Diagnosing

How many sleep studies do you normally have to have? I had one that cost me $500 and now my doctor said he wants another one because they didn't get what my pressure should be. This second one will cost me $1000. Do I really need to get this second one? The first one was awful and I had to be off work the next day. Can't I get a self adjusting machine that will adjust the pressure to what I need?

A lot of the time you would have one study in which they see if you have apnea... and they may then fit you with a machine to titrate what pressures you should have the machine set to. But very many times (don't know if it's 50:50 or ?) you return for a second study to be titrated... may not sleep as long and testing focuses on pressure setting vs diagnosis of apnea, so it's possible your doctor was inarticulate, but not wrong, in saying you needed to be titrated. HOWever, if in fact you were titrated in the first study and your results of it DO specify pressures, then you shouldn't need to return - ask to see a copy of your test.

But, if you can get him to write you a script for a good autopap machine, you may be able to do your own titration at home (with our help), which happens all the time here.

questionsgalore wrote:How many sleep studies do you normally have to have? I had one that cost me $500 and now my doctor said he wants another one because they didn't get what my pressure should be. This second one will cost me $1000. Do I really need to get this second one? The first one was awful and I had to be off work the next day. Can't I get a self adjusting machine that will adjust the pressure to what I need?

That is the usual routine. They can do a split study if you have enough apnea for diagnosis in the first part of the night. If that happens they will use the second half to put you on CPAP and titrate the pressure until they get a pressure to control your events. If you go through most of the night, without getting a good picture of your sleep until the later hours, then they bring you back for the titration part.
Whether an APAP machine would work depends on what type of events you had. If it was plain OSA, it is possible. Ask your Doctor. But even with a so called self adjusting machine it takes monitoring and adjusting the pressure until it is what you need. The machine won't do all the work. Part of the responsibility will be yours to educate your self about the machine and how it works. Also to monitor the data results to find what is best for you.

questionsgalore wrote:How many sleep studies do you normally have to have? I had one that cost me $500 and now my doctor said he wants another one because they didn't get what my pressure should be. This second one will cost me $1000. Do I really need to get this second one? The first one was awful and I had to be off work the next day. Can't I get a self adjusting machine that will adjust the pressure to what I need?

Who is paying for your machine? If you are paying for that out-of-pocket, then yes, just buy a self-adjusting machine and it will adjust to what you need. If you are getting it from insurance, then your doc may not want to negotiate on this - then get a used auto-adjusting machine. This assumes that you have ordinary apnea and not a heart or lung problem. If you had a heart or lung problem they are looking at a lot more than apnea and a titration is absolutely necessary to find out what range will work to solve your problem without creating a new one. There is a lot of learning to do if you are self-adjusting however.

I see some people get studies done at home. Can the second one be done at home? I don't think my doctor is very knowledgeable on this. He said I probably drink a lot of caffeine products. I told him no, I rarely do. He said in his opinion I probably shouldn't be driving. I told him I don't get sleepy when I'm driving. Granted there are cases where I get sleepy and take a nap during the day but his words are scary. He said I have something that could cause me to die in my sleep. I have had apnea for a very long time because I have snored terrible for years. I have a deviated septum and major congestion. I am working on the congestion part. I am def a mouth breather. Sometimes I was up with a very dry mouth and sometimes my eyes are grainy. I know I need a machine but I can't go broke getting set up. I would rather pay the $1000 on the machine than having to pay the sleep center the money.

I was also snoring, had regular nose congestion etc. before trying CPAP.

If you don't want to buy a machine before being sure you need CPAP, can't you just rent one for a few weeks (it will take a few weeks for you to get used to it)? If you rent one, you may want to rent an automatic one, so at least you will know what pressure is optimal to reduce apnea events.

questionsgalore wrote:I see some people get studies done at home. Can the second one be done at home?

The home sleep studies are for diagnosing which you have already had. The second is with a mask and cpap machine to get a pressure that controls your apnea.

questionsgalore wrote:I know I need a machine but I can't go broke getting set up. I would rather pay the $1000 on the machine than having to pay the sleep center the money.

Get a copy of your sleep study. Do you know what your AHI was on the Sleep Study and what type of events it was made up of (OA,HA,CA)? Did you have any leg movements? Discuss this with your doctor. If you have plain obstructive apnea, an auto APAP machine my be an option. Buy like I said earlier, you need to learn about the machine and how it works so you can be an active participant in your therapy. We will help you along the way but you are the one to make it wsork.

Thank you. I didn't think about getting a copy. I will call Monday to get that.

OkyDoky wrote:

questionsgalore wrote: Whether an APAP machine would work depends on what type of events you had. If it was plain OSA, it is possible. Ask your Doctor. But even with a so called self adjusting machine it takes monitoring and adjusting the pressure until it is what you need. The machine won't do all the work. Part of the responsibility will be yours to educate your self about the machine and how it works. Also to monitor the data results to find what is best for you.

That's interesting, in the UK I've purchased an APAP and returned the NHS owned CPAP machine - they said fine - we'll see you for your annual appointment next May (2017)!

y_not wrote:

OkyDoky wrote:

questionsgalore wrote: Whether an APAP machine would work depends on what type of events you had. If it was plain OSA, it is possible. Ask your Doctor. But even with a so called self adjusting machine it takes monitoring and adjusting the pressure until it is what you need. The machine won't do all the work. Part of the responsibility will be yours to educate your self about the machine and how it works. Also to monitor the data results to find what is best for you.

That's interesting, in the UK I've purchased an APAP and returned the NHS owned CPAP machine - they said fine - we'll see you for your annual appointment next May (2017)!

It is fine as long as there are no problems. Many think an APAP wide open (4cm minimum and 20cm maximum) is the answer but there can be problems with that setting. Some people have difficulty sleeping at the low setting, it doesn't feel like there is enough air. Some have untreated apnea because the low setting is too low and events happen before the machine can respond. Some have aerophagia with high pressure.
My comments were to encourage self monitoring with software to know what is happening. You may not feel comfortable making changes and still want to talk with your doctor but at least you know what is happening.