Sleep Study-Done, now, I wait

Taz wrote:

ems wrote:

Taz wrote:

I was actually in bed about 7hrs. I made two trips to the bathroom and according to the tech, I finally fell asleep shortly after 3AM and was awakened at 6AM. No, I was not tried on a CPAP, at all. The tech said I did not fall asleep soon enough for a possible split study. He said I would be coming back for a titration study. I couldn't get the tech to tell me much but he did say once I fell asleep I had some intense periods of snoring and a few strong apnea incidents. He said I would be contacted in 7-10 days after the sleep doc looked over my study.

Taz

I think we both went to the same sleep center except that I don't live in Texas. If you did some reading here, you'd probably find that the majority of us came away from the sleep study feeling like you feel. I also slept around 3 hours. Robysue's suggestions were spot on. Makes so much more sense than to sit around just waiting.

I thought I would mention that I moved things along by calling the sleep doc the day after the sleep study, and told her that I was concerned and worried, etc., and that I didn't want to go for a titration. She (pulmonary sleep specialist) said that was okay; that she would "suggest" what pressure I needed when she saw the results from the sleep study and would follow up by reading the SD card within a month. She must have contacted the DME I used bc I had my machine within the week... as I remember... about 3 days.

I know it's easy for me to say but you'll be fine. Be proactive - read Robysue's post again - maybe pamper yourself and go for a massage.

Hi ems,

I would love to get out of going back for a titration study. I've now experienced a sleep study and really do not want to do it, again. If I get the opportunity to speak with the sleep doc......exactly how do I explain why I'm concerned & worried? Are there any advantages to actually having a titration study or can this doc just as easily suggest a starting pressure by reviewing my sleep study?

Taz

Unless you are going to schedule an appointment (if that sleep doc even sees patients) you don't get to talk to the sleep doc interpreting your study. He is only being paid to interpret the results, not to interact with patients. If you want a sleep doc to talk to..you need an appointment in an office. The person you need to be talking to is your PCP who is referring you for these tests. Some primary care docs are quite used to starting patients on CPAP. When I worked in primary care I was in a federally "medically underserved area". As a primary care provider, I was expected to screen and start patients on CPAP therapy. Only if they had issues that I and the DME couldn't help with would a sleep specialists even accept a referral (because there just wasn't enough specialist for the number of patients). I say all that to tell you that you don't always need a sleep specialist-your PCP might do just fine. Most insurance companies will not cover CPAP equipment without a titration study.

Taz wrote:

ems wrote:

Taz wrote:

I was actually in bed about 7hrs. I made two trips to the bathroom and according to the tech, I finally fell asleep shortly after 3AM and was awakened at 6AM. No, I was not tried on a CPAP, at all. The tech said I did not fall asleep soon enough for a possible split study. He said I would be coming back for a titration study. I couldn't get the tech to tell me much but he did say once I fell asleep I had some intense periods of snoring and a few strong apnea incidents. He said I would be contacted in 7-10 days after the sleep doc looked over my study.

Taz

I think we both went to the same sleep center except that I don't live in Texas. If you did some reading here, you'd probably find that the majority of us came away from the sleep study feeling like you feel. I also slept around 3 hours. Robysue's suggestions were spot on. Makes so much more sense than to sit around just waiting.

I thought I would mention that I moved things along by calling the sleep doc the day after the sleep study, and told her that I was concerned and worried, etc., and that I didn't want to go for a titration. She (pulmonary sleep specialist) said that was okay; that she would "suggest" what pressure I needed when she saw the results from the sleep study and would follow up by reading the SD card within a month. She must have contacted the DME I used bc I had my machine within the week... as I remember... about 3 days.

I know it's easy for me to say but you'll be fine. Be proactive - read Robysue's post again - maybe pamper yourself and go for a massage.

Hi ems,

I would love to get out of going back for a titration study. I've now experienced a sleep study and really do not want to do it, again. If I get the opportunity to speak with the sleep doc......exactly how do I explain why I'm concerned & worried? Are there any advantages to actually having a titration study or can this doc just as easily suggest a starting pressure by reviewing my sleep study?

Taz

Most people go for a titration study... whether it's because it's necessary or they just think they have to, I don't know. I just knew I wasn't going back! My guess is that if my doctor saw a reason to have a titration, she would have said so. And, yes... if there was a reason I would have gone ahead with it.

Fortunately my sleep apnea (altho severe) was quite vanilla... meaning no centrals and the pressure she suggested kept my AHI's around .2, with few leaks to worry about. I started with CPAP but around 6 months or so later, she said she thought BPAP would help with migraines. It didn't but that's another thread.

You could get your PCP involved... that may hurry up the process. My PCP was the doc who sent me for the sleep study and after referred me to a pulmonary sleep doc. I think I called her also... in fact, I think she was the one I actually did call. Or, you could call the center where you had your sleep study done. I seem to remember calling them also... lol.

Or, you can just relax and accept the process. I know easier said than done, but just think of all you can learn between now and the time you get your machine. Seriously, I know you want it to happen this minute but things don't always happen that way. Try to relax... another few weeks really won't matter in the scheme of things.

ems wrote:

Taz wrote:

ems wrote:

Taz wrote:

I was actually in bed about 7hrs. I made two trips to the bathroom and according to the tech, I finally fell asleep shortly after 3AM and was awakened at 6AM. No, I was not tried on a CPAP, at all. The tech said I did not fall asleep soon enough for a possible split study. He said I would be coming back for a titration study. I couldn't get the tech to tell me much but he did say once I fell asleep I had some intense periods of snoring and a few strong apnea incidents. He said I would be contacted in 7-10 days after the sleep doc looked over my study.

Taz

I think we both went to the same sleep center except that I don't live in Texas. If you did some reading here, you'd probably find that the majority of us came away from the sleep study feeling like you feel. I also slept around 3 hours. Robysue's suggestions were spot on. Makes so much more sense than to sit around just waiting.

I thought I would mention that I moved things along by calling the sleep doc the day after the sleep study, and told her that I was concerned and worried, etc., and that I didn't want to go for a titration. She (pulmonary sleep specialist) said that was okay; that she would "suggest" what pressure I needed when she saw the results from the sleep study and would follow up by reading the SD card within a month. She must have contacted the DME I used bc I had my machine within the week... as I remember... about 3 days.

I know it's easy for me to say but you'll be fine. Be proactive - read Robysue's post again - maybe pamper yourself and go for a massage.

Hi ems,

I would love to get out of going back for a titration study. I've now experienced a sleep study and really do not want to do it, again. If I get the opportunity to speak with the sleep doc......exactly how do I explain why I'm concerned & worried? Are there any advantages to actually having a titration study or can this doc just as easily suggest a starting pressure by reviewing my sleep study?

Taz

Most people go for a titration study... whether it's because it's necessary or they just think they have to, I don't know. I just knew I wasn't going back! My guess is that if my doctor saw a reason to have a titration, she would have said so. And, yes... if there was a reason I would have gone ahead with it.

Fortunately my sleep apnea (altho severe) was quite vanilla... meaning no centrals and the pressure she suggested kept my AHI's around .2, with few leaks to worry about. I started with CPAP but around 6 months or so later, she said she thought BPAP would help with migraines. It didn't but that's another thread.

You could get your PCP involved... that may hurry up the process. My PCP was the doc who sent me for the sleep study and after referred me to a pulmonary sleep doc. I think I called her also... in fact, I think she was the one I actually did call. Or, you could call the center where you had your sleep study done. I seem to remember calling them also... lol.

Or, you can just relax and accept the process. I know easier said than done, but just think of all you can learn between now and the time you get your machine. Seriously, I know you want it to happen this minute but things don't always happen that way. Try to relax... another few weeks really won't matter in the scheme of things.

I got the word today from my doctor's office that he has ordered a new 2 night study for me; I'm looking forward to another 2 night study; it's uncomfortable but since I'm tested about every 7 years I'm willing to do it again to get all the data the lab needs. I'm hoping my pressure hasn't gone up too much since I'm already at 18cm.



Stevoreno_55
04/28/14

ems wrote:
Most people go for a titration study... whether it's because it's necessary or they just think they have to, I don't know. I just knew I wasn't going back! My guess is that if my doctor saw a reason to have a titration, she would have said so. And, yes... if there was a reason I would have gone ahead with it.

Fortunately my sleep apnea (altho severe) was quite vanilla... meaning no centrals and the pressure she suggested kept my AHI's around .2, with few leaks to worry about. I started with CPAP but around 6 months or so later, she said she thought BPAP would help with migraines. It didn't but that's another thread.

You could get your PCP involved... that may hurry up the process. My PCP was the doc who sent me for the sleep study and after referred me to a pulmonary sleep doc. I think I called her also... in fact, I think she was the one I actually did call. Or, you could call the center where you had your sleep study done. I seem to remember calling them also... lol.

Or, you can just relax and accept the process. I know easier said than done, but just think of all you can learn between now and the time you get your machine. Seriously, I know you want it to happen this minute but things don't always happen that way. Try to relax... another few weeks really won't matter in the scheme of things.

ems,

I think my problem is I do not have a private sleep doctor, based on what houndlover has posted. Apparently, my sleep lab just has sleep docs that interpret the sleep studies. That seems to be more inline with what the sleep tech was telling me. He did not know who the docs were that reviewed & interpreted the studies. I thought that was a little strange but now I'm beginning to understand why.

As I mentioned earlier, I'm a rather impatient person by nature and I prefer to be more proactive. I think I will make a couple of calls, tomorrow and if nothing else I'll try to have it scheduled the way I want it. My husband is scheduled for a sleep study on May 11th and if I must go through a titration study...then I want it done on the same night as his. At least I'll feel like I had some say in the matter. OK, I'll reach the point of "acceptance" in all this...it just takes me a little time.

Taz

Taz wrote: Are there any advantages to actually having a titration study or can this doc just as easily suggest a starting pressure by reviewing my sleep study?

Hi Taz -- this question may have already been addressed, but just in case: Reviewing your sleep study would not help the doc to determine what pressure(s) you will need. Severity (how many apnea events you have and/or how low your oxygen drops) is not correlated with the amount of pressure required to hold your airway open. Some people with mild apnea need very high pressures, and some with severe apnea control it with low PAP pressure. So titration has to happen one way or the other.

Some clinics like Kaiser do titration by sending patients home for a week with an APAP machine, with pressure settings wide open. At the end of the week the doc reviews the machine's data and decides on a pressure or pressure range. Some people prefer this over an in-lab titration. There are advantages and disadvantages to each approach.

I know that I'm a little late here, but I had the same experience in my sleep study, about 3 hours sleep. None the less, my sleep doctor got all the data that he needed, but no lab titration for me, either. Sleep doctor took a guess at what I'd need from past experience and was pretty darn close, as it turned out. Covered his bases by recommending an adjustable cpap (ResMed AutoSet apap). About all I've changed in the end has been to turn off the ramp, and raise my starting pressure. So, assuming you have a good, experienced sleep doctor interpreting your data, and fairly typical apnea (mostly or all OSA's), and using cpap doesn't cause you to experience an unusual number of central apneas, you should be fine as long as you get a decent cpap. I do have some centrals as a result of using cpap, but only about 1 or so per hour average, so I can pretty much ignore them.

Given the situation, seems like you're going to want an apap with full data, since you'll need to monitor things to make sure that you're actually getting full therapy (and not having too many central apneas), but one should really do that anyways *smile*. With an apap, you can start with a range of pressures and see if that works for you, and adjust it appropriately (and very carefully *smile*). It may be that you simply do better on straight cpap, and you can make an apap do straight cpap if that's what you need. In my case, my sleep doctor looked at my data after 30 days to see what was happening, and it turned out his guess was pretty good.

Anyways, just wanted to mention that I had a 3-hour sleep study that lasted about 7 hours, too. And things have worked out just fine for me, so there's every reason to believe that you'll do fine.

I just contacted the sleep center to inquire about the possibility of scheduling my titration study on the same night my husband will be having his sleep study. The nurse I spoke with got a little "short" with me and said the sleep tech should have never mentioned that I would be coming back for a titration study. She insisted that is a decision only made by the sleep doc interpreting the study. The nurse explained that many of the insurance companies do not want to pay for a second night in the sleep lab therefore the patient is often sent home with an APAP for a 2 to 4 week home titration study. I told her "great" that's exactly what I would rather do. I assured her I had no desire to return to the sleep lab unless it was absolutely necessary.

The nurse asked me to hold on while she called the clinical dept to see if my sleep study was under review, yet. When she returned she said she had spoken with one of the clinical nurses. My study has not been interpreted, yet however the clinical nurse did briefly look at my data and said it appears it will be in the "severe" category but the sleep doc will need to make that determination. Then the nurse told me that my insurance company is one that rarely approves a 2nd night in the sleep lab. Again, I told her "great", I have no problem with an in-home titration study. She will call me back as soon as a determination is made.

OK, I'm glad I made that call....at least I had the opportunity to make it known that I did not wish to return to the sleep lab and I'm perfectly comfortable with an in-home titration study. Wish me luck because I really, really do not want to return to that sleep lab!!!

Taz

[quote="Taz"}

OK, I'm glad I made that call....at least I had the opportunity to make it known that I did not wish to return to the sleep lab and I'm perfectly comfortable with an in-home titration study. Wish me luck because I really, really do not want to return to that sleep lab!!!

Taz[/quote]

Well, here's hoping that you have simple OSA...like I said above, in my case "in-home titration" using an apap worked well. I'd be overjoyed to never have to see the inside of a sleep lab again.

Good luck!