Market for Sleep Labs Will Shrink

Well, sleep study is not one of my finer moments of relaxing...

There were holes in the false ceiling with red beeping lights all the way at the top. I just kept on staring at the red lights blinking while on my back, wondering what in world are those for??

Maybe the red lights blink when your about to have a heart attack??

SG

I don't remember obtrusive blinking lights, though there was one attached to a camera. I do remember being awakened twice during the original study to ask if everything was OK. I was more like, go away and let me sleep (in my head). I was told normal sleep position was fine, but if possible to spend at least part of the night on my back to produce the worst-case scenario.

My last bi-level re-titration when I woke up, not sure if I woke up or if the tech just came in because of excessive leak, whilst awake I asked to change to my own mask and use the bathroom and when I got back in bad w/my own mask on I was asked to try sleeping on my sides since up to then I had been sleeping on my back since going to bed.I asked if he would add 2L of 02 since I feel like I can't breathe comfortably or get enough air when laying on my side and that's when I found out the A-hole who ordered the study did NOT order 02 to be available for me!!!! I had had a PFT he day before that he had the results of, I've been on 2L of 02 w/my CPAP and then bi-level since early 2007 as he well knew by my records, I'm on 02 as needed thru out the day as he well knew since I sat in his office for our consultation w/my 02- and the A-hole didn't order 02 if needed for the titration!!!!

Ah, brings back memory!! After Broom Hilda screamed at me for the fifth time it was 'Time to Get UP!!' and vacate the premises, within at least 20 seconds, she had ripped off all the wiring....

I was in such shock, I couldn't even scream!!! Screaming isn't good at a Sleep Center

Oh gee, I brought and used my Aeiomed Headrest. The tech had not heard of the Headrest until I brought mine in. He said it had the lowest leak rate he had ever seen. I asked him to keep an eye for my mouth opening which he claimed did not but I do still get dry mouth so it must be getting 'blow-by' from the 18-20cm IPAP.

I will not go back to a FFM after using the nasal pillows.

ps. when reviewing my 1st PSG with the PA he requested I go back for supine titration (which I did) that nite but let him know the tech never asked me to sleep supine during my inititial split-nite study. I thought that was just another money grubbing move at the money mill.

Boy was I ornery after 2 consecutive nites in a sleep center. I was just eager to get a machine and just followed along like a little puppy dog. Still it took another month to get that 1st Plus model tank from Apria via UPS. The UPS driver never stayed to help me get things working either.

That was long before I met the wonderful folks here.

Well, you know maybe this Home Sleep thing could really be more effective...

Suppose, well how can I put this, you well, ugh, you know what I mean, ummmm, before you go to sleep And, uh, you know, it kinda, well, helps you sleep

I think there is a old Saturday night live skit on this or Seinfeld episode!!?? Unless, maybe this doesn't bother you? It's a good test that the sensors are working!!??

No need to grit your teeth, cough and move your arms and legs around

Good night everybody,

SG

While I am a hugh fan of the home sleep tests they are being considered and used as an initial test. If the patient has co-morbidities then a PSG will be needed as well. The estimate is that home sleep testing will be effective for 70% of patients (Medicare final rule). I am not sure Medicare's numbers are accurate as I have read their analysis but they are probably somewhere in the ballpark.

leejgbt wrote:While I am a hugh fan of the home sleep tests they are being considered and used as an initial test. If the patient has co-morbidities then a PSG will be needed as well. The estimate is that home sleep testing will be effective for 70% of patients (Medicare final rule). I am not sure Medicare's numbers are accurate as I have read their analysis but they are probably somewhere in the ballpark.

Home plate is in the ballpark and so is the centerfield fence. But try stepping up to bat at the centerfield fence and see how quickly you are kicked out of the game. I guess it is good enough for government work.

What is the problem with the 30% of patients that would not be suitable for home studies? It is consistently reported that 95% of apnea cases are obstructive sleep apnea.

What comorbidities are you concerned about? Are these things your GP should be diagnosing and treating (With the help of specialists when needed.)?

I suspect that those that are profiting by the assembly-line type of McPST are not likely to give up their gravy train easily. But I would guess that the total population of people stepping up to be tested at home would increase drastically if the home testing were an option. How many of you have told friends and family your war stories about going through a sleep study and inadvertantly made them reluctant to undergo the same?

If the less-than professional portion of sleep medicine people are so insistent that a proper diagnosis and titration can only be performed in a sleep lab, why is it that after a person has been diagnosed, they are often sent home with a low-end XPAP machine and only the hours of use is monitored from that point on? Top quality care for one night and marginally mediocre for the rest of your life? Huh?

Types of co-morbidities include:

RLS, Asthma, CHF, COPD, Chronic Bronchitis, Central Apneas mingled with Obstructive Apneas

Some people may even have more than one of the issues listed above. There are more but these are some of the common ones. But a person can still have the home study done. The only reason for the PSG would be if the results were off or inonclusive. Most sleep labs that I talked to want to use home testing if reimbursement justifies as it is expensive for them to maintain manpower and training to do a full PSG on every patient suspected of OSA only.

Snorebert wrote:....If the less-than professional portion of sleep medicine people are so insistent that a proper diagnosis and titration can only be performed in a sleep lab, why is it that after a person has been diagnosed, they are often sent home with a low-end XPAP machine and only the hours of use is monitored from that point on? Top quality care for one night and marginally mediocre for the rest of your life? Huh?

Good one!

leejgbt wrote:Types of co-morbidities include:

RLS...

Actually, RLS, as a disease of Wake, would be diagnosed by patient history. PLMs, the sleep-related version of this disorder, would need NPSG.

Muffy

Muffy wrote:

leejgbt wrote:Types of co-morbidities include:

RLS...

Actually, RLS, as a disease of Wake, would be diagnosed by patient history. PLMs, the sleep-related version of this disorder, would need NPSG.

Muffy

The remainder could be identified via patient history, prior to home testing, also.

GumbyCT wrote:The remainder could be identified via patient history, prior to home testing, also.

Asthma and COPD would need PFT. Chronic bronchitis could be diagnosed by history ("chronic cough that produces phlegm that persists for at least three months for two years in a row, without the presence of any other disease that could be causing the cough") but I don't see where that would have much to do with NPSG (other than screwing up the flow waveform periodically). CompSAS wouldn't appear until titration (although there may be clues on diagnostic NPSG).

Muffy

Just how many of these things would be obstacles to home testing, IYO?