Apnea at home test. no apnea in lab?

[Burrells5]

For several years I have had problems staying asleep that progressively got worse.  I usually sleep 1 or 1.5 hrs then wake up.  Stay awake awhile then repeat all night long.  Sometimes when I would wake up I felt my legs tingly.  I would wake in the morning with a headache most mornings and I just felt drugged during the day. I literally tried everything except meds.  I have a low bmi, don't snore unless have a cold, don't wake up gasping etc. so I never thought apnea.  Finally, decided to order a watch pat sleep test because I have such a high deductible.  It came back OSA.  They send me the report which I forwarded to my PCP along with a script for a CPAP.  I asked the RT could this possibly be wrong.  He said no if positive then positive.  For 3 months I struggled tremendously with CPAP although I kept it on 85 % of the night. Oscar showed less than 1 o 0 events all night.   Still waking same as always plus issues with masks (tried 5) leaking etc.  I adjusted and adjusted settings.  I was much more miserable than before CPAP.  Much less sleep.  My pcp sent me to pulmo and she sent me for in lab split sleep study.  I had it last night and he didn't do the cpap part as he said no events and no need.  I am waiting for follow up but how do I know which is correct?  I had a total of 114 events during at home.  How can I go without any in lab?  Also, I was off cpap for 10 days as per dr request so no residual.  Can at home be that wrong?  If so, I am glad but out a lot of $$$  I can't sell as insurance has 7 more months of their part paying.

[ac123]

A couple of questions:

1. Did you feel like you slept as well in the lab as you did for the home test? I ask because my lab test shows a lower AHI/RDI and the doctor thinks it because I had very little REM sleep versus the home test which had plenty of REM. On the home test the RDI is much higher during REM than otherwise (he explained the home tests are not super great with RDI or with determining REM, but it's all he could come up with because my AHI in both tests is good)

2. Do you feel like you slept in the same positions in the home test and the lab test? Positional issues are also a potential concern - if you slept on your side the whole night in the lab and on your back the whole night for the home test, the results could be pretty different.

Otherwise, it's certainly possible that the home test was faulty in some way. Or the sensitivity is really different (I've noticed, for example, in my OSCAR data that there are very obvious OA/CA events that just aren't scored because they don't quite meet the 10 second criteria). 

I hope you get some ideas from others here and answers from your doctor!

[Burrells5]

I actually slept more sound in lab test. I never sleep on my back. Added to that I had back surgery right before home test so yes in same position . Only thing I can think of I have done differently was right after cpap I bought pillow with mask cut outs. I "wad" a blanket on top of pillow so that my upper body is a small angle. I did that early on hoping it would help with cpap gas. The weird part is I still wake up on cpap just like I did before it. Makes me think maybe isn't apnea. That test reads hr and o2 so maybe it read it wrong. Don't know. I will be curious to what dr says

[BoxcarPete]

I always suspected that I had a less bad night at the lab than normal at the time of my initial diagnosis, and after surgery they wanted me to do an at-home study. I requested in-lab for apples to apples comparison, but they wanted the home study first as a "screening" type thing for insurance purposes even though I had a diagnosis and PSG was clinically indicated over HST. At home, results were somewhat improved compared to in-lab pre-op, but when I requested to do a PSG as well it came back squeaky clean. The only thing I can think of is mattress firmness because the lab had a firmer mattress than the wallowed out junker I normally sleep on. I always sleep better camping too, being on a ground pad where my hips physically cannot get more than 3" out of alignment to my shoulders.

So, what about that? Any noticeable differences in the mattress or other sleep kit between home and lab?

[cps22]

Maybe for your home test you had some kind of after-effects from your back surgery? Medications or even just after-effects of anesthesia? I had a couple of horrible nights this year after having steroid injections. 

What did the in-lab study show about your O2?