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My Sleep Studies This Year
#1
I have been on CPAP therapy since 2011. To make a long story short, my sleep was fragmented and I woke up a lot. Mask issues persisted. In the first sleep study, I was put on a Quattro FX size Medium. CPAP therapy was not working well even though I NEVER slept without the machine. So, the DME switched me to a Quattro FX Large and things got worse from there. Then, over time, the new DME got me a small headgear and small cushion. There was some improvement but not enough. Fragmented sleep, daytime sleepiness and other things continued to plague me.

In October 2013, my primary doc ordered a consultation and another sleep study. Went for the consultation and the doc told me that if I got to pressure 14 that he was going to have the lab try me on BIPAP. Well, went to the sleep lab and had a hard time going to sleep. I slept a total of 2.9 hours that night. When I reached pressure level of 14, the tech kept raising the level rather than switching me to BIPAP and I was only at the "optimal pressure" for 29.5 minutes and they determined that I should be a pressure level 16. Went back to the doc for results. He was NOT one to listen and even the info from my 2 visits were not correct and I am in the process of getting it corrected. The office manager said that he types into an IPAD during the visit but I can say, the doc never did this while I was in the exam room. At any rate, the sleep lab blamed the doc for not switching me to BIPAP and the doc said blamed me. I fired him.

Fragmented sleep, daytime sleepiness, etc. continued to plague me so I found another doc (a pulmonologist and certified sleep doc) and crapola, he listened to me! He said that he wanted another sleep study done on BIPAP only because he felt like I might be having trouble with handling higher pressure. I was also concerned because my pressure was at the upper end of what the machine could provide.

So, met with the lab manager 2 weeks prior to find a good mask so I had time to adjust to it before the sleep study. I chose the wisp nasal mask (the first time I had ever used anything but a FFM). I needed a chin strap which the sleep lab manager provided for me. So, I was pretty comfortable with the mask and chin strap and had found the fittings for the head gear and chin strap where they were not too tight and the results were good. Pressure was lower, leaks were lower, fragmented sleep and daytime sleepiness was still there but rather than 6 or more times per night, it might be 3 times. And, I felt like part of the issues had been addressed.

So, off to the sleep lab last night for the BIPAP study. I thought I had a lot of leads, etc. during my other 2 sleep studies but not like I had last night! I had things on my throat, all over my face, eyes, etc. in my scalp......just everywhere. I was happy that they were monitoring everything that they could and felt confident this was going to be better than the other 2 studies (and this was after finding a dead roach in the bathroom and thinking they might be in the sleeping area too and hoping that I didn't have nightmares about that roach lol). The lab tech had to really work hard to get the chin strap and head gear on over the leads on my scalp and I couldn't do much to help because I was already laying in the bed. Then he turned the BIPAP on. It was a really strange feeling at first but I must have adjusted to it okay. I have not ever slept well during any of my sleep studies.

So, he said to sleep in whatever position I wanted to but if I started out in any position other than on my back, he would come in and have me lay on my back. I tried to sleep on my side but couldn't go to sleep. Flipped to my back and the next thing I know, I was out like a light. The tech said that he hooked up his next patient and came to check on my and I was on my back and out. Lights out were about 10:45 PM. I kept waking up during the night but went right back to sleep. The next thing I remember is that I woke up and couldn't go back to sleep. I looked at the time and it was 4 AM!! I couldn't go back to sleep so I asked the tech if he had enough info for me to be able to get unhooked and go home (they wake people up at 5 AM there). He said yes.

We started out at 14/8. He said that he only had to raise me 1 point during the night and that for 2 1/2 hours at that pressure, I had NO events and that my O2 was perfect. He said at one time, he detected a small mouth leak so I definitely need the chin strap. He said that he felt as though the new wisp nasal mask and chin strap and the BIPAP worked very well for me. I cannot remember ever sleeping that long without becoming fully awake and sometimes getting out of bed at home. I did cough several times during the night. I did wake up with a headache and noticed that my fingers were puffy. I also had a little bleeding on my scalp where I presume a lead was. BUT, I slept straight through. I am very happy!! Sorry this is so long. Hope I didn't bore you all.

Those that use a BIPAP, just wondering if you ever, at the beginning of using BIPAP, woke up with a headache and puffy fingers.
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#2
Thanks for the update me50. It sounds really encouraging. You have had a long journey already. Hopefully this will lead to positive therapy for you. It sounds like you had a good sleep lab last night.

I had a lot of leads during both of my sleep studies. Each side of the eyes, each side of my jaw, a microphone on my throat, a bunch of leads all over my head, one on each of my legs, two belts around my torso, oximeter on my finger and during the first sleep study little tubes in my nose and one in my mouth to measure respiration (I think they said). I seem to recall the tech told me 17 monitors in all. I'm not positive of 17 but it sticks in my mind. I remember thinking the little electronic box sure looked to have a lot more wires hooked into it. I think back and not sure how they could fit 17 leads on me. Maybe the total included the microphone, oximeter, and heart monitors on my torso.

It sure can be frustrating when doctors won't listen. Sounds like you have a good one now. Good luck moving forward with your therapy.
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#3
Thanks ImaSurvivor. I had a lead on my throat but I don't know if there was a microphone or not. I am greatful I didn't have tubes in my nose and mouth! I do think the tech did an exceptional job. He listened to my concerns, what was going on, thanked me for having my chin strap and nasal mask tried and adjusted to prior to the sleep study so he could do everything he could do to find out what therapy and pressure was right for me! I never thought I would say that I had a successful sleep study and sleep in a lab but I feel I did. Not sure what caused the headache and puffy fingers but feel that it was a very successful night. Now just need to see what my insurance will do about the machine I have now and replacing it with the Bipap machine. The lab tech told me that with a Bipap that it adjusts to every breath which the CPAP auto does not (at least that is what I think he said lol)
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#4
I've been on bilevel (bipap / vpap / whatever) for many years now. I know that in the beginning the air flow change from low to high, low to high - made me do things like count, and try to see if I could 'race' the machine, and stuff like that, but it got 'rid' of my headaches, and finger issues, well, I have always had them, but due to OA so I can't comment on that question.
*I* am not a DOCTOR or any type of Health Care Professional.  My thoughts/suggestions/ideas are strictly only my opinions.

"Only two defining forces have ever offered to die for you. Jesus Christ and the American Soldier. One died for your Soul, the other for your Freedom."
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#5
I think the tubes in my nose and mouth bothered me more than the monitors. They were much shorter than tubes used for oxygen given in a hospital. The one in my mouth made my lip constantly wet. Very irritating! I recall thinking that I didn't know how they could monitor anything through the mouth tube. With my mouth closed it was short and abutted the inside of my upper lip and seemed to me it would block any respiration moving through it. When awake I had to work at maneuvering it away from my inside lip and figured it was their problem after I was asleep if it settled back against the lip. I was hooked up with everything at least an hour before lights out and then they came in and turned on the box to start recording when they turned lights out. The mouth and nose tubes were only done with my polysomnography study (my diagnostic study). During the titration sleep study I didn't have it because they had me on a CPAP.

I didn't have a clock in my room. I feel like that is deliberate. I did have my cell phone and iPad. I didn't check them at all for time after recording started. Would have been a struggle to reach them all wired up on a chair next to the bed and I knew I was being watched by the cameras. Just didn't feel like I should be looking at my devices during the study. I got a questionnaire the next morning asking me how long it took me to get to sleep, how long I slept, how many times I woke up, etc. Not knowing the time through the night I had no clue and just guessed. I think that is a test too to see what the patient's perspective is of the timeline of sleep.

The tech told me it was a microphone on my throat both times. When removed, the tape used left red welts on my neck for a couple days. Ouch!

Sounds like you had a top notch sleep lab, technician and even doctor that sent you there. Good Luck!!
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#6
(12-13-2013, 10:05 AM)Peter_C Wrote: I've been on bilevel (bipap / vpap / whatever) for many years now. I know that in the beginning the air flow change from low to high, low to high - made me do things like count, and try to see if I could 'race' the machine, and stuff like that, but it got 'rid' of my headaches, and finger issues, well, I have always had them, but due to OA so I can't comment on that question.

is finger puffiness a side effect so to speak of OA? Thanks for your info. You are very helpful all the time.
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#7
(12-13-2013, 10:09 AM)ImaSurvivor Wrote: I think the tubes in my nose and mouth bothered me more than the monitors. They were much shorter than tubes used for oxygen given in a hospital. The one in my mouth made my lip constantly wet. Very irritating! I recall thinking that I didn't know how they could monitor anything through the mouth tube. With my mouth closed it was short and abutted the inside of my upper lip and seemed to me it would block any respiration moving through it. When awake I had to work at maneuvering it away from my inside lip and figured it was their problem after I was asleep if it settled back against the lip. I was hooked up with everything at least an hour before lights out and then they came in and turned on the box to start recording when they turned lights out. The mouth and nose tubes were only done with my polysomnography study (my diagnostic study). During the titration sleep study I didn't have it because they had me on a CPAP.

I didn't have a clock in my room. I feel like that is deliberate. I did have my cell phone and iPad. I didn't check them at all for time after recording started. Would have been a struggle to reach them all wired up on a chair next to the bed and I knew I was being watched by the cameras. Just didn't feel like I should be looking at my devices during the study. I got a questionnaire the next morning asking me how long it took me to get to sleep, how long I slept, how many times I woke up, etc. Not knowing the time through the night I had no clue and just guessed. I think that is a test too to see what the patient's perspective is of the timeline of sleep.

The tech told me it was a microphone on my throat both times. When removed, the tape used left red welts on my neck for a couple days. Ouch!

Sounds like you had a top notch sleep lab, technician and even doctor that sent you there. Good Luck!!

it was a great sleep study. I know I didn't budge all night once I went to sleep, even when I woke up several times during the night (I went back to sleep) and the tech confirmed I didn't move all night other than when I turned over. I only looked at my smart phone once and was shocked to see that it was 4 AM! I got to the lab at 9 PM and had a lot of paper work to fill out and then got hooked up. It was close to 11 PM when all that was done so lights out were immediate. I had 2 books to read to get me to sleep but with no light on, I couldn't read and I feel like that was advantageous because it made me do whatever I could to get to sleep. I couldn't fall asleep on my side like I do at home so I flipped over on my back and feel asleep fast. I am very happy how it turned out last night. Thanks for your encouragement. I am sleepy right now lol
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#8
A toast to getting up on the 'right side of the CPAP' Smile Glad for you!
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#9
(12-13-2013, 10:52 AM)ImaSurvivor Wrote: A toast to getting up on the 'right side of the CPAP' Smile Glad for you!

I think I deserve a trip to Vegas because of this successful study!! I want to ride the roller coaster!! Think I will be asking for that! lol
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#10
LoL ... the roller coasters are GREAT! I enjoy all these things with my daughter Big Grin My husband won't go near amusement rides. There is now a zip line ride under the canopy on Fremont Street. The world's largest ferris wheel is being constructed right now and scheduled to open in 2014. Is said to be 55 stories and taller than the Bellagio Casino. Is visible from all over the city. The spectacles never stop out there!! Looking forward to trying it out.
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