I didnt have sleep apnea on my first try, but my doc thinks I do. I wasnt very comfortable at the sleep center on my first try. I could hardly sleep, as I was tossing and turning and the temperature was killing me, cold and hot.
Well tonight I go in for my second try. My wife says when I sleep on my back my snoring is HORRIBLE, and I gasp for air several times throughout the night.
But, what should I do to prepare so I actually sleep this time, as the last test hardly had me sleep at all.



Last edited by Steves396lt1 on Mon Feb 11, 2008 5:40 pm; edited 2 times in total

Steves396lt1 wrote:

I didnt have sleep apnea on my first try, but my doc thinks I do. I wasnt very comfortable at the sleep center on my first try. I could hardly sleep, as I was tossing and turning and the temperature was killing me, cold and hot.
Well tonight I go in for my second try. My wife says when I sleep on my back my snoring is HORRIBLE, and I gasp for air several times throughout the night.
But, what should I do to prepare so I actually sleep this time, as the last test hardly had me sleep at all.

Hi Steve,

Okay, some quick tips:

Avoid caffeine (coffee, tea, colas, chocolate) all day. Don't take any naps today.

Usually it's allowable to take personal items that might help you feel more comfortable. For example, your own pillows.

Tell the staff that you have difficulties, and ask them for any suggestions.

After the wires are attached, take some time to notice if anything is particularly uncomfortable. Sometimes the techs can make adjustments, for example, if something is pulling or pinching you.

Ask the staff if it's possible to adjust the temp to what you are used to at home.

Try to not worry - it's often enough if a person can get a few hours of sleep.

An overnight sleep study in a lab/clinic provides the most data. However, if you are not able to sleep at all, then you may be a candidate for an at-home sleep study and/or auto-titration.

** People who do not have sleep apnea sometimes have a condition named UARS (Upper Airway Resistance Syndrome).

Good luck to you. Please post back about how it goes.

Guest MJ

Thanks for the suggestions. I will definitely take my own pillow and comfortable pajamas. Temperature is hard, as here in Hawaii I sleep with the windows open, so it is outside air, usually in the low 70's. A/C can be the same temp, but will feel colder.

Steves396lt1 wrote:

  I will definitely take my own pillow and comfortable pajamas. ..A/C can be the same temp, but will feel colder.

better add your own blanket to the list too.

It is also allowable, from what I've been told. To take some tylenol or advil PM or even benedryl if it will make you drowsy. It does not effect the outcome of your study. If you fall asleep reading, then a book is an excellent idea. You can even bring your own music to listen to...Just some thoughts

Good luck and sweet dreams!

Thanks everyone. I leave in about 1 hour to go get this done.

Best of luck!

You will be amazed at how you feel in the morning once they get you "dialed in".

Well I got in bed by 9pm. The Doctor requested I be tested with the CPAP after 2 hours of sleep, dont know why. maybe because I was close to requiring the CPAP my first time in for a study. Well at 1130pm I was on the machine till 445 am. I didnt move, I was in the same position all night. Never done that before. The tech said the first two hours I was snoring really bad (he said he noticed some gasping etc), but he wouldnt go further into details with me. I felt rested this morning. Just about to have a cup of coffee, no 830 am.
So, I will make my follow up in 3 weeks to see my Doctor to go over whats next.

First off, right off the bat, when the doctor says you have OSA and need therapy make it clear that you want some say in what CPAP machine the TWO OF YOU AGREE on. You want a fully data capable CPAP and will NOT accept anything less than one that is fully data capable.

Bare bones straight CPAPs thru full data capable autoPAPS are all billed under one HCPCS code, E0601. As such they are all billed and reimbursed at that one HCPCS code rate. The ONLY one who benefits from a less than fully data capable CPAP is the local DME supplier and their profit margin. YOU (thru your insurance) are paying for your CPAP equipment so you SHOULD get the device you want and you DESERVE the device you want.

Bi-levels and STs, etc. are billed under an entirely different HCPCS code and I have no experience w/them. But if all you are going to need is a CPAP, then do NOT accept anything less than a fully data capable CPAP. You will eventually regret it if you allow them to foist off anything less on you.

Also insist that your equipment order specifically states: Nasal mask, Full Face mask, or Nasal Pillows mask of patient's choice. This ensures that you can try several masks, including a Full Face mask (sometimes they insist on a script specifying full face if the script just says mask, or will only provide the exact mask mentioned in the equipment order).

That limits the local DME supplier to only being able to supply you w/a Resmed S8 Elite, Resmed S8 AutoSet Vantage, Respironics M Series Pro w/C-Flex, Respironics M Series Auto w/C-Flex, Respironics M Series Auto w/A-Flex, Puritan Bennett GoodKnight 420G or Puritan Bennett GoodKnight 420E (the E is an auto).

Meanwhile, call your insurance company and ask what local DME CPAP suppliers they are contracted with. Hopefully you will have the option of more than one to choose from. You can then "shop" those your insurance is contracted w/to determine how liberal their mask exchange policy is, how comfortable they are going to be to work with and what FULLY DATA CAPABLE CPAP they will provide you with.

Ask your doctor for a copy of his dictated results report (about 1-2 pages each) from both your sleep evaluation AND your titration studies AS WELL AS a copy of the full data summary report w/condensed graphs (about 5-7 pages each) AND that he give you your equipment order (script) so that you can shop the various local DME suppliers to get the best "deal" and determine that you will feel most comfortable working with. These are all part of your medical records and you have a legal right to these copies under HIPAA if you are in the USA. Most patients don't think to ask for these reports so he may be taken by surprise but shouldn't give you any grief about giving you the copies. If he does just remind him of HIPAA.


_________________
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.

Thanks for information. I am in the military and the tests etc are paid for.My Doctor showed me my original tests, but when he said I was a mild case, I felt no need to get the documents. My next appointment with him I will get everything.

Okay , I have my results. I do have mild sleep apnea, and they have ordered me a CPAP. What data do you need for me to put in here, so we can discuss it, or help understand.
I have summary, cardio report, heart rate reportpressure level analysis, split night summary diagnostic and treatment charts.

As CrohnieToo pointed out, ask that a fully data capable machine be scripted.  These are machines that track your mask leakage and your nightly AHI in detail.  Ask your doctor to also script that you be able to view the data on the screens (more on that in a minute).

Some machines track only "compliance" data -- total blower hours and hours you used the machine -- this is of no help in fine-tuning your therapy to be the best it can be for you.  With a fully data capable machine you will be able to see if your mask is leaking too much while you sleep, which can contribute to higher AHI and poor rest.  You can also see your nightly AHI and the averages for 7 days and 30 days etc.  And just as (or more) importantly, your doctor can see these numbers and recommend any settings changes to improve your therapy.

When you are given your machine, ask to be shown how to see the leak and AHI each morning.  They are often hidden by default and providers do not unhide them unless instructed by the doctor.  Many a person has received a data capable machine only to go home and find out they can't see the numbers!

Also ask your doctor to script the mask as "patient's choice".  If you liked the mask you used at your titration, fine, but you may want the freedom to try on different masks and possibly choose another.  Mask type and fit, hose position, headgear are all different on various masks and you may prefer one configuration over another.  Often the doctor will script the mask you used at your titration with the assumption you like it.  If that happens your equipment provider is locked into giving you that one.  

A specific mask is not typically part of the prescription as above all the doctor would like you to be comfortable and therefore compliant with therapy.  So they are not usually averse to scripting "patient's choice" unless they have a good reason not to.

Blessings,
--pseudonym

EXCELLENT reply, Pseudonym!!!

Steve, I'm not ignoring your question about what info to post in this forum from your data report. Its just that there are others w/more experience I was hoping would respond to your question.

Lets try this: pick a part of the report you are most curious about and we'll explain or tell you we don't know about that one.

Heck, pick a couple you are most curious about and post them and if you have a specific question about them include that too.


_________________
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.

The doctor said a person will come to the house and set it up. I will ask that person about the machine. Are there any specific company names that work well?
The CPAP was at 9.0 cmH20, I had some sinus bradycardia, the AHI went from 35 without a mask down to the final of .9 with the Mask, I was in REM/Delta for 8.8% without a mask and 16.4% witha mask, and had up to 70 seconds without breathing several times. O2 saturation was lowest at 91% without a mask and 94 with mask.
I am not overweight, and the doctor talked of different surgery options, UPPP and I have already had 2 deviated septum surgerys, and have been on Hypertension meds for over a year.

Steves396lt1 wrote:

The doctor said a person will come to the house and set it up. I will ask that person about the machine. Are there any specific company names that work well?

If you wait until they come to your house to ask, you will get what they bring and have no options.  You should call this person now and ask what brands/models they carry.  I wish I had as now I am going through some hoops to get a "real" machine.