I was in a strange place and I had no idea why she was being so hateful towards me when she had made a point to tell me to let her know if I was uncomfortable! She threw the mask down on the bed and left the room. I didn't even know what to say or think. She came back with a different brand (ResMed Quattro) and put it on me. I was too confused and upset to tell her it was even worse so I just layed down and took deep breaths and tried to calm down and just deal with it. I had also asked her to turn down the humidifier a bit before she left and I think she turned it WAY down because suddenly I was very dry and it was hurting my nose. I was too scared to ask her to come in again and eventually fell asleep. I woke up about 2 hours later and felt like I was suffocating. The air was blowing very hard and I felt like I couldn't breathe. I tapped on the wall and she came in and asked what was wrong. I told her I needed to take the mask off and felt like I couldn't breathe. She said "well you are breathing!" and took the mask off. By this point I was so angry I had no idea what to say. I told her I wanted to try the old mask again because at least I didn't feel like I was suffocating with that one. I also asked her to turn the humidifier back up and she sighed and said "you just can't make up your mind, can you??" I was so angry. I thought the point of this study was to work out what was right for you. I definitely did not expect to be belittled and I have no idea what I did to upset her to make her act like that to me! I was finally able to doze off and slept pretty comfortably the rest of the night. She was short with me again when she came to wake me up. I am just so upset over it and feel like it was a horrible experience!!! Is this normal??? I seriously hope not!!!

You didn't have a very nice technician. You should have started with a nasal mask as the titration is the only time you will be able to tell if you are a natural mouth breather or not. Did you at least sleep long enough to get the titration complete? Comfort is very low on the list of priorities during a titration. Results are paramount, and if you slept for any reasonable period of time, they got results. When you get your cpap, make sure the DME you use has a mask exchange guaranty, and start with the most minimal mask possible, working your way up only if needed. My DME told me that a lot of people immediately go for the full face mask under some incorrect assumptions.

I took a sleeping pill for my titration and it made me feel like I was hung over the next day. Bad experience, but they did get the right prescription.

I am sorry that you had a bad experience. No excuse, but everyone has bad days. It is uncomfortable and awkward at best. At worst, no useful information is gathered. I hope it was at least helpful for diagnosis and to determine your prescription.

I hope you let your doctor know. They are the ones with power. At least where they refer, if you are somewhere where there is more than 1 sleep clinic.

I hope the next stages of your journey are easier.

Best Regards.

Let your doctor know about your experience, by all means.
This person seems to be anything but professional, and her employer needs to know.

However, be aware that we all have bad experiences with our sleep tests as it is our first time with the unfamiliar setup. If they say they did not get enough sleep time to make a determination, you might want to look into an at-home test, where you can control your environment better. 2 hours of sleep might have been enough for them to get accurate readings.

Not sure how they could get good data with all the leakage that you were experiencing. Unless the leakage wasn't quite as bad as it felt. At-home titration is often used, where you are using an Autoset-style cpap with a fairly open range of pressures. Then, by looking at your sleep data, the range of pressures can be narrowed down to tune your therapy, until you reach a good place. That's not always the right answer, but it often can give good results for ordinary (not complex) sleep apnea.

Anyways, I agree that the sleep tech you described doesn't seem to be well matched with their job. They need to be patient when doing titration to get good enough mask fit to get good data, and to help you tolerate the process. Sorry that you had that experience, sounds frustrating.

I also had the in lab sleep titration study from hell....and a good bit of it was the dufus tech (actual descriptive wording is a bit too colorful for public viewing ).
We survive though. It was miserable but I got past it and moved on. Try to make sure to get a machine with APAP mode capabilities especially since the titration could be flawed. It's a good idea anyway but especially so in this situation.

Good point.
The worst study "should" result in the best permanent equipment.
They owe you. Accept no less.