Musta been a great vacation!
Either that, or Costco had the bale in stock.
Help understanding Sleep study
Re: Help understanding Sleep study
Either that, or Costco had the bale in stock.
Re: Help understanding Sleep study
Or, we could be letting just a little more line out before...
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.
Make each sensation a little bit stronger.
Experience slips away.
Re: Help understanding Sleep study
Roby Sue asked
What I knew about OSA before is that it wasn't good for your health, and that it was horrible to have to sleep with a thing strapped to your face. I also had seen some things about in-lab sleep studies where they wire you up with goo and pasted on sensors and watch you sleep (or not).
For years I was in deep, deep denial.
The "I'm not snoring, you are" kind. The "Oh, it's allergies" kind. The "both my parents snored, it's hereditary, and they never used CPAP" kind.
For more than a year, my dear, sweet husband slept on the couch because he could not sleep with my construction level snoring noise going on all night. He bought footie pajamas in cute designs to make light of it. My kids didn't want to share a room with me if we traveled and complained about me keeping them awake in their own bedrooms with doors closed between us. And on and on I snored, refluxed, aspirated all night long.
Finally I said OK when the doctor suggested I see the sleep department--again--for the hundredth time.
They "invite' you to a group class to teach how to use the WatchPat. Not knowing about the WatchPat, I was fully prepared to REFUSE testing and REFUSE CPAP, and I was mad as hell about the whole thing. Including their scheduling scheme, which is not "when would you like an appointment, but you WILL show up at such and such time and such and such date. Damn THEM. I had a life!
They showed the WatchPat. I was so relieved not to have to do an in-lab sleep test, and it didn't seem so bad, so I took a unit home, strapped it on my two fingers, and slept in my own bed for the test. Ha, I thought in the morning. I slept really well. It's going to be negative.
A few weeks later I needed a pulmonary function test because my asthma was really bad. The respiratory therapist could see my WatchPat results in my medical record (they hadn't been shared with me yet) and would NOT let me leave the testing room without taking home a PRS1 (No humidifier) and mask for titration--she was worried I wouldn't be alive to attend their titration class.
You get "invited" to another group to go over results and to be issued a take home machine for titration (but instead of the week titration, the respiratory therapist made me keep the titration machine I was already issued until my own got ordered). They teach about the dangers of OSA and then hand out a summary of results, but it had a graph of respiratory events at the bottom (sample here: https://www.itamar-medical.com/wp-conte ... L-A4-1.pdf). Blue lines were periods of apnea, blank white was no apnea. Some people in class shared their graphs, showing mostly white with a blue line here or there. My graph was almost solid blue from the time I fell asleep until the time I woke up. A few narrow bands of white here or there. AHI very high (can't remember the numbers any more but it was very high) and O2 sats in the toilet most of the night. THAT's when I got religion.
If it hadn't been for the WatchPat I would NEVER, EVER have agreed to testing. I have significant sensory issues related to my underlying genetic condition so the thought of all those sensors and wires on my body fills me with a dread most people cannot imagine. There's probably a healthy dose of PTSD mixed in from heart surgery I had at age 8, a time I "fondly" call "the time before child psychology" because it was a harrowing experience for me. And the thought of being watched all night, in a strange place, with people I don't know around me, is another personal horror. Except for childbirth (where you don't really sleep anyway!), I've only had to stay in the hospital once since my heart surgery, with a high fever, and I had nightmares about a male nurse who checked on me during the night for months (and all he did was check on me!).
And without testing I would never get treatment. Without that chart I never would have stuck with it. I remember your journey with CPAP, Roby Sue. Mine was pretty bad, too. But every time I thought about throwing that damn machine in the garbage, I remembered that graph. I remembered that failure is not an option if I wanted to survive. And I kept going.
THAT is the benefit of the WatchPat. It WILL catch a very high percentage of people with OSA for less cost and trouble, in the comfort of their own beds. Most of those people would never be tested in a lab setting. What's wrong with that??? It makes OSA testing available to the masses, not just people with good insurance and equally good income to meet their deductibles, and who are willing to put themselves through that. It makes OSA testing available in areas where there's limited access to sleep doctors and sleep labs. It's efficient, and accurate enough. Who cares if your AHI is 79 or 109, there's enough information there to show that apnea is severe and OSA needs treatment, and then you go from there to whether the treatment is working to improve your symptoms and function or you need further study.
I also wonder why everyone is going after the WatchPat in particular, except that it may be the most common HST. The WatchPat test I had included 9 channels of data, including the required actigraphy, oximetry, and peripheral arterial tone. Currently our hosts at cpap.com are in a partnership to offer an inexpensive home sleep test for $175. It appears to be a little disposable device you strap to one finger, my guess is you get the minimum 3 channels of data and a teledoc consult for a prescription, all for one low price. I don't see any claims on the CPAP.com site or sleepmedrx about studies validating their technology. It's specifically designed to bypass insurance and sell you a CPAP machine. CPAP.com on Sleep Med RX are definitely going after the OSA market with a lot less effort than WatchPat has put in to get HST validated, accepted, certified for Medicare and other insurers.
I probably wouldn't be here. By "here", I mean on this forum, and by "here" I mean in this world any more, without a WatchPat study.In other words, what's the real benefit of a WatchPAT study? Other than the obvious that it's cheap and done in your own bed?
What I knew about OSA before is that it wasn't good for your health, and that it was horrible to have to sleep with a thing strapped to your face. I also had seen some things about in-lab sleep studies where they wire you up with goo and pasted on sensors and watch you sleep (or not).
For years I was in deep, deep denial.
The "I'm not snoring, you are" kind. The "Oh, it's allergies" kind. The "both my parents snored, it's hereditary, and they never used CPAP" kind.
For more than a year, my dear, sweet husband slept on the couch because he could not sleep with my construction level snoring noise going on all night. He bought footie pajamas in cute designs to make light of it. My kids didn't want to share a room with me if we traveled and complained about me keeping them awake in their own bedrooms with doors closed between us. And on and on I snored, refluxed, aspirated all night long.
Finally I said OK when the doctor suggested I see the sleep department--again--for the hundredth time.
They "invite' you to a group class to teach how to use the WatchPat. Not knowing about the WatchPat, I was fully prepared to REFUSE testing and REFUSE CPAP, and I was mad as hell about the whole thing. Including their scheduling scheme, which is not "when would you like an appointment, but you WILL show up at such and such time and such and such date. Damn THEM. I had a life!
They showed the WatchPat. I was so relieved not to have to do an in-lab sleep test, and it didn't seem so bad, so I took a unit home, strapped it on my two fingers, and slept in my own bed for the test. Ha, I thought in the morning. I slept really well. It's going to be negative.
A few weeks later I needed a pulmonary function test because my asthma was really bad. The respiratory therapist could see my WatchPat results in my medical record (they hadn't been shared with me yet) and would NOT let me leave the testing room without taking home a PRS1 (No humidifier) and mask for titration--she was worried I wouldn't be alive to attend their titration class.
You get "invited" to another group to go over results and to be issued a take home machine for titration (but instead of the week titration, the respiratory therapist made me keep the titration machine I was already issued until my own got ordered). They teach about the dangers of OSA and then hand out a summary of results, but it had a graph of respiratory events at the bottom (sample here: https://www.itamar-medical.com/wp-conte ... L-A4-1.pdf). Blue lines were periods of apnea, blank white was no apnea. Some people in class shared their graphs, showing mostly white with a blue line here or there. My graph was almost solid blue from the time I fell asleep until the time I woke up. A few narrow bands of white here or there. AHI very high (can't remember the numbers any more but it was very high) and O2 sats in the toilet most of the night. THAT's when I got religion.
If it hadn't been for the WatchPat I would NEVER, EVER have agreed to testing. I have significant sensory issues related to my underlying genetic condition so the thought of all those sensors and wires on my body fills me with a dread most people cannot imagine. There's probably a healthy dose of PTSD mixed in from heart surgery I had at age 8, a time I "fondly" call "the time before child psychology" because it was a harrowing experience for me. And the thought of being watched all night, in a strange place, with people I don't know around me, is another personal horror. Except for childbirth (where you don't really sleep anyway!), I've only had to stay in the hospital once since my heart surgery, with a high fever, and I had nightmares about a male nurse who checked on me during the night for months (and all he did was check on me!).
And without testing I would never get treatment. Without that chart I never would have stuck with it. I remember your journey with CPAP, Roby Sue. Mine was pretty bad, too. But every time I thought about throwing that damn machine in the garbage, I remembered that graph. I remembered that failure is not an option if I wanted to survive. And I kept going.
THAT is the benefit of the WatchPat. It WILL catch a very high percentage of people with OSA for less cost and trouble, in the comfort of their own beds. Most of those people would never be tested in a lab setting. What's wrong with that??? It makes OSA testing available to the masses, not just people with good insurance and equally good income to meet their deductibles, and who are willing to put themselves through that. It makes OSA testing available in areas where there's limited access to sleep doctors and sleep labs. It's efficient, and accurate enough. Who cares if your AHI is 79 or 109, there's enough information there to show that apnea is severe and OSA needs treatment, and then you go from there to whether the treatment is working to improve your symptoms and function or you need further study.
I also wonder why everyone is going after the WatchPat in particular, except that it may be the most common HST. The WatchPat test I had included 9 channels of data, including the required actigraphy, oximetry, and peripheral arterial tone. Currently our hosts at cpap.com are in a partnership to offer an inexpensive home sleep test for $175. It appears to be a little disposable device you strap to one finger, my guess is you get the minimum 3 channels of data and a teledoc consult for a prescription, all for one low price. I don't see any claims on the CPAP.com site or sleepmedrx about studies validating their technology. It's specifically designed to bypass insurance and sell you a CPAP machine. CPAP.com on Sleep Med RX are definitely going after the OSA market with a lot less effort than WatchPat has put in to get HST validated, accepted, certified for Medicare and other insurers.
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Don't Pay that Upcharge! http://tinyurl.com/2ck48rm
Re: Help understanding Sleep study
What point are you trying to make here?Janknitz wrote: ↑Thu Jan 12, 2023 5:18 pmI also wonder why everyone is going after the WatchPat in particular, except that it may be the most common HST. The WatchPat test I had included 9 channels of data, including the required actigraphy, oximetry, and peripheral arterial tone. Currently our hosts at cpap.com are in a partnership to offer an inexpensive home sleep test for $175. It appears to be a little disposable device you strap to one finger, my guess is you get the minimum 3 channels of data and a teledoc consult for a prescription, all for one low price. I don't see any claims on the CPAP.com site or sleepmedrx about studies validating their technology. It's specifically designed to bypass insurance and sell you a CPAP machine. CPAP.com on Sleep Med RX are definitely going after the OSA market with a lot less effort than WatchPat has put in to get HST validated, accepted, certified for Medicare and other insurers.
That all versions of WatchPat equipment is "certified" (by someone) for Medicare, while the the equipment supplied by CPAP.com and sleepmedrx is not?
Moreover what does that have to do with the question originally asked?
I am neither a physician nor a lawyer, so DO NOT rely on me for professional medical or legal advice.
Re: Help understanding Sleep study
Would you define who "everyone" is and what exactly "going after" entails?
TIA.
Freeze this moment a little bit longer.
Make each sensation a little bit stronger.
Experience slips away.
Make each sensation a little bit stronger.
Experience slips away.
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GrumpyHere
- Posts: 523
- Joined: Sat Feb 13, 2021 2:40 am
Re: Help understanding Sleep study
The test they sell is one of the Octosense NightOwl tests. It has been FDA cleared.
The validation study is below
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175785/
ResMed Lumis Tx
Re: Help understanding Sleep study
My position is simply the following:
Each time a HST is used as a basis to allow someone the subsequent opportunity to trial PAP, I applaud its use. That is proper use of a HST.
Each time a HST is used as a basis to deny someone the opportunity to trial PAP, I boo and hiss, since that is an improper use of HST.
I believe that position is in thought harmony with the AASM 2017 position stating:
HST is especially and particularly valuable for any patient who would find lab NPSG to be traumatic, painful, anxiety-inducing, or significantly inconvenient in any other way.
I personally appreciate the reminder about that from Janknitz.
Each time a HST is used as a basis to allow someone the subsequent opportunity to trial PAP, I applaud its use. That is proper use of a HST.
Each time a HST is used as a basis to deny someone the opportunity to trial PAP, I boo and hiss, since that is an improper use of HST.
I believe that position is in thought harmony with the AASM 2017 position stating:
I do not believe that I, or the AASM, is "going after" HST in general, or any particular brand, in any of the statements above.We recommend that if a single home sleep apnea test is negative, inconclusive, or technically inadequate, polysomnography be performed for the diagnosis of OSA. (STRONG) -- https://jcsm.aasm.org/doi/10.5664/jcsm.6506
HST is especially and particularly valuable for any patient who would find lab NPSG to be traumatic, painful, anxiety-inducing, or significantly inconvenient in any other way.
I personally appreciate the reminder about that from Janknitz.
Re: Help understanding Sleep study
Interesting report, I was particularly interested in this:
So, could a disturbing dream trigger a autonomic arousal? Could a bed partner trigger an autonomic arousal? Could a dog barking trigger an autonomic arousal? Could acid reflux, could an episode atrial fibrillation?......A known limitation of the analysis of the PAT channel is that changes in the PAT caused by autonomic arousals associated with nonrespiratory events such as periodic limb movements could lead to misclassifications of these changes in the PAT as a respiratory event. However, this limitation of the PAT channel to accurately discriminate between types of autonomic arousal associated events can be reduced by the incorporation of concurrent analysis of other PPG-derived features such as SpO2.
The authors suggest that accurate discrimination between respiratory and non-respiratory arousal events should rely on concurrent SpO2 analysis. Yes, that sounds reasonable, but that approach fails to recognize that 1) SpO2 changes are not always associated with actual respiratory events and 2) that the evidence of SpO2 change may be many seconds delayed from an actual respiratory event ( some suggestion that apnea events may not "show" up in SpO2 for 30 to 40 seconds - known as oximetry "lag").
The Medicare study group, referred to PAT results as "a predictive algorithm". I think that is an apt characterization. So, can we rely on the algorithm, that infers respiratory events, but does not measure the criteria needed for fulsome evaluation?
When I look at the scatter plots of PSG AHI vs PAT AHI I'm taken by the degree of scatter that increases beyond 15. It would be really instructive to see the correlation coefficients at levels above therapeutic intervention levels. (well known statistical trick is to populate the data with near zero/zero results)
All this is not to suggest that PAT is useless, rather that, when used with caution, it is another tool that can/may be employed to treat , but it should not be the only diagnostic tool.
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