I'm currently undiagnosed, but due for a take home sleep study on September 13th, because on my student budget its all I can afford.
On many occasions I have noticed myself awakening with choking sensations and the inability to breath...but on many more occasions I've found myself suddenly wake up a few seconds after the onset of sleep not breathing (but also not choking), which leads me to believe that I may have either OSA, CSA, or both.

I know the only way to determine if one has CSA is an over night study at a sleep lab, but if OSA is ruled out after my take home test but my oxygen levels are low, would that mean that there's a possibility that I have CSA?

thedeadpoet it sure sounds like you have SA, but I think the qualms I have about the at home studies, is even if they determine you have SA and you are having Obstructive SA's how do they know you are not having Centrals also? and if you are,  CPAP and standard BiPAP might not be the proper treatment for that. If your O2 Sats are really low then I would think a regular sleep center sleep study would be the best way to go. Good Luck to You


_________________
White Beard with a White Beard
Resmed VPAP Adapt SV Enhanced, HumidAire 2i, ResLink with Model 8000 Flex sensor Pulse Oximeter, and ResScan 3.5 software. Respironic EverFlo OPI Oxygen Concentrator 3 lpm
EEP 9.0, min PS 6.0, max PS 16.0

White Beard wrote:

thedeadpoet it sure sounds like you have SA, but I think the qualms I have about the at home studies, is even if they determine you have SA and you are having Obstructive SA's how do they know you are not having Centrals also? and if you are,  CPAP and standard BiPAP might not be the proper treatment for that. If your O2 Sats are really low then I would think a regular sleep center sleep study would be the best way to go. Good Luck to You

Sometimes it doesnt matter because the home evaluation is being used as a screening tool. For instance, I had a similar experience as deadpoet and elected for the cheap home study. It revealed a normal RDI. Had it showed something, then I would have signed up for the sleep study at 10 times the cost.

Thanks RAM_Sleep if the home study is only being used as a screening tool I can understand its usefullness!  But I am still a little fuzzy  or confused about it,  is this used  just only as a screening tool? or do they use this to put people on CPAP for OSA?  And if so how do they know the person, isn't having Centrals, does this home study show that?  Oh an by the way RAM_Sleep haven't seen you around that much have you been on vacation?   Good to see your post!


_________________
White Beard with a White Beard
Resmed VPAP Adapt SV Enhanced, HumidAire 2i, ResLink with Model 8000 Flex sensor Pulse Oximeter, and ResScan 3.5 software. Respironic EverFlo OPI Oxygen Concentrator 3 lpm
EEP 9.0, min PS 6.0, max PS 16.0

White Beard wrote:

Thanks RAM_Sleep if the home study is only being used as a screening tool I can understand its usefullness!  But I am still a little fuzzy  or confused about it,  is this used  just only as a screening tool? or do they use this to put people on CPAP for OSA?  And if so how do they know the person, isn't having Centrals, does this home study show that?  Oh an by the way RAM_Sleep haven't seen you around that much have you been on vacation?   Good to see your post!

From what I have been told by a local DME, home studies can be used to diagnose OSA.

How do they know that the patients are not having centrals? I doubt that they do. I guess if they see that treatment (CPAP) is not helping, then they get them into a lab for a full PSG? Im not sure exactly how they handle it.

I have been on vacation and am still on vacation until Tuesday of next week. I went into work yesterday to fill out paperwork and meeting with physicians, but I only QC'd some studies from the previous weekend. Im working on my 3rd week off in a row, so its tough getting back into the swing of things.

RAM_Sleep wrote:

White Beard wrote:

Thanks RAM_Sleep if the home study is only being used as a screening tool I can understand its usefullness!  But I am still a little fuzzy  or confused about it,  is this used  just only as a screening tool? or do they use this to put people on CPAP for OSA?  And if so how do they know the person, isn't having Centrals, does this home study show that?  Oh an by the way RAM_Sleep haven't seen you around that much have you been on vacation?   Good to see your post!

From what I have been told by a local DME, home studies can be used to diagnose OSA.

How do they know that the patients are not having centrals? I doubt that they do. I guess if they see that treatment (CPAP) is not helping, then they get them into a lab for a full PSG? Im not sure exactly how they handle it.

I have been on vacation and am still on vacation until Tuesday of next week. I went into work yesterday to fill out paperwork and meeting with physicians, but I only QC'd some studies from the previous weekend. Im working on my 3rd week off in a row, so its tough getting back into the swing of things.

In a number of European countries Limited Home Studies are used to diagnose Sleep Apnoea and are followed up with 'Home' titration studies using APAPs. Not a perfect situation, but most European countries have very large Public Health Systems, long waiting lists etc., and the feeling is to get some form of diagnosis in place, get the patient on XPAP as soon as possible and then to follow up the case, with the more complex cases receiving the full overnight sleep study. Nothing is perfect, but at least it gets the ball rolling and treatment in place.

I believe that this method will increase in popularity, certainly with Public Sleep Clinics, as they are being swamped.

In Ireland DME suppliers will carry out Home Studies (on instruction from a sleep clinic, in selected cases) and return the data to the sleep clinic, who then arrange for a home titration study. The whole concept is controlled by the sleep clinic. It's pretty much on a trial basis at present and our health insurers will not cover the cost......at the moment .

Daniel


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The untreated Sleep Apnoea sufferer died quietly in his sleep.......
Unlike his three passengers who died screaming !!!!!!

(Anon)

I am a little late to this discussion thread but I wanted to weigh in on home testing.

Your referring physician, which could be your primary care physician or a sleep specialist, will know whether you have indications of obstructive sleep apnea. If so, the home test may very well be appropriate to diagnose OSA. There are benefits to being at home for your sleep study--comfort, cost (lots cheaper than a sleep lab)--and as long as OSA is the suspected problem, the home tests are completely appropriate. There have been many studies (sponsored by the manufacturers, granted, but still valid) that show how home testing results are just as accurate as a full attended Polysomnography. Once the results are scored and reviewed by the physician, they will know whether they feel comfortable to proceed to CPAP titration and treatment or whether indications suggest further testing in a sleep lab. That is where they would find central apnea or other conditions. Home testing devices are getting very sophisticated and can even provide indications of more complex sleep disorders, like RLS. You are exactly right about CSA, if the home device measures pulmonary readings that do not indicate snoring or choking but do indicate low PSAT or AHI incidents, then the physician will probably want more testing which insurance should cover. A lot of insurances cover home testing too.

FULL DISCLOSURE: I am associated with a company called SleepQuest which provides home sleep testing and CPAP treatment. Obviously I am more of a fan of home testing than the sleep lab, but for some patients the sleep lab is not necessary, home testing is not only adequate but even superior in terms of patient comfort.

I have read that the home studies do pretty well with OSA, but not with CSA.