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Doctor wants new sleep study, what would you do?
#1
I have been insane with work and have read and kept up but not posted. Happy New Year to all.

My numbers have been so good that the doctor wants to have me do another sleep study to see if I need this machine. I am a little nervous about it, I hope I don't get the same thing as last time, telling me I need pressure 17 when I really needed only 6, and now down to 4 with low AHI in the 0. something or other. I told the doctor that if the guy makes me sleep on my back, I am leaving. That is what they made me do last time and I don't sleep on my back!!!!!

Any advice?

I am going to take all my stats with me for the doctor, for the past months, he is a pulmonary doctor/sleep specialist. I want him to know he is not dealing with a dumb person, I have connections and know better by you all!!!! Grin
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#2
(01-06-2015, 07:32 PM)Marnid2014 Wrote: I have been insane with work and have read and kept up but not posted. Happy New Year to all.

My numbers have been so good that the doctor wants to have me do another sleep study to see if I need this machine. I am a little nervous about it, I hope I don't get the same thing as last time, telling me I need pressure 17 when I really needed only 6, and now down to 4 with low AHI in the 0. something or other. I told the doctor that if the guy makes me sleep on my back, I am leaving. That is what they made me do last time and I don't sleep on my back!!!!!

Any advice?

I am going to take all my stats with me for the doctor, for the past months, he is a pulmonary doctor/sleep specialist. I want him to know he is not dealing with a dumb person, I have connections and know better by you all!!!! Grin

My 2 cents:

If your AHI is 0 at pressure of 4cm straight, then your sleep apnea severity has definitely reduced from a pressure of 6cm. It may be due to many factors like weight loss etc. Now you want to evaluate if you have eliminated apnea.

I am assuming you have plain vanilla Obstructive sleep apnea (OSA) and not the more complicated one (central, Cheyne Stokes etc.). In this case, a full in-lab PSG is an overkill and a waste of money. An at-home sleep study with a device like Resmed Apnea Link Plus may suffice. It will be much cheaper as well.

An even cheaper (and more durable) solution will be that you buy an overnight pulse oximeter (for example CMS50F). You can have one from one of the suppliers above for $130. You can use that to record your Spo2 level and see if it dips too much OR not. And good thing is, you can use it once a month/quarter/year to keep checking if you are still free of apnea.

If your apnea issues were more complex than straight OSA, then a PSG may be in order.

On a lighter note, you can use your connections and have your people call his people to discuss bidness. Smile
Started APAP 4-20, Closed range to 7.5-14, then straight 8.0 w/ Aflex 3
RDI always below 1. But sleep much much better at straight pressure.
Started on F10, Tried Quattro Air successfully. Finally settled on P10.
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#3
When was your last sleep study. And what is the stated goal of a new study.
INFORMATION ON APNEA BOARD FORUMS OR ON APNEABOARD.COM SHOULD NOT BE CONSIDERED AS MEDICAL ADVICE. ALWAYS SEEK THE ADVICE OF A PHYSICIAN BEFORE SEEKING TREATMENT FOR MEDICAL CONDITIONS, INCLUDING SLEEP APNEA. INFORMATION POSTED ON THE APNEA BOARD WEB SITE AND FORUMS ARE PERSONAL OPINION ONLY AND NOT NECESSARILY A STATEMENT OF FACT.
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#4
(01-06-2015, 09:12 PM)AshSF Wrote: An even cheaper (and more durable) solution will be that you buy an overnight pulse oximeter (for example CMS50F). You can have one from one of the suppliers above for $130. You can use that to record your Spo2 level and see if it dips too much OR not. And good thing is, you can use it once a month/quarter/year to keep checking if you are still free of apnea.

Hi Marnid2014,

The type of pulse oximeter which is wrist-mounted (with a finger sensor cup) is more comfortable and less likely to fall off the finger.

Some models have the ability to record multiple nights (sessions) before you need to download data, which can be a helpful feature.

I think Supplier #19 has a good reputation. (Link to Supplier List is given at top of all forum pages.)

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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#5
And you might want to MAXIMIZE your AHI during a sleep study if you are happy with your machine.

You can always choose not to use it if you don't really need it (much) but if the Doc decides you don't need it there goes any insurance support you have.

Just a strategy and the implications you might wish to consider.
Sweet Dreams,

HerbM
Sleep study AHI: 49 RDI: 60 -- APAP 10-11 w/AHI: 1.5 avg for 7-days (up due likely to hip replacement recovery)

"We can all breathe together or we will all suffocate alone."
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#6
Do you own your machine yet?

Are you looking to stop using CPAP completely? Are you feeling good with it? Have you tried sleeping without CPAP?

Have you done something like lose weight to cure your apnea?

Why did you start using CPAP to begin with?

While a pulsox may give you a good clue that you have apenea, it can never rule out apnea. You can have severe apnea and never show a glitch on a pulseox. Some people wake up enough to stop their apneas before their SpO2 drops. They'll have really poor sleep, but never have low SpO2.

If you do go for the test, be sure to talk to the sleep lab and get it clear that you won't be sleeping on your back.

Be sure to precertify that your insurance will pay for the test.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#7
Marnid - unless you have had massive weight loss (if you have simple OSA) and have also managed to tone your throat like crazy singing or playing the digeridoo, you are unlikely to be "cured" of SA. That you need lowered pressures is normal. If it has been several years in between tests, a check-up test is not out of order, especially when your numbers are good, but ask for an at-home test kit rather than a PSG in the lab if you can. Say that you don't sleep well in the lab and that unless he absolutely needs an EEG to measure CA (do you have CA at all?), an at home kit will reflect real-world results more accurately for you.
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#8
I lost about 30 lbs but then managed to "find" 10 of it when I got the shingles. I find that I am sleeping very well without it during the shingles outbreak, all through the night with none of the "starts" I used to have. My husband said I don't snore, and I feel rested when I wake up. I was having issues with the mask for a long time, itching nose and such, and the fit was giving me problems as well, but then I added the extra strap to the P-10 and that really made the mask secure. Without the strap, my numbers go up, (leaks) and then my AHI is higher but I am sure it's because it's not secure.

It's been a year, so I am not sure if I own the machine yet, it's under Medicare, not sure how long that is. Medicare will pay for the study, I hate to lose the machine if I need it, but on the other hand don't want to need it LOL. Kind of in the middle about this. I guess that the sleep study will tell if I do, then that is it. I am finding I am taking off the mask around 6:00 am every morning and sleeping without it very deeply for another 2 hours. Not sure what will happen here.
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#9
Medicare is usually 13 months rental. You might consider waiting that long. It would be bad to get a study, lose the machine, and then find you actually still need it. Or develop the need again due to weight, age, sickness, mystery reasons, etc.

I presume you simply stop getting billed for the machine at the end of the 13 months.
Get the free SleepyHead software here.
Useful links.
Click here for information on the main alternative to CPAP.
If it's midnight and a DME tells you it's dark outside, go and check it yourself.
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#10
THANKS!!! I did not know it was 13 months. I had my last sleep study January 2014, so I just cancelled the appt. and rescheduled for the end of March. I will own the machine then.

I would hate to not have it in case the study comes back negative and they take it away, and then find myself back with Apnea. The weight loss has given way to less medications as well, everything is changing.
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