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Do I really need Sleep Apnea Test in order to use CPAP machine?
#31
(12-20-2014, 11:33 PM)Sleeprider Wrote: For all the sleep study advocates, I had a sleep study that confirmed I had OSA but I did not tolerate the study (didn't sleep) and was prescribed an Auto titrating CPAP. The machine did the titration, just as Destin's has done. With the support of another forum, I learned to read and interpret the data and narrow the range of pressure to optimally treat my problem.

Destin, good for you getting this far. Your data do show the machine is working in auto mode to treat apnea events, and you are being treated at inhalation pressure ranging from 7 to 14.5 cmH2O, and have an exhale pressure relieve of 4 cmH2O. It looks like you could have been treated with an Autoset machine, but this seems to be working fine...especially if you feel good. Keep going and I'm sure you'll get lots of support here as you post results of data. If you have questions of what that data is showing you, ask. Looks like you're doing great.

Hi Sleeprider,
Welcome to the forum! Thanks for contributing to this thread!


Hi Destin,

Your choice of machine was perhaps more than needed, but excellent all the same.

ResMed has said the S9 VPAP Auto was their optimal machine to treat Obstructive Sleep Apnea (simple OSA uncomplicated by Central Sleep Apnea).

In my view, the summary data you posted indicate you do not have any significant amount of Central Sleep Apnea and the machine will be completely sufficient to treat your OSA. So, in my view, there is no need to have an in-lab or in-home sleep test unless required by a family doctor or sleep doctor before providing you with a prescription for the machine you already have (any medical doctor, not just a specialized sleep doctor, can provide the prescription) or unless treatment with your machine still leaves you with disrupted sleep and daytime fatigue, etc.

As Archangle has posted, a primary benefit of an in-lab overnight sleep study would be to find out what else is wrong, in case more besides Obstructive Sleep Apnea needs to be addressed. I think an in-home study provides much less data and I don't know how necessary or valuable it may be to you at this point.

I think an in-lab or in-home sleep test is unlikely to find anything more than simple OSA (it usually doesn't), but this doesn't mean it would be a waste of money, any more than having paid for Term Life Insurance last year would have been a waste of money since you didn't die last year. If you can afford it, it is appropriate and wise to have Life Insurance which will provide for your family when you no longer can, and having a Sleep Test may help save your life if it uncovers another condition needing attention. Is having a sleep test medically necessary, even if you have no insurance and the cost would be destructive? I think not, but only you and your doctor can make that decision.

At the very least, I suggest working with a family physician or sleep doctor (neurologist, usually) to obtain a prescription for your current machine.

In particular, I wouldn't get an in-home sleep test unless your doctor would require it (some doctors may simply accept the evidence provided by your current machine), and in any case I would research what sort of conditions the particular in-home sleep test would be able to diagnose. If the test results would not be able to do more than detect and distinguish between obstructive versus central sleep apnea, I wouldn't see any added value to having the in-home sleep test, since your machine already does that. If it would be able to detect heartbeat irregularities like Atrial Fibrillation then it may be valuable, but a basic cardiology "Holter monitor" test may do that better and more economically.

A danger which may be created by spending an unaffordable amount on an optional sleep test is that it may "croud out" spending on more important testing and treatment. For example, the money may be better spent to see a cardiologist and have basic tests taken to see if previously-untreated OSA has caused you to develop Atrial Fibrillation or some other condition which may need immediate treatment, such as blood thinners to prevent stroke, or high blood pressure meds or whatever.

Take care,
-- Vaughn



Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#32
(12-20-2014, 01:02 PM)Destin Wrote: Not sure if it anyone can read from the attachment, here is Review Statistic after 1st day.

Hi Destin,

By the way, after the first few days of CPAP treatment many find that a Minimum EPAP pressure of 4 cm H2O (your machine's default value) is uncomfortably low, making us feel as if we need to work slightly too hard to breathe.

EPAP is the low pressure the machine produces while we are exhaling. IPAP is the pressure the machine produces while we are inhaling. Pressure Support (PS) is the name for the amount of boost (pressure difference) added to EPAP to get IPAP.

Your present Pressure Support setting is 4.

I recommend requesting by email your machine's set-up manual (Clinician Guide), as described in the Important Threads section at the top of the forum. Lots of useful info in there, plus instructions on what the different settings mean and how to change the Clinical settings, like MIN EPAP, Max IPAP, and Pressure Support.

Be on the lookout for problems caused by high pressure. Most people don't have any problems worse than a moderate amount of air-swallowing, or noisy/bothersome leaks requiring an extended search for a better mask or use of a mask liner or nose protector gel pad. But if after stopping therapy, taking off the mask and trying to breathe normally you find have problems inflating your lungs normally, as if air pressure has built up in your chest and is stopping you from being able to inhale regularly, that could be very serious and would be a reason to investigate whether you have developed spontaneous pneumothorax. (I'm not talking about having sore chest muscles the first week, that is normal until our muscles build strength.)

Or if we develop dizziness from too much internal pressure in our ears. Or hearing loss or tinnitus. Or headaches or anything affecting our eyesight. There are rare but serious side affects sometimes which may make us unable to continue CPAP treatment, or which may make us need to limit or reduce the therapy pressure.

Take care,
--- Vaughn
Membership in the Advisory Member group should not be understood as in any way implying medical expertise or qualification for advising Sleep Apnea patients concerning their treatment. The Advisory Member group provides advice and suggestions to Apnea Board administrators and staff on matters concerning Apnea Board operation and administrative policies - not on matters concerning treatment for Sleep Apnea. I think it is now too late to change the name of the group but I think Voting Member group would perhaps have been a more descriptive name for the group.
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#33
Congratulations Destin! You have defied the system and bucked the odds most admirably! You even took the barrage of early criticism very well. I doubt I would have had the restraint you exercised. Wink These are all good folks and they mean only to help but the printed word can often come across the wrong way, especially if you are a newcomer. I can see that you remained cool through it all. Kudos for that!

You are one of the lucky ones that can tolerate the mask and air pressure right from the get go. Many people, including myself, had or will have a problem adjusting and accepting PAP therapy.

Since you have such great readings to show that your machine is doing a fine job, I wouldn't dare tell you to change anything. I will give you a little piece of advice that may help you someday later. That is to not pay much attention to short term readings and don't waste time and energy worrying about the fact that you will almost always have a few events reported. If your AHI is below 5 and you feel good, you don't need to stress out over a few remaining events. Bottom line: don't argue with feeling good. Feeling good and < 5 events is reward enough.

Sleep-well

All the best, Dude
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#34
Destin, I congratulate you. I am a big supporter of being in control of one's own health, even if it means diagnosing possible conditions based on informed research and observations. As far as I am concerned doctors are great as a 'second opinion' and it always pays to have done your own research and record keeping before going to see them. Nobody takes your health more seriously than you.
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#35
Resmed VPAP Auto it's not for central it is a bi level least that's what my doctor and the DME told me
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#36
Sleep studies are pretty cheap online. $200-$400. They give you the basic info on the severity of sleep apnea and they use the same equipment as a brick-and-mortar sleep lab. Home studies are good at 'ruling in' sleep apnea, but bad at 'ruling out' less severe cases.

If you really want to avoid doing an official sleep test, you could get a wireless pulse oximeter on Amazon, CMS-50 series, and see how your blood oxygen levels look throughout the nighttime. There have been plenty of studies showing strong agreement between pulseox sleep studies vs traditional home sleep tests. This will give you data, but won't get you much closer to a good treatment, because most doctors will ask for an official sleep study.
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