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After being on CPAP a while, has anyone here ever had a second sleep-test done?
#11
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
(06-14-2018, 07:02 PM)nathanoj Wrote: Thanks for your describing your experiences everyone. Mogy and Crowter - did your home tests studies generally agree with each other?

I see the point made by some of you that CPAP machines provide a wealth of data, so why the need for a home test? I think that home test studies can measure ECG which may confirm apparent clear airway events? AFAIK, CPAP machines can't be absolutely sure that CA's are 'real'. Ability to measure time spent in REM sleep is another feature of HTS's.

My home test study reported an obstructive index of 1.7, and centrals (clear airway) of zero, yet my Resmed regularly scores CA's > OA's. Which is correct, and how many Resmed CA's are real? That question made me ponder the usefulness of another home study.... but hiring the gear can be $100 a night :-(

I would say that the tests agree within plus or minus 5 AHI. Part of it depends on how much time you spend sleeping in different positions. On my back, as with most people, my sleep apnea is worse.
There is definitely some variation night to night. The last 2 tests I did, on successive nights, I got an AHI of 6.5 and 3.5. I posted the tests here:

http://www.apneaboard.com/forums/Thread-...nea?page=4

About the central apenas. With CPAP therapy you can have what is called 'treatment emergent' central sleep apnea. I went through it at the beginning of my CPAP journey. Quite often, as you get used to the treatment, the centrals/clear airways will diminish. I posted a bit of my experience in that same thread.
If the centrals do not diminish and you have enough of them, they call it 'Complex' Sleep Apnea.  So the CPAP reduces your OA but may increase you CA if you are one of the 'lucky' ones.
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#12
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
I got a sleep study done in October 2016. AHI was 38. Then immediately started with dreamstation auto cpap with 100% compliance. Never missed a day of therapy. Then got a sleep study done again in August 2017. AHI was 32. Now i am considering going in for a third sleep study sometime soon since i used otrivin nasal spray in last study.


Cpap is not a cure. Just keeps symptoms under control. If weight is the issue, reducing weight can lowrr your AHI. I am just 28 years old but have a short neck. Will never be able ti change that. I have to use it for lifetime now.
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#13
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
Yes, second sleep studies can be suggested, or in some cases may be required by the insurance to support a higher level of xPAP machine. An example is myself: I started on a CPAP and failed due to inability to breathe out as a noob. A failed compliance followed. I then went through weight loss surgery and its prep for the year 2016. BTW weight loss of 100 lbs. halved my overall AHI from 70+ to about 38, so weight loss can be a big issue. Pun not necessarily intended.

After the weight loss, I still had to pursue xPAP therapy, and I requested and was granted a sleep study to focus on BPAP. The qualifier was CPAP intolerant failure. A new sleep study required to satisfy insurance. Follow this with BPAP failure with Central Apnea scoring a 124 over the 24 obstructive on that new PSG, and the effects of centrals making therapy cause drastically worsening of fatigue, headaches, etc. Major loud complaints to the Duck from this patient triggered another sleep study for ASV, again without which my insurance would not approve leveling up to ASV.

Short version: new and/or secondary sleep studies may be required, and might be sometimes "suggested". That is even if the first might reveal the same info as a subsequent test, if the insurance is involved, you might be "forced" to obtain another PSG and/or titration.

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I'm not a doctor in real or fictional life. My posts include opinions based upon user experience regarding CPAP therapy and should not be considered medically professional direction or advice. Even a 1,000 mile trip requires a good first step. My recommended first steps include getting good walking shoes, 1 great cup of coffee, and a good GPS.

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#14
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
Wow - so many different journeys. Respect, y'all! :-o
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#15
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
(06-16-2018, 07:17 AM)arc0509 Wrote: I got a sleep study done in October 2016. AHI was 38. Then immediately started with dreamstation auto cpap with 100% compliance. Never missed a day of therapy. Then got a sleep study done again in August 2017. AHI was 32. Now i am considering going in for a third sleep study sometime soon since i used otrivin nasal spray in last study.


Cpap is not a cure. Just keeps symptoms under control. If weight is the issue, reducing weight can lowrr your AHI. I am just 28 years old but have a short neck. Will never be able ti change that. I have to use it for lifetime now.

I am confused by many of the responses. For example, was the second sleep study with pressure?  If it was then your treatment is terrible.  If it wasn't, what was the purpose of the second study?


Regarding the home sleep tests, can they be performed while using PAP?  I thought thy were only used to diagnose?

Thanks
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#16
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
Hi, 

Both the times my sleep study was done without any oressure. I guess by pressure you mean the titration part of the study where they put on cpap machine, adjusts and try out various pressures to find out the optimal one even while monitoring all the parameters.


The second time I had my study was because i just wanted to know the status of my sleep apnea. In first study i jad barely slept for an hour or so. So to confirm the first one's result or any changes therein I went in for a second one. Another reason for going in for the test was that i became so dependent on cpap that sleeping or napping for like even 15-20 minutes became impossible for me without my cpap machine which certainly wasn't the case when i got my first study done. So i wanted to know if it has gotten worse or something.



Neither of my studies was with any pressure or titration. I am not sure about how the ones at home is done and what type of device they use.


But if they are using pressure, they are probably doing a titration study to find the best possible pressure range based on the duration of  your sleep study done without any cpap machine/pressure..


You should read about titration. According to me, sleep study done in 2 nights i.e. first day without cpap and 2nd night with cpap must produce the most exact and accurate results. Same day titration are also done but then your whole night sleep pattern cannot be studied but just half.



Now coming to the point where you said my treatment is terrible, i had AHI of 32 in second study. With cpap hooked up at home, i normally have an AHI of around 5 which may occasionally spike. 


You must understand that sleep apnea is not like a viral fever for which you can take a medicine and it will disappear. Cpap is a symptomatic treatment only. It does not cure sleep apnea but helps in keeping its effect low.

Lot of factors are responsible for sleep apnea like short neck, genetics etc. These cannot be fixed. If you are having obstructive alneas because of obesity only then that can be fixed by reducing weight.

Since i have a short neck, doc says i cannot do much about it. So to keep AHI under control i use cpap. I am a bit overweight but two different doctors have told me that weight is not the issue with me.


I hope you get what i mean, if not then maybe i can help you further.Similarly, my mother had a AHI of 22 in first study in 2016 but it was 32 in second study in 2018. Although, with cpap her readings are much better than mine. She generally have AHI of around 3-3.5 even without full compliance and tons of leakages.
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#17
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
Thanks for the response. Glad to see that your AHI with treatment is reasonable.
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#18
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
It spikes sometimes. Yesterday had an AHI of 10. Ordered cervical collar from amazon today.
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#19
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
(06-16-2018, 03:11 PM)arc0509 Wrote: It spikes sometimes. Yesterday had an AHI of 10. Ordered cervical collar from amazon today.

Ouch.  Keep working on it. If the collar doesn't help, post some charts.
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