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Need advice about sleep study please
#1
Need advice about sleep study please
First off me say thanks to everyone for all the great information here.  Here is my situation...

Wife and I both are in mid 30, slightly overweight, and I'm hypertensive.  We both had been having trouble sleeping and exhibiting the symptoms of Sleep Apnea for some time.  My wife finally go fed up with being tired all the time and ended up with a home sleep study followed up by a titration.  Now she is sleeping great with a Dreamstation.  Myself, well last Sunday I was on about a 2 week bender of horrible interrupted sleep, and insomnia so she convinced me to let her hook her machine up to me and take a nap.  After a few minutes of adjusting to it I dozed off and slept great for the first time in weeks, if only for a few hours.  I have attached the graph from Sleepyhead below. Fast forward to Monday, I was talking with my parents about it and dad mentioned he had an old RemStar Auto machine i could have if i wanted.  So I got it, went and bought a mask and needed accessories and set it up like my wifes RX on her machine.  The last couple nights I have slept great and feel like a new person.  It is honestly a night and day difference.

Now to my dilemma.  I fast tracked a referral to a local sleep clinic and have an appt for a split study on 3/19.  Is using my "bootleg" setup going to have any detrimental effect on the official test?  Should I stop using the machine until after the test or continue using it.  I don't really want to do anything that will negatively effect the official test for obvious cost reasons.  I did not mention to the sleep doc about my health hacking and I figured he would not appreciate it and I'd get a lecture about it. Any insight would be great!


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#2
RE: Need advice about sleep study please
I'll add that since using the machine my AHI is generally 1.3 or so.  I presume that means it is working since it was over 19 for the time I napped.
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#3
RE: Need advice about sleep study please
Looking at your chart your min and or max pressure should be raised but I have no info to gauge to what or how much.
Please see the organize link in my signature. That is how you should organize your charts unless we ask for some additional charts.

There are a bunch of users here who manage their own apnea.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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
RE: Need advice about sleep study please
G'day discojon. Welcome to Apnea Board.

Congratulations on taking the initiative! The fact that you're using a machine at the moment won't affect your sleep study. Sleep apnea is not really curable - the machine will treat it, but if you don't use the machine you're straight back to square one. If your doctor gives you a hard time about trying the machine out first listen politely and ignore him.

I'm a strong advocate of a diagnostic sleep study (full polysomnogram with all 19 probes and electrodes). It will of course determine if you do have apnea; whether your apnea is central or obstructive or mixed; and quite a few other heart / lung / brain things which can be detected. I don't much like the concept of a titration study where the technician fiddles with the pressures to try and get "your pressure". A good autoset machine will allow you to self-titrate in the comfort of your own bed over a period of time, and will respond as your needs change.

Make sure you read this before you get set up for a machine: http://www.apneaboard.com/forums/Thread-...ew-machine We generally lean more towards the Resmed machines, but as your wife already had a DreamStation there's probably advantages in you having one too. Be careful that you get the full auto model - some DreamStations will give you auto for 30 days then revert to a fixed pressure - you don't want that!.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


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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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#5
RE: Need advice about sleep study please
Thanks for the excellent replies.  I'll work on getting sleepyhead cleared up.  As I lay here unable to sleep I've convinced myself to request an short term Rx for ambian to get me through the split study.  I don't sleep 5 hours on a good night and once I'm awake that's it.  I'm afraid once they wake me to put the mask on I won't be able to go back to sleep and it will be a waste of money and time.  I skipped taking melatonin tonight to see the effect it would have and sure enough here I am up after just 2 hours with no relief in sight.
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#6
RE: Need advice about sleep study please
Insomnia is a real downer. I used to have it really bad but it did improve once I took to the hose. My machine is a bit different - it's an ASV which kid of gently lulls you off to sleep. I think its probably a good idea to use a little help for your study, but follow instructions carefully. Some meds can increase the amount of apneas and give a false reading. But I don't think a single zolpidem (ambien) will do much harm.
DeepBreathing
Apnea Board Moderator
www.ApneaBoard.com


Bed

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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#7
RE: Need advice about sleep study please
I had real problems trying to sleep for my diagnostic study years ago, and it is related to the apnea I experienced as soon as I transitioned to sleep. I just kept drifting into light sleep and being aroused by the apnea. As you found when you tried your wife's machine, you will sleep easier and better once you have the mask on.

Your experiment as shown in the chart above is impressive in that you actually got a Philips Dreamstation set to 4-20 pressure to reach maximum pressure. The Philips machines are really slow to respond as compared to a Resmed, and in this case your obstructive problem is severe enough to even make Philips DS increase pressure. That said, your pressure needs appear to be pretty high. Once you get in for a sleep study, if you are unable to complete the titration portion, you should just ask for a prescription for an Auto CPAP and do the pressure settings yourself. You will get better results from a Resmed Airsense 10 Autoset than the Philips Dreamstation Auto, because the Resmed will raise pressure faster ahead of events, and can actually provide a comfortable exhale pressure relief (EPR) that acts like a bilevel machine (BiPAP).

Given what you already know of your problem and your experience with your wife's machine, you might ask your primary doctor to simply prescribe the CPAP. The only reason to do a sleep study is if insurance requires it for coverage. Many people with high copay or deductibles find they can simply buy a machine for far less than what it costs through insurance. Supplier #33 will sell a new Resmed Airsense 10 Autoset for about $600, and there are many machines available on Craigslist for far less.

If you borrow your dad's old Resmed, you can get a Clinician Manual for it from Apnea Board. https://www.apneaboard.com/adjust-cpap-p...tup-manual Once you know the exact model, we can help you set some preliminary settings. Most older machines prior to the S9 series, will not give you the data that will help you fine-tune your settings.
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#8
RE: Need advice about sleep study please
After the worst night I've had yet last night I finally broken-down (literally) and was waiting in my PCP parking lot when they opened today.  I took a melatonin, quickly fell asleep around 10pm only to wake around 11:30.  I felt strange, like my body was "buzzing", headache, but teiwd to tough it out and fall back asleep.  Wasn't going to happen so I went to the couch as to not bother the wife slumbering peacefully (I'm so jelous).  I came back to bet about the time she normally wakes and it hit me freight train.  I assume it was a combination of lack of sleep, stress, and who knows what else, but I got to experience the first full blown panic attack of my life.  I was shaking uncontrollably, hyperventilating, and I'm not to proud to admit, I cried like a baby.  She has only see me cry one other time, (when I had to put my dog down) so she knew it was significant.  She talked me through it and got me calmed down enough that I felt like I was gonna pull through.  At the pcp office I politely asked to be seen without an appt and the immediately worked me in.  Explained things to Dr and walked out with a script for anxiety meds and ambian cr 12.5.  She was hesitant toprescribe the ambian but she could tell I was desperate.  So a 10 days supply is sitting my night stand right now . That's enough to get me through the sleep study and one day after.  I think the stress of not being able to complete the split study due to insomnia coupled with the lack of sleep recently triggered it.

So I've set the remstar to split night mode, cpap pressure at 4 so the events can occur for the first 2 hours, then to auto 4-20 to get a titration hopefully.   I estimate my effective pressure to be around 7-9.  What are your thoughts on the split night mode vs just sticking with CPAP of 8 tonight for some rest?
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#9
RE: Need advice about sleep study please
How you handle your treatment is your choice. We are here to help you with whatever choice you make. You have shown us enough to convince us that you have apnea which also means that a CPAP machine is in your future.

If you us to help titrate you we just need see some more data from your previous night to get you started.
It would be nice if you could read the model number off the bottom of your dads machine mostly to understand its capabilities.
Our machine of choice is one of the AutoSets by ResMed. SleepRider did a good job of describing why. Otherwise we like the DreamStation Auto and then finally any machine that has good data and many of them do not.
Fred Bonjour - Project Manager and Lead Tester for OSCAR - Open Source CPAP Analysis Reporter 
OSCAR

Download OSCAR
New to Apnea? Helpful tips to ensure success
Mask Primer
Dealing with a DME
Organize Charts
Attaching Charts

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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#10
RE: Need advice about sleep study please
Fortunately the machine I have is a resmed auto with a-flex.  I'll work on getting some data posted in a few days once I am able to sleep long enough for it to be useful.  Thanks everyone!
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