I am Sleep tech, do you guys have any suggestions?

sleeptech87 · Post by **sleeptech87** » Mon Sep 05, 2005 5:22 am

I am a sleep technologist in Colorado. I do not use CPAP or have OSA. However, I would like to know if there is anything specifically that I can do to help people through their first sleep study and CPAP titration. I know it can be a tough night for most patients. I want to try and make the whole process as easy and painless as possible. Was there anything particularly unpleasant about your sleep studies? Anything the tech could have done to make it easier for you? What was good about it? I would appreciate any feedback you guys can give.

Sleepless on LI · Post by **Sleepless on LI** » Mon Sep 05, 2005 7:08 am

How wonderful of you to care so much. You are one of the good ones. Thanks for asking. Now be prepared for the Pandora's box you just opened. I'm sure this is going to be a long thread when it's all done .

My most important suggestion is to please not strap on a mask so tight that the patient wants to cry and rip it off and go home. The worst part of my study was how uncomfortably tight the RT made my masks (two of them). If the patient is telling you it's really hurting them, it's too tight. Maybe these sleep clinics need to look into masks like the Activa which is very comfortable and works for most people. It wouldn't scare off the patient thinking CPAP has to be painful. It's a very scary experience to begin with, but when you have the RT making it worse by digging this mask into your face, it is really much worse.

My other suggestion to you would be, try to listen to what the patient is telling you and be kind and considerate to him/her. I had a lovely man who was just that at mine and it made all the difference in the world. You feel so lost and alone when you go for these PSG's and having someone compassionate to your needs makes it far less stressful.

I get the impression since you wrote this post that you are compassionate to the needs of the people you treat and I am so impressed by it. I'll step back now and let the other members of this site post their suggestions, of which I'm sure there will be many good ones coming. Thanks for writing.

capt · Post by **capt** » Mon Sep 05, 2005 8:33 am

What a joy it is to read a post like yours!

I think you have already have accomplished the first step in helping your patients, in that you obviously care! The second step is listening. The third step is to not to think or assume what generally works will work or be the best for your new patient. You have to be able to look at each patient as different. I do not think this can be overstated. There are so many factors that can have a bad or good effect on the study (size, weight, nerves, sleep habits, other illnesses and allergies, lack of a sleep partner, bedding materials, temperature of the room). This list is by no means complete. My final suggestion would be to include your patient in their study. Let them know that you want them to be as comfortable as possible, but the study will be intrusive. Try to teach and share with them everything that is going on, and let them participate with you in making things better.

Be willing to try different masks if you can. This may not be easy, as it takes time, and time is what you do not have

Keep in mind that the study is important and will be used to determine treatment. I hate to say this, but sometimes the study will be used by someone that is not as expert or knowledgeable as the should be. You could quite possibly be the patient's most critical advocate!

rock and roll · Post by **rock and roll** » Mon Sep 05, 2005 8:50 am

Add to these, keep the room temp comfortable, explain what all the items you attach are, let us nknkow what to expect, and let us keep a degree of modesty. My biggest problem is that I was required to sleep on my back and keep still. If I could do this, I would not need a sleep study.

wb9tpg · Post by **wb9tpg** » Mon Sep 05, 2005 12:13 pm

My tech said "if we see you have sleep aphnea, we may come in during the night an put you on the machine". WRONG THING TO SAY - my mind was going 100% on that thought and I only got 1.5 hrs sleep the entire night.

I'd rather been kept in the dark and surprised later on.

Busybee · Post by **Busybee** » Mon Sep 05, 2005 12:39 pm

Thank You for asking the people who have been through this process. The problem I had at my sleep study was I claustrophobic and I ask if I could remove the mask for a moment and then put it back on and the sleep tech told me no that if I could not tolerate the mask then I might as well go home. It really upset me that there was no compassion for what I was going through. My advice would be if someone is claustrophobic let them be in control of holding the mask on their face for a few minutes to get used to what it feels like to breath with the cpap and then strap in it on their face and let them sit on the side of the bed and adapt to it before trying to lay down. Good Luck we need more people like you working in the sleep lab.

mac · Post by **mac** » Mon Sep 05, 2005 1:28 pm

How about later arrival times, This whole process is set up for someone that
works 9-5.

I work nights and don't normally go to bed until after 2am. So bringing me
in at 8pm and putting me to bed at 9pm allowed me to have a great
experience of staring at the ceiling for 5 hours.

Georgia Hosehead · Post by **Georgia Hosehead** » Mon Sep 05, 2005 2:31 pm

When you come in the patient's room to check something or to adjust the mask, DO NOT turn on the overhead lights. It thoroughly disturbs the possibility of the patient sleeping. The sleep tech did this to me about 6-7 times. I suggested to the management that they have a light under the bed or have the tech use a penlight. Thanks for asking! Georgia Hosehead

Guest · Post by **Guest** » Mon Sep 05, 2005 2:31 pm

Don't laugh at your patients. When I went for my titration study, the tech. kept laughing at me when she put the different masks on...I wanted to hit her. I was miserable that I had to be going through the whole process and the indignity of wearing this god-awful mask on my face...and then she started laughing. She also had no idea how to put the mask (Breeze) on me...she kept fiddling around and pulling my hair. It took forever!
I would have been much happier with somebody that gave a "darn" about how I was feeling.

Sergeant Bob · Post by **Sergeant Bob** » Mon Sep 05, 2005 3:11 pm

Great replies so far!
The sleep tech's I had were really great!
My only real complaint was the bed. It was like trying to sleep on a brick!
They probably could have used a better selection of masks too, as they only had the Comfort Classic mask. Worked OK for me but I'm sure some would have problems with it.

Fatigue Fighter · Post by **Fatigue Fighter** » Mon Sep 05, 2005 3:52 pm

I'm glad you asked!
1: Don't tell the patient they will probably sleep better here than at home.
2: Don't tell them before they've seen the room that it is like a hotel.
3: Have a good mask selection. The only non-claustrophic mask they offered me was the Breeze and then they set me up in such as way that the only reasonable sleep position was on my back.
4: Offer them a sleeping pill if they need it. My first titration study was so traumatic, I wanted to die (really).
5: All techs should undergo a sleep study AND a PES just to see what it feels like.
I am sure there are more but these are my top 5.
FF

snork1 · Post by **snork1** » Mon Sep 05, 2005 8:56 pm

rock and roll wrote:.... My biggest problem is that I was required to sleep on my back and keep still. If I could do this, I would not need a sleep study.

This was EXACTLY what first popped into my brain when thinking back to my study.

Realize that people have their little rituals for getting to sleep. Disturb that ritual and you do not have a clean study unless you acknowledge and somehow allow that process. I have a routine of sleeping on a particular side then the other to get to sleep. Occasionally I sleep on my back during the night. I absolutely could not get to sleep when told to "go to sleep on your back", and then they wondered what my problem was, which made me all the more frustrated.

Otherwise it was about as comfortable experience as you could have with a hundred or so wires glued to your face and body.

It would be NICE if they had less clausterphobic chin straps and masks for the "first timers". That was another problem in my first study, before I could supply my own interfaces and anti-leakhardware.

WAFlowers · Post by **WAFlowers** » Tue Sep 06, 2005 1:48 pm

Fatigue Fighter wrote:5: All techs should undergo a sleep study AND a PES just to see what it feels like.

It is difficult for me to add anything to all the good suggestions already made, but the above really stands out.

My titration went so well largely because my RT had weight-related OSA and had used a CPAP before losing enough weight to keep it under control. He knew in a way that a non-user couldn't exactly what I was about to go through. He also had personal experience in the complexities of fitting a mask and keeping it on and not leaking while tossing and turning with 101 different leads attached to your body.

Try it for a night and you will likely gain some insights, esp. into the issues surrounding mask selection and adjustment. Just putting on a mask while awake for a few minutes isn't enough.

TXKajun · Post by **TXKajun** » Tue Sep 06, 2005 3:06 pm

WAFlowers wrote:
Fatigue Fighter wrote:5: All techs should undergo a sleep study AND a PES just to see what it feels like.
It is difficult for me to add anything to all the good suggestions already made, but the above really stands out.

My titration went so well largely because my RT had weight-related OSA and had used a CPAP before losing enough weight to keep it under control. He knew in a way that a non-user couldn't exactly what I was about to go through. He also had personal experience in the complexities of fitting a mask and keeping it on and not leaking while tossing and turning with 101 different leads attached to your body.

Try it for a night and you will likely gain some insights, esp. into the issues surrounding mask selection and adjustment. Just putting on a mask while awake for a few minutes isn't enough.

ditto, but I think it should also be mandatory for ALL sleep techs to spend a couple of nights undergoing full polysomnograms, including a mask fit and titration as well as have to spend a full week trying to sleep wearing a mask. That would give them a bit more understanding of what we go through.

It's good that you are asking this at the beginning of your career. I bet you're going to be a SUPER tech! Best of luck!

This therapy WORKS!!!

bratt122 · Post by **bratt122** » Wed Sep 07, 2005 8:05 am

I think its great you care.The tech I had should have crawled back in the hole he came from.
Be kind,Be patient,Be sympathetic.

I am Sleep tech, do you guys have any suggestions?

I am Sleep tech, do you guys have any suggestions?

Sleep study