In an adjacent forum here I posted my experience going in and coming out.  Both were disappointing.

Sleep Testing Schedule for Wednesday Evening, but...

Comments Welcome.


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Thanks,
Roger...

Roger... wrote:

In an adjacent forum here I posted my experience going in and coming out.  Both were disappointing.

Sleep Testing Schedule for Wednesday Evening, but...

Comments Welcome.

Hi Roger,

I read your posts and was most disturbed by them, by what was happening to you.  I am only a sleep apneac like you, I'm no professional of any sort, but in my mind this is horrible.

I would strongly suggest that you find out who is the director of this sleep lab and talk directly to him/her.  Was this at a hospital?  If so, they should tell you who runs it.  If it's a matter of one inexperienced employee doing the wrong thing, then they should correct it.  You nor your insurance company should have to pay for such a sleep study, IMHO.  If it's a matter of unprofessionalism at the sleep study clinic, then well, there are more problems, aren't there.  Either way, you should not be made to suffer, financially and with delays.  

So did I read it right, they did not do the titration simply because this inexperienced technician felt you didn't need it?
I take it this was scheduled to be a split night study, with both the first testing part and then the titration, from what you've said.  
I also had the split night.  I've been told by one sleep lab director that the split night is not preferable, that at their lab they go by strict guidelines, of a minimum number of hours sleeping and I believe some other factors, factors which have to be satisfied before doing the titration.  Sometimes it takes all night for the patient to satisfy the requirements in order to get adequate results, and a second night for the titration is required.   If she had told you that, then it might be understandable.  But to say no titration because of no snoring?  Sheesh!  Wow.  My sleep study report was quite detailed and the technician could tell immediately following the first part if you have sufficient apnea to warrant titration.   The tech may not be writing the report (and typically it takes days for the report to get to the doctor), but they know right away from monitoring the computer if you've satisfied the criteria and have significant apneas.  I guess if there's some doubt, the doctor needs to make that determination.  Regardless, you need to see that report.

I would also get on the horn with your doctor about it, if you haven't already.  Perhaps he can intervene.  I don't know.

You said you had a sleep study years ago, was it at this same facility?
Which facility is it and do you know if it's accredited?  Not all, in fact maybe most, sleep labs are not accredited by the American Academy of Sleep Medicine.  I understand there are many great ones out there that are not accredited.  You can check, with the link below to search for sleep labs, but I didn't see one for San Jose.  If it is accredited and you continue to have major problems with them, I suggest you complain to the AASM, it couldn't hurt.  And even if they aren't accredited, it might be wise.  

http://www.sleepcenters.org/


Learning more and more about this, the issue of sleep labs is a concern of mine, borne out of interest more than anything else.  Guess it's just my soap box.  Again, I understand many labs are not accredited, and maybe this isn't necessary.  But I also understand that sleep labs are now expanding or are popping up everywhere because of the demand.  In my view, they should all hold to some professional standard, and an overview of that standard should be made available to the patient should they wish it.  There has to be guidelines.....if this, then do that, etc.  And maybe there are guidelines and they just aren't implementing them, or at least explaining them to us in ways we need to know.  

I'd be curious to know how things progress with you.  You are smart to ask the questions.  

Linda

Hello Linda,

Quote:

So did I read it right, they did not do the titration simply because this inexperienced technician felt you didn't need it?

I can only go by what the lady-technician mentioned as she pulled wires and hair:
After laying in bed awake for about a half hour I decided not to wait any longer for a restroom break.  I delayed the break hoping I could trick myself into getting some sleep on my back.  That did happen, so I called for a time out and went.
 
When I returned the lady said the study would be over at 6:00 AM, 20-minutes from my return, so I said we should begin the ending when I learned we wouldn’t do anything else.  She explained why she didn't come in to do the CPAP testing while she pulled the wires off.  Her words were, “I didn’t hear you snoring much at all and everything seem to look like a normal sleep period and didn’t see how a CPAP session would help.â€�  For certain the stuff I mentioned to the first technician didn’t get to her, or it didn’t sink in.  
 
With no help as a result, I didn't know what to think upon leaving.  When I got home, I showered, and went to bed to get some more sleep before writing today’s posting.  While I wrote that brief outline I kept wondering what am I missing.  I also began to wonder why this didn't go better and tried to review everything that transpired.  I’ve made some notes and will share them with the doctor in a fax later today.
 

Quote:

I take it this was scheduled to be a split night study, with both the first testing part and then the titration, from what you've said.

Yes - This is correct.  This was even confirmed by the more experienced technician when I was being wired.  At the beginning of the sleep study, he came in near the start with a mask that he said they would use.  I mentioned how it was blowing air into my eyes and he said he would go get a smaller mask and return.  He never came back and it wasn't long before the lights went out.
 

Quote:

You said you had a sleep study years ago, was it at this same facility?

No.  It wasn't far from this place, but I don't believe it was the same business.  In thinking back, that study did do a split night process, but again the mask was blowing air into my eyes causing them to water.  It was also a very noisy full-face mask that I didn't think I could handle hearing all night.  I don’t know if I got any sleep after the mask because they never gave me any report or even said how it went.
 
With no documentation, I’ve only got the memory of what I think happened back then.  At that time my doctor said the report indicated I was borderline for needing a machine.  She went on to say I might be able to get by with my side sleeping strategy I told her about.  It wasn’t long after that meeting that my doctor got pregnant and left the office.
 
Getting off my side has been my primary motivator for this recent study because of the damage I'm doing to my right hand.  I've now got nerve damage from having it in a position where it goes numb a lot during sleep.  A doctor who is treating me for the nerve damage said, “If I stop making it numb it could regenerate and be fine.â€�  Right now I have trouble using fingers 4 & 5, making a lot of task clumsy, like squeezing the brake on my motorcycle.
 

Quote:

Which facility is it and do you know if it's accredited?

Last night's clinic was SleepMed and they aren't listed on the accreditation link you posted.  My guess, they are not more than a service business with a lot of locations and an online store, and at least one unhappy customer.

There is a sleep clinic in Sunnyvale just a few more miles away that I’ll try if the doctor thinks it makes sense.

Thanks for the thoughtful reply.


_________________
Thanks,
Roger...

Hi Roger,

Thanks for the explanations.  I'm sure others may have some comments or questions.  

Whatever you do, always demand a copy of the sleep study report, even if it takes some time to get.  I got mine when I had my followup visit with the pulmonary doctor.  He went over the report with me and I got a copy.  It's your right to have this.  A graph should accompany it too.  Some doctors think you don't need to see that, that you won't understand it.  But get it, insist on a copy, IMHO.   It may be this lab you were at doesn't even produce them, don't know.

As for me, they tested me on whichever side I most slept in.  The mess of wires and such made it hard to even sleep on the side of my choice, but finally I did.  I laugh when I see the graph which shows a space of an hour when I was clearly awake, an hour I took trying to shift from one side to the other with all those wires!  lol

If you post some of your results here, there is some good help at interpreting the results.  You might read some of the other posts  here to get some idea.

Now that you've mentioned this sleep lab, I'm now even more curious about what forms of diagnostic care there is out there for people.  Thanks for explaining things more.  And keep us posted.  And good luck to you.

Nice avatar, btw!!  

Linda