OK, however, the MD I am talking about is the MD at the sleeplab.  The sleeplab and the MD's office are in one building.  I called him hours after the test and spoke with him directly and he said he had it scored and made an immediate recommendation for the titration.  Since he is the MD there, I guess he can interpret and make that determination.  He even asked if I wanted to come back that night (Tuesday night) and I did not want to, needed to get what sleep I could at home.  I am scheduled for 6/24 now.  So the MD at the sleeplab has the scores obviously if he was able to make that determination within hours.  He said it is very rare they score something that quickly but in his words, the scores were so "shocking", they did them.   My primary Doc, as I emailed him, I got his out of office reply, he is out of the country til 6/14, so I would not hear from him until then.

I think the MD at the sleeplab should tell me if I have to wait for the primary doc, or send me the scores already, UNLESS as you said I am waiting for them to be transcribed.  

Yeah, as you said, the techs have 2 patients per night.  I don't think she came in at all.  When I was trying to get on my side, I pulled one or 2 wires but I was able to replace them myself.

Forgot to add (as usual) that the reason it wasn't a split night, was that by the time I finally fell asleep long enogh (at 2am) it was too late for them to get enough time in for the titration.  They just let me sleep.  I thought that was cool at least since I woke up at 6:30 or so.

Well, you had your chance for an immediate titration and passed. That puts you on the list for first come, first served. You were next in line for the 24th so that's where you are at.

Do your homework so you have an idea of what you want by the night of your titration. Good luck at your titration.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

Crohnie,
I only passed because it was literally the night after my 1st study and I could not go there 2 nights in a row.  I figured the 4 or 5 hours of sleep I get at home are better than 2 nights of restless sleep all hooked up.  Also my partner was not going to be home til 8 anyways, I had to come home to take care of the dogs.  As it was, when I went to work right after, I told my boss to be easy, because I had a rough night, ended up telling her she was being a b!#$%, because she didn't heed to that warning.  LOL!!!  I needed to sleep at home so yes the 24th was the next available and that is fine.

I think I am going to call the doc at the sleeplab again tomorrow again and find out where my scores are.  

So when you say I should get an idea of what I want, you mean kind of CPAP?? Mask, pillows, etc.  Costs??  My co-worker has a Puritan Bennett, if you know anything about those.

By the way, it is freakin HOT!! here and supposed to be in the upper 90's and then 70's and humid at night, for the next 10 days, that makes my sleeping even worse.

Puritan Bennett makes an excellent CPAP. HOWEVER, if you want full data capability the only PB model that is fully data capable is their autoPAP, the PB GoodKnight 420E (the E is the key identifier). And I do not believe that the data is available via an LCD screen. I think it is only available via their Silverlining software which is easy to purchase online.

I wouldn't be too concerned about what mask, I'd rather my script just read: "Full face, nasal cushion, nasal pillows or "hybrid" style mask OF PATIENT'S CHOICE" so that I could at least try several masks of different styles and sizes at the local DME suppliers before deciding on one.

However, when it comes to xPAP, yep, I'd have an idea of which ones I would accept and which ones I wouldn't accept. Costs you have no real control over. That is determined between your insurance and the local DME suppliers they are contracted with. Online costs are deceiving now due to Resmed and Respironics recent MAP (minimum advertised price) policies for online DME suppliers. They can all be gotten online cheaper than the online advertised price.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

yeah, it is downloadable.  I am hearing too that  Resmed is decent.  I'll ask you this, what do you have??  I am overwhelmed by having to figure it all out, but I am sure the payoff will be worth it.

I have the Resmed S8 Elite w/EPR (my starting unit), the Resmed S8 AutoSet Vantage (self-purchased it when I got "auto fever") and was recently switched by my sleep doctor to the new Resmed VPAP Auto bi-level due to my COPD.

I had originally self-purchased the Respironics pre-M Series Auto w/C-Flex when I first got "auto fever" and I got good therapy w/it but I missed the Resmed easy access to so much data via the LCD screen each morning even tho I had the Respironics software and cable reader as well as the "combination" for accessing data via the LCD screen. It was just more of a hassle to do so than w/the Resmeds so when the opportunity came along to buy the Vantage I sold the Respironics to my son in law as a travel and back up machine and bought the Vantage.


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

Well... After much phone calling and gnashing of teeth, my titration results have been faxed to the pulmonologist. I have an appt. to see him at 9:30am tomorrow. Yay!

to Linda and ChronieToo, thank you for your kind responses to my original post. My numbers from the first study are:

length of study 360 minutes

sleep efficiency: 75%
stage 1 12%
stage 2 67%
stages 3 & 4 7%
REM 14%

respiratory-event index 36.1
CSAs 4
OSAs 84
MSAs 14
hypopneas 47
lowest desaturation 84%

Sinus arrhythmia without other arrhythmias, no periodic leg movements and no EEG abnormalities

I'll post again after my visit tomorrow. (It ain't over yet.)

Waylon

Waylon, guess what? You didn't sleep pheshtunga! Your sleep efficiency was lousier than mine. You get too much of the light stage 2 sleep and not enough of the restful, restorative stage 3 & 4 sleep.  Desaturation to 84% isn't such a good idea. BUT the key to that is HOW LONG you desatted below 90%.

So, 149 "events" attributable to slowed or stopped breathing during a 6 hour period. That 6 hours must have been the total bed time not the total sleep time to get an RDI of 36.1

Congratulations on getting the results to your pulmo and the quick appointment.

Just keep in mind: Diplomacy, tact, firm, but diplomacy and tact. Patient, perseverence and a sense of humor help a lot!


_________________
Some people are like Slinkies... Not really good for anything, but they still bring a smile to your face when you push them down a flight of stairs.
Resmed VPAP Auto. Humidaire 3i, Simplicity & Micro masks, ResScan 3.4, S8 ResLink, Embla oximeter.

Not sure about percentages, but that sounds like much more than the 12 minutes of REM I got in a 4.5 hr total sleep time.  I think I got about 67 minutes of stage 3 and the rest was stage 2.  The total recording time, or time in bed was just under 8 hrs.  

To top it off, I had to deal with AM rush hour traffic to get home the morning after as I live on the other side of Richmond from the sleep lab.  That was really FUN!!  I got some funny looks when I stopped at starbucks up the street with all that glue and !@#! in my hair.

CrohnieToo: I was below 91% for 6% of the study time.

My numbers from the titration study:

length of study 306 minutes

sleep efficiency: 85%
stage 1 13%
stage 2 46%
stages 3 & 4 23%
REM 18%

respiratory-event index not stated
CSAs 28
OSAs 1
MSAs 15
hypopneas 32

Interestingly, the pulmonologist did not seem to be familiar with the term ASV (adaptive servo ventilation), so we talked about that for a while. Thanks to everyone here, I had come with a list of proposed xPAP machines. We talked about my insurance, and whether they would agree to give me a more advanced machine. He agreed to start at the top of my list, and work his way down until they got to one the insurance company would allow.

My list:
1.ResMed VPAP Adapt SV
2.Respironics BiPAP autoSV w/ SMARTCARD
3.Respironics REMStar Auto with A-Flex w/SmartCard
4.Puritan Bennett GoodKnight 420E Auto-CPAP
5.ResMed AutoSet Vantage

Of course, the list also included the request for humidifier, fully data capable, mask of patients choice, etc.

Now I just have to see how long it will take for the DME company to call me.

I got the call from the DME. I'm getting a Respironics REMstar Pro w/C-Flex, a smartcard and a humidifier. When I asked about one of the better machines, she said "The insurance company won't pay for any of that fancy stuff." I am disappointed, but kind of did expect that. I found one site that had the insurance company prescribing guidelines, which stated that a patient had to fail on a lower machine before they could get a more expensive one.

She will be be bringing it to the house tomorrow after I get home from work, so I'll let you all know how that goes.

Waylon

Well, I got my machine. It's a REMstar 400M with humidifier, and a Hybrid mask. My first impressions are that it's easy to use, but noisy.

I used it last night, and I will say that I do feel different today. How do I feel? I'm not really sure. I think the problem is that I have felt so bad for so long that I don't remember what "good" feels like anymore. I also expect it to be some time before I "catch up" on enough of the missed sleep to really feel "good".

Question: Is there any consensus on which C-Flex setting is best? Mine shows 1, 2 & 3. The DME suggested using number 3.

I also found out that it's not that the insurance company won't allow me a more expensive machine, it's that the DME gets paid a flat amount to give me one, whether it's a low end CPAP, or a top of the line ASV. I am trying to stay open minded about whether this CPAP will properly address my needs, and will wait until the pulmonologist can read some accumulated data from my smartcard to see if I am still having CSAs. If I am, I plan to educate the doctor and firmly but politely insist on a prescription specifying one of the ASV devices.

Any guidance from the community is of course appreciated.

Waylon