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Took the titration test.
#1
Took the titration test.
Ok, so this is a long story but I need advice now more than ever. I was called in last night to do the final sleep test (the one with the mask) because someone cancelled. I went to the sleep lab and took the Xanax like the doctor prescribed me and it did nothing... I had been up since 3am that morning but it still did nothing. Anyways, I got the wires on and the CPAP Mask. I layed there from 10pm until 6am this morning with my eyes closed. The sleep tech said I managed to sleep for an hour. He said "you slept enough to get you a CPAP, but I cannot promise you it will be calibrated right because you didn't sleep enough." I explained to him on this my third time to the sleep lab, that I simply could not sleep with those wires piercing me. Anyways, I don't think I have to go back. I go to the doctor next Thursday to get my CPAP. My concern is, what if it is calibrated wrong? Will any trucking companies still hire me? And, what do I have to do to get it re calibrated? I'm really worried that I went through all of this for nothing now, and I want to drive a truck more than anything. If the calibration is off on my machine will the trucking compnaies care?
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#2
RE: Took the titration test.
I don't know why they keep putting you through that.  They need to put you on an APAP  and be done with it.  It would be 100% more effective at treating you than settings derived from a titration study under those conditions.  

I wouldn't worry about the accuracy of the machine settings.  Even if the machine has been set up incorrectly, you can change the settings to suit your needs.  I think in this case it is vitally important that you get a data capable machine so you can view the efficacy of the therapy and make changes.  I personally would stand firm until they gave me an APAP, but you may need to get your doctor to specifically ask for an APAP.  You can find Apnea Board's guide to machine choices HERE

As for the trucking company, I don't know what they require, but I have to imagine that they are looking for compliance above all else.  That is generally accepted to mean >4 hours a night, 21 days a month for use.   The reality is that they are looking to lower legal liability, nothing else.
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#3
RE: Took the titration test.
(03-02-2017, 07:56 AM)C0mbe Wrote: I don't know why they keep putting you through that.  They need to put you on an APAP  and be done with it.  It would be 100% more effective at treating you than settings derived from a titration study under those conditions.  

I wouldn't worry about the accuracy of the machine settings.  Even if the machine has been set up incorrectly, you can change the settings to suit your needs.  I think in this case it is vitally important that you get a data capable machine so you can view the efficacy of the therapy and make changes.  I personally would stand firm until they gave me an APAP, but you may need to get your doctor to specifically ask for an APAP.  You can find Apnea Board's guide to machine choices HERE

As for the trucking company, I don't know what they require, but I have to imagine that they are looking for compliance above all else.  That is generally accepted to mean >4 hours a night, 21 days a month for use.   The reality is that they are looking to lower legal liability, nothing else.

If they do give me the standard CPAP, do I have to go to another sleep study to get it recalibrated? I'm not going back.
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#4
RE: Took the titration test.
If you get a data capable CPAP and #Sleepyhead software you will be able to set it yourself, even if it is a straight CPAP. However an APAP is a far better solution for a whole range of reasons.
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#5
RE: Took the titration test.
There's some idiot on another forum telling me APAP machines are useless becasue they can't detect when you go in REM sleep.

(03-02-2017, 07:56 AM)C0mbe Wrote: I don't know why they keep putting you through that.  They need to put you on an APAP  and be done with it.  It would be 100% more effective at treating you than settings derived from a titration study under those conditions.  

I wouldn't worry about the accuracy of the machine settings.  Even if the machine has been set up incorrectly, you can change the settings to suit your needs.  I think in this case it is vitally important that you get a data capable machine so you can view the efficacy of the therapy and make changes.  I personally would stand firm until they gave me an APAP, but you may need to get your doctor to specifically ask for an APAP.  You can find Apnea Board's guide to machine choices HERE

As for the trucking company, I don't know what they require, but I have to imagine that they are looking for compliance above all else.  That is generally accepted to mean >4 hours a night, 21 days a month for use.   The reality is that they are looking to lower legal liability, nothing else.

There is some idiot on another forum telling me APAP machines are useless because they can't detect when you go into REM sleep.
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#6
RE: Took the titration test.
First of all, there probably isnt a cpap machine out there that will tell you when you are in REM sleep, or any sleep stage.  This has nothing to do with your situation.  

You are getting the best advice here.  There is never a time you have more power than "before" you accept a machine.  Talk to your doctor, and be sure he writes the script for a fully data capable auto machine.  You need to tell him you didnt sleep enough to be titrated properly, and an Apap can help you get the proper settings to optimize your therapy.

And forget that word "calibrated."  You don't need them to set your pressures.  We can help here.  It will be harder for you if you end up with a straight pressure cpap.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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: Took the titration test.
Ok, thanks guys. If I do end up with just a straight CPAP, is there any hope left?
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#8
RE: Took the titration test.
(03-02-2017, 10:05 AM)UKwildcatfan Wrote: Ok, thanks guys. If I do end up with just a straight CPAP, is there any hope left?


Well, I apologize if I made you feel like there is no hope with a straight Cpap, that was not my intention.  It will just be harder to dial in your settings, and it may take longer to do so, but can be done.

http://www.apneaboard.com/forums/Thread-...ew-machine

You need to take charge of the situation "before" you are given a machine.
OpalRose
Apnea Board Administrator
www.apneaboard.com

_______________________
OSCAR Chart Organization
How to Attach Images and Files.
OSCAR - The Guide
Soft Cervical Collar
Optimizing therapy
OSCAR supported machines
Mask Primer



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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#9
RE: Took the titration test.
UK the comments in your last thread have not changed.  You need an auto CPAP, and if you have a choice, I would recommend the Resmed Airsense 10 Autoset.  Clearly, the best the titration study can claim is that they managed to get a snapshot of your CPAP needs.  They may well recommend a pressure, but it certainly won't be applicable for all sleep stages or positions.  Our needs constantly change, and an APAP accommodates that by varying pressure.   Even with a good titration study, most people do better on an auto CPAP that brackets the recommended CPAP pressure.  Sometimes, the clinic results are simply wrong.  We get to see hundreds of people here with their prescribed results, and then find what really works.  

Here is what you need to know.  It sounds like your doctor is integrated with the clinical studies and dispensing of equipment.  This is a conflict of interest as the company will try to maximize profit by scheduling the maximum number of studies, and giving you the least capable machine to keep you dependent on them.   You can off set that dependence by being informed and educated.

  1. Demand a written copy of all your study results, (better to get the full study).  These patient records are required to be provided to you under the HiPPA law.
  2. Get a copy of any recommendations and prescriptions.
  3. Refuse any machine you know is not data capable, or that will meet your needs.  You should ONLY accept one of the following:
  • Philips Respironics Dreamstation 400 series (Pro) or 500 series (Auto). Refuse the 200 series CPAP Plus.
  • Resmed Airsense 10 Elite, or Autoset. Refuse any thing labeled only CPAP or AirStart.
If they refuse to provide the machine you want/ need, politely decline the machine, and let them know you will be using another in-network provider. Remind them that the study results are far from perfect due to lack of sleep and testing time.  Also say, "Please provide me with my written prescription".  Remind them that you need to demonstrate ongoing compliance to DOT and want the machine to provide optimum therapy. To do this you need a machine that provides data.  The list above includes fixed pressure CPAP machines that provide data. Those will work, but you should try for Auto based on the poor sleep results in the clinic.

That will probably make them back off, but if it doesn't, you need to call your medicaid office and obtain a list of in-network DME providers in your area.  In fact, you should do this before ever going to your follow-up appointment or to get the machine.  Above all, you are in control. Do not surrender that control or get bullied because these guys are doctors or professionals.  They are just like a car dealer, and their objective is to maximize profit.  Getting the machine of your choice will not cost you any more than one of their bricks.  Don't be bullied.
Sleeprider
Apnea Board Moderator
www.ApneaBoard.com

____________________________________________
Download OSCAR Software
Soft Cervical Collar
Optimizing Therapy
Organize your OSCAR Charts
Attaching Files
Mask Primer
How To Deal With Equipment Supplier


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: Took the titration test.
I see you live in the USA. Therefore, if your sleep apnea is effecting your livelihood you need to consult a doctor that is a certified medical examiner in you state. You may want to consult the FMCSA website
https://nationalregistry.fmcsa.dot.gov/N.../home.seam

The criteria for driver with sleep apnea varies from state to state in the USA, and it is different than Medicare or private insurance requirements. I have fond that sleep labs and DME’s are quite often confused about these requirements. They often will quote a standard from there billing agreements that they believe is universal. To get directly to the root of the problem make sure your talking to a doctor that has the authority to put you back on the road
2004-Bon Jovi
it'll take more than a doctor to prescribe a remedy

Observations and recommendations communicated here are the perceptions of the writer and should not be misconstrued as medical advice.
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