I have been able to get my wife to undertake a home sleep study and I am wondering what the normal / best way for things to progress from here is?
We live in Newcastle Australia. Our fairly young GP has not encountered sleep Aponea in a patient before and has refereed my wife to a common sleep centres chain for an in home sleep study.
The study identified,
- RDI 26.9/hr
- AHI 26/hr
- "Hypopnoeas and OSA were severe during supine sleep (AHI 79/hr)"
- "Respiratory related arousal per hour were 19hr"
- "Oxygen nadir 86% and De-saturation event index 11.8/hr"
- Epworth Sleepiness score (11/24)
- Average heart rate 80bpm.
We were advised by the sleep clinic lady (who was not a sleep doctor) that we should look into a CPAP machine and made a booking for a trial. I asked about other treatments and investigating the root cause of the problem and she said in a roundabout way that a mouthpiece and losing weight would help but not enough and that the root cause wasn’t all that relevant as the treatment would likely be a CPAP regardless. She also stated a few times that CPAP was “The gold standard” in treatment (it kind of reminded me of fancy dish washing tablets). We went back to our GP who said to do the trial and recommend that my wife have a consultation with a sleep specialist prior to buying a CPAP machine.
We found out that our local chemist has people trained to do home sleep studies and CPAP trials etc. We started a trail of a machine through the chemist as they were more convenient and appeared to offer the same service as the sleep centre. Unlike the sleep centre the chemist does not have a sleep doctor on staff but refers their clients back to their GP to get a referral if they discover anything that requires further investigation (their sleep study results are reviewed by a sleep doctor at their head office in another state).
Last night was the first night of the trial and it appears to have gone well. The machine reports that last night’s AHI was 2. My wife says that the only thing different was that she has a sore nose. I have observed that her general mood appears better than normal and she has not mentioned that she is tired or fatigued in any way (normally it will come up in conversation that she is still tired).
What is a typical pathway from here? I got the distinct impression from the lady at the sleep centre was that you try a machine and if it helps you, you buy it and happy days. The chemist was much the same. This largely sounds like what I have read online too. Our GPs advice about a consultation with a specialist before buying a machine sounds good and conservative but contradicts the general impression I am getting about Sleep Aponea treatment. Also I read online that people get a “prescription” for a machine, but here we are without a prescription trailing an automatic machine set with “typical” settings by the chemist lady as the sleep study did not state any recommended settings. I think the machine is set to work between 4 and 20.
In regards to buying a machine I am finding it’s not like buying a telly. There is not a lot of information about the machines available and the information I am finding is either directed at healthcare professionals or is just full of incoherent marketing spin. Also only a few places appear to be advertising their prices and some appear to want to see a prescription first before discussing machines. We are trialling a Philips “DreamStation Auto CPAPHumHT” I believe that the unit has a heated humidifier and a heated tube. I believe that this is a high end machine and that the chemist is asking $2400(they will even credit us the trial costs off the price if we buy the machine). The chemist also has a very reasonable payment plan. If the machine works for my wife, has all the features we would want and isn’t overpriced I would be happy buy the machine and not bother shopping around). Is this a good machine and is the price right? Are there any other features or considerations that we should take into consideration?
This machine has Bluetooth and the app on the phone tells you how many hours of sleep you got and your AHI. There is also an optional Wi-Fi gadget that appears to send your data back to Philips for review and they will advise you if they see anything odd (although the brochures didn’t really explain what the Wi-Fi did). I noticed that there is third party SD card software available online to read the SD cards. Being technically minded I would be quite happy to help my wife review the data on the card and make adjustments where necessary in the long term. What is a typical process for reviewing the treatment and the machines settings? Is it beneficial to manage this ourselves or just go back to the specialist periodically. Also how often do people retake the home sleep studies? I believe that Medicare will cover one every 12 months.
I know this is a long post; any help comment or suggestions would be greatly appreciated to help get this sorted out and my wife some well-earned sleep :-)