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question regarding sleep study results
#1
Another question regarding sleep study results. I read if you to not enter onto REM cycle, the sleep study is invalid. This happened to me, but was diagnosed with OSA. My ahi was 27: Rsi 28.9. I am waiting for the dme provider to contact me for an appointment. Since I was diagnosed and will be using the cpap: does it matter that there are no rem statistics? Thanks again.
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#2
Lindsk, that's not correct, if they can get an AHI that will be enough, you have moderate sleep apnea ( between 15 - 30) and will obviously need a CPAP
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#3
If you don't get into REM, then the reported untreated AHI may be an underestimate of the true AHI since most people's apnea is worse in REM and some people's apnea is substantially worse in REM.

Hence, if you don't get into REM and the reported AHI is very close to 5.0, the border between "no apnea" and "very mild apnea", the study may be a "false negative"---i.e. you could have clinically significant OSA (due to REM-based events), but the test is "negative" because you didn't get into REM.

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#4
Thank you for your responses. This is all very confusing.
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#5
Lindsk, at this stage you have an AHI of 27 which is considered moderate sleep apnea (between 15 - 30), I would just go with that for now. Not all people get to REM sleep prior to being dignosed so I wouldn't worry about it for now, it is more important you get your CPAP and start using it Smile
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#6
(01-11-2014, 01:42 AM)Lindsk Wrote: Since I was diagnosed and will be using the cpap: does it matter that there are no rem statistics? Thanks again.
It does not matter that much, APAP is the right machine choice. The machine adjust pressure to your needs during the night as it deliver the right treatment pressure whether you sleep on your side or back and in any sleep stage including REM sleep
Ask the doctor to specify the machine on the prescription and write "dispense as written"
Example: ResMed S9 AutoSet (not S9 Auto or Escape Auto) H5i humidifier, climate line (might be optional item) and mask of choice

As for machine choice, you cannot go wrong with either ResMed S9 AutoSet or Phillips Respironcis REMStar System One Auto (PRS1) model number 560 - 60 series machine with the heated hose option (same as S9 climate line)

ResMed S9 ... Model name printed next to on/off button
PRS1 ... Model number printed on the label at the bottom of the machine
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#7
(01-13-2014, 12:04 AM)zonk Wrote: It does not matter that much, APAP is the right machine choice. The machine adjust pressure to your needs during the night as it deliver the right treatment pressure whether you sleep on your side or back and in any sleep stage including REM sleep
Ask the doctor to specify the machine on the prescription and write "dispense as written"
Example: ResMed S9 AutoSet (not S9 Auto or Escape Auto) H5i humidifier, climate line (might be optional item) and mask of choice

As for machine choice, you cannot go wrong with either ResMed S9 AutoSet or Phillips Respironcis REMStar System One Auto (PRS1) model number 560 - 60 series machine with the heated hose option (same as S9 climate line)

ResMed S9 ... Model name printed next to on/off button
PRS1 ... Model number printed on the label at the bottom of the machine


Hi Lindsk, welcome to the forum!

Also, may be best to ask doctor to include a pressure range on the prescription, reinforcing that an auto machine is being prescribed.

If doctor insists on a fixed pressure prescription, still request him to include the machine of your choice on the prescription and "dispense as written". The ResMed S9 AutoSet or PRS1 Auto can be operated in fixed-pressure mode and periodically changed to Auto mode to recheck your titration.

But if the doctor refuses to prescribe at least a fully data-capable machine, tell him you will be seeking a second opinion because you are concerned that he is either behind the times or does not have your best interests at heart. (When he sees he may lose you as a patient he may change his attitude.)

Much better for the doctor to be offended than for you to attempt treatment on a "brick". No matter what, refuse to accept a brick.

Sometimes all we need to do is to call up other Durable Medical Equipment providers (DMEs) in our area who are also accepted by our insurance company and tell them we are looking for a DME who will dispense to us the Auto machine we have chosen.

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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#8
(01-11-2014, 01:42 AM)Lindsk Wrote: Another question regarding sleep study results. I read if you to not enter onto REM cycle, the sleep study is invalid.

Hi Lindsk, I'm new at this but, based on my limited experience, am convinced that a one-night titration study can be misleading.

In my case the doctor prescribed that my ResMed AutoSet be configured as a straight CPAP (autoset disabled) and set at a pressure of 4.0.

After a lot of reading and the discovery of SleepyHead, I concluded that 4.0 was not adequate. I also concluded that the disabled autoset feature was designed to help get the pressure right. I reasoned that if the autoset was enabled it would only supply the pressure needed. So what's the harm in using it?

So, after a long fight with the sleep lab, I finally got the autoset feature enabled. The doctor's initial position was to have me stick with the straight CPAP, 4.0 pressure for 90 days.

I now have the autoset enabled, the pressure set at 8 min, 16 max. My average pressure is 10.25, my 95% pressure is 14.22 and all my numbers are good!

So, one might suspect that a one-night titration study could be misleading, especially if the patient was pretty much awake (no REM) throughout the night. At least, the study should be evaluated in the context of several nights experience at home. And this evaluation should be done much sooner than 90 days after the titration study.

I'm no expert. But that's my opinion.

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#9
Also, if they try and argue AutoSet is more expensive, CPAP and APAP (AutoSet) are the same line on insurance claims.
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#10
Wow! Thanks so much for the info. The Dr. Did prescribe a ResMed S9 Auto with pressures at 5 - 12, mask my choice. The first dme was out of my network, only 2 in-network. Faxed info to one of the suppliers, now waiting to hear from them. I have a high deductible so machine and supplies will be out of pocket. I am grateful for everyone who took the time to answer my questions. Hoping everything will work out!
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