How often do you think you should have a new sleep study?

coreyg wrote:There have been so many negative comments about sleep studies, I just wanted to add my experience. At my sleep study, I was able to talk to the technician who was very knowledgeable and although he was not allowed to answer certain questions, he did help me understand the process and CPAPs in general and even a little bit about OSA. My only complaint about the sleep study was that I never talked to the sleep doctor. The sleep doctor looked at the data after I left (I think it was after, but I'm not 100% certain), make up a report and sent it to my doctor who sent it off to a DME.

And they did the titration correctly, they found the lowest pressure that gave me an effective treatment and the correct style mask that works for me.

-Corey

My statement of "inexperience" is about what the technicians have to do if a problem arise, something outside of the normal. They have been trained to be technicians but if one patient has a problem that deviates from the norm then they don't know what to do and they made things worse.

For example my first sleep study. I went to Houston with a severe sinus problem ( I have posted this before), mucus so thick that sometimes prevented me to breath even when awake. He told me that does not produce an apnea but for definition apnea is "is a term for suspension of external breathing. " The mucus obstructed my air way and I stopped breathing in or out.

Second study. in Denver. That night I went to determine my pressure, I used a nasal mask, that I couldn't use (pain in my face), switched to a swift nasal pillow, it was ok but I had mouth leaks. She tried a chip strap, didn't work so I switch to a full face mask. My face is not symmetrical and full face mask don't seal properly.
The next morning, she told me that there were so much leaks so to compensate she elevated the pressure up to 20 and having 10 episodes after that per hour. (She had a problem and she was not able to fix it, so she just raised pressure. very knowledgeable, RIGHT? ) Doctor told me my pressure will be at 16 and we have to rested later.

I decreased my pressure to 11 and I have an AHI of 0.0 ~ 1.0 every night. I reduced my clear apneas with lower pressure. I don't need another inexperienced sleep test.

I wasn't saying the sleep study people were perfect

But, I probably was a fairly normal (or even easier than normal) case. The only issue that came up with me was my mouth leaked with the nasal mask and they switched to FFM.

-Corey

coreyg wrote:I wasn't saying the sleep study people were perfect

But, I probably was a fairly normal (or even easier than normal) case. The only issue that came up with me was my mouth leaked with the nasal mask and they switched to FFM.

-Corey

You are right, I was not attacking you or anything, sorry If it looked like that. I was just saying that those test are quite expensive and It is not like I can have several to find the right technician to help me with my issues.

For that kind of money, I expected a more seasonal traned technician. In other words I wasted money or my insurance wasted money for very unsuccessful tests. I knew that I had sleep apnea, I needed the confirmation to get the prescription to get the cpap, So at least I got something from my money/insurance money.

If a have a flu or something I can go to several doctors to find the right diagnose, the money spend is low so I can afford to have a second, third opinion, Sleep apnea being so problematic creating havoc in our bodies (strokes, heart condition, gerd, cognitive problems, etc) and test so expensive, I expected more from my money.

This is what I am talking about another sleep test going bad. viewtopic/t50431/CPAP--Real-Need-or-Jus ... -Grab.html

fidelfs wrote:This is what I am talking about another sleep test going bad. viewtopic/t50431/CPAP--Real-Need-or-Jus ... -Grab.html

That's more than just the sleep study going bad, that's the whole system going bad. (as if it's not bad enough normally!)

coreyg wrote:

fidelfs wrote:This is what I am talking about another sleep test going bad. viewtopic/t50431/CPAP--Real-Need-or-Jus ... -Grab.html

That's more than just the sleep study going bad, that's the whole system going bad. (as if it's not bad enough normally!)

Amen!

coreyg wrote:There have been so many negative comments about sleep studies, I just wanted to add my experience. At my sleep study, I was able to talk to the technician who was very knowledgeable and although he was not allowed to answer certain questions, he did help me understand the process and CPAPs in general and even a little bit about OSA. My only complaint about the sleep study was that I never talked to the sleep doctor. The sleep doctor looked at the data after I left (I think it was after, but I'm not 100% certain), make up a report and sent it to my doctor who sent it off to a DME.

And they did the titration correctly, they found the lowest pressure that gave me an effective treatment and the correct style mask that works for me.

-Corey

If you think about it, it makes sense. These forums are where people look when they have problems with their therapy or their "medical professionals".......and that would include the sleep studies. If everything was going fine with their therapy, they probably wouldn't be that inquisitive. However, some people just tend to go to the Internet these days to find out as much as they can about "everything".
From my own personal experience, my sleep study probably went pretty well (other than I didn't think I slept worth a darn).....but, at least I had a nice person who was working the sleep lab that night. It was the ordeal with my sleep doctor that left much to be desired. He was a JERK and I trusted him about as far as I could throw him (even though he isn't all that big). Months before I had my sleep study, I found CPAP.COM shortly after my GP mentioned the word "Sleep Apnea".......I was investigating the condition and what would be needed to treat it. I found this forum and started reading and preparing. One thing that has pissed me off in the ensuing years is that neither my GP or sleep doc asked me if I could breathe through my nose or referred me to an ENT......since I've since come to suspect that my breathing problem while sleeping has more to do with enlarged turbinates and deviated septum.


Den

In an ideal situation, this is what I see happening, or at least something like it...

Every sleep apnea candidate should go home first with an oximeter and an air (not 02) canula rigged to sense cardiac oscillation and snore, along with a zeo-style eeg monitor. There is probably enough to go on without the eeg, but it might be useful for determining sleep state. A one-button blood pressure cuff could used to check the bp just before sleep and at waking.

If obstructive apneas are detected, they go home with a hospital/respiratory-office/facility-owned diagnostic, auto, full-data machine with incorporated oximetry to see if it works at home first. Patients pay for the mask and the hose, but the diagnostic machine belongs to the facility.

The Respiratory Therapist should be paid the same way other physical therapists are paid - by the session, not by the items a distributor wants them to sell. They should work out of an RT office as part of a hospital or a large Physical therapy office, and not a DME office. They probably need a stiffer certification process to meet the qualifications more like other physical therapists. As far as I can tell, RT's only get a modicum of education on CPAP machinery and almost no education on the latest trends.

Equipment should be sold at the pharmacy like diabetic supplies - not like narcotics. They should be scheduled to meet with and teach each person in a classroom-style or a one-to-one office visit situation with a test 'bed' - like a massage table - as part of the process. People who are taking home a cpap machine should be encouraged to join a weekly discussion group that discusses methods of coping with large leaks, mask fit, and sleep therapy in general for a period of at least one month. Educational videos of proper best practices should be reviewed and discussed. Patient care should not be based on the price of the machine. Diagnosed patients should be allowed to buy the machine they want, small and light straight cpap without data or full-data auto.

Patients must be made fully competent to be in charge of their own titration at least using LED screen data. Full data should be available with software to those patients (or their preferred patient advocate) who want it.

PSG's should be relegated to patients who show central/complex/mixed apnea, or lack of response to in-home titration at the suggestion of the RT.

coreyg wrote:

fidelfs wrote:This is what I am talking about another sleep test going bad. viewtopic/t50431/CPAP--Real-Need-or-Jus ... -Grab.html

That's more than just the sleep study going bad, that's the whole system going bad. (as if it's not bad enough normally!)

I think it's much more than that. It is just my opinion, but there seems to be a very negative personallity in the mix. Often when we face the world with a positive face and try to bring about a positive result, that is exactly what happens. As coreyg mentioned, I spent time with my sleep tech being certain they knew what my problems are. I take time to know them as a person and for them to know me as a person. I do this with any service provider with whom I am working. It always helps improve the results.

DreamDiver wrote:In an ideal situation, this is what I see happening, or at least something like it...

Every sleep apnea candidate should go home first with an oximeter and an air (not 02) canula rigged to sense cardiac oscillation and snore, along with a zeo-style eeg monitor. There is probably enough to go on without the eeg, but it might be useful for determining sleep state. A one-button blood pressure cuff could used to check the bp just before sleep and at waking.

If obstructive apneas are detected, they go home with a hospital/respiratory-office/facility-owned diagnostic, auto, full-data machine with incorporated oximetry to see if it works at home first. Patients pay for the mask and the hose, but the diagnostic machine belongs to the facility.

The Respiratory Therapist should be paid the same way other physical therapists are paid - by the session, not by the items a distributor wants them to sell. They should work out of an RT office as part of a hospital or a large Physical therapy office, and not a DME office. They probably need a stiffer certification process to meet the qualifications more like other physical therapists. As far as I can tell, RT's only get a modicum of education on CPAP machinery and almost no education on the latest trends..

This part is how our tests in quebec function. The RT at the clinic lab were very thorough and knowledgeable and took lots of time making sure I knew exactly how to put on the equipment as well as a very clear check list and set of instructions with pictures. I just went home and put it on and slept in my own bed no problems. If I had had other problems there would have been an in hospital sleep test but those are reserved for people with more complex issues.

The only issue I had was that the DME people that sold me the equipment were much less knowledgeable or willing to take any time to explain things.

JohnBFisher wrote:

coreyg wrote:

fidelfs wrote:This is what I am talking about another sleep test going bad. viewtopic/t50431/CPAP--Real-Need-or-Jus ... -Grab.html

That's more than just the sleep study going bad, that's the whole system going bad. (as if it's not bad enough normally!)

I think it's much more than that. It is just my opinion, but there seems to be a very negative personallity in the mix. Often when we face the world with a positive face and try to bring about a positive result, that is exactly what happens. As coreyg mentioned, I spent time with my sleep tech being certain they knew what my problems are. I take time to know them as a person and for them to know me as a person. I do this with any service provider with whom I am working. It always helps improve the results.

You are absolutely right, being positive makes 90% of everything. Believe me, I faced these 2 sleep test positively, I even made suggestions, but the outcome was a not good one.

The first test, i told the technician about my sinus problem, he discarded my concern because he said that is not possible (This is when I told myself, something was not right.) He said that I woke up so often then I had so many arousals. I have always been light sleep, and he kept talking all night with the other patient, probably he was for his second study and required changes to pressure or what not. He said that didn't matter.

Second sleep study. I told them that my sinus still was a problem (she also disregard my concern). When she couldn't stop the leaks, I expected to find a solution, but she didn't and I had a bad diagnosis.

fidelfs wrote:... You are absolutely right, being positive makes 90% of everything. Believe me, I faced these 2 sleep test positively, I even made suggestions, but the outcome was a not good one. ...

fidelfs, I was not in anyway doubting you. I see you TRY to make things work. In spite of all we do, we can encounter bad sleep labs. I've had that happen.

My point was that no matter WHO did the sleep titration for the other poster the results would not be good.

You on the other had were an ideal patient. In SPITE OF, not because of, the sleep study you were able to work toward effective therapy. It is a shame that is sometimes necessary. But we live in the real world. Sometimes we need to just accept where we are, decide on where we want to go, and figure out how to get from point A to point B. It's not some grand conspiracy. Stuff happens and you deal with it.

You dealt with it. You found fairly successful therapy. The other poster decided everyone was against them and to heck with it ... and then complained that it was a waste of money and time. Therapy was a non starter for that poster. Both results were pretty predictable.

BlackSpinner wrote:The only issue I had was that the DME people that sold me the equipment were much less knowledgeable or willing to take any time to explain things.

THAT is the UNIVERSAL part of the HealthCare System??

The problem is we (and Sleep Clinics and Doctors) are all human. We all learn at different rates. Some are passionate about their work and will embrace it and want to talk to patients to learn new niches of information where others just consider it a job and nothing more.

Although Sleep Apnea isn't something overly new, you used to here a lot more horror stories in early technology and treatment like in Cancer, Heart disease and other things. As treatment evolves and doctors and sleep clinics become better equipped and have more knowledge, I believe the overall quality will improve. Sure there will still be pockets where it doesn't, but overly hopefully it will improve.

That's where we all should come in to try and help it improve not only for ourselves but for new patients to come. Helping and working with the doctors and clinicians (and possibly with somewhat regularly sleep studies) can hopefully only improve upon what we have today. All unite and become a single voice on when things don't go right and we should tell our doctors and clinicians but equally tell them when they're doing a great job too!

GumbyCT wrote:

BlackSpinner wrote:The only issue I had was that the DME people that sold me the equipment were much less knowledgeable or willing to take any time to explain things.

THAT is the UNIVERSAL part of the HealthCare System??

No that was the free market capitalist part of the health care system. Notice how much better a free market system does in providing fast but crappy service for a very high price?