Questioning the validity of my sleep study results

I have been doing a lot of thinking lately about two things; 1)my chronic use of sleep/hypnotics and 2) being instructed not once, but twice to sleep on my back during my last sleep study (I am a side sleeper). I believe the concomitant use of of not one, but two sleep medications caused upper airway laxity and sleeping on my back naturally caused epidsodes of OSA. My AHI was 43.9. Study was done for excessive daytime sleepiness. My dose of medication had recently been increased and by the time the tech had wired me up, I had completely fallen asleep in the chair.

My previous studies which were done because of excessive daytime sleepiness showed mild OSA when I was on my back. No episodes occurred on my side.

I am using APAP and in reviewing my reports, I am really amazed to find out that I only have 2 or 3 apneic or hypoapneic events all night long. My snore index is very low. I have not seen one bit of evidence that xPAP is helping me with EDS. As a matter of fact, I feel worse now than I did before using xPAP.

I submit that my EDS is medication-induced and that my sleep studies have been directly
influenced by medication and sleep position (being forced to sleep on my back). Last night I did not use my xPAP because I waiting for a replacement hose and I woke up feeling MUCH BETTER.

I am thinking out loud and would appreciate a critical analysis so that I can see if there are any flaws in my logic. Laurie

You make a good point, Laurie. At best, any sleep study only shows what happened at that point, under those circumstances. For most of us, that's a good place to start, but your situation seems a bit more complicated. Hope you find a solution.

During my sleep study, I was asked to change positions from side to back - both with and without the CPAP. I figured it was to see where the worst of my OSA was and how the CPAP therapy affected the same positions in sleep.

Cheers,
xena

It might be worth a repeat PSG without sleep aids or CPAP. Perhaps a home study, so that your sleep would be less disrupted by the sleep lab experience. Then you can sleep under your normal conditions and in your normal positions and you'll have a clearer picture for yourself.

Personally I would do something like that before drawing any conclusions about whether or not you need the therapy from data showing low AHI. The good score can simply mean that your apnea is being well treated, too. Data may help clear up the picture for you, one way or another.

Why not drop your pressure a few points below what was titrated for you and see if your good ahi numbers still hold.

Asking you to back-sleep during the PSG was definitely to get a worst-case reading for a future baseline. I wish the techs would tell that to people so they wouldn't think it meant they should do it otherwise!

brain_cloud wrote:Why not drop your pressure a few points below what was titrated for you and see if your good ahi numbers still hold.

That is an interesting idea that I had not considered. My titrated pressure is 7 cms and my machine is set for 7-12 cms. I will discuss this thought with my doctor. Thank you for your response! Laurie

Janknitz wrote:It might be worth a repeat PSG without sleep aids or CPAP. Perhaps a home study, so that your sleep would be less disrupted by the sleep lab experience. Then you can sleep under your normal conditions and in your normal positions and you'll have a clearer picture for yourself.

Personally I would do something like that before drawing any conclusions about whether or not you need the therapy from data showing low AHI. The good score can simply mean that your apnea is being well treated, too. Data may help clear up the picture for you, one way or another.

My first step to get a clearer picture is to get off these darn medications for sleep. What a trap sleep meds can be! I guess the important thing is that I am being treated for OSA now and reducing my health risks. When I get off of these meds, I will have a repeat PSG. In the meantime, I'll enjoy the fact that my AHI has greatly improved! Thanks for your input - brilliant as usual! Laurie

Yes, I'm always surprised when doctors recommend a sleep aid for a sleep study--seems to me that it would really skew the results.

At the same time, I recognize how hard it must be to sleep during a sleep study in a lab and a lot of time and money is wasted if you don't get enough sleep.

I know I'm one of those people who never would have slept in a lab setting--thank goodness for home testing!