Sleep study tests - Do I need a Second one to confirm my Apnea ?

Hello,
I'm devastated hearing that I may have Sleep Apnea. I've mutiple mental health issues including mania, bipolar, depression. last year, i was not sleeping which lead me to be manic/ menatal health hospitalization. I'm doing better with mental health medications but i still have poor quality of sleep even with sleep medications such as seraquil . My psycharictist reffered me to the sleep doctor and i did a home sleep dtudy (with belt on my hest, plugs in my nose and finter tip oxygen measurements)

My results shows AHI of 21.

That night I didnt sleep well. I asked my doctor if I need to repeat the Sleep study test to re-confirm my Apnea disgonis ans she said no but willing to write it. I dont know if I snore or gasp as i sleep alone but i do sometimes wake up and have poor quality of sleep and often foggy and hit headache in the mornings - sounds like symptoms of sleep apnea

Do i need a second test to confirm my sleep apnea ?

If I do need to go with CPAP, what is the best masks ? are nose pillows good ?

this is my first post and i've been depressed since my diagonis in last 2 weeks. I am sorry but hoping someone will reply.

I had one test 15 years ago. If your AHI was under 10 maybe a second test would be ok., but with 21, you most likely have moderate Sleep Apnea. AHI of 5-14 is Mild, 15-29 is Moderate and 30+ is Severe.

What you do need is a titration study where they try to get the right pressure for you. This method is much faster than you trying at home, alone.

When the Dr writes the order make sure it says "Split nite" that means they will again Dx you for sleep disorders but if/when you test positive they will begin titration that nite and put you on a mask and check some pressures to find a point that may eliminate any problems.

There are times when the 2nd part of the nite isn't long enuff and you will have to come back for another titration.

Masks vary for everyone but if you can and do breath thru your nose - nasal pillows are a good choice. Be sure to try on as many mask styles as you can while there.

Check https://www.cpap.com/category/cpap-masks for diff mask styles.

Good advice from other people. I’ll add that it can be a real plus to get a diagnosis of a sleep problem, especially when it’s as treatable as apnea. You may need some time to get used to the idea, but it sure does beat not knowing what’s wrong, or knowing but being unable to do anything about it.

sleepmentalhealth01 wrote: ↑

Tue Jun 13, 2023 6:42 pm

Hello,
I'm devastated hearing that I may have Sleep Apnea.

It's a treatable condition. And a correctly set up CPAP has improved quality of life for many people. Try to think of it as a fortunate diagnosis of a fixable problem.

My results shows AHI of 21.

It's important to know which types of apneas, and in which phases of sleep they happened. This can be done more reliably in a sleep lab, where your EEG is monitored, to indicate whether you're awake or asleep and in which stage of sleep you are.
Ruling out events that happen when you're awake will give better info about what type of sleep disordered breathing you have.

That night I didnt sleep well. I asked my doctor if I need to repeat the Sleep study test to re-confirm my Apnea disgonis ans she said no but willing to write it. I dont know if I snore or gasp as i sleep alone but i do sometimes wake up and have poor quality of sleep and often foggy and hit headache in the mornings - sounds like symptoms of sleep apnea

Yes, it does

Do i need a second test to confirm my sleep apnea ?

Not a second home sleep study.

If I do need to go with CPAP, what is the best masks ? are nose pillows good ?

The best is whichever helps you sleep well - its very personal.

Some people are prescribed automatically adjusting CPAP machines, with a wide open range of pressures. This can be good for the very beginning, for the machine to indicate who the pressure range shoule be narrowed.

SleepGeek wrote: ↑

Tue Jun 13, 2023 7:30 pm

When the Dr writes the order make sure it says "Split nite" that means they will again Dx you for sleep disorders but if/when you test positive they will begin titration that nite and put you on a mask and check some pressures to find a point that may eliminate any problems.

There are times when the 2nd part of the nite isn't long enuff and you will have to come back for another titration.

I agree. However, for some people, sleeping in the lab is such a disruptive experience that it makes sense to go through the process of titrating at home. Do you think you will be able to sleep under lab conditions?

Do you have info about the type of apneas in your sleep study? About the sleep position in which they were more prevalent? About sleep stages?

ozij wrote: ↑

Tue Jun 13, 2023 8:24 pm

Do you have info about the type of apneas in your sleep study? About the sleep position in which they were more prevalent? About sleep stages?

Here arte my results, not sure how to read it

BODY MASS INDEX (BMI) 36.1 BMI
BMI
EPWORTH
#
TIB : LIGHTS OUT -> LIGHTS ON 352.4 mins
mins
SPT : SLEEP ONSET -> LAST SLEEP PAGE 352.4 mins
mins
TST : REM + NREM + MVT (DURING SPT) 352.4 mins
mins
SLEEP EFFICIENCY (100 X TST/TIB) 100.0 %
%
WASO: WAKE DURATION IN MINUTES (SLEEP ONSET-LIGHT ON) 0.0 mins
mins
LATENCY : SLEEP ONSET (FROM LIGHTS OUT) 0.0 mins
mins
LATENCY : R (FROM SLEEP ONSET TO FIRST PAGE OF R)
mins
PERCENTAGE OF R DURING TST 0.0 %
%
PERCENTAGE OF N1 DURING TST 0.0 %
%
PERCENTAGE OF N2 DURING TST 100.0 %
%
PERCENTAGE OF N3 DURING TST 0.0 %
%
CA INDEX 0.0 #/hr
#/hr
AHI 21.8 #/hr
#/hr
RDI 21.8 #/hr
#/hr
AROUSAL TOT LEG MVT AROUSAL
#
AROUSAL TOT LEG MVT AROUSAL INDEX
#/hr
AROUSAL TOT TOTAL AROUSAL INDEX 0.0 #/hr
#/hr
LEG MOVEMENTS 0 #
#
LEG MOVEMENT INDEX 0.0 #/hr
#/hr
SAO2 AVERAGE TOTAL 95 %
%
DESAT INDEX DURING TOTAL 21.2 #/hr
#/hr
# OF HYP EVENTS DURING SLEEP (CPAP LEVEL: 15)
#
# OF HYP EVENTS DURING TST (BODY POS.: .) 0 #
#
DURATION OF WK WITH ETCO2 >= 55 TORR (MINUTE)
mins
AROUSAL NREM LEG MVT AROUSAL
#
HYP EVENT INDEX #/H SLEEP (CPAP LEVEL: 15)
#/hr
AHI (BODY POS.: .) 0.0 #/hr
#/hr
DURATION OF REM WITH ETCO2 >= 55 TORR
mins
AROUSAL NREM SPONTANEOUS AROUSAL 0 #
#
MINIMUM SPO2 VALUE DURING SLEEP 86 #
#
MEAN DURATION OF APNEAS DURING NREM 13.9 secs
secs
MEAN DURATION OF MA DURING NREM 0.0 secs
secs
MEAN DURATION OF APNEA + HYP EVENTS DURING NREM 25.1 secs
secs
MEAN DURATION OF HYP DURING NREM 27.1 secs
secs

SleepGeek wrote: ↑

Tue Jun 13, 2023 7:30 pm

What you do need is a titration study where they try to get the right pressure for you. This method is much faster than you trying at home, alone.
.

Thank you

do I need the Titration study prior to getting the CPAP machine ?

The doctor sent the CPAP machine prescription to some durebale machine company and they are supposed to call me, nurse says it will take 4-6 weeks before insurance approvals etc

How do I request Resmed CPAP with nasal pillows ?

Any idea why your sleep study says (CPAP LEVEL: 15) twice?

ozij wrote: ↑

Tue Jun 13, 2023 11:20 pm

Any idea why your sleep study says (CPAP LEVEL: 15) twice?

Thanks. I think i am not able to format my results but 2 CPAP Level: 15 lines are this:
1st line:
# OF HYP EVENTS DURING SLEEP (CPAP LEVEL: 15) -

2nsd line:
HYP EVENT INDEX #/H SLEEP (CPAP LEVEL: 15)

for me both values is either missing / null / not recorded

My Sleep Doctor said she reviwed the data carefully.

Sorry, my question was not clear.
I could see the lines you mentioned. It was their meaning I was wondering about.

sleepmentalhealth01 wrote: ↑

Tue Jun 13, 2023 11:32 pm

My Sleep Doctor said she reviwed the data carefully.

As she should.

In other words, why was there a mention of CPAP in the sleep study report?

I find some other things puzzling as well. The report seems to say you didn't wake up at all during the night; does that correspond to your experience? It also seems to say you had no REM sleep and no deep sleep; did your doctor comment on that? -- Or maybe I'm misreading??

Many feel that the diagnostic sleep study was the last one they needed.
Titration has been inaccurate at best, and too often little more than an excuse
to stick the patient with a single pressure, no-data machine.
My titration study was a total loss--a miserable night, followed by 9 months of
misery with the wrong, damn machine!

Miss Emerita wrote: ↑

Wed Jun 14, 2023 11:50 am

In other words, why was there a mention of CPAP in the sleep study report?

I find some other things puzzling as well. The report seems to say you didn't wake up at all during the night; does that correspond to your experience? It also seems to say you had no REM sleep and no deep sleep; did your doctor comment on that? -- Or maybe I'm misreading??

Or a side effect of antipsychotic drugs?

sleepmentalhealth01 wrote: ↑

Tue Jun 13, 2023 10:52 pm

do I need the Titration study prior to getting the CPAP machine ?

That depends on the doc and the insurance.

sleepmentalhealth01 wrote: ↑

Tue Jun 13, 2023 10:52 pm

The doctor sent the CPAP machine prescription to some durebale machine company and they are supposed to call me, nurse says it will take 4-6 weeks before insurance approvals etc

Yes, the insurance can be a delay, no doubt.
The equipment provider (aka DME) can be yet another delay. Who is your DME?
Who is your insurance? Your location can also make a diff.

sleepmentalhealth01 wrote: ↑

Tue Jun 13, 2023 10:52 pm

How do I request Resmed CPAP with nasal pillows ?

Start by calling your insurance and get a list of DME's you can use.
Then call each one to ask about getting a Resmed Autoset this should also be on the Equipment Order from the doc - get a copy in your hand in case you need it on short notice. Tell the doc you travel and want it in case you need equipment like a mask or hose that got damaged.

For the Resmed Autoset it should say "Do Not Substitute".
For the Mask it should say "Mask of Patients Choice" so the DME can't give you a hard time about trying a diff style mask.
Honestly, getting a mask that works for you is the hardest part.


If it looks like the wait for your equipment will be too long, consider buying a lightly used Autoset. You can often find them for sale in this forum, on Craigslist, or on Facebook among other places. It is always recommended to have a backup/spare cpap in case yours stops working or gets damaged. In fact, it is a good idea to have a spare of everything you need to sleep and once you get used to cpap you won't want to sleep without it.

ozij wrote: ↑

Wed Jun 14, 2023 5:25 pm

Miss Emerita wrote: ↑

Wed Jun 14, 2023 11:50 am

In other words, why was there a mention of CPAP in the sleep study report?

I find some other things puzzling as well. The report seems to say you didn't wake up at all during the night; does that correspond to your experience? It also seems to say you had no REM sleep and no deep sleep; did your doctor comment on that? -- Or maybe I'm misreading??

Or a side effect of antipsychotic drugs?

I'm not sure, I understand the report, do you guys suggest to do a followup with the doctor ?

I did wake up few times that right so maybe my sleep report is not right ?