So I had my first sleep study last night.   I think that reading about it beforehand on this forum was helpful. I didn't sleep very well, so I'm pretty tired today but oh well...  The attendant/nurse/tech person was great.  He endured all of my geeky questions.  This morning he showed me the software they use to monitor me.  It was pretty neat.

So I have a couple of questions.  My study hadn't been "scored" or whatever yet, but I asked him how many apneas I had.  In a 2 hour block he said I had about 43 apneas and hypoapneas.  Reading on here tells me that that means an AHI (?) of about 20.  How moderate or severe is that?  What can I expect, is it severe enough to require treatment?  He showed me the O2 blood level also.  In what I saw, it never dropped below the low 70s.  

Thanks in advance for the replies...

--Matt

Hi mundele and welcome!

http://apneasupport.org/viewtopic.php?t=2344  is a link to a "Sticky" thread at the top of this forum, it explains sleep study terms, you might take a look so you have a better understanding of your sleep study report and scoring when you see it.

An AHI of 5-15 is considered mild apnea, 15-30 moderate, 30 and up severe.  For that small block of time your apnea will probably be scored moderate, although your overall might be 'mild' based on entire night.  Some people are 'even' throughout the night, others experience more events when in a certain position (sleep on back is the most common, some of us have more events on our sides).  Also some people experience more events at a certain stage of sleep (most common is REM and/or deep sleep stages, some of us experience more events during falling asleep and waking).

Be sure to get a copy of your full, detailed sleep study report (about 5-6 pages with graphs) and not just the 1 or 2 page summary written by the doctor.  In the US at least, you have a right to a copy of the detailed report and it can provide helpful information.

You will likely be scheduled for another overnight study using CPAP.

When you get the detailed report, if you have questions you can post it here and someone can give you a hand intrepreting it.  Keep in mind almost no one here is in the medical profession (there are a couple of respiratory therapists that help out, also a dentist with SA! LOL).   Even though it will just be opinion, many people here can offer you some insight or questions to ask your doctor.

Best of luck to you, Blessings,
--pseudonym

You had a great tech! It IS fascinating seeing what the data they collect looks like during your sleep evaluation! Eh, 43 apnea/hypopneas over 8 hours would give an AHI high enough to qualify as at least mild OSA. So, yeah, you most likely qualify for CPAP therapy.

Be glad your 02 saturations didn't drop any lower than the 70s! The 70s is NOT good! Of course, how long and how often you got that low is even more important. Understand that 02 saturation below 90% is NOT good. Again, how long and how often one's 02 saturation drops below 90% is the greatest interest and concern. So, 70% was NOT a good thing to have happen and enforces the need for CPAP therapy.

Now is the time to check out the various CPAPs available and decide which ones you are most interested in. Now is the time to call your insurance company and find out what local DME CPAP suppliers they are contracted with. Now is the time to ask your insurance company just what your DME benefits are. Now is the time to visit the various local DME suppliers your insurance company is contracted with (hopefully MORE THAN ONE!) to get a feel for how well you might like working w/them, how helpful they will be, how lenient their mask exchange policy is, etc. Now is the time to request a copy of the sleep doctor's dictated results (about 1-2 pages) AND of the full scored data summary report w/condensed graphs (5+ pages) from your sleep evaluation study.

Hopefully your sleep doctor is as good and informative as your sleep tech and will go over your sleep evaluation results w/you and answer any question or will have one of the sleep lab staff go over them w/you and answer any questions.

If you were interested enough to search for and find this and perhaps other OSA support forums, you most likely are NOT going to be satisfied w/anything other than a full data capable CPAP. There are bare-bones CPAPs not even capable of providing compatability data (how many hours and how often you use your CPAP) and THEN there are the fully data capable CPAPs which I'm willing to be are the only ones that are going to satisfy you and your curiosity and interest in your own health care.

In order of importance: 1] the proper CPAP pressure for YOU, 2] the most comfortable, leak free mask for YOU, 3] a fully data capable CPAP.

Check out the Equipment Pricing Guide link provided here. Read thru the information provided on the various CPAPs. Some of the online DME suppliers even let you prepare an individualized CPAP comparison chart w/just the CPAPs that are of interest to you. You can print it out for future reference and even go over the pros and cons of each model that interests you w/your sleep doctor. I would make it clear that I would NOT accept ANY equipment until the doctor and I had MUTUALLY agreed on which CPAP he would order for me. I did that by both telling my sleep tech the night of my titration AND ALSO putting it in writing right on the paperwork I had to fill out the night of my titration study as added insurance.

The only two manufacturers providing fully data capable straight CPAPS are the two leaders in the CPAP therapy field: Resmed and Respironics. In fully data capable autoPAPs, Puritan Bennett has one model, Resmed one model and Respironics two models. DeVilBiss has come out w/an intriguing, attractive xPAP, the DeVilBiss IntelliPAP - but - so far they've only PROMISED software will be available and are not providing information on just what data that xPAP will provide so I wouldn't give it any consideration at this time despite DeVilBiss does make a good device (one of the IntelliPAP modesl is a straight CPAP, the other an autoPAP which is why I used the term xPAP).

Now is the time to gain an understanding of how insurances and local DME suppliers interact and do business w/each other. First off, there will be a BILLED amount. That amount is a pipe dream. Then there is the ALLOWED amount. This is the first amount that matters. Then there is the CONTRACTED or PAID amount after which there may be a COPAY amount if your insurance doesn't pay 100% (and most don't). The copay amount, of course, is going to be the one you are the most interested in as that will be coming out of YOUR pocket.

Most all insurances pay for DME equipment by HCPCS code. When it comes to xPAPs, both straight CPAPs and autoPAPs care reimbursed by the SAME ONE HCPCS code: E0601. The reimbursement amount is the contracted amount and it is the same for a bare-bones, compliance data only CPAP as it is for a fully data capable autoPAP. In your search on the various xPAPs you will have noticed a difference in price levels between the straight CPAPs and the autoPAPs. So you can see that the local DME suppliers make more profit if they provide you w/a bare-bones, compliance data only CPAP than if they provide you w/a fully data capable autoPAP. The middle road, and the easiest one to negotiate, is a fully data capable CPAP. But not necessarily the only option for you. That depends on your diplomacy, firmness and tact, your sleep doctor's willingness to support your choices of which xPAP you want and how badly the local DME supplier wants your business.

Also understand that Resmed, Respironics and Fisher & Paykel, the leading mask manufacturers will ALL replace FREE to the local DME supplier most any of their masks that a patient had taken home and tried and been unsuccessful w/as long as the DME supplier fills out a form and returns them w/in 30 DAYS. That 30 days is the key. Not just for exchanging a mask but also for ensuring that you get THE xPAP you want. The easiest thing, of course, is to get the RIGHT machine right from the get go because DME suppliers can not sell a used machine as a new machine.

Most insurances pay for all CPAP equipment up front at time of delivery EXCEPT the CPAP machine itself. Usually, there is some rental time involved w/the CPAP device. It may be anywhere from 1 month to 13 months rental before the CPAP is paid in full and becomes entirely your property. Most CPAPs come w/a 2 year warranty and most insurance companies won't purchase a new CPAP device more than once every 5 years, some will purchase a new one ONLY when the original is proven to be beyond repair. (And many CPAPs last as long as 10 years and even longer, they are pretty much well-built devices).

All of this "homework" should keep you busy until your titration study. Ah, AFTER your titration study you will want to be sure to ask for a copy of the doctor's dictated results, the full scored data summary report w/condensed graphs from the titration study AND the original of your equipment order (script) so that you may shop the various local DME suppliers yourself before committing to purchase from one of them. (Keep copies of these yourself and ONLY provide copies of the copies to the local DME supplier).

One last comment: autoPAPs are nice, they can be used in straight CPAP mode or in auto mode. In auto mode they can be used as an at-home titration device to "tweak" your pressure needs if necessary. BUT don't get hung up on getting an autoPAP over a fully data capable CPAP. You don't get any better therapy w/one over the other. You can also "tweak" your pressure if needed w/a fully data capable CPAP, just not quite as easily or fast. The key is the full data capability so your doctor has the data needed to determine what problems you may be having and what changes in therapy settings might be needed. If he doesn't have that data he can only make necessary changes by guess and by gosh or via another expensive in-lab sleep study.


_________________
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's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.

CrohnieToo wrote:

Eh, 43 apnea/hypopneas over 8 hours would give an AHI high enough to qualify as at least mild OSA. So, yeah, you most likely qualify for CPAP therapy.

It was 43 for 2 hours.  Thanks for hte awesome reply. it's gonna take some time to digest all of this.  I appreciate it!!

--Matt

I am a bit confused about what I need to do next. I've not been told that I need a CPAP... yet.  If/when I am told I need one, what is the procedure for getting one?  Does the Dr. specify what model of machine I need and I just go pick it up, or do I have say in the matter?  What kind of timeframe am I looking at?  I know I'll have to have another sleep study, but does that mean I'll need to wait until that is done before investigating machines?

--Matt

Yep, you'll need an in-lab titration study before a script for CPAP therapy is made. I've outlined what you can be doing [b]NOW[/] until that titration study in my post above. It varies from lab to lab how much time is involved before you get your results and are scheduled for the 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's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.

I'm spending time reading through your very helpful post.  Thanks again for the information.    I was reading the recommendation for the data capable CPAP, and I have a question.  You mentioned how you wrote on the form you signed before the titration study that you wanted to mutually agree with your doctor on a CPAP machine prior to ordering it.  I had the impression that I would be contacted and talk to the doctor prior to a titration study.  Is this generally the way it happens, or will the sleep center call me back before I get to talk to the Doc?

thanks again for your help...

--Matt

Still no word from the sleep center but I got an envelope from the sleep dr. with a bunch of forms to fill out and bring to my appointment, which they scheduled without even talking to me and is 2 months away.  I hate to have to wait that long.

Question:  Will the sleep center release the results to me directly if I ask?

--Matt

Procedures vary from sleep lab to sleep lab. The only way you will know what to expect in what order and when is to ask your sleep lab.

The sleep lab has no choice. Given the HIPAA law they have to provide you w/the copies. They are part of your medical records. However, they can elect to drag their feet providing them and they can charge you a "reasonable fee" for the copies. And they can try playing ignorant of just what you are requesting with the full scored data summary report w/condensed graphs. If they stall or give you any argument about providng the copies send a written request via Certified Mail, Return Receipt Requested. That generally gets their attention and they are aware that you now have PROOF of your request.

Frankly, I would be surprised if you have any real difficulty getting copies of those reports given your experience w/this sleep lab so far.

Rather than just passively wait for that appointment two months away, call them and ask to be put on their cancellation list. And then continue to call every couple of days to see where you are on the cancellation list. Often rather than scheduling the first person at the top of the cancellation list if you call shortly after a cancellation they will schedule you rather than call thru the cancellation list to find someone willing and able to take that cancellation slot.


_________________
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's new VPAP Auto. Humidaire 3i, Simplicity & Micro mask, ResScan 3.4 software, SPO 7500 oximeter.

Got results back...  See my other post:
http://www.apneasupport.org/viewtopic.php?t=16183

Newbie here.  It takes forever to get an appointment for a sleep study.  I am not sleeping at all and I work full time. I can hardly stay awake during the day at work.  I am so glad to have found this forum.

The reason for the sleep study is that I was sleepwalking.  I was even baking cookies in my sleep.  Finally I fell while sleeping and cut myself.  I don't remember it.  I just saw my arm had been bleeding.  I called the doctor the next day.

Hi Dixiepeep,

Were they chocolate chip cookies???  

Hope you get your sleep study soon.  Let us know how things go.  
I've heard of sleepwalking (I did that as a kid).  I've heard of sleep hitting/punching.  I've recently heard of sleep eating.  Haven't heard of sleep cooking.  
But hurting yourself, that's bad.  Hope they can get you into a sleep study soon.

And welcome to our forum!  
You might want to start a new topic for yourself, either in this sleep study section or the main Sleep Apnea Help section.  I'm sure others would like hearing about your experience.  And maybe there are others out there going through the same thing.
Welcome aboard!


Linda


_________________
Click here for link to FAQ and topics
Click here for link to section on machines and masks

The cookies were good.  My husband was up when I made them.  He did not know I was sleep walking.  He said that I talked normally but that I was extra nice so he wondered what was up. lol

I fell somewhere and cut my arm. I must have landed on my tailbone because it hurt for a month.  I have also ate food while asleep.  The next morning I see the mess I have made as evidence.
Thanks for you input. :)

Dixiepeep,

Your description of your husband is funny.

Actually, I do remember sleep-making-coffee!

When I was a kid I wanted to be grown up like my mother.  She let me have coffee, but in truth I just watered it down with a LOT of milk and sugar.  It hardly resembled coffee.
Well, one time I was sleepwalking.  I walked out to the kitchen, grabbed a cup, went into the fridge for the milk and proceeded preparations of making coffee (we used instant at the time).  The only reason I remember it is because my mother had been watching and in her attempt to get me to go back to bed, I guess I started to wake up out of it a little, enough to remember the end of it later.  Of course, I'm sure my mother later described the episode to me.  I'm told once I was sleepwalking and apparently had crawled up onto a dresser and curled up to sleep.  I didn't remember any of that.

Now, if there were a thing like sleep cleaning, my apartment might actually look decent!  


Linda


_________________
Click here for link to FAQ and topics
Click here for link to section on machines and masks