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After being on CPAP a while, has anyone here ever had a second sleep-test done?
#1
After being on CPAP a while, has anyone here ever had a second sleep-test done?
Having a science background, I was surprised that I went out and spent a bunch of money, and significantly changed my sleeping culture, all based on one night's-worth of measurements! To be fair, there were also year's of observations by my wife of my snoring and periods of suspended breathing!

I was wondering if anyone here had submitted to more than one sleep test, perhaps before and after trialing CPAP, and whether the original results had been confirmed, or a change noted?
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#2
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
It's what happened in my case.  I first developed atrial fibrillation and had the usual battery of tests, all of which were negative.  Last assessment was a polysomnography which indicated that I do have apnea, and that it is rated as 'severe'.  I was issued a trail machine and a mask I felt I could live with, and went home. A month later, I had a second polysomnography, but this was to show adaptability/compliance and to finalize the prescription for pressure support.  So, the way it works for people with insurance, I guess, is that the insurer wants to see that there is going to be a minimum efficacy.
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#3
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
You have a lot of data available to you with your Airsense 10 Autoset and Sleepyhead. We rely on a sleep test to provide the initial diagnosis and motivate or qualify us to start therapy. I personally don't see the benefit of a follow up test unless the therapy is ineffective or there is some doubt as to whether residual apnea is central or obstructive, or using a therapy that does not provide therapeutic data, i.e. surgery, INSPIRE or a non-data recording CPAP.

I share your science background, and the curiosity to document problem, then solve it by applying tests that are evaluated for effectiveness. There is a lot of scientific method involved in the trial and error of PAP therapy. The more you learn about generalized responses and the exceptions, the better you can apply a broad spectrum of therapies to resolve the many individual permutations of the problem. That may involve a second polysomnography, but I think the need for that is fairly rare where we have data from modern xPAP machines.
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#4
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
I'm sure there is an odd scenario when a second sleep study is warranted. I think the latest generation of machines are so comprehensive in sleep data collection that a second lab evaluation is nearly, if not totally, impractical with the exception of the titration study for advanced bilevel machines.

It would be way out of the ordinary for a second study, like I tell my associates and clients, just when you think you've seen it all, something else comes along.
Jesse


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#5
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
I think the diagnosis of OSA is straightforward - it is not hard to determine if someone is struggling for air.
Titration study is different. It is very easy to see how the wrong conclusion can be reached.
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#6
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
Well I had 2 studies last year. Started APAP in August, two weeks later developed AFIB. Later in the year, had the second sleep study. Still felt like crap, but doctor said "you are doing good". So I dropped that doctor and went to another this year. Had 2 studies this year. Finally this doctor put me on Auto BIPAP to try. This helped much better then the "dumb" Auto-CPAP machine. But still I'm having some other issues which are being looked into by other doctors.

Moral of the story...if one doctor claims "you are doing good" and they just look at the AHI, but you still feel bad...Then go find another doctor for a second opinion. Or third opinion. I'm on the edge of going to a third doctor, since my current one only looks at the AHI summary and never the detailed graphs showing my breathing and other issues I've pointed out to him.
ResMed AirCurve 10 vAuto
Pressure EPAP min 4.4, IPAP 8.4, IPAP Max 18, PS 4.

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#7
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
I don't tolerate xPAP that well so I sleep more without my machine than with. I have had a few home sleep tests done so I  can monitor how well I am doing. I  get the tester over the weekend so I  can get a few nights of data each time. I am trying to reduce my sleep apnea as much as I  can and I find the feedback good for motivation.
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#8
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
I've had over 6 studies over 2 years, at 3 different doctors
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#9
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
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 :-(
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#10
RE: After being on CPAP a while, has anyone here ever had a second sleep-test done?
I am actually on my third sleep study. The first occurred after my first encounter with a sleep specialist to ascertain my pap settings. The second because I was switching providers and the new clinician was much better at the job. He was unhappy with the amount of data collected and wanted additional information. This was very helpful because he captured data allowing for the diagnosis and successful treatment of PLMDS (in addition to apnea) for several years. The most recent and third one occurred after being treated via CPAP was no longer clinically effective necessitating the move to a bipap.

So no, based on what I and others have experienced, it is pretty common. Plus, realistically speaking, our bodies are going to change over time and sometimes you need to refresh the data.

J
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