my first and last sleep study

Where do I start ? I've had sleep problems for years and was excited to finally get a sleep study done. So last night I was scheduled for a Split Night. I get to the lab right on time at 8:30PM.........then our group of sleepers (6) has to go to the admitting dept !! In other words, I have to give them all the info i've already given them a month ago. By the time that's over, it's 10PM !! Then I get all wired up and ready for bed. It's 10:30PM ! Mind you, i'm usually up at 4:15AM every day, so my usual bedtime is 9-9:30PM. When the lights finally go out, I realize I can hear the LOUD A/C unit outside or on the roof above my room!! Sounds like Medevac is landing on the roof. And the guy across the hall was speaking in loud Baltimoronese for what seemed like an hour. It was like trying to sleep in a subway. I feel like I was up all night and i'm sure I was because CPAP titration was never initiated. I'm sure the study will prove inconclusive because I wasn't asleep long enough to get a diagnosis ! I got out of there around 5:35 this morning, feeling like s*^@. I'm very disappointed. I will complain to whomever heads up the sleep lab. First of all, they are supposedly there to help the patients. It need to be more individualized. If a patient (like me) usually goes to bed around 9, that patients study should be tailored to that patients schedule, and that patient should already be admitted and all set for lights out by 9, his/her usual bedtime. Instead, they apparently do it this way so it is more convenient for the lab, and everyone is admitted and wired up around the same time. I don't want to go through that again, so no more sleep studies for me.

I would like opinions as to what the consensus would be on my buying a Respironics Auto C Flex with the Encore software out of pocket and starting treatment now, as opposed to waiting 2 weeks for the results or lack thereof. Please advise. All I want is to sleep well without all of this unecessary aggravation and red tape.

Thanks

Unfortunately you will need a Rx first ... don't ask me why cuz I don't know.

Surely someone else will chime in here with more usful response ... but not give up ... get another sleep specialist if need be.

Good luck with the dreams ...

- roberto

I think that you should wait until the study results are in. They don't need very much data for a diagnosis. I understand your feeling that the procedure should be individualized for a patient's sleep habits, but that may be too much to ask and it may not make a difference. You're on edge, as many of us are in sleep studies, and while inconvenient, and bothersome, I haven't heard anything that necessarily would change the result. Obviously, you didn't get titrated, but there could be reasons for that, such as, that you have a different sleep disorder. You're assuming that it was because everything was so inefficient that they didn't get around to putting a mask on you or that you didn't give them any sleep from which to judge.

Yes, you may have to go back. And that's really inconvenient and disconcerting. But it happens. If you don't go back, assuming that you need to be titrated, you have no data from which to make informed decisions, about treatment, and that rips you off.

If they feel your sleep study needs to be repeated because they didn't get enough data for a diagnosis, it wouldn't be the first time. But you should still go back. Loud air conditioners and bothersome fellow patients are distractions, that although unfortunate, are bound to happen, at least in part because you're in a heightened state because of the test situation. Did you call the sleep techs to see what could be done about the air conditioner or fellow patient? You have to do that. You have to do what you can to minimize the distractions and alert the sleep techs to problems so they can be fixed as best as possible.

Everything bothered me during my sleep studies--I hate them. I got to my most recent sleep study and found they use cotton/polyester sheets, and I am allergic to polyester. So I slept on top of the bedspread and had them bring me an extra bedspread as a blanket and threw a towel over the pillow. Comfortable? No. Bearable, yes.

Bad idea to buy equipment without even a for-sure diagnosis.

Just my thoughts.

Caroline

p.s. My first sleep study had to be repeated because they got no data because I was up all night because I hated everything about it. So I feel for you. So if you need a next time, my advice is to do what you can to get through it.

My non-medical opinion for what it is worth is wait and see what the report says. Then go talk to your REGULAR doc about a prescription for an Auto machine (if that is what makes sense). Ditch the whole sleep doc and sleep study thing and give the Auto a try. Your insurance most probably won't cover without the titration nor will they most likely want to cover an auto anyway. But if you can afford the $709 and software go for it.

I repeat. I have no medical training, just the experiences you have had and I am also NEVER going back for another study.

snoregal--my BCBS HMO insurance didn't even whimper about the extra cost of an auto, so it may depend on the insurance.

Caroline

I would like opinions as to what the consensus would be on my buying a Respironics Auto C Flex with the Encore software out of pocket and starting treatment now

Wait till you get the bill for that great sleep study experience. If you did not have any REM sleep, then the study results are worthless, Unless they detected some RLS.

I, for one, think you should buy a unit and get started on your treatment.
You don't need a script for this one:


http://auctions.yahoo.com/i::111095668

I agree that SOME insurances will pick up auto without a whimper. But the original poster was already talking about buying out of pocket so I guess I just assumed that they had looked into whether or not insurance would pay without the complete sleep study and titration study.

Good point about insurance companies are all different

My point is the next or repeat sleep study and associated costs may almost reach the cost of buying out of pocket. And the poster enjoyed the first one so much!! (copay for study, maybe even two if they have to repeat then titrate) copay of cost for sleep doc to "read" study, cost for copay of unit (we are getting near the end of the calendar year and if the machine isn't obtained soon, the patient MAY go into a new insurance year with a new deductable to meet........

inneedofsleep wrote:I would like opinions as to what the consensus would be on my buying a Respironics Auto C Flex with the Encore software out of pocket and starting treatment now, as opposed to waiting 2 weeks for the results or lack thereof. Please advise. All I want is to sleep well without all of this unecessary aggravation and red tape.

Before you do that, you need to be sure that indeed obstructive apnea is the cause of your problems. Otherwise the AUTO won't really improve your situation. If you want to fast-track it (and I can sympathize with that), AND you have an excellent rapport with your primary physician, you might persuade him/her to call the sleep lab and ask if the preliminary findings suggest obstructive apnea. If so, he can write you a prescription on the spot, that is his prerogative. And assuming money/reimbursement is not an issue, I would say yes go for it. In fact with prescription in hand you could probably have the equipment within a day if you really want it bad enough.

On balance, it usually takes several weeks for a sleep lab to analyze the data and type it up and send off the report. And if xPAP is indicated, they will probably schedule another session to titrate you. Then more waiting. And one day the ordering physician will discover the report and "get back to you". More delay. In my case the sleep lab called me to schedule yet another appointment "to discuss my equipment options". Their earliest available appointment was four months down the road. Yes, FOUR FREAKIN MONTHS! Imagine your house is on fire and you call the fire department and they tell you they will mail you the request forms, which must be properly filled out and signed, and returned, and then call them back so they can schedule a "visit" to put out the fire. That is the attitude of many elements of the sleep industry today, sad to say.

Yes DO get a copy of the sleep study. You are legally entitled to it. Also get a copy of your prescription. It doesn't weigh much, but it is certainly worth MORE than it's weight in gold. It will give you many options down the road. Like your birth certificate, when you really need it, THEY won't be able to find it.

Sorry you had such a rotten experience at the sleep study, that really isn't typical. And YES you should complain to somebody who won't just make excuses, what you describe seems very unprofessional. Good luck, I actually hope you can fast track it, you sound like someone who will be involved and take responsibility for the details of your APAP therapy. You have the ingredients to succeed with this.

-Ric

Sleep centers are as different as are patients' needs. I've had 5 studies in 3 facilities over the last 9 years. Some are like a nice hotel with quality mattresses, others like a stark hospital room and about as comfortable. Within each facility there are prime rooms - farthest from the nurses station, away from a/c unit, etc. I'm not saying go back or don't, get a machine now or later - just IF you end up truly needing to go back, speak to them in advance. Ask to be scheduled in the quietest room. Every test I've had they targeted my bedtime, never quite making it, and the worst was because the center was participating in research and had several patients there that night a part of the study. The protocol is so strict on those, that they get first service. Ask in advance what time you need to arrive to accomodate your bedtime. Hearing loud talking is not acceptable. The staff is responsible to not unnecessarily disturb the patients and to control the noise volume of the patients as much as possible. It sounds like your issues could be addressed by informing the management that the study they provided was not conducive to sleep, and ask them if a second experience could be expected to be any different. But even at it's best, perfect silence is not going to happen. Earplugs maybe, if allowed. I'm sorry you had such a miserable experience. At it's best, it's an unpleasant night. But done in a professional manner in a quality facility, the misery factor can be lessened.
Best wishes.
Kathy

What a horrible night for you! My first sleep study night did not go well. I finally fell asleep around 3:00 AM and was roused out at 5:20 AM. I was really upset about that because I wondered if there was enough info to make a diagnosis. I ended up with a second study with titration. PLEASE don't give up on this. You have the future in your hands. Either get a machine on your own or talk to the sleep lab and tell them about your experience and give them a second chance if you can afford to. Your life may be at stake.

As Ric said, the main point is how do you know you have apnea if not from your sleep study? If it turns out you have apnea and are willing to spend the money out of pocket for an apap, go for it.

Caroline

My first sleep study experience was similar to yours. I was supposed to have a Split Study but didn't sleep enough to move to the titration part. Somehow I fell asleep right at the beginning of the study, then woke up and never went back to sleep. The location of the sleep clinic was in an office building on a busy street. Noisy motorcycles went by all night and the a/c cycled on and off all night, not to mention the ambulances, and the technician who asked me to stay awake while he microwaved his dinner! The pillow was hard as a rock and the bedspread was disgusting.

I complained to my ENT who recommended another facility in the basement of a nearby hospital for the titration part of the test. It was like being in a very nice hotel. The technicians spoke English and were very nice and extremely competent.

Don't give up. Complain when you think you are not being treated properly.

On balance, it usually takes several weeks for a sleep lab to analyze the data and type it up and send off the report.

My current lab provides a preliminary report to the doctor the next morning and has a standard of two weeks or less to deliver the full typed report.

My first study was the same way. I had an incomptent, uncaring tech and the facility looked like those mental wards you see in movies. I could barely sleep all night. The results were deemed "inconclusive," by an internist, who was not sleep medicine trained.

My second study was ordered by a great sleep doc, who understood I might have a problem and gave me a prescription sleep aid. The techs were great and the room was like a small hotel room, with one of those "sleep number" beds and my own thermostat. I slept like a log and got a good study. My doc said that I actually should have been diagnosed by the internist off the first study, even though I did not sleep much.

The prescription for my CPAP was written the day after the second sleep study, on the basis of the preliminary report. So I had a full week with the machine before I even had the follow up with the sleep doc and got to see the full report.

Bottom line: Don't put up with uncaring, incompetent medical professionals!

My sleep studies were done in a private lab, in the basement of a large office building... so quiet that it took me a bit to fall asleep the first time I was there. They had to wake me up half way because one of the electrodes came off my legs. The room was very dark. There are 3 or 4 labs in my city and all the studies are covered under our provincial health insurance, which everyone has.

Have you thought of getting your doctor to refer you to another lab? I know in the US, it can be a bit expensive. I can understand those costs as my dad passed away in New Orleans about 7 years ago and we got a tally of what the costs in the hospital were (for 11 days)... oh my god! Thank god for Canadian Health Insurance!

Lynne